Hospital Santa Cruz-Watsonville, CA

Watsonville Community Hospital

Watsonville Community Hospital in Watsonville, CA publishes cash prices for 303 common procedures listed here, from its own machine-readable price file updated Oct 8, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the California median for 223 of 302 procedures and below it for 78. By typical cash price it ranks #189 of 226 California hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

75 NIELSON STREET,WATSONVILLE,CA,95076-2468 Collected Oct 10, 2026 Source price file Check a bill from this hospital (831) 724-4741

Acute care hospital For-profit hospital Emergency department CMS star rating 2 of 5 CCN 050194 · CMS hospital register

State law

This state limits hospital bills for lower-income patients

California law (Health and Safety Code §127405): if you are uninsured or have high medical costs and your family income is at or below 400% of the federal poverty level, a hospital may not expect you to pay more than it would expect from Medicare or Medi-Cal, whichever is greater. That can be less than the cash prices below; ask the hospital for its discount payment policy. A separate physician fee may still apply. Other states' laws.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Watsonville Community Hospital in Watsonville, CA:

Dec 13, 2024 Warning notice
Mar 19, 2025 Corrective action plan requested
Apr 15, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$6,736.80	$11,228.00	$340.87–$11,228.00	138% above	40%
Abdominal CT scan without and with contrast CPT 74170 CT-ABDOMEN WWO	$6,736.80	$11,228.00	$340.87–$11,228.00	138% above	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT-ABDOMEN WWO	$6,736.80	$11,228.00	$340.87–$11,228.00	—	40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD WO CNTRST FLWD CNTRST	$6,736.80	$11,228.00	$340.87–$11,228.00	—	40%
Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS	$1,060.38	$1,767.30	$39.33–$1,767.30	146% above	40%
Abdominal X-ray, 2 views CPT 74019 CH-ABDOMEN 2 VWS CR	$1,060.38	$1,767.30	$39.33–$1,767.30	146% above	40%
Abdominal X-ray, 2 views inpatient CPT 74019 RADEX ABDOMEN 2 VIEWS	$1,060.38	$1,767.30	$39.33–$1,767.30	—	40%
Abdominal X-ray, 2 views inpatient CPT 74019 CH-ABDOMEN 2 VWS CR	$1,060.38	$1,767.30	$39.33–$1,767.30	—	40%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 LE-ANKLE 3VWS BI CR	$1,194.15	$1,990.25	$35.79–$4,946.65	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$886.92	$1,478.20	$35.79–$4,946.65	72% above	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 LE-LT ANKLE 3VPLUS CR	$886.92	$1,478.20	$35.79–$4,946.65	72% above	40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 LE-RT ANKLE 3VPLUS CR	$886.92	$1,478.20	$35.79–$4,946.65	72% above	40%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 LE-ANKLE 3VWS BI CR	$1,194.15	$1,990.25	$35.79–$4,946.65	—	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY EXAM OF ANKLE	$886.92	$1,478.20	$35.79–$4,946.65	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 LE-RT ANKLE 3VPLUS CR	$886.92	$1,478.20	$35.79–$4,946.65	—	40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 LE-LT ANKLE 3VPLUS CR	$886.92	$1,478.20	$35.79–$4,946.65	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$431.55	$719.25	$35.43–$1,084.14	23% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US-EXT ARTERIAL LTD	$431.55	$719.25	$35.43–$1,084.14	23% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$431.55	$719.25	$35.43–$1,084.14	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US-EXT ARTERIAL LTD	$431.55	$719.25	$35.43–$1,084.14	—	40%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE	$4,268.40	$7,114.00	$227.45–$14,228.00	87% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT-RT UPPER EXT WO	$4,268.40	$7,114.00	$227.45–$14,228.00	87% above	40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT-LT UPPER EXT WO	$4,268.40	$7,114.00	$227.45–$14,228.00	87% above	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O DYE	$4,268.40	$7,114.00	$227.45–$14,228.00	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT-RT UPPER EXT WO	$4,268.40	$7,114.00	$227.45–$14,228.00	—	40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT-LT UPPER EXT WO	$4,268.40	$7,114.00	$227.45–$14,228.00	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL-ESOPHAGUS SINGLE CONTRAST	$1,125.72	$1,876.20	$54.64–$1,876.20	86% above	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$1,125.72	$1,876.20	$54.64–$1,876.20	86% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL-ESOPHAGUS SINGLE CONTRAST	$1,125.72	$1,876.20	$54.64–$1,876.20	—	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$1,125.72	$1,876.20	$54.64–$1,876.20	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN BODY	$3,290.88	$5,484.80	$202.29–$5,484.80	55% above	40%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$3,290.88	$5,484.80	$202.29–$5,484.80	55% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$3,290.88	$5,484.80	$202.29–$5,484.80	—	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE SCAN BODY	$3,290.88	$5,484.80	$202.29–$5,484.80	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST COMPLETE BILATERAL	$919.83	$1,533.05	$127.60–$4,110.05	—	40%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$773.10	$1,288.50	$127.60–$4,110.05	10% above	40%
Breast ultrasound, complete, one breast one side CPT 76641 US-LT BREAST COMPLETE	$773.10	$1,288.50	$127.60–$4,110.05	10% above	40%
Breast ultrasound, complete, one breast one side CPT 76641 US-RT BREAST COMPLETE	$773.10	$1,288.50	$127.60–$4,110.05	10% above	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST COMPLETE BILATERAL	$919.83	$1,533.05	$127.60–$4,110.05	—	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE	$773.10	$1,288.50	$127.60–$4,110.05	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US-RT BREAST COMPLETE	$773.10	$1,288.50	$127.60–$4,110.05	—	40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US-LT BREAST COMPLETE	$773.10	$1,288.50	$127.60–$4,110.05	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 POC US-BREAST LMTD	$184.80	$308.00	$101.83–$1,403.05	65% below	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 US-BREAST LIMITED	$657.03	$1,095.05	$101.83–$1,403.05	23% above	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$657.03	$1,095.05	$101.83–$1,403.05	23% above	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 POC US-BREAST LMTD	$184.80	$308.00	$101.83–$1,403.05	—	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED	$657.03	$1,095.05	$101.83–$1,403.05	—	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US-BREAST LIMITED	$657.03	$1,095.05	$101.83–$1,403.05	—	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST	$13,204.14	$22,006.90	$500.74–$22,006.90	144% above	40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA-ABDOMEN PELVIS	$13,204.14	$22,006.90	$500.74–$22,006.90	144% above	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA-ABDOMEN PELVIS	$13,204.14	$22,006.90	$500.74–$22,006.90	—	40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD&PLVS W/CONTRAST	$13,204.14	$22,006.90	$500.74–$22,006.90	—	40%
CT angiography (CTA) of the head CPT 70496 CTA-HEAD	$6,332.49	$10,554.15	$373.49–$10,554.15	112% above	40%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$6,332.49	$10,554.15	$373.49–$10,554.15	112% above	40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA-HEAD	$6,332.49	$10,554.15	$373.49–$10,554.15	—	40%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD	$6,332.49	$10,554.15	$373.49–$10,554.15	—	40%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK	$6,332.49	$10,554.15	$372.31–$10,554.15	114% above	40%
CT angiography (CTA) of the neck CPT 70498 CTA-NECK	$6,332.49	$10,554.15	$372.31–$10,554.15	114% above	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK	$6,332.49	$10,554.15	$372.31–$10,554.15	—	40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA-NECK	$6,332.49	$10,554.15	$372.31–$10,554.15	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$6,736.71	$11,227.85	$375.07–$11,227.85	96% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA-CHEST	$6,736.71	$11,227.85	$375.07–$11,227.85	96% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA-CHEST	$6,736.71	$11,227.85	$375.07–$11,227.85	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$6,736.71	$11,227.85	$375.07–$11,227.85	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT-HRT WO DYE W/CA	$228.00	$380.00	$68.40–$382.50	39% below	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$228.00	$380.00	$68.40–$382.50	39% below	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$228.00	$380.00	$68.40–$382.50	—	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT-HRT WO DYE W/CA	$228.00	$380.00	$68.40–$382.50	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT-ABD PELVIS WO	$9,352.98	$15,588.30	$197.14–$15,588.30	192% above	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$9,352.98	$15,588.30	$197.14–$15,588.30	192% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$9,352.98	$15,588.30	$197.14–$15,588.30	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT-ABD PELVIS WO	$9,352.98	$15,588.30	$197.14–$15,588.30	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT-ABD PELVIS W	$10,527.06	$17,545.10	$404.21–$17,545.10	155% above	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$10,527.06	$17,545.10	$404.21–$17,545.10	155% above	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT-ABD PELVIS W	$10,527.06	$17,545.10	$404.21–$17,545.10	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST	$10,527.06	$17,545.10	$404.21–$17,545.10	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-ABD PELVIS WWO	$11,625.93	$19,376.55	$454.44–$19,376.55	147% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$11,625.93	$19,376.55	$454.44–$19,376.55	147% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$11,625.93	$19,376.55	$454.44–$19,376.55	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-ABD PELVIS WWO	$11,625.93	$19,376.55	$454.44–$19,376.55	—	40%
CT scan of the abdomen with contrast CPT 74160 CT-ABDOMEN W	$5,606.40	$9,344.00	$299.45–$9,344.00	122% above	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$5,606.40	$9,344.00	$299.45–$9,344.00	122% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$5,606.40	$9,344.00	$299.45–$9,344.00	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN W	$5,606.40	$9,344.00	$299.45–$9,344.00	—	40%
CT scan of the abdomen without contrast CPT 74150 CT-ABDOMEN WO	$4,871.40	$8,119.00	$158.60–$8,119.00	155% above	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$4,871.40	$8,119.00	$158.60–$8,119.00	155% above	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$4,871.40	$8,119.00	$158.60–$8,119.00	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN WO	$4,871.40	$8,119.00	$158.60–$8,119.00	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT-MAXILLOFACIAL WO	$3,924.27	$6,540.45	$170.78–$6,540.45	80% above	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$3,924.27	$6,540.45	$170.78–$6,540.45	80% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE	$3,924.27	$6,540.45	$170.78–$6,540.45	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-MAXILLOFACIAL WO	$3,924.27	$6,540.45	$170.78–$6,540.45	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT-HEAD WO	$4,010.07	$6,683.45	$145.26–$6,683.45	75% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$4,010.07	$6,683.45	$145.26–$6,683.45	75% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-HEAD WO	$4,010.07	$6,683.45	$145.26–$6,683.45	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE	$4,010.07	$6,683.45	$145.26–$6,683.45	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$4,843.80	$8,073.00	$186.61–$8,073.00	79% above	40%
