Hospital Dallas-Fort Worth-Arlington, TX

Medical City Surgery City Alliance

Medical City Surgery City Alliance in Ft Worth, TX 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 Texas median for 294 of 297 procedures and below it for 3. By typical cash price it ranks #276 of 306 Texas hospitals and #75 of 82 hospitals in the Dallas, TX area, cheapest first. Select a procedure to compare it with other hospitals nearby.

3200 N TARRANT PARKWAY, FT WORTH, TX, 76177 Collected Sep 28, 2026 Source price file Check a bill from this hospital

The price file shows no self-pay discount

For 711 of the 711 prices listed here, the cash price in Medical City Surgery City Alliance's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W&WO CONT	$10,273.35	$10,273.35	$719.13–$10,273.35	256% above	—
Abdominal X-ray, 2 views CPT 74019 ABD XR 2V	$1,283.30	$1,283.30	$89.83–$1,283.30	228% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V LT	$892.95	$892.95	$62.51–$892.95	137% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V RT	$892.95	$892.95	$62.51–$892.95	137% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP ART 1-2 LEVELS BIL	$1,945.78	$1,945.78	$136.20–$1,945.78	220% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREM W/O CONT LT	$5,999.01	$5,999.01	$419.93–$5,999.01	225% above	—
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREM W/O CONT RT	$5,999.01	$5,999.01	$419.93–$5,999.01	225% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age 21+	$1,928.97	$1,928.97	$107.32	285% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$1,928.97	$1,928.97	$135.03–$1,928.97	285% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age Under 21	$1,928.97	$1,928.97	$109.27	285% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study	$1,928.97	$1,928.97	$341.20–$401.74	285% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body Age 21+	$7,173.60	$7,173.60	$303.23	314% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$7,173.60	$7,173.60	$502.15–$7,173.60	314% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body Age Under 21	$7,173.60	$7,173.60	$308.74	314% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body	$7,173.60	$7,173.60	$471.74–$848.52	314% above	—
Breast ultrasound, complete, one breast CPT 76641 US BRST UNI W AX COMP	$795.41	$795.41	$55.68–$795.41	80% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI RT W AX COMP	$795.41	$795.41	$55.68–$795.41	80% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI LT W AX COMP	$795.41	$795.41	$55.68–$795.41	80% above	—
Breast ultrasound, limited (one breast or one area) CPT 76642 US BRST UNI W AX LTD	$533.91	$533.91	$37.37–$533.91	43% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI RT W AX LTD	$533.91	$533.91	$37.37–$533.91	43% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI LT W AX LTD	$533.91	$533.91	$37.37–$533.91	43% above	—
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PEL W CONT	$17,339.95	$17,339.95	$1,213.80–$17,339.95	313% above	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD VIZ AI TECH	$7,410.23	$7,410.23	$518.72–$7,410.23	162% above	—
CT angiography (CTA) of the head CPT 70496 CTA HEAD	$7,410.23	$7,410.23	$518.72–$7,410.23	162% above	—
CT angiography (CTA) of the neck CPT 70498 CTA NECK	$7,006.28	$7,006.28	$490.44–$7,006.28	170% above	—
CT angiography (CTA) of the neck CPT 70498 CTA NECK VIZ AI TECH	$7,006.28	$7,006.28	$490.44–$7,006.28	170% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$7,508.61	$7,508.61	$525.60–$7,508.61	165% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PELVIS W/O CONT	$13,203.33	$13,203.33	$924.23–$13,203.33	293% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PELVIS W/CONT	$15,882.82	$15,882.82	$1,111.80–$15,882.82	308% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS W&WO CONT	$18,798.41	$18,798.41	$1,315.89–$18,798.41	351% above	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT	$8,859.50	$8,859.50	$620.16–$8,859.50	239% above	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$7,470.56	$7,470.56	$522.94–$7,470.56	271% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIFAC W/O CNT	$3,112.30	$3,112.30	$217.86–$3,112.30	87% above	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT	$5,880.98	$5,880.98	$411.67–$5,880.98	208% above	—
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONT	$6,927.59	$6,927.59	$484.93–$6,927.59	293% above	—
CT scan of the head without and with contrast CPT 70470 CT HD/BR W&W/O CONT	$8,139.45	$8,139.45	$569.76–$8,139.45	257% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST	$5,950.49	$5,950.49	$416.53–$5,950.49	190% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST	$5,950.49	$5,950.49	$416.53–$5,950.49	189% above	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$7,023.34	$7,023.34	$491.63–$7,023.34	219% above	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUP EXTRACRANIAL BIL	$3,170.30	$3,170.30	$221.92–$3,170.30	139% above	—
Chest CT scan without and with contrast CPT 71270 CT CHEST W&W/O CONT	$7,643.70	$7,643.70	$535.06–$7,643.70	181% above	—
Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 V	$1,150.95	$1,150.95	$80.57–$1,150.95	192% above	—
Chest X-ray, single view CPT 71045 CHEST XRAY 1 V	$872.91	$872.91	$61.10–$872.91	169% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMP LT	$892.95	$892.95	$62.51–$892.95	165% above	—
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMP RT	$892.95	$892.95	$62.51–$892.95	165% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COM	$2,433.89	$2,433.89	$170.37–$2,433.89	230% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$588.95	$588.95	$41.23–$588.95	42% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) Age Under 21	$426.42	$426.42	$35.55	93% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY PERIPHL	$426.42	$426.42	$29.85–$426.42	93% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) Age 21+	$426.42	$426.42	$34.91	93% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)	$426.42	$426.42	$83.86–$182.03	93% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$5,640.96	$5,640.96	$394.87–$5,640.96	236% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$6,454.12	$6,454.12	$451.79–$6,454.12	198% above	—
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$1,548.59	$1,548.59	$165.73–$263.00	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG CAD BI	$1,548.59	$1,548.59	$108.40–$1,548.59	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Other Outpatient	$1,548.59	$1,548.59	$114.38	—	—
Diagnostic mammogram, one breast CPT 77065 MAMMO DIAG CAD UNI	$1,332.02	$1,332.02	$93.24–$1,332.02	389% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI RT	$1,332.02	$1,332.02	$93.24–$1,332.02	389% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI LT	$1,332.02	$1,332.02	$93.24–$1,332.02	389% above	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUP LE ART BIL	$2,096.36	$2,096.36	$146.75–$2,096.36	16% above	—
Duplex ultrasound of the leg veins, both legs CPT 93970 DUP VEIN BIL	$2,096.36	$2,096.36	$146.75–$2,096.36	5% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D COMP W CF DOP	$9,013.53	$9,013.53	$630.95–$9,013.53	284% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc	$9,013.53	$9,013.53	$372.65–$1,514.00	284% above	—
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT	$835.49	$835.49	$58.48–$835.49	158% above	—
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT	$835.49	$835.49	$58.48–$835.49	158% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 + V RT	$1,203.10	$1,203.10	$84.22–$1,203.10	214% above	—
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 + V LT	$1,203.10	$1,203.10	$84.22–$1,203.10	214% above	—
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/IAC WO	$6,357.06	$6,357.06	$444.99–$6,357.06	279% above	—
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES 3 + V	$1,334.09	$1,334.09	$93.39–$1,334.09	216% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT	$860.87	$860.87	$60.26–$860.87	129% above	—
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT	$860.87	$860.87	$60.26–$860.87	129% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present;	$6,503.49	$6,503.49	$471.74–$848.52	306% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present; Age Under 21	$6,503.49	$6,503.49	$339.43	306% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present; Age 21+	$6,503.49	$6,503.49	$333.37	306% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPA IMAG INCL GB	$6,503.49	$6,503.49	$455.24–$6,503.49	306% above	—
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 V RT	$799.38	$799.38	$55.96–$799.38	143% above	—
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 V LT	$799.38	$799.38	$55.96–$799.38	143% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2 + V RT	$733.88	$733.88	$51.37–$733.88	153% above	—
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2 + V LT	$733.88	$733.88	$51.37–$733.88	153% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V RT	$1,183.04	$1,183.04	$82.81–$1,183.04	193% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V LT	$1,183.04	$1,183.04	$82.81–$1,183.04	193% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 + V LT	$1,386.23	$1,386.23	$97.04–$1,386.23	226% above	—