CT scan of the head with contrast CPT 70460 CT-HEAD W	$4,843.80	$8,073.00	$186.61–$8,073.00	79% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT-HEAD W	$4,843.80	$8,073.00	$186.61–$8,073.00	—	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/DYE	$4,843.80	$8,073.00	$186.61–$8,073.00	—	40%
CT scan of the head without and with contrast CPT 70470 CT-HEAD WWO	$5,101.80	$8,503.00	$222.82–$8,503.00	65% above	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$5,101.80	$8,503.00	$222.82–$8,503.00	65% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT-HEAD WWO	$5,101.80	$8,503.00	$222.82–$8,503.00	—	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$5,101.80	$8,503.00	$222.82–$8,503.00	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT-LUMB SPINE WO	$5,868.00	$9,780.00	$178.35–$9,780.00	105% above	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$5,868.00	$9,780.00	$178.35–$9,780.00	105% above	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-LUMB SPINE WO	$5,868.00	$9,780.00	$178.35–$9,780.00	—	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$5,868.00	$9,780.00	$178.35–$9,780.00	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$5,665.71	$9,442.85	$179.29–$9,442.85	95% above	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT-CERV SPINE WO	$5,665.71	$9,442.85	$179.29–$9,442.85	95% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-CERV SPINE WO	$5,665.71	$9,442.85	$179.29–$9,442.85	—	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE	$5,665.71	$9,442.85	$179.29–$9,442.85	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT-PELVIS W	$5,359.20	$8,932.00	$293.26–$8,932.00	110% above	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$5,359.20	$8,932.00	$293.26–$8,932.00	110% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W	$5,359.20	$8,932.00	$293.26–$8,932.00	—	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE	$5,359.20	$8,932.00	$293.26–$8,932.00	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,802.04	$3,003.40	$117.48–$9,010.20	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US-TEMPORAL ARTERY DOPPLER BILATERAL	$1,802.04	$3,003.40	$117.48–$9,010.20	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US-CAROTID DPLX SCAN	$1,802.04	$3,003.40	$117.48–$9,010.20	47% above	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,802.04	$3,003.40	$117.48–$9,010.20	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US-TEMPORAL ARTERY DOPPLER BILATERAL	$1,802.04	$3,003.40	$117.48–$9,010.20	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US-CAROTID DPLX SCAN	$1,802.04	$3,003.40	$117.48–$9,010.20	—	40%
Chest CT scan without and with contrast CPT 71270 CT-CHEST WWO	$5,958.84	$9,931.40	$274.85–$9,931.40	82% above	40%
Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+	$5,958.84	$9,931.40	$274.85–$9,931.40	82% above	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX DX C-/C+	$5,958.84	$9,931.40	$274.85–$9,931.40	—	40%
Chest CT scan without and with contrast inpatient CPT 71270 CT-CHEST WWO	$5,958.84	$9,931.40	$274.85–$9,931.40	—	40%
Chest X-ray, 2 views CPT 71046 CH-CHEST 2V CR	$979.92	$1,633.20	$37.34–$1,633.20	141% above	40%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$979.92	$1,633.20	$37.34–$1,633.20	141% above	40%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$979.92	$1,633.20	$37.34–$1,633.20	—	40%
Chest X-ray, 2 views inpatient CPT 71046 CH-CHEST 2V CR	$979.92	$1,633.20	$37.34–$1,633.20	—	40%
Chest X-ray, single view CPT 71045 CH-CHEST 1V CR	$661.62	$1,102.70	$18.95–$1,102.70	82% above	40%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$661.62	$1,102.70	$18.95–$1,102.70	82% above	40%
Chest X-ray, single view inpatient CPT 71045 CH-CHEST 1V CR	$661.62	$1,102.70	$18.95–$1,102.70	—	40%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$661.62	$1,102.70	$18.95–$1,102.70	—	40%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 UE-CLAVICLE CR BILATERAL	$1,485.39	$2,475.65	$28.77–$4,951.25	—	40%
Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE	$742.68	$1,237.80	$28.77–$4,951.25	53% above	40%
Collarbone (clavicle) X-ray, complete CPT 73000 UE-CLAVICLE CR	$742.68	$1,237.80	$28.77–$4,951.25	53% above	40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 UE-RT CLAVICLE CR	$742.68	$1,237.80	$28.77–$4,951.25	53% above	40%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 UE-CLAVICLE CR BILATERAL	$1,485.39	$2,475.65	$28.77–$4,951.25	—	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 UE-CLAVICLE CR	$742.68	$1,237.80	$28.77–$4,951.25	—	40%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 X-RAY EXAM OF COLLAR BONE	$742.68	$1,237.80	$28.77–$4,951.25	—	40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 UE-RT CLAVICLE CR	$742.68	$1,237.80	$28.77–$4,951.25	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$2,881.32	$4,802.20	$108.61–$4,802.20	240% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US-ABDOMEN RETROPER	$2,881.32	$4,802.20	$108.61–$4,802.20	240% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$2,881.32	$4,802.20	$108.61–$4,802.20	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-ABDOMEN RETROPER	$2,881.32	$4,802.20	$108.61–$4,802.20	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL	$776.04	$1,293.40	$49.16–$1,293.40	54% above	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$776.04	$1,293.40	$49.16–$1,293.40	54% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$776.04	$1,293.40	$49.16–$1,293.40	—	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL	$776.04	$1,293.40	$49.16–$1,293.40	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA PERIPHERAL	$516.63	$861.05	$30.84–$861.05	87% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULR	$516.63	$861.05	$30.84–$861.05	87% above	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY APPENDICULR	$516.63	$861.05	$30.84–$861.05	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA PERIPHERAL	$516.63	$861.05	$30.84–$861.05	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$1,662.09	$2,770.15	$151.62–$2,770.15	84% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US-PLV PRG TA DETAIL	$1,662.09	$2,770.15	$151.62–$2,770.15	84% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS	$1,662.09	$2,770.15	$151.62–$2,770.15	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US-PLV PRG TA DETAIL	$1,662.09	$2,770.15	$151.62–$2,770.15	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$3,609.78	$6,016.30	$182.63–$6,016.30	78% above	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-CHEST WO	$3,609.78	$6,016.30	$182.63–$6,016.30	78% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$3,609.78	$6,016.30	$182.63–$6,016.30	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-CHEST WO	$3,609.78	$6,016.30	$182.63–$6,016.30	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$5,958.84	$9,931.40	$230.85–$9,931.40	107% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT-CHEST W	$5,958.84	$9,931.40	$230.85–$9,931.40	107% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX C+	$5,958.84	$9,931.40	$230.85–$9,931.40	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-CHEST W	$5,958.84	$9,931.40	$230.85–$9,931.40	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BILAT	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BI GG	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO DX BILATERAL	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BI GG	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BILAT	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO DX BILATERAL	$878.97	$1,464.95	$134.54–$5,859.80	—	40%
Diagnostic mammogram, one breast CPT 77065 BR-DIG MAMMO UNI GG	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-DIG MAMMO UNILAT	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-RT DIG MAMMO UNIL	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-RT DIG MAM UNI	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-LT DIG MAM UNI	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-LT DIG MAMMO UNIL	$878.97	$1,464.95	$105.00–$8,789.70	134% above	40%
Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Diagnostic mammogram, one breast inpatient CPT 77065 BR-DIG MAMMO UNI GG	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-LT DIG MAM UNI	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-RT DIG MAM UNI	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-LT DIG MAMMO UNIL	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-RT DIG MAMMO UNIL	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-DIG MAMMO UNILAT	$878.97	$1,464.95	$105.00–$8,789.70	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 NI-LW EXT DPX ART BI	$3,356.85	$5,594.75	$72.65–$11,189.50	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US-LW EXT DPX ART BI	$3,356.85	$5,594.75	$72.65–$11,189.50	—	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$3,356.85	$5,594.75	$72.65–$11,189.50	221% above	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US-LW EXT DPX ART BI	$3,356.85	$5,594.75	$72.65–$11,189.50	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 NI-LW EXT DPX ART BI	$3,356.85	$5,594.75	$72.65–$11,189.50	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 LOWER EXTREMITY STUDY	$3,356.85	$5,594.75	$72.65–$11,189.50	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 US-EXT VEINS DPLX WC	$1,807.23	$3,012.05	$121.13–$9,516.95	52% above	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$3,902.94	$6,504.90	$121.13–$9,516.95	229% above	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 NI-EXT VEINS DPLX WC	$3,902.94	$6,504.90	$121.13–$9,516.95	229% above	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US-EXT VEINS DPLX WC	$1,807.23	$3,012.05	$121.13–$9,516.95	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 NI-EXT VEINS DPLX WC	$3,902.94	$6,504.90	$121.13–$9,516.95	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$3,902.94	$6,504.90	$121.13–$9,516.95	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US-TTE 2D W DOPP WO	$5,795.73	$9,659.55	$177.42–$9,659.55	116% above	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$5,795.73	$9,659.55	$177.42–$9,659.55	116% above	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US-TTE 2D W DOPP WO	$5,795.73	$9,659.55	$177.42–$9,659.55	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$5,795.73	$9,659.55	$177.42–$9,659.55	—	40%
Elbow X-ray, 2 views both sides CPT 73070 UE-ELBOW 2VW BI CR	$1,019.07	$1,698.45	$29.18–$3,963.05	—	40%
Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW	$679.38	$1,132.30	$29.18–$3,963.05	71% above	40%
Elbow X-ray, 2 views one side CPT 73070 UE-LT ELBOW 2V CR	$679.38	$1,132.30	$29.18–$3,963.05	71% above	40%
Elbow X-ray, 2 views one side CPT 73070 UE-RT ELBOW 2V CR	$679.38	$1,132.30	$29.18–$3,963.05	71% above	40%
Elbow X-ray, 2 views inpatient both sides CPT 73070 UE-ELBOW 2VW BI CR	$1,019.07	$1,698.45	$29.18–$3,963.05	—	40%
Elbow X-ray, 2 views inpatient CPT 73070 X-RAY EXAM OF ELBOW	$679.38	$1,132.30	$29.18–$3,963.05	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 UE-LT ELBOW 2V CR	$679.38	$1,132.30	$29.18–$3,963.05	—	40%