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 + V RT	$1,386.23	$1,386.23	$97.04–$1,386.23	226% above	—
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTRM W/O C	$5,505.88	$5,505.88	$385.41–$5,505.88	212% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTRM W/O C RT	$5,505.88	$5,505.88	$385.41–$5,505.88	212% above	—
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTRM W/O C LT	$5,505.88	$5,505.88	$385.41–$5,505.88	212% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD	$2,504.71	$2,504.71	$175.33–$2,504.71	298% above	—
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREM NON VASC LTD	$795.41	$795.41	$55.68–$795.41	71% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 V RT	$931.72	$931.72	$65.22–$931.72	169% above	—
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 V LT	$931.72	$931.72	$65.22–$931.72	169% above	—
MR angiography (MRA) of the head without contrast CPT 70544 Magnetic resonance angiography, head; without contrast material(s) Age 21+	$7,149.09	$7,149.09	$244.42	234% above	—
MR angiography (MRA) of the head without contrast CPT 70544 Magnetic resonance angiography, head; without contrast material(s) Age Under 21	$7,149.09	$7,149.09	$248.86	234% above	—
MR angiography (MRA) of the head without contrast CPT 70544 MRA HD W/O CONT	$7,149.09	$7,149.09	$500.44–$7,149.09	234% above	—
MR angiography (MRA) of the head without contrast CPT 70544 Magnetic resonance angiography, head; without contrast material(s)	$7,149.09	$7,149.09	$313.62–$517.79	234% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT LT	$8,363.98	$8,363.98	$585.48–$8,363.98	279% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT RT	$8,363.98	$8,363.98	$585.48–$8,363.98	279% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LW JNT W&WO CONT RT	$13,952.24	$13,952.24	$976.66–$13,952.24	340% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LW JNT W&WO CONT LT	$13,952.24	$13,952.24	$976.66–$13,952.24	340% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) Age Under 21	$9,732.79	$9,732.79	$226.03	343% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)	$9,732.79	$9,732.79	$313.62–$517.79	343% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) Age 21+	$9,732.79	$9,732.79	$221.99	343% above	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT	$9,732.79	$9,732.79	$681.30–$9,732.79	343% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences	$14,129.29	$14,129.29	$348.50–$1,630.50	344% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences Age 21+	$14,129.29	$14,129.29	$383.35	344% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences Age Under 21	$14,129.29	$14,129.29	$390.32	344% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONT	$14,129.29	$14,129.29	$989.05–$14,129.29	344% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material Age Under 21	$9,307.85	$9,307.85	$226.41	325% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$9,307.85	$9,307.85	$651.55–$9,307.85	325% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material Age 21+	$9,307.85	$9,307.85	$222.37	325% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material	$9,307.85	$9,307.85	$313.62–$517.79	325% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences Age Under 21	$12,380.49	$12,380.49	$367.48	310% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences Age 21+	$12,380.49	$12,380.49	$360.92	310% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONT	$12,380.49	$12,380.49	$866.63–$12,380.49	310% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences	$12,380.49	$12,380.49	$616.10–$828.27	310% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Age Under 21	$9,795.44	$9,795.44	$220.80	329% above	—
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT	$9,795.44	$9,795.44	$685.68–$9,795.44	329% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$9,795.44	$9,795.44	$313.62–$517.79	329% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Age 21+	$9,795.44	$9,795.44	$216.85	329% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar Age Under 21	$12,618.85	$12,618.85	$368.63	295% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&W/O CONT	$12,618.85	$12,618.85	$883.32–$12,618.85	295% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar	$12,618.85	$12,618.85	$329.13–$1,630.50	295% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar Age 21+	$12,618.85	$12,618.85	$362.04	295% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material Age Under 21	$9,762.75	$9,762.75	$219.68	356% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material Age 21+	$9,762.75	$9,762.75	$215.75	356% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT	$9,762.75	$9,762.75	$683.39–$9,762.75	356% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material	$9,762.75	$9,762.75	$313.62–$517.79	356% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&W/O CONT	$13,434.68	$13,434.68	$940.43–$13,434.68	311% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical	$13,434.68	$13,434.68	$616.10–$828.27	311% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical Age 21+	$13,434.68	$13,434.68	$362.77	311% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical Age Under 21	$13,434.68	$13,434.68	$369.36	311% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material	$10,022.90	$10,022.90	$313.62–$517.79	332% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material Age Under 21	$10,022.90	$10,022.90	$220.06	332% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT	$10,022.90	$10,022.90	$701.60–$10,022.90	332% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material Age 21+	$10,022.90	$10,022.90	$216.13	332% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences Age Under 21	$11,414.84	$11,414.84	$388.82	237% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences	$11,414.84	$11,414.84	$616.10–$828.27	237% above	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&WO CONT	$11,414.84	$11,414.84	$799.04–$11,414.84	237% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences Age 21+	$11,414.84	$11,414.84	$381.88	237% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT	$9,070.86	$9,070.86	$634.96–$9,070.86	269% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)	$9,070.86	$9,070.86	$313.62–$517.79	269% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) Age Under 21	$9,070.86	$9,070.86	$261.49	269% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) Age 21+	$9,070.86	$9,070.86	$256.82	269% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT RT	$8,363.98	$8,363.98	$585.48–$8,363.98	280% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT LT	$8,363.98	$8,363.98	$585.48–$8,363.98	280% above	—
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4-5 V	$1,891.54	$1,891.54	$132.41–$1,891.54	247% above	—
Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST	$6,927.59	$6,927.59	$484.93–$6,927.59	238% above	—
Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST	$5,142.57	$5,142.57	$359.98–$5,142.57	195% above	—
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE	$822.11	$822.11	$57.55–$822.11	246% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCRD SPECT R/S MULT	$19,831.94	$19,831.94	$1,388.24–$19,831.94	357% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat Age Under 21	$19,831.94	$19,831.94	$490.62	357% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat	$19,831.94	$19,831.94	$1,623.62–$2,938.37	357% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat Age 21+	$19,831.94	$19,831.94	$481.86	357% above	—
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST	$5,735.40	$5,735.40	$401.48–$5,735.40	250% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD OR FU	$2,142.41	$2,142.41	$149.97–$2,142.41	343% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$2,828.86	$2,828.86	$198.02–$2,828.86	228% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRI	$2,884.69	$2,884.69	$201.93–$2,884.69	342% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMTR	$2,928.28	$2,928.28	$204.98–$2,928.28	377% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD	$1,262.57	$1,262.57	$88.38–$1,262.57	175% above	—
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI 2 V RT	$1,034.66	$1,034.66	$72.43–$1,034.66	190% above	—
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI 2 V LT	$1,034.66	$1,034.66	$72.43–$1,034.66	190% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI W/CXR 3+V RT	$1,106.83	$1,106.83	$77.48–$1,106.83	180% above	—
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI W/CXR 3+V LT	$1,106.83	$1,106.83	$77.48–$1,106.83	180% above	—
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR CAD BI	$789.09	$789.09	$55.24–$789.09	—	—
Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Other Outpatient	$789.09	$789.09	$94.36	—	—
Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	$789.09	$789.09	$137.05–$217.46	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V LT	$994.55	$994.55	$69.62–$994.55	189% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V RT	$994.55	$994.55	$69.62–$994.55	189% above	—