Elbow X-ray, 2 views inpatient one side CPT 73070 UE-RT ELBOW 2V CR	$679.38	$1,132.30	$29.18–$3,963.05	—	40%
Elbow X-ray, complete, 3 or more views both sides CPT 73080 UE-ELBOW 3VW BI CR	$1,921.62	$3,202.70	$37.27–$7,473.00	—	40%
Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW	$1,281.09	$2,135.15	$37.27–$7,473.00	165% above	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 UE-LT ELBOW 3V CR	$1,281.09	$2,135.15	$37.27–$7,473.00	165% above	40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 UE-RT ELBOW 3V CR	$1,281.09	$2,135.15	$37.27–$7,473.00	165% above	40%
Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 UE-ELBOW 3VW BI CR	$1,921.62	$3,202.70	$37.27–$7,473.00	—	40%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 X-RAY EXAM OF ELBOW	$1,281.09	$2,135.15	$37.27–$7,473.00	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 UE-RT ELBOW 3V CR	$1,281.09	$2,135.15	$37.27–$7,473.00	—	40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 UE-LT ELBOW 3V CR	$1,281.09	$2,135.15	$37.27–$7,473.00	—	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT-ORBIT EAR WO	$5,499.00	$9,165.00	$218.52–$9,165.00	140% above	40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$5,499.00	$9,165.00	$218.52–$9,165.00	140% above	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT-ORBIT EAR WO	$5,499.00	$9,165.00	$218.52–$9,165.00	—	40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE	$5,499.00	$9,165.00	$218.52–$9,165.00	—	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES	$1,715.10	$2,858.50	$50.16–$2,858.50	247% above	40%
Facial bones X-ray, complete, 3 or more views CPT 70150 HE-FACIAL BNES 3V CR	$1,715.10	$2,858.50	$50.16–$2,858.50	247% above	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 HE-FACIAL BNES 3V CR	$1,715.10	$2,858.50	$50.16–$2,858.50	—	40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 X-RAY EXAM OF FACIAL BONES	$1,715.10	$2,858.50	$50.16–$2,858.50	—	40%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 UE-FOREARM 2VW BI CR	$1,516.59	$2,527.65	$27.96–$6,282.75	—	40%
Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM	$1,126.53	$1,877.55	$27.96–$6,282.75	164% above	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 UE-LT FOREARM 2V CR	$1,126.53	$1,877.55	$27.96–$6,282.75	164% above	40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 UE-RT FOREARM 2V CR	$1,126.53	$1,877.55	$27.96–$6,282.75	164% above	40%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 UE-FOREARM 2VW BI CR	$1,516.59	$2,527.65	$27.96–$6,282.75	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 X-RAY EXAM OF FOREARM	$1,126.53	$1,877.55	$27.96–$6,282.75	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 UE-RT FOREARM 2V CR	$1,126.53	$1,877.55	$27.96–$6,282.75	—	40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 UE-LT FOREARM 2V CR	$1,126.53	$1,877.55	$27.96–$6,282.75	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HEPATOBILIARY SYS	$4,352.49	$7,254.15	$417.42–$7,254.15	145% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$4,352.49	$7,254.15	$417.42–$7,254.15	145% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HEPATOBILIARY SYS	$4,352.49	$7,254.15	$417.42–$7,254.15	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$4,352.49	$7,254.15	$417.42–$7,254.15	—	40%
Hand X-ray, 2 views both sides CPT 73120 UE-HAND 2VWS BI CR	$1,412.40	$2,354.00	$23.28–$5,492.00	—	40%
Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND	$941.40	$1,569.00	$23.28–$5,492.00	131% above	40%
Hand X-ray, 2 views one side CPT 73120 UE-LT HAND 2V CR	$941.40	$1,569.00	$23.28–$5,492.00	131% above	40%
Hand X-ray, 2 views one side CPT 73120 UE-RT HAND 2V CR	$941.40	$1,569.00	$23.28–$5,492.00	131% above	40%
Hand X-ray, 2 views inpatient both sides CPT 73120 UE-HAND 2VWS BI CR	$1,412.40	$2,354.00	$23.28–$5,492.00	—	40%
Hand X-ray, 2 views inpatient CPT 73120 X-RAY EXAM OF HAND	$941.40	$1,569.00	$23.28–$5,492.00	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 UE-LT HAND 2V CR	$941.40	$1,569.00	$23.28–$5,492.00	—	40%
Hand X-ray, 2 views inpatient one side CPT 73120 UE-RT HAND 2V CR	$941.40	$1,569.00	$23.28–$5,492.00	—	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL	$742.68	$1,237.80	$26.33–$2,475.60	111% above	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 LT LE-CALCANEUS 2PLS CR	$742.68	$1,237.80	$26.33–$2,475.60	111% above	40%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 RT-CALCANEUS 2PLS CR	$742.68	$1,237.80	$26.33–$2,475.60	111% above	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY EXAM OF HEEL	$742.68	$1,237.80	$26.33–$2,475.60	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 LT LE-CALCANEUS 2PLS CR	$742.68	$1,237.80	$26.33–$2,475.60	—	40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 RT-CALCANEUS 2PLS CR	$742.68	$1,237.80	$26.33–$2,475.60	—	40%
Knee X-ray, 3 views both sides CPT 73562 LE-KNEE 3VWS BI CR	$1,981.44	$3,302.40	$33.54–$7,706.30	—	40%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$1,321.17	$2,201.95	$33.54–$7,706.30	188% above	40%
Knee X-ray, 3 views one side CPT 73562 LE-LT KNEE 3V CR	$1,321.17	$2,201.95	$33.54–$7,706.30	188% above	40%
Knee X-ray, 3 views one side CPT 73562 LE-RT KNEE 3V CR	$1,321.17	$2,201.95	$33.54–$7,706.30	188% above	40%
Knee X-ray, 3 views inpatient both sides CPT 73562 LE-KNEE 3VWS BI CR	$1,981.44	$3,302.40	$33.54–$7,706.30	—	40%
Knee X-ray, 3 views inpatient CPT 73562 X-RAY EXAM OF KNEE 3	$1,321.17	$2,201.95	$33.54–$7,706.30	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 LE-RT KNEE 3V CR	$1,321.17	$2,201.95	$33.54–$7,706.30	—	40%
Knee X-ray, 3 views inpatient one side CPT 73562 LE-LT KNEE 3V CR	$1,321.17	$2,201.95	$33.54–$7,706.30	—	40%
Knee X-ray, complete, 4 or more views both sides CPT 73564 LE-KNEE 4VWPLS BI CR	$2,019.69	$3,366.15	$39.43–$6,866.95	—	40%
Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$1,050.24	$1,750.40	$39.43–$6,866.95	79% above	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 LE-LT KNEE 4V PLUS CR	$1,050.24	$1,750.40	$39.43–$6,866.95	79% above	40%
Knee X-ray, complete, 4 or more views one side CPT 73564 LE-RT KNEE 4V PLUS CR	$1,050.24	$1,750.40	$39.43–$6,866.95	79% above	40%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 LE-KNEE 4VWPLS BI CR	$2,019.69	$3,366.15	$39.43–$6,866.95	—	40%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 X-RAY EXAM KNEE 4 OR MORE	$1,050.24	$1,750.40	$39.43–$6,866.95	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 LE-RT KNEE 4V PLUS CR	$1,050.24	$1,750.40	$39.43–$6,866.95	—	40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 LE-LT KNEE 4V PLUS CR	$1,050.24	$1,750.40	$39.43–$6,866.95	—	40%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE	$7,696.77	$12,827.96	$178.35–$25,655.92	261% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT-LT LOWER EXT WO	$7,696.77	$12,827.96	$178.35–$25,655.92	261% above	40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT-RT LOWER EXT WO	$7,696.77	$12,827.96	$178.35–$25,655.92	261% above	40%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O DYE	$7,696.77	$12,827.96	$178.35–$25,655.92	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT-RT LOWER EXT WO	$7,696.77	$12,827.96	$178.35–$25,655.92	—	40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT-LT LOWER EXT WO	$7,696.77	$12,827.96	$178.35–$25,655.92	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 POC US-ABDOMEN LTD WO	$223.31	$372.19	$87.13–$9,845.49	73% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$2,841.99	$4,736.65	$87.13–$9,845.49	243% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US-ABDOMEN LTD WO	$2,841.99	$4,736.65	$87.13–$9,845.49	243% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 POC GALLBLADDER/BILIARY	$2,841.99	$4,736.65	$87.13–$9,845.49	243% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 POC US-ABDOMEN LTD WO	$223.31	$372.19	$87.13–$9,845.49	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 POC GALLBLADDER/BILIARY	$2,841.99	$4,736.65	$87.13–$9,845.49	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$2,841.99	$4,736.65	$87.13–$9,845.49	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US-ABDOMEN LTD WO	$2,841.99	$4,736.65	$87.13–$9,845.49	—	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 POC US-EXT LMTD JT	$223.20	$372.00	$16.89–$2,702.40	59% below	40%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$699.12	$1,165.20	$16.89–$2,702.40	28% above	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US-RT EXT LTD JNT UNI	$699.12	$1,165.20	$16.89–$2,702.40	28% above	40%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US-LT EXT LTD JNT UNI	$699.12	$1,165.20	$16.89–$2,702.40	28% above	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 POC US-EXT LMTD JT	$223.20	$372.00	$16.89–$2,702.40	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US LMTD JT/FCL EVL NVASC XTR	$699.12	$1,165.20	$16.89–$2,702.40	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US-RT EXT LTD JNT UNI	$699.12	$1,165.20	$16.89–$2,702.40	—	40%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US-LT EXT LTD JNT UNI	$699.12	$1,165.20	$16.89–$2,702.40	—	40%
Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 LE-TIB FIB 2V BI CR	$2,560.71	$4,267.85	$29.18–$8,706.35	—	40%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG	$1,331.55	$2,219.25	$29.18–$8,706.35	208% above	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LE-RT TIB FIB 2V CR	$1,331.55	$2,219.25	$29.18–$8,706.35	208% above	40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LE-LT TIB FIB 2V CR	$1,331.55	$2,219.25	$29.18–$8,706.35	208% above	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 LE-TIB FIB 2V BI CR	$2,560.71	$4,267.85	$29.18–$8,706.35	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 X-RAY EXAM OF LOWER LEG	$1,331.55	$2,219.25	$29.18–$8,706.35	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LE-RT TIB FIB 2V CR	$1,331.55	$2,219.25	$29.18–$8,706.35	—	40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LE-LT TIB FIB 2V CR	$1,331.55	$2,219.25	$29.18–$8,706.35	—	40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA-HEAD WO	$7,360.05	$12,266.75	$302.57–$12,266.75	154% above	40%
MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$7,360.05	$12,266.75	$302.57–$12,266.75	154% above	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE	$7,360.05	$12,266.75	$302.57–$12,266.75	—	40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA-HEAD WO	$7,360.05	$12,266.75	$302.57–$12,266.75	—	40%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR-LW JOINT WO BILATERAL	$6,642.42	$11,070.70	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR LOWER EXTREMITY JOINT BILATERAL WO	$9,299.28	$15,498.80	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$6,642.42	$11,070.70	$282.46–$48,544.85	119% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR-RT LW JOINT WO	$6,542.79	$10,904.65	$282.46–$48,544.85	116% above	40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR-LT LW JOINT WO	$6,642.42	$11,070.70	$282.46–$48,544.85	119% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR-LW JOINT WO BILATERAL	$6,642.42	$11,070.70	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR LOWER EXTREMITY JOINT BILATERAL WO	$9,299.28	$15,498.80	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$6,642.42	$11,070.70	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR-RT LW JOINT WO	$6,542.79	$10,904.65	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR-LT LW JOINT WO	$6,642.42	$11,070.70	$282.46–$48,544.85	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$11,049.54	$18,415.90	$552.06–$18,415.90	139% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR-LW JOINT WWO	$11,049.54	$18,415.90	$552.06–$18,415.90	139% above	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR-LW JOINT WWO	$11,049.54	$18,415.90	$552.06–$18,415.90	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$11,049.54	$18,415.90	$552.06–$18,415.90	—	40%