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES 3 + V	$1,327.41	$1,327.41	$92.92–$1,327.41	215% above	—
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 V	$1,034.66	$1,034.66	$72.43–$1,034.66	195% above	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or	$9,453.87	$9,453.87	$411.29–$1,514.00	247% above	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS W CONT ECG	$9,453.87	$9,453.87	$661.77–$9,453.87	247% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study Age 21+	$2,264.48	$2,264.48	$137.46	277% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study	$2,264.48	$2,264.48	$154.52–$401.74	277% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study Age Under 21	$2,264.48	$2,264.48	$139.96	277% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLW FUNC W/C&V	$2,264.48	$2,264.48	$158.51–$2,264.48	277% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 V LT	$1,014.61	$1,014.61	$71.02–$1,014.61	189% above	—
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 V RT	$1,014.61	$1,014.61	$71.02–$1,014.61	189% above	—
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE W/O CONTRAST	$5,950.49	$5,950.49	$416.53–$5,950.49	200% above	—
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2 + V LT	$779.34	$779.34	$54.55–$779.34	165% above	—
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2 + V RT	$779.34	$779.34	$54.55–$779.34	165% above	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$2,828.86	$2,828.86	$198.02–$2,828.86	340% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UT TRANSVAGINAL	$2,399.82	$2,399.82	$167.99–$2,399.82	368% above	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$2,886.06	$2,886.06	$202.02–$2,886.06	234% above	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CNTS	$2,472.02	$2,472.02	$173.04–$2,472.02	304% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD AND NECK	$2,845.20	$2,845.20	$199.16–$2,845.20	351% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study	$2,078.68	$2,078.68	$341.20–$401.74	182% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age 21+	$2,078.68	$2,078.68	$135.26	182% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age Under 21	$2,078.68	$2,078.68	$137.72	182% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SNGL CONTRAST	$2,078.68	$2,078.68	$145.51–$2,078.68	182% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 + V LT	$1,555.99	$1,555.99	$108.92–$1,555.99	340% above	—
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 + V RT	$1,555.99	$1,555.99	$108.92–$1,555.99	340% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP VEIN UNI/LTD	$1,397.58	$1,397.58	$97.83–$1,397.58	74% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT	$783.35	$783.35	$54.83–$783.35	146% above	—
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT	$783.35	$783.35	$54.83–$783.35	146% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V RT	$1,011.93	$1,011.93	$70.84–$1,011.93	163% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V LT	$1,011.93	$1,011.93	$70.84–$1,011.93	163% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP W PEL UN 2-3 VIEW	$860.87	$860.87	$60.26–$860.87	113% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W PEL UN 2-3 V LT	$860.87	$860.87	$60.26–$860.87	113% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W PEL UN 2-3 V RT	$860.87	$860.87	$60.26–$860.87	113% above	—
X-ray of the abdomen, 1 view CPT 74018 ABD XR 1V	$867.56	$867.56	$60.73–$867.56	156% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$1,133.57	$1,133.57	$79.35–$1,133.57	277% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$1,133.57	$1,133.57	$79.35–$1,133.57	277% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V LT	$671.06	$671.06	$46.97–$671.06	154% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V RT	$671.06	$671.06	$46.97–$671.06	154% above	—
X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEWS	$872.91	$872.91	$61.10–$872.91	162% above	—
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$872.91	$872.91	$61.10–$872.91	162% above	—
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$872.91	$872.91	$61.10–$872.91	162% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V RT	$863.56	$863.56	$60.45–$863.56	132% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V LT	$863.56	$863.56	$60.45–$863.56	132% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V LT	$903.65	$903.65	$63.26–$903.65	131% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V RT	$903.65	$903.65	$63.26–$903.65	131% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V RT	$892.95	$892.95	$62.51–$892.95	203% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V LT	$892.95	$892.95	$62.51–$892.95	203% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VIEWS	$1,306.03	$1,306.03	$91.42–$1,306.03	180% above	—
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4 + VIEWS	$1,939.66	$1,939.66	$135.78–$1,939.66	210% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS	$1,220.48	$1,220.48	$85.43–$1,220.48	203% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP	$890.30	$890.30	$62.32–$890.30	205% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS	$1,098.83	$1,098.83	$76.92–$1,098.83	195% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS	$855.53	$855.53	$59.89–$855.53	130% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 + V	$1,530.61	$1,530.61	$107.14–$1,530.61	367% above	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH) Age 21+	$1,191.73	$1,191.73	$35.68	395% above	—
ACTH blood test CPT 82024 ACTH QN	$1,191.73	$1,191.73	$83.42–$1,191.73	395% above	—
ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH)	$1,191.73	$1,191.73	$42.10	395% above	—
ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH) Other Outpatient	$1,191.73	$1,191.73	$40.55	395% above	—
ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH) Age Under 21	$1,191.73	$1,191.73	$36.33	395% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$435.54	$435.54	$30.49–$435.54	641% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$435.54	$435.54	$30.49–$435.54	652% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA Age Under 21	$1,507.25	$1,507.25	$9.05	289% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA Age 21+	$1,507.25	$1,507.25	$8.89	289% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$1,507.25	$1,507.25	$105.51–$1,507.25	289% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA Other Outpatient	$1,507.25	$1,507.25	$50.01	289% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA	$1,507.25	$1,507.25	$47.63	289% above	—
Albumin blood test CPT 82040 ALBUMIN SERUM QN	$334.37	$334.37	$23.41–$334.37	799% above	—
Aldosterone blood test CPT 82088 ALDOSTERONE QN	$967.11	$967.11	$67.70–$967.11	570% above	—
Aldosterone blood test CPT 82088 ALDOSTERONE UR QN	$1,316.91	$1,316.91	$92.18–$1,316.91	813% above	—
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS (ALP)	$636.17	$636.17	$44.53–$636.17	988% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Age Under 21	$366.94	$366.94	$4.91	1224% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH	$366.94	$366.94	$25.69–$366.94	1224% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Other Outpatient	$366.94	$366.94	$5.48	1224% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Age 21+	$366.94	$366.94	$4.82	1224% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each	$366.94	$366.94	$5.69	1224% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROT SERUM	$737.34	$737.34	$51.61–$737.34	501% above	—
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROT SERUM MAT	$1,304.92	$1,304.92	$91.34–$1,304.92	964% above	—
Ammonia blood test CPT 82140 AMMONIA	$538.43	$538.43	$37.69–$538.43	269% above	—
Amylase blood test CPT 82150 AMYLASE	$216.06	$216.06	$15.12–$216.06	120% above	—
Amylase blood test CPT 82150 AMYLASE BLD	$848.78	$848.78	$59.41–$848.78	765% above	—
Amylase blood test CPT 82150 AMYLASE FL	$865.94	$865.94	$60.62–$865.94	783% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Age Under 21	$543.56	$543.56	$12.19	784% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody	$543.56	$543.56	$14.12	784% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Age 21+	$543.56	$543.56	$11.97	784% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Other Outpatient	$543.56	$543.56	$13.60	784% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$543.56	$543.56	$38.05–$543.56	784% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BODY FLUID QL	$485.28	$485.28	$33.97–$485.28	449% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUAL SCREEN	$787.06	$787.06	$55.09–$787.06	790% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$1,809.05	$1,809.05	$126.63–$1,809.05	873% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT ENVIRON EPIDEMI	$30.17	$30.17	$2.11–$30.17	57% below	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT	$967.11	$967.11	$67.70–$967.11	1292% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT NOSE	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCH BRUSH	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE PLACENTA	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCH WASH	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCHIAL	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BILE	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SKIN	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SINUS	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SURGICAL SPEC	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GASTRIC	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SYNOVIAL FLUID	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TISSUE	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TRACHEA	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT NASOPHARYNGEAL	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CERVICAL	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ABSCESS	$1,039.12	$1,039.12	$72.74–$1,039.12	1396% above	—
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BONE MARROW	$1,484.95	$1,484.95	$103.95–$1,484.95	2037% above	—
Basic metabolic panel (blood test) CPT 80048 BMP TOTAL CALCIUM	$1,532.98	$1,532.98	$107.31–$1,532.98	545% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT	$641.30	$641.30	$44.89–$641.30	856% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT FL	$821.36	$821.36	$57.50–$821.36	1124% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT NEONATAL	$1,001.40	$1,001.40	$70.10–$1,001.40	1392% above	—
Bilirubin blood test, total CPT 82247 BILIRUBIN TOT BLD	$1,138.58	$1,138.58	$79.70–$1,138.58	1597% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4	$1,404.37	$1,404.37	$98.31–$1,404.37	373% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast,	$1,404.37	$1,404.37	$49.76	373% above	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$679.03	$679.03	$47.53–$679.03	197% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$72.01	$72.01	$5.04–$72.01	264% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN	$514.42	$514.42	$36.01–$514.42	1058% above	—
Blood lead test CPT 83655 LEAD BLOOD	$387.53	$387.53	$27.13–$387.53	631% above	—
Blood lead test CPT 83655 LEAD URINE	$737.34	$737.34	$51.61–$737.34	1290% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QL SERUM/URINE INSTR	$888.22	$888.22	$62.18–$888.22	546% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM	$888.22	$888.22	$62.18–$888.22	546% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$324.08	$324.08	$22.69–$324.08	267% above	—
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN OTHER	$241.78	$241.78	$16.92–$241.78	311% above	—
Blood urea nitrogen (BUN) test CPT 84520 BUN	$334.37	$334.37	$23.41–$334.37	469% above	—
C-peptide blood test CPT 84681 C-peptide Age 21+	$1,210.58	$1,210.58	$19.23	1389% above	—
C-peptide blood test CPT 84681 C-PEPTIDE	$1,210.58	$1,210.58	$84.74–$1,210.58	1389% above	—
C-peptide blood test CPT 84681 C-peptide	$1,210.58	$1,210.58	$22.68	1389% above	—
C-peptide blood test CPT 84681 C-peptide Other Outpatient	$1,210.58	$1,210.58	$21.85	1389% above	—
C-peptide blood test CPT 84681 C-peptide Age Under 21	$1,210.58	$1,210.58	$19.58	1389% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$378.95	$378.95	$26.53–$378.95	551% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE AMP PROB	$130.45	$130.45	$9.13–$130.45	26% below	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX B NAP1 ST AMP	$130.45	$130.45	$9.13–$130.45	26% below	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Age Under 21	$480.12	$480.12	$19.58	254% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Age 21+	$480.12	$480.12	$19.23	254% above	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QN	$480.12	$480.12	$33.61–$480.12	254% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Other Outpatient	$480.12	$480.12	$21.85	254% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9	$480.12	$480.12	$22.68	254% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125	$1,138.58	$1,138.58	$20.81	609% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125 Age 21+	$1,138.58	$1,138.58	$19.23	609% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125 Other Outpatient	$1,138.58	$1,138.58	$21.85	609% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Immunoassay for tumor antigen, quantitative; CA 125 Age Under 21	$1,138.58	$1,138.58	$19.58	609% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QN	$1,138.58	$1,138.58	$79.70–$1,138.58	609% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique	$75.32	$75.32	$51.31	15% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Age 21+	$75.32	$75.32	$47.41	15% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Age Under 21	$75.32	$75.32	$48.27	15% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 DNA/RNA AMP	$75.32	$75.32	$5.27–$75.32	15% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Other Outpatient	$75.32	$75.32	$53.88	15% below	—
Calcium blood test, total CPT 82310 CALCIUM UR RANDOM QN	$402.95	$402.95	$28.21–$402.95	540% above	—
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$402.95	$402.95	$28.21–$402.95	540% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen (CEA) Age 21+	$1,054.56	$1,054.56	$17.52	577% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen (CEA)	$1,054.56	$1,054.56	$11.38–$102.23	577% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen (CEA) Age Under 21	$1,054.56	$1,054.56	$17.84	577% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$1,054.56	$1,054.56	$73.82–$1,054.56	577% above	—
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic antigen (CEA) Other Outpatient	$1,054.56	$1,054.56	$19.91	577% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARIC ZOSTER IGG	$430.40	$430.40	$30.13–$430.40	582% above	—
Chickenpox (varicella) immunity blood test CPT 86787 VARIC ZOSTER IGM	$956.81	$956.81	$66.98–$956.81	1417% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE	$689.31	$689.31	$48.25–$689.31	447% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$1,428.37	$1,428.37	$99.99–$1,428.37	647% above	—
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$877.95	$877.95	$61.46–$877.95	819% above	—
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$1,920.49	$1,920.49	$134.43–$1,920.49	566% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL PM	$1,303.20	$1,303.20	$91.22–$1,303.20	1320% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL .5 HR	$1,303.20	$1,303.20	$91.22–$1,303.20	1320% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL AM	$1,303.20	$1,303.20	$91.22–$1,303.20	1320% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL 1 HR	$1,303.20	$1,303.20	$91.22–$1,303.20	1320% above	—
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$1,428.37	$1,428.37	$99.99–$1,428.37	1456% above	—
Creatine kinase (CK) blood test, total CPT 82550 CREAT KINASE (CK) TOTAL	$397.81	$397.81	$27.85–$397.81	458% above	—
Creatinine blood test CPT 82565 CREATININE BLD	$392.67	$392.67	$27.49–$392.67	549% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 Antibody; cytomegalovirus (CMV) Other Outpatient	$946.52	$946.52	$15.11	1129% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 Antibody; cytomegalovirus (CMV) Age Under 21	$946.52	$946.52	$13.54	1129% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 Antibody; cytomegalovirus (CMV)	$946.52	$946.52	$14.39	1129% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG QUAL	$946.52	$946.52	$66.26–$946.52	1129% above	—
Cytomegalovirus (CMV) antibody test CPT 86644 Antibody; cytomegalovirus (CMV) Age 21+	$946.52	$946.52	$13.30	1129% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$1,814.19	$1,814.19	$126.99–$1,814.19	937% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S)	$2,285.73	$2,285.73	$22.23	1386% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Other Outpatient	$2,285.73	$2,285.73	$23.34	1386% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Age 21+	$2,285.73	$2,285.73	$20.54	1386% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$2,285.73	$2,285.73	$160.00–$2,285.73	1386% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Age Under 21	$2,285.73	$2,285.73	$20.91	1386% above	—
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCR ANY NBR PER DOS	$2,460.64	$2,460.64	$172.24–$2,460.64	3318% above	—
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$1,248.34	$1,248.34	$87.38–$1,248.34	546% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGG QUAL	$956.81	$956.81	$66.98–$956.81	896% above	—
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGM QUAL	$956.81	$956.81	$66.98–$956.81	896% above	—
Estradiol blood test CPT 82670 Estradiol; total Age Under 21	$2,296.03	$2,296.03	$26.29	1482% above	—
Estradiol blood test CPT 82670 Estradiol; total	$2,296.03	$2,296.03	$27.94	1482% above	—
Estradiol blood test CPT 82670 Estradiol; total Age 21+	$2,296.03	$2,296.03	$25.82	1482% above	—
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$2,296.03	$2,296.03	$160.72–$2,296.03	1482% above	—