MRI of the abdomen without contrast CPT 74181 MR-ABDOMEN WO	$8,047.89	$13,413.15	$273.91–$13,413.15	188% above	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$8,047.89	$13,413.15	$273.91–$13,413.15	188% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR-ABDOMEN WO	$8,047.89	$13,413.15	$273.91–$13,413.15	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$8,047.89	$13,413.15	$273.91–$13,413.15	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$5,617.56	$9,362.60	$478.40–$9,362.60	29% above	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR-ABDOMEN WWO	$5,617.56	$9,362.60	$478.40–$9,362.60	29% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$5,617.56	$9,362.60	$478.40–$9,362.60	—	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR-ABDOMEN WWO	$5,617.56	$9,362.60	$478.40–$9,362.60	—	40%
MRI of the brain, no contrast dye CPT 70551 MR-BRAIN WO	$8,215.98	$13,693.30	$272.77–$13,693.30	183% above	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$8,215.98	$13,693.30	$272.77–$13,693.30	183% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE	$8,215.98	$13,693.30	$272.77–$13,693.30	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR-BRAIN WO	$8,215.98	$13,693.30	$272.77–$13,693.30	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$4,712.52	$7,854.20	$430.66–$7,854.20	9% above	40%
MRI of the brain, with and without contrast dye CPT 70553 MR-BRAIN WWO	$4,712.52	$7,854.20	$430.66–$7,854.20	9% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR-BRAIN WWO	$4,712.52	$7,854.20	$430.66–$7,854.20	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE	$4,712.52	$7,854.20	$430.66–$7,854.20	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$7,131.18	$11,885.30	$266.80–$11,885.30	133% above	40%
MRI of the lower back, no contrast dye CPT 72148 MR-LUMB SPINE WO	$7,131.18	$11,885.30	$266.80–$11,885.30	133% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR-LUMB SPINE WO	$7,131.18	$11,885.30	$266.80–$11,885.30	—	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE	$7,131.18	$11,885.30	$266.80–$11,885.30	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR-LUMB SPINE WWO	$6,285.84	$10,476.40	$432.37–$10,476.40	39% above	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$6,285.84	$10,476.40	$432.37–$10,476.40	39% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$6,285.84	$10,476.40	$432.37–$10,476.40	—	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR-LUMB SPINE WWO	$6,285.84	$10,476.40	$432.37–$10,476.40	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR-THOR SPINE WO	$7,669.86	$12,783.10	$249.39–$12,783.10	165% above	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$7,669.86	$12,783.10	$249.39–$12,783.10	165% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE	$7,669.86	$12,783.10	$249.39–$12,783.10	—	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR-THOR SPINE WO	$7,669.86	$12,783.10	$249.39–$12,783.10	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$6,099.03	$10,165.05	$433.68–$10,165.05	37% above	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR-CERV SPINE WWO	$6,099.03	$10,165.05	$433.68–$10,165.05	37% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI NECK SPINE W/O & W/DYE	$6,099.03	$10,165.05	$433.68–$10,165.05	—	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR-CERV SPINE WWO	$6,099.03	$10,165.05	$433.68–$10,165.05	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$8,215.98	$13,693.30	$266.30–$13,693.30	174% above	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR-CERV SPINE WO	$8,215.98	$13,693.30	$266.30–$13,693.30	174% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR-CERV SPINE WO	$8,215.98	$13,693.30	$266.30–$13,693.30	—	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE	$8,215.98	$13,693.30	$266.30–$13,693.30	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$5,617.56	$9,362.60	$477.53–$9,362.60	35% above	40%
MRI of the pelvis without and with contrast CPT 72197 MR-PELVIS WWO	$5,617.56	$9,362.60	$477.53–$9,362.60	35% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR-PELVIS WWO	$5,617.56	$9,362.60	$477.53–$9,362.60	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE	$5,617.56	$9,362.60	$477.53–$9,362.60	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MR-PELVIS WO	$5,633.58	$9,389.30	$324.66–$9,389.30	119% above	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$5,633.58	$9,389.30	$324.66–$9,389.30	119% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR-PELVIS WO	$5,633.58	$9,389.30	$324.66–$9,389.30	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE	$5,633.58	$9,389.30	$324.66–$9,389.30	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MR-UPPER JOINT WO BILATERAL	$9,806.43	$16,344.05	$280.80–$41,783.55	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$7,631.85	$12,719.75	$280.80–$41,783.55	191% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR-LT UPPER JOINT WO	$7,631.85	$12,719.75	$280.80–$41,783.55	191% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR-RT UPPER JOINT WO	$7,631.85	$12,719.75	$280.80–$41,783.55	191% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MR-UPPER JOINT WO BILATERAL	$9,806.43	$16,344.05	$280.80–$41,783.55	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$7,631.85	$12,719.75	$280.80–$41,783.55	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR-RT UPPER JOINT WO	$7,631.85	$12,719.75	$280.80–$41,783.55	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR-LT UPPER JOINT WO	$7,631.85	$12,719.75	$280.80–$41,783.55	—	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 SP-CERV SP 4TO5VW CR	$2,675.10	$4,458.50	$52.26–$4,458.50	315% above	40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$2,675.10	$4,458.50	$52.26–$4,458.50	315% above	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 SP-CERV SP 4TO5VW CR	$2,675.10	$4,458.50	$52.26–$4,458.50	—	40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$2,675.10	$4,458.50	$52.26–$4,458.50	—	40%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE	$5,428.86	$9,048.10	$250.68–$9,048.10	99% above	40%
Neck soft tissue CT scan with contrast CPT 70491 CT-NECK SOFT TIS W	$5,428.86	$9,048.10	$250.68–$9,048.10	99% above	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/DYE	$5,428.86	$9,048.10	$250.68–$9,048.10	—	40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT-NECK SOFT TIS W	$5,428.86	$9,048.10	$250.68–$9,048.10	—	40%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE	$3,879.00	$6,465.00	$190.96–$6,465.00	83% above	40%
Neck soft tissue CT scan without contrast CPT 70490 CT-NECK SOFT TIS WO	$3,879.00	$6,465.00	$190.96–$6,465.00	83% above	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT-NECK SOFT TIS WO	$3,879.00	$6,465.00	$190.96–$6,465.00	—	40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O DYE	$3,879.00	$6,465.00	$190.96–$6,465.00	—	40%
Neck soft tissue X-ray CPT 70360 SP-NECK SOFT TISS CR	$567.42	$945.70	$23.95–$945.70	75% above	40%
Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK	$567.42	$945.70	$23.95–$945.70	75% above	40%
Neck soft tissue X-ray inpatient CPT 70360 X-RAY EXAM OF NECK	$567.42	$945.70	$23.95–$945.70	—	40%
Neck soft tissue X-ray inpatient CPT 70360 SP-NECK SOFT TISS CR	$567.42	$945.70	$23.95–$945.70	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM-MYOCRD SPECT MULT	$8,283.93	$13,806.55	$499.34–$13,806.55	104% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$8,283.93	$13,806.55	$499.34–$13,806.55	104% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-MYOCRD SPECT MULT	$8,283.93	$13,806.55	$499.34–$13,806.55	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$8,283.93	$13,806.55	$499.34–$13,806.55	—	40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE	$4,871.40	$8,119.00	$159.23–$8,119.00	148% above	40%
Pelvic CT scan without contrast CPT 72192 CT-PELVIS WO	$4,871.40	$8,119.00	$159.23–$8,119.00	148% above	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O DYE	$4,871.40	$8,119.00	$159.23–$8,119.00	—	40%
Pelvic CT scan without contrast inpatient CPT 72192 CT-PELVIS WO	$4,871.40	$8,119.00	$159.23–$8,119.00	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 POC US-PELVIC LMTD	$223.20	$372.00	$41.12–$1,238.20	59% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$519.72	$866.20	$41.12–$1,238.20	4% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-PELVIS NON OB LIMITED OR FU (TA)	$519.72	$866.20	$41.12–$1,238.20	4% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 POC US-PELVIC LMTD	$223.20	$372.00	$41.12–$1,238.20	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$519.72	$866.20	$41.12–$1,238.20	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIS NON OB LIMITED OR FU (TA)	$519.72	$866.20	$41.12–$1,238.20	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$1,950.27	$3,250.45	$97.04–$3,250.45	107% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US-PELVIS NON OB COMPLETE(TA)	$1,950.27	$3,250.45	$97.04–$3,250.45	107% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIS NON OB COMPLETE(TA)	$1,950.27	$3,250.45	$97.04–$3,250.45	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$1,950.27	$3,250.45	$97.04–$3,250.45	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$2,728.74	$4,547.90	$135.29–$4,547.90	216% above	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US-PELV PRG TA >= 14 WEEKS	$2,728.74	$4,547.90	$135.29–$4,547.90	216% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS	$2,728.74	$4,547.90	$135.29–$4,547.90	—	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-PELV PRG TA >= 14 WEEKS	$2,728.74	$4,547.90	$135.29–$4,547.90	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US-PELV PREG TA <14 WKS	$2,374.65	$3,957.75	$93.28–$3,957.75	206% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$2,374.65	$3,957.75	$93.28–$3,957.75	206% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$2,374.65	$3,957.75	$93.28–$3,957.75	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US-PELV PREG TA <14 WKS	$2,374.65	$3,957.75	$93.28–$3,957.75	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-PELVIS PREG LTD >= 1 FETUSES	$1,817.94	$3,029.90	$90.30–$3,029.90	201% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$1,817.94	$3,029.90	$90.30–$3,029.90	201% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$1,817.94	$3,029.90	$90.30–$3,029.90	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PELVIS PREG LTD >= 1 FETUSES	$1,817.94	$3,029.90	$90.30–$3,029.90	—	40%
Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$1,250.25	$2,083.75	$35.48–$4,167.50	170% above	40%
Rib X-ray, one side, 2 views one side CPT 71100 CH-LT RIBS UNILAT CR	$1,250.25	$2,083.75	$35.48–$4,167.50	170% above	40%
Rib X-ray, one side, 2 views one side CPT 71100 CH-RT RIBS UNILAT CR	$1,250.25	$2,083.75	$35.48–$4,167.50	170% above	40%