Estradiol blood test CPT 82670 Estradiol; total Other Outpatient	$2,296.03	$2,296.03	$29.34	1482% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Age Under 21	$1,809.05	$1,809.05	$17.48	1030% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH)	$1,809.05	$1,809.05	$20.25	1030% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Age 21+	$1,809.05	$1,809.05	$17.17	1030% above	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$1,809.05	$1,809.05	$126.63–$1,809.05	1030% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Other Outpatient	$1,809.05	$1,809.05	$19.51	1030% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal Age 21+	$773.35	$773.35	$18.14	262% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal Age Under 21	$773.35	$773.35	$18.47	262% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal	$773.35	$773.35	$19.63	262% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$773.35	$773.35	$54.13–$773.35	262% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal Other Outpatient	$773.35	$773.35	$20.61	262% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$586.43	$586.43	$41.05–$586.43	467% above	—
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$397.81	$397.81	$27.85–$397.81	341% above	—
Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) SER	$535.00	$535.00	$37.45–$535.00	466% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum Age Under 21	$535.00	$535.00	$13.83	466% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum	$535.00	$535.00	$14.70	466% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum Age 21+	$535.00	$535.00	$13.59	466% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum Other Outpatient	$535.00	$535.00	$15.44	466% above	—
Free T3 thyroid hormone test CPT 84481 T3 FREE	$675.60	$675.60	$47.29–$675.60	384% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free	$675.60	$675.60	$18.46	384% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Other Outpatient	$675.60	$675.60	$17.79	384% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Age Under 21	$675.60	$675.60	$15.94	384% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Age 21+	$675.60	$675.60	$15.65	384% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free	$615.58	$615.58	$9.83	597% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$615.58	$615.58	$43.09–$615.58	597% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Other Outpatient	$615.58	$615.58	$9.47	597% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Age 21+	$615.58	$615.58	$8.34	597% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Age Under 21	$615.58	$615.58	$8.49	597% above	—
Free testosterone test CPT 84402 Testosterone; free	$1,083.70	$1,083.70	$25.47	880% above	—
Free testosterone test CPT 84402 TESTOSTERONE FREE	$1,083.70	$1,083.70	$75.86–$1,083.70	880% above	—
Free testosterone test CPT 84402 Testosterone; free Age Under 21	$1,083.70	$1,083.70	$23.96	880% above	—
Free testosterone test CPT 84402 Testosterone; free Other Outpatient	$1,083.70	$1,083.70	$26.74	880% above	—
Free testosterone test CPT 84402 Testosterone; free Age 21+	$1,083.70	$1,083.70	$23.53	880% above	—
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT	$946.52	$946.52	$66.26–$946.52	1378% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)	$3,366.01	$3,366.01	$45.36	654% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GEN HEALTH PANEL	$3,366.01	$3,366.01	$2,524.51	654% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR W GLUCOLA	$603.85	$603.85	$42.27–$603.85	568% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR W GLUCOLA	$704.76	$704.76	$49.33–$704.76	680% above	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$608.73	$608.73	$42.61–$608.73	301% above	—
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TT 1ST 3 SPEC	$1,356.35	$1,356.35	$94.94–$1,356.35	793% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE	$689.31	$689.31	$48.25–$689.31	387% above	—
H. pylori antibody blood test CPT 86677 H PYLORI AB QUAL	$329.22	$329.22	$23.05–$329.22	152% above	—
H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGA	$776.78	$776.78	$54.37–$776.78	494% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient	$1,488.39	$1,488.39	$15.10	1397% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age Under 21	$1,488.39	$1,488.39	$13.53	1397% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$1,488.39	$1,488.39	$14.38	1397% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age 21+	$1,488.39	$1,488.39	$13.29	1397% above	—
H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL	$1,488.39	$1,488.39	$104.19–$1,488.39	1397% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN	$3,273.42	$3,273.42	$229.14–$3,273.42	915% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed	$3,273.42	$3,273.42	$85.10	915% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Other Outpatient	$3,273.42	$3,273.42	$89.36	915% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Age Under 21	$3,273.42	$3,273.42	$80.06	915% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Age 21+	$3,273.42	$3,273.42	$78.63	915% above	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 AB QUAL	$339.52	$339.52	$23.77–$339.52	225% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$1,290.66	$1,290.66	$24.08	816% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient	$1,290.66	$1,290.66	$25.28	816% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age Under 21	$1,290.66	$1,290.66	$22.66	816% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1AG HIV-1/2AB SINGLE	$1,290.66	$1,290.66	$90.35–$1,290.66	816% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age 21+	$1,290.66	$1,290.66	$22.25	816% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN	$797.36	$797.36	$55.82–$797.36	766% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$797.36	$797.36	$55.82–$797.36	766% above	—
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$334.37	$334.37	$23.41–$334.37	611% above	—
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL	$435.54	$435.54	$30.49–$435.54	387% above	—
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B core antibody (HBcAb); total Other Outpatient	$435.54	$435.54	$12.65	387% above	—
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B core antibody (HBcAb); total Age 21+	$435.54	$435.54	$11.13	387% above	—
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B core antibody (HBcAb); total	$435.54	$435.54	$12.05	387% above	—
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B core antibody (HBcAb); total Age Under 21	$435.54	$435.54	$11.33	387% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUAL	$354.95	$354.95	$24.85–$354.95	407% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B S AG EIA QL	$354.95	$354.95	$24.85–$354.95	355% above	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB QUAL	$953.39	$953.39	$66.74–$953.39	996% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C DNA QN	$334.37	$334.37	$23.41–$334.37	14% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QN	$2,304.59	$2,304.59	$161.32–$2,304.59	683% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB IGG	$330.94	$330.94	$23.17–$330.94	320% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB QL	$752.76	$752.76	$52.69–$752.76	855% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGG	$478.42	$478.42	$33.49–$478.42	431% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB QL	$752.76	$752.76	$52.69–$752.76	735% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP)	$596.73	$596.73	$7.77–$69.34	649% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$596.73	$596.73	$41.77–$596.73	649% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) Age Under 21	$596.73	$596.73	$12.19	649% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) Other Outpatient	$596.73	$596.73	$13.60	649% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) Age 21+	$596.73	$596.73	$11.97	649% above	—
Homocysteine blood test CPT 83090 Homocysteine Age Under 21	$1,423.23	$1,423.23	$16.86	849% above	—
Homocysteine blood test CPT 83090 Homocysteine Age 21+	$1,423.23	$1,423.23	$16.56	849% above	—
Homocysteine blood test CPT 83090 Homocysteine Other Outpatient	$1,423.23	$1,423.23	$18.82	849% above	—
Homocysteine blood test CPT 83090 HOMOCYSTEINE QN	$1,423.23	$1,423.23	$99.63–$1,423.23	849% above	—
Homocysteine blood test CPT 83090 Homocysteine	$1,423.23	$1,423.23	$17.92	849% above	—
Insulin blood test CPT 83525 Insulin; total Age Under 21	$538.43	$538.43	$10.75	537% above	—
Insulin blood test CPT 83525 Insulin; total Age 21+	$538.43	$538.43	$10.56	537% above	—
Insulin blood test CPT 83525 Insulin; total	$538.43	$538.43	$12.46	537% above	—
Insulin blood test CPT 83525 Insulin; total Other Outpatient	$538.43	$538.43	$12.00	537% above	—
Insulin blood test CPT 83525 INSULIN TOTAL	$538.43	$538.43	$37.69–$538.43	537% above	—
Iron blood test (serum iron) CPT 83540 IRON	$378.95	$378.95	$26.53–$378.95	336% above	—