Rib X-ray, one side, 2 views inpatient CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS	$1,250.25	$2,083.75	$35.48–$4,167.50	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CH-RT RIBS UNILAT CR	$1,250.25	$2,083.75	$35.48–$4,167.50	—	40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 CH-LT RIBS UNILAT CR	$1,250.25	$2,083.75	$35.48–$4,167.50	—	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CH-RT RIB UNI PA CXR CR	$1,785.78	$2,976.30	$40.34–$5,952.60	190% above	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$1,785.78	$2,976.30	$40.34–$5,952.60	190% above	40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 CH-LT RIB UNI PA CXR CR	$1,785.78	$2,976.30	$40.34–$5,952.60	190% above	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CH-RT RIB UNI PA CXR CR	$1,785.78	$2,976.30	$40.34–$5,952.60	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST	$1,785.78	$2,976.30	$40.34–$5,952.60	—	40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 CH-LT RIB UNI PA CXR CR	$1,785.78	$2,976.30	$40.34–$5,952.60	—	40%
Screening mammogram, both breasts both sides CPT 77067 BR-DIG MAMMO SCRN BI	$658.65	$1,097.75	$111.11–$4,391.00	—	40%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$658.65	$1,097.75	$111.11–$4,391.00	—	40%
Screening mammogram, both breasts one side CPT 77067 BR-RT DIG MAM SCRN UN	$658.65	$1,097.75	$111.11–$4,391.00	110% above	40%
Screening mammogram, both breasts one side CPT 77067 BR-LT DIG MAM SCRN UN	$658.65	$1,097.75	$111.11–$4,391.00	110% above	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 BR-DIG MAMMO SCRN BI	$658.65	$1,097.75	$111.11–$4,391.00	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD	$658.65	$1,097.75	$111.11–$4,391.00	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 BR-LT DIG MAM SCRN UN	$658.65	$1,097.75	$111.11–$4,391.00	—	40%
Screening mammogram, both breasts inpatient one side CPT 77067 BR-RT DIG MAM SCRN UN	$658.65	$1,097.75	$111.11–$4,391.00	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 UE-SHOULDER 2V BI CR	$1,274.31	$2,123.85	$34.79–$5,278.95	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$946.53	$1,577.55	$34.79–$5,278.95	72% above	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 UE-RT SHLDR 2VW PLUS CR	$946.53	$1,577.55	$34.79–$5,278.95	72% above	40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 UE-LT SHLDR 2VW PLUS CR	$946.53	$1,577.55	$34.79–$5,278.95	72% above	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 UE-SHOULDER 2V BI CR	$1,274.31	$2,123.85	$34.79–$5,278.95	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY EXAM OF SHOULDER	$946.53	$1,577.55	$34.79–$5,278.95	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 UE-RT SHLDR 2VW PLUS CR	$946.53	$1,577.55	$34.79–$5,278.95	—	40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 UE-LT SHLDR 2VW PLUS CR	$946.53	$1,577.55	$34.79–$5,278.95	—	40%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES	$1,446.93	$2,411.55	$44.22–$2,411.55	217% above	40%
Sinus X-ray, complete, 3 or more views CPT 70220 HE-SINUSES 3VPLUS CR	$1,446.93	$2,411.55	$44.22–$2,411.55	217% above	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY EXAM OF SINUSES	$1,446.93	$2,411.55	$44.22–$2,411.55	—	40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 HE-SINUSES 3VPLUS CR	$1,446.93	$2,411.55	$44.22–$2,411.55	—	40%
Skull X-ray, fewer than 4 views CPT 70250 HE-SKULL LIMITED CR	$788.49	$1,314.15	$33.44–$1,314.15	94% above	40%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL	$788.49	$1,314.15	$33.44–$1,314.15	94% above	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 HE-SKULL LIMITED CR	$788.49	$1,314.15	$33.44–$1,314.15	—	40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY EXAM OF SKULL	$788.49	$1,314.15	$33.44–$1,314.15	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL-MOD BA SWALLOW	$1,813.11	$3,021.85	$74.46–$3,021.85	174% above	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$1,813.11	$3,021.85	$74.46–$3,021.85	174% above	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL-MOD BA SWALLOW	$1,813.11	$3,021.85	$74.46–$3,021.85	—	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$1,813.11	$3,021.85	$74.46–$3,021.85	—	40%
Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 FEMUR 2V BILATERAL	$1,883.52	$3,139.20	$40.93–$6,278.40	—	40%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/>	$941.76	$1,569.60	$40.93–$6,278.40	131% above	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 LE-LT FEMUR 2V CR	$941.76	$1,569.60	$40.93–$6,278.40	131% above	40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 LE-RT FEMUR 2V CR	$941.76	$1,569.60	$40.93–$6,278.40	131% above	40%
Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 FEMUR 2V BILATERAL	$1,883.52	$3,139.20	$40.93–$6,278.40	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 X-RAY EXAM OF FEMUR 2/>	$941.76	$1,569.60	$40.93–$6,278.40	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 LE-RT FEMUR 2V CR	$941.76	$1,569.60	$40.93–$6,278.40	—	40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 LE-LT FEMUR 2V CR	$941.76	$1,569.60	$40.93–$6,278.40	—	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT-THOR SPINE WO	$5,932.80	$9,888.00	$178.84–$9,888.00	111% above	40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE	$5,932.80	$9,888.00	$178.84–$9,888.00	111% above	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT-THOR SPINE WO	$5,932.80	$9,888.00	$178.84–$9,888.00	—	40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT CHEST SPINE W/O DYE	$5,932.80	$9,888.00	$178.84–$9,888.00	—	40%
Toe X-ray, 2 or more views both sides CPT 73660 LE-BI TOE S 2VPLUS CR	$1,019.25	$1,698.75	$22.36–$3,963.75	—	40%
Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S)	$679.50	$1,132.50	$22.36–$3,963.75	106% above	40%
Toe X-ray, 2 or more views one side CPT 73660 LE-LT TOE S 2VPLUS CR	$679.50	$1,132.50	$22.36–$3,963.75	106% above	40%
Toe X-ray, 2 or more views one side CPT 73660 LE-RT TOE S 2VPLUS CR	$679.50	$1,132.50	$22.36–$3,963.75	106% above	40%
Toe X-ray, 2 or more views inpatient both sides CPT 73660 LE-BI TOE S 2VPLUS CR	$1,019.25	$1,698.75	$22.36–$3,963.75	—	40%
Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY EXAM OF TOE(S)	$679.50	$1,132.50	$22.36–$3,963.75	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 LE-RT TOE S 2VPLUS CR	$679.50	$1,132.50	$22.36–$3,963.75	—	40%
Toe X-ray, 2 or more views inpatient one side CPT 73660 LE-LT TOE S 2VPLUS CR	$679.50	$1,132.50	$22.36–$3,963.75	—	40%
Transvaginal pelvic ultrasound CPT 76830 US-TRANSVAGINAL	$1,201.65	$2,002.75	$97.04–$2,002.75	68% above	40%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$1,201.65	$2,002.75	$97.04–$2,002.75	68% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANSVAGINAL	$1,201.65	$2,002.75	$97.04–$2,002.75	—	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB	$1,201.65	$2,002.75	$97.04–$2,002.75	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US-PLV PRG UTERUS, TRANSVAGINAL	$1,201.65	$2,002.75	$100.95–$2,002.75	80% above	40%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$1,201.65	$2,002.75	$100.95–$2,002.75	80% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$1,201.65	$2,002.75	$100.95–$2,002.75	—	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-PLV PRG UTERUS, TRANSVAGINAL	$1,201.65	$2,002.75	$100.95–$2,002.75	—	40%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$2,881.32	$4,802.20	$119.34–$4,802.20	163% above	40%
Ultrasound of the abdomen, complete CPT 76700 US-ABDOMEN COMP WO	$2,881.32	$4,802.20	$119.34–$4,802.20	163% above	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$2,881.32	$4,802.20	$119.34–$4,802.20	—	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN COMP WO	$2,881.32	$4,802.20	$119.34–$4,802.20	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$1,213.89	$2,023.15	$64.11–$2,023.15	36% above	40%
Ultrasound of the scrotum and testicles CPT 76870 US-SCROTUM	$1,213.89	$2,023.15	$64.11–$2,023.15	36% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US-SCROTUM	$1,213.89	$2,023.15	$64.11–$2,023.15	—	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM	$1,213.89	$2,023.15	$64.11–$2,023.15	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 POC US-HEAD NECK SFT TIS	$223.20	$372.00	$85.69–$5,380.85	73% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US-HEAD NECK SFT TIS	$3,005.31	$5,008.85	$85.69–$5,380.85	262% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$3,005.31	$5,008.85	$85.69–$5,380.85	262% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 POC US-HEAD NECK SFT TIS	$223.20	$372.00	$85.69–$5,380.85	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-HEAD NECK SFT TIS	$3,005.31	$5,008.85	$85.69–$5,380.85	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$3,005.31	$5,008.85	$85.69–$5,380.85	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL-GI SERIES W KUB	$1,268.13	$2,113.55	$127.03–$2,113.55	106% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$1,268.13	$2,113.55	$127.03–$2,113.55	106% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$1,268.13	$2,113.55	$127.03–$2,113.55	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL-GI SERIES W KUB	$1,268.13	$2,113.55	$127.03–$2,113.55	—	40%
Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS	$742.68	$1,237.80	$29.18–$2,475.60	74% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 UE-RT HUMERUS CR	$742.68	$1,237.80	$29.18–$2,475.60	74% above	40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 UE-LT HUMERUS CR	$742.68	$1,237.80	$29.18–$2,475.60	74% above	40%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 X-RAY EXAM OF HUMERUS	$742.68	$1,237.80	$29.18–$2,475.60	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 UE-RT HUMERUS CR	$742.68	$1,237.80	$29.18–$2,475.60	—	40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 UE-LT HUMERUS CR	$742.68	$1,237.80	$29.18–$2,475.60	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$1,361.85	$2,269.75	$71.03–$4,539.50	51% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US-RT EXT VEINS DPX LTD	$1,361.85	$2,269.75	$71.03–$4,539.50	51% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US-LT EXT VEINS DPX LTD	$1,361.85	$2,269.75	$71.03–$4,539.50	51% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$1,361.85	$2,269.75	$71.03–$4,539.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US-RT EXT VEINS DPX LTD	$1,361.85	$2,269.75	$71.03–$4,539.50	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US-LT EXT VEINS DPX LTD	$1,361.85	$2,269.75	$71.03–$4,539.50	—	40%
Wrist X-ray, 2 views both sides CPT 73100 UE-WRIST 2VW BI CR	$1,282.92	$2,138.20	$24.29–$4,988.50	—	40%
Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST	$855.09	$1,425.15	$24.29–$4,988.50	120% above	40%
Wrist X-ray, 2 views one side CPT 73100 UE-LT WRIST 2V CR	$855.09	$1,425.15	$24.29–$4,988.50	120% above	40%
Wrist X-ray, 2 views one side CPT 73100 UE-RT WRIST 2V CR	$855.09	$1,425.15	$24.29–$4,988.50	120% above	40%
Wrist X-ray, 2 views inpatient both sides CPT 73100 UE-WRIST 2VW BI CR	$1,282.92	$2,138.20	$24.29–$4,988.50	—	40%
Wrist X-ray, 2 views inpatient CPT 73100 X-RAY EXAM OF WRIST	$855.09	$1,425.15	$24.29–$4,988.50	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 UE-LT WRIST 2V CR	$855.09	$1,425.15	$24.29–$4,988.50	—	40%
Wrist X-ray, 2 views inpatient one side CPT 73100 UE-RT WRIST 2V CR	$855.09	$1,425.15	$24.29–$4,988.50	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 UE-WRIST 3VW BI CR	$1,316.22	$2,193.70	$36.06–$5,120.00	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$877.89	$1,463.15	$36.06–$5,120.00	75% above	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 UE-LT WRIST 3V PLUS CR	$877.89	$1,463.15	$36.06–$5,120.00	75% above	40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 UE-RT WRIST 3V PLUS CR	$877.89	$1,463.15	$36.06–$5,120.00	75% above	40%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 UE-WRIST 3VW BI CR	$1,316.22	$2,193.70	$36.06–$5,120.00	—	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY EXAM OF WRIST	$877.89	$1,463.15	$36.06–$5,120.00	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 UE-LT WRIST 3V PLUS CR	$877.89	$1,463.15	$36.06–$5,120.00	—	40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 UE-RT WRIST 3V PLUS CR	$877.89	$1,463.15	$36.06–$5,120.00	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$837.63	$1,396.05	$53.47–$2,792.10	108% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 LE-LT HIP PV UN2OR3V CR	$837.63	$1,396.05	$53.47–$2,792.10	108% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 LE-RT HIP PV UN2OR3V CR	$837.63	$1,396.05	$53.47–$2,792.10	108% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$837.63	$1,396.05	$53.47–$2,792.10	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 LE-LT HIP PV UN2OR3V CR	$837.63	$1,396.05	$53.47–$2,792.10	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 LE-RT HIP PV UN2OR3V CR	$837.63	$1,396.05	$53.47–$2,792.10	—	40%
X-ray of the abdomen, 1 view CPT 74018 CH-ABDOMEN 1 VIEW CR	$866.67	$1,444.45	$34.46–$1,444.45	185% above	40%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$866.67	$1,444.45	$34.46–$1,444.45	185% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 CH-ABDOMEN 1 VIEW CR	$866.67	$1,444.45	$34.46–$1,444.45	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADEX ABDOMEN 1 VIEW	$866.67	$1,444.45	$34.46–$1,444.45	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 LE-ANKLE 2VW BI CR	$1,626.93	$2,711.55	$27.07–$6,328.35	—	40%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$1,085.04	$1,808.40	$27.07–$6,328.35	177% above	40%
X-ray of the ankle, 2 views one side CPT 73600 LE-RT ANKLE 2V CR	$1,085.04	$1,808.40	$27.07–$6,328.35	177% above	40%
X-ray of the ankle, 2 views one side CPT 73600 LE-LT ANKLE 2V CR	$1,085.04	$1,808.40	$27.07–$6,328.35	177% above	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 LE-ANKLE 2VW BI CR	$1,626.93	$2,711.55	$27.07–$6,328.35	—	40%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY EXAM OF ANKLE	$1,085.04	$1,808.40	$27.07–$6,328.35	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 LE-RT ANKLE 2V CR	$1,085.04	$1,808.40	$27.07–$6,328.35	—	40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 LE-LT ANKLE 2V CR	$1,085.04	$1,808.40	$27.07–$6,328.35	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$679.50	$1,132.50	$22.36–$2,265.00	86% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 UE-RT FINGER S 2VPLS CR	$679.50	$1,132.50	$22.36–$2,265.00	86% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 UE-LT FINGER S 2VPLS CR	$679.50	$1,132.50	$22.36–$2,265.00	86% above	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S)	$679.50	$1,132.50	$22.36–$2,265.00	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 UE-LT FINGER S 2VPLS CR	$679.50	$1,132.50	$22.36–$2,265.00	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 UE-RT FINGER S 2VPLS CR	$679.50	$1,132.50	$22.36–$2,265.00	—	40%
X-ray of the foot, 2 views both sides CPT 73620 LE-FOOT 2VWS BI CR	$1,703.40	$2,839.00	$24.29–$6,624.50	—	40%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$1,135.71	$1,892.85	$24.29–$6,624.50	180% above	40%
X-ray of the foot, 2 views one side CPT 73620 LE-LT FOOT 2V CR	$1,135.59	$1,892.65	$24.29–$6,624.50	180% above	40%
X-ray of the foot, 2 views one side CPT 73620 LE-RT FOOT 2V CR	$1,135.71	$1,892.85	$24.29–$6,624.50	180% above	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 LE-FOOT 2VWS BI CR	$1,703.40	$2,839.00	$24.29–$6,624.50	—	40%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY EXAM OF FOOT	$1,135.71	$1,892.85	$24.29–$6,624.50	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 LE-LT FOOT 2V CR	$1,135.59	$1,892.65	$24.29–$6,624.50	—	40%
X-ray of the foot, 2 views inpatient one side CPT 73620 LE-RT FOOT 2V CR	$1,135.71	$1,892.85	$24.29–$6,624.50	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 LE-FOOT 3VWPLS BI CR	$1,732.98	$2,888.30	$34.00–$7,179.90	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$1,287.48	$2,145.80	$34.00–$7,179.90	161% above	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 LE-LT FOOT 3V PLUS CR	$1,287.48	$2,145.80	$34.00–$7,179.90	161% above	40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 LE-RT FOOT 3V PLUS CR	$1,287.48	$2,145.80	$34.00–$7,179.90	161% above	40%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 LE-FOOT 3VWPLS BI CR	$1,732.98	$2,888.30	$34.00–$7,179.90	—	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY EXAM OF FOOT	$1,287.48	$2,145.80	$34.00–$7,179.90	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 LE-RT FOOT 3V PLUS CR	$1,287.48	$2,145.80	$34.00–$7,179.90	—	40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 LE-LT FOOT 3V PLUS CR	$1,287.48	$2,145.80	$34.00–$7,179.90	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 UE-HAND 3VWS BI CR	$1,729.89	$2,883.15	$35.79–$6,728.05	—	40%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$1,153.47	$1,922.45	$35.79–$6,728.05	127% above	40%
X-ray of the hand, 3 or more views one side CPT 73130 UE-RT HAND 3V CR	$1,153.47	$1,922.45	$35.79–$6,728.05	127% above	40%
X-ray of the hand, 3 or more views one side CPT 73130 UE-LT HAND 3V CR	$1,153.47	$1,922.45	$35.79–$6,728.05	127% above	40%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 UE-HAND 3VWS BI CR	$1,729.89	$2,883.15	$35.79–$6,728.05	—	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY EXAM OF HAND	$1,153.47	$1,922.45	$35.79–$6,728.05	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 UE-LT HAND 3V CR	$1,153.47	$1,922.45	$35.79–$6,728.05	—	40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 UE-RT HAND 3V CR	$1,153.47	$1,922.45	$35.79–$6,728.05	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 LE-KNEE 1TO2V BI CR	$1,298.34	$2,163.90	$27.28–$4,896.35	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$964.41	$1,607.35	$27.28–$4,896.35	143% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 LE-RT KNEE 1 TO 2V CR	$675.06	$1,125.10	$27.28–$4,896.35	70% above	40%
X-ray of the knee, 1 or 2 views one side CPT 73560 LE-LT KNEE 1 TO 2V CR	$964.41	$1,607.35	$27.28–$4,896.35	143% above	40%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 LE-KNEE 1TO2V BI CR	$1,298.34	$2,163.90	$27.28–$4,896.35	—	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$964.41	$1,607.35	$27.28–$4,896.35	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 LE-RT KNEE 1 TO 2V CR	$675.06	$1,125.10	$27.28–$4,896.35	—	40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 LE-LT KNEE 1 TO 2V CR	$964.41	$1,607.35	$27.28–$4,896.35	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$1,525.89	$2,543.15	$40.76–$2,543.15	224% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP-LS SPN 2 TO 3V CR	$1,525.89	$2,543.15	$40.76–$2,543.15	224% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$1,525.89	$2,543.15	$40.76–$2,543.15	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP-LS SPN 2 TO 3V CR	$1,525.89	$2,543.15	$40.76–$2,543.15	—	40%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$1,693.98	$2,823.30	$62.90–$2,823.30	160% above	40%
X-ray of the lower back, 4 or more views CPT 72110 SP-LS SPNE 4VPLUS CR	$1,693.98	$2,823.30	$62.90–$2,823.30	160% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$1,693.98	$2,823.30	$62.90–$2,823.30	—	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SP-LS SPNE 4VPLUS CR	$1,693.98	$2,823.30	$62.90–$2,823.30	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SP-T SPINE 2 VIEW CR	$1,859.67	$3,099.45	$37.18–$3,099.45	303% above	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$1,859.67	$3,099.45	$37.18–$3,099.45	303% above	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$1,859.67	$3,099.45	$37.18–$3,099.45	—	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SP-T SPINE 2 VIEW CR	$1,859.67	$3,099.45	$37.18–$3,099.45	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$606.63	$1,011.05	$35.56–$1,011.05	40% above	40%
X-ray of the nasal bones, 3 or more views CPT 70160 HE-NASAL BONES CR	$606.63	$1,011.05	$35.56–$1,011.05	40% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES	$606.63	$1,011.05	$35.56–$1,011.05	—	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HE-NASAL BONES CR	$606.63	$1,011.05	$35.56–$1,011.05	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$1,692.78	$2,821.30	$33.94–$2,821.30	276% above	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP-CERV SP 2TO3VW CR	$1,692.78	$2,821.30	$33.94–$2,821.30	276% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP-CERV SP 2TO3VW CR	$1,692.78	$2,821.30	$33.94–$2,821.30	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$1,692.78	$2,821.30	$33.94–$2,821.30	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$1,090.77	$1,817.95	$31.01–$3,635.90	183% above	40%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 LE-LT PELVIS CR	$1,090.77	$1,817.95	$31.01–$3,635.90	183% above	40%
X-ray of the pelvis, 1 or 2 views one side CPT 72170 LE-RT PELVIS CR	$1,090.77	$1,817.95	$31.01–$3,635.90	183% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS	$1,090.77	$1,817.95	$31.01–$3,635.90	—	40%
X-ray of the pelvis, 1 or 2 views inpatient one side CPT 72170 LE-RT PELVIS CR	$1,090.77	$1,817.95	$31.01–$3,635.90	—	40%
X-ray of the pelvis, 1 or 2 views inpatient one side CPT 72170 LE-LT PELVIS CR	$1,090.77	$1,817.95	$31.01–$3,635.90	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$1,050.24	$1,750.40	$34.15–$1,750.40	123% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SP-SCRM COCCYX 2V CR	$1,050.24	$1,750.40	$34.15–$1,750.40	123% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SP-SCRM COCCYX 2V CR	$1,050.24	$1,750.40	$34.15–$1,750.40	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE	$1,050.24	$1,750.40	$34.15–$1,750.40	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALT	$791.34	$1,318.90	$5.30–$1,318.90	1735% above	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$791.34	$1,318.90	$5.30–$1,318.90	1735% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$791.34	$1,318.90	$5.30–$1,318.90	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALT	$791.34	$1,318.90	$5.30–$1,318.90	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE AST	$791.34	$1,318.90	$5.18–$1,318.90	1645% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$791.34	$1,318.90	$5.18–$1,318.90	1645% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$791.34	$1,318.90	$5.18–$1,318.90	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE AST	$791.34	$1,318.90	$5.18–$1,318.90	—	40%
Albumin blood test CPT 82040 Q14966 ALBUMIN SERUM	$4.72	$7.88	$3.26–$33.05	81% below	40%
Albumin blood test CPT 82040 ALBUMIN SERUM	$6.18	$10.30	$3.26–$33.05	75% below	40%
Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN	$6.18	$10.30	$3.26–$33.05	75% below	40%
Albumin blood test inpatient CPT 82040 Q14966 ALBUMIN SERUM	$4.72	$7.88	$3.26–$33.05	—	40%
Albumin blood test inpatient CPT 82040 ASSAY OF SERUM ALBUMIN	$6.18	$10.30	$3.26–$33.05	—	40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$6.18	$10.30	$3.26–$33.05	—	40%
Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE	$17.80	$29.67	$5.34–$271.82	31% below	40%
Aldosterone blood test CPT 82088 Q17181 ALDOST LCMSMS	$17.80	$29.67	$5.34–$271.82	31% below	40%