Iron blood test (serum iron) CPT 83540 IRON LIVER TISSUE QN	$574.44	$574.44	$40.21–$574.44	560% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity	$397.81	$397.81	$8.74	306% above	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING (TIBC)	$397.81	$397.81	$27.85–$397.81	306% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Other Outpatient	$397.81	$397.81	$9.18	306% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Age Under 21	$397.81	$397.81	$8.22	306% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Age 21+	$397.81	$397.81	$8.07	306% above	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$1,692.45	$1,692.45	$118.47–$1,692.45	854% above	—
LH (luteinizing hormone) test CPT 83002 LH	$1,536.40	$1,536.40	$107.55–$1,536.40	916% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH)	$1,536.40	$1,536.40	$18.52	916% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Age Under 21	$1,536.40	$1,536.40	$17.43	916% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Other Outpatient	$1,536.40	$1,536.40	$19.45	916% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Age 21+	$1,536.40	$1,536.40	$17.12	916% above	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$821.36	$821.36	$57.50–$821.36	739% above	—
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BODY FL	$821.36	$821.36	$57.50–$821.36	739% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD)	$456.13	$456.13	$31.93–$456.13	870% above	—
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD) BODY FLUID	$543.56	$543.56	$38.05–$543.56	1057% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$768.20	$768.20	$53.77–$768.20	708% above	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$1,851.93	$1,851.93	$129.64–$1,851.93	786% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB IGG QL	$781.91	$781.91	$54.73–$781.91	845% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB IGM QL	$2,155.42	$2,155.42	$150.88–$2,155.42	2506% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB QL	$2,484.65	$2,484.65	$173.93–$2,484.65	2904% above	—
Magnesium blood test CPT 83735 MAGNESIUM URINE	$392.67	$392.67	$27.49–$392.67	692% above	—
Magnesium blood test CPT 83735 MAGNESIUM OTHER	$392.67	$392.67	$27.49–$392.67	692% above	—
Magnesium blood test CPT 83735 MAGNESIUM BLD	$392.67	$392.67	$27.49–$392.67	692% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$1,121.43	$1,121.43	$78.50–$1,121.43	2866% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$1,154.01	$1,154.01	$80.78–$1,154.01	2952% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE)	$651.60	$651.60	$45.61–$651.60	666% above	—
Mumps immunity blood test CPT 86735 MUMPS IGG QUAL	$318.94	$318.94	$22.33–$318.94	418% above	—
Mumps immunity blood test CPT 86735 MUMPS IGM QUAL	$318.94	$318.94	$22.33–$318.94	418% above	—
Mumps immunity blood test CPT 86735 MUMPS AB QUAL	$591.58	$591.58	$41.41–$591.58	860% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Age 21+	$1,328.92	$1,328.92	$17.00	1078% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PROS SPEC AG FREE	$1,328.92	$1,328.92	$93.02–$1,328.92	1078% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free	$1,328.92	$1,328.92	$20.05	1078% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Other Outpatient	$1,328.92	$1,328.92	$19.31	1078% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Age Under 21	$1,328.92	$1,328.92	$17.30	1078% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA) TOTAL	$1,207.17	$1,207.17	$84.50–$1,207.17	1251% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$660.16	$660.16	$46.21–$660.16	205% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH C TERMINAL	$781.91	$781.91	$54.73–$781.91	261% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$768.20	$768.20	$53.77–$768.20	1320% above	—
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS BLD	$397.81	$397.81	$27.85–$397.81	533% above	—
Potassium blood test CPT 84132 POTASSIUM BLD	$334.37	$334.37	$23.41–$334.37	413% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL ANEPLOIDY 131821	$17,653.14	$17,653.14	$1,235.72–$17,653.14	1929% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 Age Under 21	$17,653.14	$17,653.14	$714.11	1929% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21	$17,653.14	$17,653.14	$759.05	1929% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 Age 21+	$17,653.14	$17,653.14	$701.36	1929% above	—
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy X) genomic sequence analysis panel, circulating cell-free fetal DNA in maternal blood, must include analysis of chromosomes 13, 18, and 21 Other Outpatient	$17,653.14	$17,653.14	$797.00	1929% above	—
Progesterone blood test CPT 84144 Progesterone Other Outpatient	$1,599.85	$1,599.85	$21.90	1291% above	—
Progesterone blood test CPT 84144 Progesterone Age Under 21	$1,599.85	$1,599.85	$19.62	1291% above	—
Progesterone blood test CPT 84144 PROGESTERONE	$1,599.85	$1,599.85	$111.99–$1,599.85	1291% above	—
Progesterone blood test CPT 84144 Progesterone	$1,599.85	$1,599.85	$22.74	1291% above	—
Progesterone blood test CPT 84144 Progesterone Age 21+	$1,599.85	$1,599.85	$19.27	1291% above	—
Prolactin blood test CPT 84146 Prolactin Other Outpatient	$1,843.35	$1,843.35	$20.35	1486% above	—
Prolactin blood test CPT 84146 Prolactin	$1,843.35	$1,843.35	$21.12	1486% above	—
Prolactin blood test CPT 84146 Prolactin Age Under 21	$1,843.35	$1,843.35	$18.23	1486% above	—
Prolactin blood test CPT 84146 Prolactin Age 21+	$1,843.35	$1,843.35	$17.91	1486% above	—
Prolactin blood test CPT 84146 PROLACTIN	$1,843.35	$1,843.35	$129.03–$1,843.35	1486% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$768.20	$768.20	$53.77–$768.20	1526% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS B AG OIA	$339.52	$339.52	$23.77–$339.52	256% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS A AG OIA	$339.52	$339.52	$23.77–$339.52	256% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS AG OIA	$675.60	$675.60	$47.29–$675.60	609% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A OPTICAL IA	$608.73	$608.73	$42.61–$608.73	511% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A Age 21+	$608.73	$608.73	$15.28	511% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A	$608.73	$608.73	$18.02	511% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A Other Outpatient	$608.73	$608.73	$17.36	511% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A Age Under 21	$608.73	$608.73	$15.56	511% above	—
Renin blood test CPT 84244 Renin Other Outpatient	$787.06	$787.06	$23.09	667% above	—
Renin blood test CPT 84244 RENIN	$787.06	$787.06	$55.09–$787.06	667% above	—
Renin blood test CPT 84244 Renin Age Under 21	$787.06	$787.06	$20.69	667% above	—
Renin blood test CPT 84244 Renin Age 21+	$787.06	$787.06	$20.32	667% above	—
Renin blood test CPT 84244 Renin	$787.06	$787.06	$21.99	667% above	—
Rh blood typing CPT 86901 RH TYPE	$197.20	$197.20	$13.80–$197.20	206% above	—
Rheumatoid factor (RF) test CPT 86431 RA QN	$768.20	$768.20	$53.77–$768.20	1293% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative	$768.20	$768.20	$5.67	1293% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Age Under 21	$768.20	$768.20	$5.33	1293% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Age 21+	$768.20	$768.20	$5.24	1293% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Other Outpatient	$768.20	$768.20	$5.95	1293% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB QUAL	$480.12	$480.12	$33.61–$480.12	887% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$1,049.42	$1,049.42	$73.46–$1,049.42	2057% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG	$1,049.42	$1,049.42	$73.46–$1,049.42	2057% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$608.73	$608.73	$42.61–$608.73	985% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen analysis; volume, count, motility, and differential Other Outpatient	$821.36	$821.36	$12.93	537% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$821.36	$821.36	$57.50–$821.36	537% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen analysis; volume, count, motility, and differential	$821.36	$821.36	$13.42	537% above	—
Sodium blood test CPT 84295 SODIUM BLD	$334.37	$334.37	$23.41–$334.37	438% above	—
Stool ova and parasites exam CPT 87177 O&P SMEAR CONC ID	$1,001.40	$1,001.40	$70.10–$1,001.40	1025% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD SCN 3 SPEC	$193.76	$193.76	$13.56–$193.76	404% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA AB CONFIRM	$401.24	$401.24	$28.09–$401.24	756% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA AB CSF	$627.59	$627.59	$43.93–$627.59	1239% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 TP PA CONFIRMATION	$1,033.98	$1,033.98	$72.38–$1,033.98	2106% above	—
Syphilis antibody test (Treponema pallidum) CPT 86780 MHA TP CONFIRM	$1,138.58	$1,138.58	$79.70–$1,138.58	2329% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL BLD QUAL	$853.95	$853.95	$59.78–$853.95	1527% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$853.95	$853.95	$59.78–$853.95	1527% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF QUAL	$1,087.14	$1,087.14	$76.10–$1,087.14	1971% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$805.92	$805.92	$56.41–$805.92	696% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL UR	$3,137.96	$3,137.96	$219.66–$3,137.96	2998% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICRO AB	$644.75	$644.75	$45.13–$644.75	621% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL AB	$787.06	$787.06	$55.09–$787.06	780% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$956.81	$956.81	$66.98–$956.81	970% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$713.35	$713.35	$49.93–$713.35	480% above	—