Aldosterone blood test inpatient CPT 82088 ASSAY OF ALDOSTERONE	$17.80	$29.67	$5.34–$271.82	—	40%
Aldosterone blood test inpatient CPT 82088 Q17181 ALDOST LCMSMS	$17.80	$29.67	$5.34–$271.82	—	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK, PHOSPHATASE BONE SPECIFIC	$16.98	$28.30	$5.18–$751.50	54% below	40%
Alkaline phosphatase (ALP) blood test CPT 84075 Q231 PHOSPHATASE,ALK	$17.16	$28.60	$5.18–$751.50	54% below	40%
Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE	$416.76	$694.60	$5.18–$751.50	1028% above	40%
Alkaline phosphatase (ALP) blood test CPT 84075 PHOSPHATASE,ALKALINE	$416.76	$694.60	$5.18–$751.50	1028% above	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALK, PHOSPHATASE BONE SPECIFIC	$16.98	$28.30	$5.18–$751.50	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Q231 PHOSPHATASE,ALK	$17.16	$28.60	$5.18–$751.50	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 PHOSPHATASE,ALKALINE	$416.76	$694.60	$5.18–$751.50	—	40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ASSAY ALKALINE PHOSPHATASE	$416.76	$694.60	$5.18–$751.50	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH (I6) IGE	$3.08	$5.14	$5.22–$152.80	38% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA(M6)IGE	$3.08	$5.14	$5.22–$152.80	38% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILUS FUMIGATUS (M3)IGE	$3.08	$5.14	$5.22–$152.80	38% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q2813 ALG F13 IGE	$3.08	$5.14	$5.22–$152.80	38% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q2803 ALG F3 IGE IA	$3.08	$5.14	$5.22–$152.80	38% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$3.08	$5.14	$5.22–$152.80	38% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q8904 ALLERGEN IGE	$3.16	$5.28	$5.22–$152.80	37% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE CRUDE ALLERGEN XTRC EA	$26.83	$44.72	$5.22–$152.80	437% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 Q10715 ALLERGEN IGE	$46.26	$77.10	$5.22–$152.80	825% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q2803 ALG F3 IGE IA	$3.08	$5.14	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILUS FUMIGATUS (M3)IGE	$3.08	$5.14	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$3.08	$5.14	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q2813 ALG F13 IGE	$3.08	$5.14	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA(M6)IGE	$3.08	$5.14	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH (I6) IGE	$3.08	$5.14	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q8904 ALLERGEN IGE	$3.16	$5.28	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE CRUDE ALLERGEN XTRC EA	$26.83	$44.72	$5.22–$152.80	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Q10715 ALLERGEN IGE	$46.26	$77.10	$5.22–$152.80	—	40%
Ammonia blood test CPT 82140 AMMONIA	$487.62	$812.70	$14.57–$812.70	169% above	40%
Ammonia blood test CPT 82140 ASSAY OF AMMONIA	$487.62	$812.70	$14.57–$812.70	169% above	40%
Ammonia blood test inpatient CPT 82140 ASSAY OF AMMONIA	$487.62	$812.70	$14.57–$812.70	—	40%
Ammonia blood test inpatient CPT 82140 AMMONIA	$487.62	$812.70	$14.57–$812.70	—	40%
Amylase blood test CPT 82150 AMYLASE ISOENZYNES	$8.69	$14.49	$6.48–$1,757.24	83% below	40%
Amylase blood test CPT 82150 AMYLASE	$1,045.65	$1,742.75	$6.48–$1,757.24	1946% above	40%
Amylase blood test CPT 82150 ASSAY OF AMYLASE	$1,045.65	$1,742.75	$6.48–$1,757.24	1946% above	40%
Amylase blood test inpatient CPT 82150 AMYLASE ISOENZYNES	$8.69	$14.49	$6.48–$1,757.24	—	40%
Amylase blood test inpatient CPT 82150 AMYLASE	$1,045.65	$1,742.75	$6.48–$1,757.24	—	40%
Amylase blood test inpatient CPT 82150 ASSAY OF AMYLASE	$1,045.65	$1,742.75	$6.48–$1,757.24	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$6.00	$10.00	$1.80–$84.46	70% below	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Q11173 CCP AB IGG IA	$6.00	$10.00	$1.80–$84.46	70% below	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$6.00	$10.00	$1.80–$84.46	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Q11173 CCP AB IGG IA	$6.00	$10.00	$1.80–$84.46	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Q91739 CARDIO IQ� NT PROBNP	$51.00	$85.00	$39.26–$871.80	72% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Q11188PROBNP N-T ECL	$51.00	$85.00	$39.26–$871.80	72% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$421.08	$701.80	$39.26–$871.80	128% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$421.08	$701.80	$39.26–$871.80	128% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Q11188PROBNP N-T ECL	$51.00	$85.00	$39.26–$871.80	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Q91739 CARDIO IQ� NT PROBNP	$51.00	$85.00	$39.26–$871.80	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$421.08	$701.80	$39.26–$871.80	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$421.08	$701.80	$39.26–$871.80	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIA OTH	$659.07	$1,098.45	$8.62–$1,098.45	446% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$659.07	$1,098.45	$8.62–$1,098.45	446% above	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIA OTH	$659.07	$1,098.45	$8.62–$1,098.45	—	40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE OTHR SPECIMN AEROBIC	$659.07	$1,098.45	$8.62–$1,098.45	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL TOTAL CA	$902.01	$1,503.35	$8.46–$1,503.35	367% above	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABO CA TOTA	$902.01	$1,503.35	$8.46–$1,503.35	367% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL TOTAL CA	$902.01	$1,503.35	$8.46–$1,503.35	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABO CA TOTA	$902.01	$1,503.35	$8.46–$1,503.35	—	40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL	$594.93	$991.55	$5.02–$991.55	1215% above	40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL	$594.93	$991.55	$5.02–$991.55	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$376.05	$626.75	$24.63–$637.75	189% above	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS LVL4	$376.05	$626.75	$24.63–$637.75	189% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$376.05	$626.75	$24.63–$637.75	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS LVL4	$376.05	$626.75	$24.63–$637.75	—	40%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$709.02	$1,181.70	$10.32–$1,181.70	161% above	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD BACTER	$709.02	$1,181.70	$10.32–$1,181.70	161% above	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD BACTER	$709.02	$1,181.70	$10.32–$1,181.70	—	40%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$709.02	$1,181.70	$10.32–$1,181.70	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE,ROUTINE	$38.85	$64.75	$8.83–$64.75	85% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$38.85	$64.75	$8.83–$64.75	85% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE,ROUTINE	$38.85	$64.75	$8.83–$64.75	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$38.85	$64.75	$8.83–$64.75	—	40%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$369.27	$615.45	$3.93–$615.45	884% above	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE, QUANT	$369.27	$615.45	$3.93–$615.45	884% above	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, QUANT	$369.27	$615.45	$3.93–$615.45	—	40%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$369.27	$615.45	$3.93–$615.45	—	40%
Blood lead test CPT 83655 Q7655 LEAD	$6.78	$11.30	$2.79–$80.73	34% below	40%
Blood lead test inpatient CPT 83655 Q7655 LEAD	$6.78	$11.30	$2.79–$80.73	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, QUAL	$689.16	$1,148.60	$7.52–$1,148.60	331% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$689.16	$1,148.60	$7.52–$1,148.60	331% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$689.16	$1,148.60	$7.52–$1,148.60	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, QUAL	$689.16	$1,148.60	$7.52–$1,148.60	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 O51008 ABO	$15.60	$26.00	$2.99–$545.85	85% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 O51201 ABO	$15.60	$26.00	$2.99–$545.85	85% below	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$296.31	$493.85	$2.99–$545.85	188% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$296.31	$493.85	$2.99–$545.85	188% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 O51201 ABO	$15.60	$26.00	$2.99–$545.85	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 O51008 ABO	$15.60	$26.00	$2.99–$545.85	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$296.31	$493.85	$2.99–$545.85	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$296.31	$493.85	$2.99–$545.85	—	40%
Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN	$18.42	$30.70	$3.95–$843.40	44% below	40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN,QUAN	$487.62	$812.70	$3.95–$843.40	1371% above	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 ASSAY OF UREA NITROGEN	$18.42	$30.70	$3.95–$843.40	—	40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN,QUAN	$487.62	$812.70	$3.95–$843.40	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE	$443.88	$739.80	$37.27–$739.80	190% above	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$443.88	$739.80	$37.27–$739.80	190% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$443.88	$739.80	$37.27–$739.80	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE	$443.88	$739.80	$37.27–$739.80	—	40%
Calcium blood test, total CPT 82310 ASSAY OF CALCIUM	$11.10	$18.50	$5.16–$121.50	82% below	40%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$11.10	$18.50	$5.16–$121.50	82% below	40%
Calcium blood test, total CPT 82310 Q8837 CALCIUM TOTAL	$61.80	$103.00	$5.16–$121.50	1% above	40%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$11.10	$18.50	$5.16–$121.50	—	40%
Calcium blood test, total inpatient CPT 82310 ASSAY OF CALCIUM	$11.10	$18.50	$5.16–$121.50	—	40%
Calcium blood test, total inpatient CPT 82310 Q8837 CALCIUM TOTAL	$61.80	$103.00	$5.16–$121.50	—	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG	$41.31	$68.85	$13.87–$126.30	51% below	40%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN	$41.31	$68.85	$13.87–$126.30	51% below	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN	$41.31	$68.85	$13.87–$126.30	—	40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG	$41.31	$68.85	$13.87–$126.30	—	40%
Chickenpox (varicella) immunity blood test CPT 86787 Q8683 VZV AB IGM IA	$5.04	$8.40	$7.81–$85.94	84% below	40%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODIES (TOTAL, IGM) ACIF/IFA, CSF	$18.15	$30.25	$7.81–$85.94	41% below	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Q8683 VZV AB IGM IA	$5.04	$8.40	$7.81–$85.94	—	40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODIES (TOTAL, IGM) ACIF/IFA, CSF	$18.15	$30.25	$7.81–$85.94	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$739.11	$1,231.85	$13.39–$1,231.85	629% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$739.11	$1,231.85	$13.39–$1,231.85	—	40%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$902.01	$1,503.35	$7.77–$1,503.35	714% above	40%
Complete blood count (CBC) with differential CPT 85025 CBC W-PLT AUTO COMPD	$902.01	$1,503.35	$7.77–$1,503.35	714% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W-PLT AUTO COMPD	$902.01	$1,503.35	$7.77–$1,503.35	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$902.01	$1,503.35	$7.77–$1,503.35	—	40%