Total IgE blood test CPT 82785 IGE	$483.56	$483.56	$33.85–$483.56	444% above	—
Total IgE blood test CPT 82785 Gammaglobulin (immunoglobulin); IgE	$483.56	$483.56	$17.94	444% above	—
Total IgE blood test CPT 82785 Gammaglobulin (immunoglobulin); IgE Age 21+	$483.56	$483.56	$15.21	444% above	—
Total IgE blood test CPT 82785 Gammaglobulin (immunoglobulin); IgE Age Under 21	$483.56	$483.56	$15.49	444% above	—
Total IgE blood test CPT 82785 Gammaglobulin (immunoglobulin); IgE Other Outpatient	$483.56	$483.56	$17.28	444% above	—
Total cholesterol blood test CPT 82465 CHOLESTEROL BLD	$483.56	$483.56	$33.85–$483.56	618% above	—
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4 TOTAL	$535.00	$535.00	$37.45–$535.00	563% above	—
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$1,303.20	$1,303.20	$91.22–$1,303.20	935% above	—
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3; total (TT-3) Age 21+	$1,303.20	$1,303.20	$13.10	935% above	—
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3; total (TT-3)	$1,303.20	$1,303.20	$14.18	935% above	—
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3; total (TT-3) Age Under 21	$1,303.20	$1,303.20	$13.34	935% above	—
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3; total (TT-3) Other Outpatient	$1,303.20	$1,303.20	$14.89	935% above	—
Transferrin blood test CPT 84466 TRANSFERRIN	$483.56	$483.56	$33.85–$483.56	306% above	—
Transferrin blood test CPT 84466 Transferrin Age Under 21	$483.56	$483.56	$12.01	306% above	—
Transferrin blood test CPT 84466 Transferrin Age 21+	$483.56	$483.56	$11.79	306% above	—
Transferrin blood test CPT 84466 Transferrin Other Outpatient	$483.56	$483.56	$13.40	306% above	—
Transferrin blood test CPT 84466 Transferrin	$483.56	$483.56	$12.76	306% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique Age 21+	$787.06	$787.06	$32.43	800% above	—
Trichomonas test (NAAT) CPT 87661 TRICH VAGINALIS AMP PRBE	$787.06	$787.06	$55.09–$787.06	800% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique Other Outpatient	$787.06	$787.06	$36.84	800% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique Age Under 21	$787.06	$787.06	$33.02	800% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique	$787.06	$787.06	$38.25	800% above	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$946.52	$946.52	$66.26–$946.52	978% above	—
Triglycerides blood test CPT 84478 TRIGLYCERIDES OTHER	$946.52	$946.52	$66.26–$946.52	978% above	—
Troponin test, quantitative CPT 84484 TROPONIN QUANT	$1,472.95	$1,472.95	$103.11–$1,472.95	987% above	—
Uric acid blood test CPT 84550 URIC ACID BLD	$608.73	$608.73	$42.61–$608.73	570% above	—
Urinalysis with microscope exam, automated CPT 81001 UA W MICRO AUTO	$644.75	$644.75	$45.13–$644.75	498% above	—
Urinalysis without microscope exam, automated CPT 81003 PROTEIN UR QUAL AUTO	$173.20	$173.20	$12.12–$173.20	245% above	—
Urinalysis without microscope exam, automated CPT 81003 SPEC GRAV UR AUTO	$183.48	$183.48	$12.84–$183.48	266% above	—
Urinalysis without microscope exam, automated CPT 81003 GLUC UR QUAL AUTO	$217.77	$217.77	$15.24–$217.77	334% above	—
Urinalysis without microscope exam, automated CPT 81003 PH UR AUTO	$217.77	$217.77	$15.24–$217.77	334% above	—
Urinalysis without microscope exam, automated CPT 81003 NITRITES UR AUTO	$217.77	$217.77	$15.24–$217.77	334% above	—
Urinalysis without microscope exam, automated CPT 81003 KETONES UR AUTO	$217.77	$217.77	$15.24–$217.77	334% above	—
Urinalysis without microscope exam, automated CPT 81003 BLOOD URINE AUTO	$217.77	$217.77	$15.24–$217.77	334% above	—
Urinalysis without microscope exam, automated CPT 81003 LEUK EST UR AUTO	$217.77	$217.77	$15.24–$217.77	334% above	—
Urinalysis without microscope exam, automated CPT 81003 BILIRUBIN UR AUTO	$221.21	$221.21	$15.48–$221.21	341% above	—
Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO	$334.37	$334.37	$23.41–$334.37	567% above	—
Urinalysis without microscope exam, manual CPT 81002 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate Age Under 21	$411.55	$411.55	$3.27	1050% above	—
Urinalysis without microscope exam, manual CPT 81002 UA W O MICRO MANUAL	$411.55	$411.55	$28.81–$411.55	1050% above	—
Urinalysis without microscope exam, manual CPT 81002 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate	$411.55	$411.55	$3.79	1050% above	—
Urinalysis without microscope exam, manual CPT 81002 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate Other Outpatient	$411.55	$411.55	$3.65	1050% above	—
Urinalysis without microscope exam, manual CPT 81002 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate Age 21+	$411.55	$411.55	$3.21	1050% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR	$631.02	$631.02	$44.17–$631.02	355% above	—
Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg, microalbumin), quantitative Other Outpatient	$797.36	$797.36	$6.07	1463% above	—
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QN	$797.36	$797.36	$55.82–$797.36	1463% above	—
Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg, microalbumin), quantitative	$797.36	$797.36	$6.30	1463% above	—
Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg, microalbumin), quantitative Age Under 21	$797.36	$797.36	$5.44	1463% above	—
Urine microalbumin (albumin) test CPT 82043 Albumin; urine (eg, microalbumin), quantitative Age 21+	$797.36	$797.36	$5.35	1463% above	—
Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL BY DOO	$888.22	$888.22	$62.18–$888.22	944% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12);	$538.43	$538.43	$16.44	493% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$538.43	$538.43	$37.69–$538.43	493% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Other Outpatient	$538.43	$538.43	$15.83	493% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Age 21+	$538.43	$538.43	$13.94	493% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Age Under 21	$538.43	$538.43	$14.19	493% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D3 25-OH	$787.06	$787.06	$55.09–$787.06	539% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH W/WO FRAC	$1,589.55	$1,589.55	$111.27–$1,589.55	1191% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1-25 W/WO FRAC	$1,827.91	$1,827.91	$127.95–$1,827.91	1000% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed	$1,827.91	$1,827.91	$38.50	1000% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Other Outpatient	$1,827.91	$1,827.91	$40.43	1000% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Age 21+	$1,827.91	$1,827.91	$35.57	1000% above	—
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Age Under 21	$1,827.91	$1,827.91	$36.22	1000% above	—
Zinc blood test CPT 84630 Zinc Age 21+	$324.08	$324.08	$10.53	369% above	—
Zinc blood test CPT 84630 Zinc	$324.08	$324.08	$11.39	369% above	—
Zinc blood test CPT 84630 Zinc Other Outpatient	$324.08	$324.08	$11.96	369% above	—
Zinc blood test CPT 84630 Zinc Age Under 21	$324.08	$324.08	$10.72	369% above	—
Zinc blood test CPT 84630 ZINC BLOOD	$324.08	$324.08	$22.69–$324.08	369% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT TUMOR	$893.37	$893.37	$62.54–$893.37	695% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE	$1,649.57	$1,649.57	$115.47–$1,649.57	1368% above	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Cardiac catheterization with coronary angiogram CPT 93458 CTH PLC/INJ LHC & L VENT	$54,106.47	$54,106.47	$7,304.37–$54,106.47	362% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion, elective, electrical conversion of arrhythmia; external	$6,750.17	$6,750.17	$1,266.00–$3,293.00	376% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$6,750.17	$6,750.17	$472.51–$6,750.17	376% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including without Cardiac Cath	$54,227.89	$54,227.89	$5,591.00	50% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including	$54,227.89	$54,227.89	$7,668.00	50% above	—
Catheter ablation for atrial fibrillation CPT 93656 COM EP REPO CTH TX AFIB	$54,227.89	$54,227.89	$7,320.77–$54,227.89	50% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including with Cardiac Cath	$54,227.89	$54,227.89	$7,818.00	50% above	—
Left heart catheterization, diagnostic one side CPT 93452 CATH HRT LT/INJ L VENT	$54,106.47	$54,106.47	$7,304.37–$54,106.47	465% above	—
Pacemaker implant (dual chamber) CPT 33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular	$61,153.50	$61,153.50	$6,773.44–$85,680.00	222% above	—
Pacemaker implant (dual chamber) CPT 33208 INS PACEMAKER ATR/VENT	$61,153.50	$61,153.50	$8,255.72–$61,153.50	222% above	—
Pacemaker implant (dual chamber) CPT 33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular Age Under 21	$61,153.50	$61,153.50	$7,225.01	222% above	—
Pacemaker implant (dual chamber) CPT 33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular Age 21+	$61,153.50	$61,153.50	$7,095.99	222% above	—
Paracentesis with imaging guidance CPT 49083 Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance Age 21+	$7,939.20	$7,939.20	$368.44	388% above	—
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W IMAGE	$7,939.20	$7,939.20	$555.74–$7,939.20	388% above	—
Paracentesis with imaging guidance CPT 49083 Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance	$7,939.20	$7,939.20	$351.70–$5,773.00	388% above	—
Paracentesis with imaging guidance CPT 49083 Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance Age Under 21	$7,939.20	$7,939.20	$375.14	388% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture, lumbar, diagnostic;	$4,653.77	$4,653.77	$2,095.00–$2,960.00	345% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 PUNCTURE LUMBAR DX	$4,653.77	$4,653.77	$325.76–$4,653.77	345% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture, lumbar, diagnostic; Age 21+	$4,653.77	$4,653.77	$289.15	345% above	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal puncture, lumbar, diagnostic; Age Under 21	$4,653.77	$4,653.77	$294.40	345% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance	$6,613.90	$6,613.90	$234.94–$4,850.00	365% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance Age Under 21	$6,613.90	$6,613.90	$250.60	365% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance Age 21+	$6,613.90	$6,613.90	$246.13	365% above	—
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMAG	$6,613.90	$6,613.90	$462.97–$6,613.90	365% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,950.51	$1,950.51	$136.54–$1,950.51	130% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INH TX AC AWY OBST	$379.05	$379.05	$26.53–$379.05	86% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HYP SPUTUM	$541.24	$541.24	$37.89–$541.24	166% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MINS	$11,816.71	$11,816.71	$1,595.26–$11,816.71	356% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram (EEG); including recording awake and drowsy	$3,636.55	$3,636.55	$854.32–$1,662.03	272% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AW & DROWSY	$3,636.55	$3,636.55	$254.56–$3,636.55	272% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$1,318.27	$1,318.27	$92.28–$1,318.27	364% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report	$1,318.27	$1,318.27	$151.28–$1,514.00	364% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LVL 1 EMER DEPT	$1,478.97	$1,478.97	$199.66–$1,478.97	464% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LVL 2 EMER DEPT	$1,782.77	$1,782.77	$240.67–$1,782.77	280% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LVL 3 EMER DEPT	$2,857.78	$2,857.78	$385.80–$2,857.78	249% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LVL 4 EMER DEPT	$3,669.03	$3,669.03	$495.32–$3,669.03	180% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LVL 5 EMER DEPT	$7,974.05	$7,974.05	$1,076.50–$7,974.05	297% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$6,953.14	$6,953.14	$486.72–$6,953.14	454% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation an	$6,953.14	$6,953.14	$696.02–$1,514.00	454% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INIT UP TO 1HR	$1,079.48	$1,079.48	$75.56–$1,079.48	140% above	—
IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HOUR	$1,079.48	$1,079.48	$75.56–$1,079.48	130% above	—
IV push of a medicine, first drug CPT 96374 IVP SINGLE/INITIAL DRUG	$1,074.28	$1,074.28	$75.20–$1,074.28	364% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ	$173.81	$173.81	$12.17–$173.81	14% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination Other Outpatient	$902.33	$902.33	$102.52	196% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination	$902.33	$902.33	$106.43	196% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st	$345.81	$345.81	$106.43	73% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st Other Outpatient	$345.81	$345.81	$102.52	73% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o	$681.98	$681.98	$106.43	170% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o Other Outpatient	$681.98	$681.98	$102.52	170% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKECESS 3-10 MIN	$76.63	$76.63	$5.36–$76.63	73% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes	$76.63	$76.63	$34.68–$67.46	73% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEB	$546.04	$546.04	$38.22–$546.04	129% above	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL < 7 YRS VAC IM	$237.03	$237.03	$177.77	163% above	—
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VAC <7YRS IM	$276.48	$276.48	$19.35–$276.48	206% above	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis B, and inactivated poliovirus vaccine (DTaP-HepB-IPV), for intramuscular use	$1,145.08	$1,145.08	$218.96	368% above	—
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEPB-IPV VAC IM	$1,145.08	$1,145.08	$858.81	368% above	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use	$832.45	$832.45	$233.10	197% above	—
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL VAC IM	$832.45	$832.45	$58.27–$832.45	197% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX PED 5MCG IM	$244.78	$244.78	$17.13–$244.78	158% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use Other Outpatient	$244.78	$244.78	—	158% above	—
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use	$244.78	$244.78	$54.78	158% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB VAC PRP-OMP 3DOSE IM	$329.02	$329.02	$23.03–$329.02	351% above	—
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use	$329.02	$329.02	$62.07	351% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB 4 DOSE VAC IM	$277.89	$277.89	$208.42	491% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use	$1,020.51	$1,020.51	$193.28	313% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC LIVE SQ	$1,020.51	$1,020.51	$765.38	313% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI VAC IM	$982.66	$982.66	$737.00	38% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use	$982.66	$982.66	$350.43	38% above	—
Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA VAC IM	$1,223.45	$1,223.45	$917.59	57% above	—
Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use	$1,223.45	$1,223.45	$447.05	57% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use	$2,084.77	$2,084.77	$425.45	328% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 Pneumococcal conjugate vaccine, 13 valent (PCV13), for intramuscular use Other Outpatient	$2,084.77	$2,084.77	—	328% above	—
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VAC IM	$2,084.77	$2,084.77	$145.93–$2,084.77	328% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAXNEUVANCE VAC IM	$1,314.41	$1,314.41	$92.01–$1,314.41	23% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use Other Outpatient	$1,314.41	$1,314.41	—	23% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use	$1,314.41	$1,314.41	$261.23–$2,195.30	23% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use	$618.43	$618.43	$220.23	145% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use Other Outpatient	$618.43	$618.43	—	145% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VAC IMSQ	$618.43	$618.43	$43.29–$618.43	145% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MAB SEASONAL 0.5MLIM	$2,802.32	$2,802.32	$196.16–$2,802.32	186% above	—
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use	$2,802.32	$2,802.32	$611.85–$5,326.78	186% above	—
Rabies vaccine, one dose CPT 90675 RABAVERT 1 ML VAC IM	$2,257.47	$2,257.47	$158.02–$2,257.47	120% above	—
Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VAC IM	$2,460.63	$2,460.63	$172.24–$2,460.63	140% above	—
Rabies vaccine, one dose CPT 90675 RABIES VAC IM	$2,860.43	$2,860.43	$200.23–$2,860.43	179% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use	$361.35	$361.35	$37.59–$404.68	195% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VAC PF >=7YRS IM	$361.35	$361.35	$271.01	195% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VAC >=7YRS IM	$792.36	$792.36	$55.47–$792.36	433% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use	$792.36	$792.36	$65.14	433% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN SGL	$140.39	$140.39	$9.83–$140.39	88% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDTL	$140.39	$140.39	$105.29	163% above	—

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

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

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

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

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

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

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

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

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

Source file: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/46-4027347_MEDICAL-CITY-SURGERY-CITY-ALLIANCE_standardcharges.json?si=dpx-pt-json-access-policy&spr=https&sv=2026-02-06&sr=c&sig=ks%2BgfAjyEHlZmeP2PYJ%2F9NpMuCoRStjTb2bhIy9Y6LM%3D