Complete blood count (CBC), no differential CPT 85027 CBC W-PLT	$610.23	$1,017.05	$6.47–$1,017.05	594% above	40%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$610.23	$1,017.05	$6.47–$1,017.05	594% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$610.23	$1,017.05	$6.47–$1,017.05	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W-PLT	$610.23	$1,017.05	$6.47–$1,017.05	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METAB PANEL	$1,278.96	$2,131.60	$10.56–$2,131.60	401% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$1,278.96	$2,131.60	$10.56–$2,131.60	401% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METAB PANEL	$1,278.96	$2,131.60	$10.56–$2,131.60	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$1,278.96	$2,131.60	$10.56–$2,131.60	—	40%
Cortisol blood test, total CPT 82533 Q11281 CORT TOT LCMS	$64.20	$107.00	$16.30–$567.20	33% below	40%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$252.75	$421.25	$16.30–$567.20	164% above	40%
Cortisol blood test, total CPT 82533 TOTAL CORTISOL	$252.75	$421.25	$16.30–$567.20	164% above	40%
Cortisol blood test, total inpatient CPT 82533 Q11281 CORT TOT LCMS	$64.20	$107.00	$16.30–$567.20	—	40%
Cortisol blood test, total inpatient CPT 82533 TOTAL CORTISOL	$252.75	$421.25	$16.30–$567.20	—	40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$252.75	$421.25	$16.30–$567.20	—	40%
Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK)	$648.30	$1,080.50	$6.51–$1,080.50	642% above	40%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$648.30	$1,080.50	$6.51–$1,080.50	642% above	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$648.30	$1,080.50	$6.51–$1,080.50	—	40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 ASSAY OF CK (CPK)	$648.30	$1,080.50	$6.51–$1,080.50	—	40%
Creatinine blood test CPT 82565 CREATININE BLOOD	$487.62	$812.70	$5.12–$812.70	953% above	40%
Creatinine blood test CPT 82565 ASSAY OF CREATININE	$487.62	$812.70	$5.12–$812.70	953% above	40%
Creatinine blood test inpatient CPT 82565 ASSAY OF CREATININE	$487.62	$812.70	$5.12–$812.70	—	40%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$487.62	$812.70	$5.12–$812.70	—	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Q6732 CMV AB	$10.92	$18.20	$6.80–$95.68	60% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY	$11.79	$19.66	$6.80–$95.68	57% below	40%
Cytomegalovirus (CMV) antibody test CPT 86644 Q403 CMV AB IGG IA	$11.79	$19.66	$6.80–$95.68	57% below	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Q6732 CMV AB	$10.92	$18.20	$6.80–$95.68	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV ANTIBODY	$11.79	$19.66	$6.80–$95.68	—	40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Q403 CMV AB IGG IA	$11.79	$19.66	$6.80–$95.68	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANT	$590.37	$983.95	$10.18–$983.95	311% above	40%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$590.37	$983.95	$10.18–$983.95	311% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$590.37	$983.95	$10.18–$983.95	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANT	$590.37	$983.95	$10.18–$983.95	—	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Q7178Z MARIJ-100 SCN	$13.21	$22.02	$62.14–$730.17	79% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Q453 DRUG SCN4 MEC	$30.00	$50.00	$62.14–$730.17	52% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN	$38.85	$64.75	$62.14–$730.17	37% below	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PRS DRG IA ANAZ	$356.04	$593.40	$62.14–$730.17	474% above	40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$356.04	$593.40	$62.14–$730.17	474% above	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Q7178Z MARIJ-100 SCN	$13.21	$22.02	$62.14–$730.17	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Q453 DRUG SCN4 MEC	$30.00	$50.00	$62.14–$730.17	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN	$38.85	$64.75	$62.14–$730.17	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV CHEM ANLYZR	$356.04	$593.40	$62.14–$730.17	—	40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PRS DRG IA ANAZ	$356.04	$593.40	$62.14–$730.17	—	40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$367.44	$612.40	$7.01–$612.40	336% above	40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$367.44	$612.40	$7.01–$612.40	—	40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Q6421EPSTE-BARR, VCA	$7.50	$12.50	$3.51–$107.54	72% below	40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Q6421EPSTE-BARR, VCA	$7.50	$12.50	$3.51–$107.54	—	40%
Estradiol blood test CPT 82670 Q4021 ESTRADIOL IA	$91.80	$153.00	$27.94–$326.00	6% above	40%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$91.80	$153.00	$27.94–$326.00	6% above	40%
Estradiol blood test CPT 82670 Q36169 ESTRADIOL	$103.80	$173.00	$27.94–$326.00	20% above	40%
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$91.80	$153.00	$27.94–$326.00	—	40%
Estradiol blood test inpatient CPT 82670 Q4021 ESTRADIOL IA	$91.80	$153.00	$27.94–$326.00	—	40%
Estradiol blood test inpatient CPT 82670 Q36169 ESTRADIOL	$103.80	$173.00	$27.94–$326.00	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$35.56	$59.27	$18.58–$177.81	65% below	40%
FSH (follicle-stimulating hormone) test CPT 83001 Q470 FSH IA	$71.12	$118.54	$18.58–$177.81	30% below	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$35.56	$59.27	$18.58–$177.81	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Q470 FSH IA	$71.12	$118.54	$18.58–$177.81	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$65.97	$109.95	$19.63–$249.95	9% below	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$65.97	$109.95	$19.63–$249.95	9% below	40%
Fecal calprotectin (stool inflammation test) CPT 83993 Q16796 CALPRO STL IA	$84.00	$140.00	$19.63–$249.95	15% above	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$65.97	$109.95	$19.63–$249.95	—	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$65.97	$109.95	$19.63–$249.95	—	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Q16796 CALPRO STL IA	$84.00	$140.00	$19.63–$249.95	—	40%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$575.61	$959.35	$13.63–$959.35	440% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$575.61	$959.35	$13.63–$959.35	440% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$575.61	$959.35	$13.63–$959.35	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$575.61	$959.35	$13.63–$959.35	—	40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY	$770.91	$1,284.85	$9.72–$1,284.85	477% above	40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY	$770.91	$1,284.85	$9.72–$1,284.85	—	40%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$1,112.64	$1,854.40	$14.70–$1,854.40	919% above	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$1,112.64	$1,854.40	$14.70–$1,854.40	919% above	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$1,112.64	$1,854.40	$14.70–$1,854.40	—	40%
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$1,112.64	$1,854.40	$14.70–$1,854.40	—	40%
Free T3 thyroid hormone test CPT 84481 Q34429 T3 FREE IA	$64.80	$108.00	$15.00–$113.01	20% below	40%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$64.80	$108.00	$15.00–$113.01	20% below	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$64.80	$108.00	$15.00–$113.01	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 Q34429 T3 FREE IA	$64.80	$108.00	$15.00–$113.01	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE T4, FREE	$487.62	$812.70	$9.02–$812.70	616% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$487.62	$812.70	$9.02–$812.70	616% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE T4, FREE	$487.62	$812.70	$9.02–$812.70	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$487.62	$812.70	$9.02–$812.70	—	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT	$345.84	$576.40	$7.20–$576.40	660% above	40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT	$345.84	$576.40	$7.20–$576.40	660% above	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 ASSAY OF GGT	$345.84	$576.40	$7.20–$576.40	—	40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT	$345.84	$576.40	$7.20–$576.40	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$414.90	$691.50	$4.75–$691.50	698% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, POST DOSE	$414.90	$691.50	$4.75–$691.50	698% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST	$414.90	$691.50	$4.75–$691.50	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, POST DOSE	$414.90	$691.50	$4.75–$691.50	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$979.62	$1,632.70	$12.87–$1,632.70	614% above	40%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPEC	$979.62	$1,632.70	$12.87–$1,632.70	614% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPEC	$979.62	$1,632.70	$12.87–$1,632.70	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$979.62	$1,632.70	$12.87–$1,632.70	—	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$242.91	$404.85	$16.85–$404.85	113% above	40%
H. pylori antibody blood test CPT 86677 H PYLORI AB QL	$242.91	$404.85	$16.85–$404.85	113% above	40%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB QL	$242.91	$404.85	$16.85–$404.85	—	40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODY	$242.91	$404.85	$16.85–$404.85	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Q40085 HIV1RNA RTPCR	$39.00	$65.00	$11.70–$293.99	61% below	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$39.00	$65.00	$11.70–$293.99	61% below	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$39.00	$65.00	$11.70–$293.99	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Q40085 HIV1RNA RTPCR	$39.00	$65.00	$11.70–$293.99	—	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV1/2 RAPID BLOOD TEST 3RD GENERATION	$22.50	$37.50	$6.75–$94.25	62% below	40%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$22.50	$37.50	$6.75–$94.25	62% below	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$22.50	$37.50	$6.75–$94.25	—	40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV1/2 RAPID BLOOD TEST 3RD GENERATION	$22.50	$37.50	$6.75–$94.25	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$529.65	$882.75	$4.60–$887.55	712% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$529.65	$882.75	$4.60–$887.55	—	40%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$176.79	$294.65	$2.37–$297.65	338% above	40%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$176.79	$294.65	$2.37–$297.65	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Q499 HBSAB QL IA	$42.00	$70.00	$10.74–$483.05	1% below	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$119.43	$199.05	$10.74–$483.05	182% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB	$119.43	$199.05	$10.74–$483.05	182% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Q499 HBSAB QL IA	$42.00	$70.00	$10.74–$483.05	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$119.43	$199.05	$10.74–$483.05	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB	$119.43	$199.05	$10.74–$483.05	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$128.97	$214.95	$10.33–$331.95	80% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG	$128.97	$214.95	$10.33–$331.95	80% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$128.97	$214.95	$10.33–$331.95	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG	$128.97	$214.95	$10.33–$331.95	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C ANTIBODY TEST	$27.00	$45.00	$14.27–$142.00	51% below	40%
Hepatitis C antibody blood test (screening) CPT 86803 Q91438HEPC AB QT PCR	$55.20	$92.00	$14.27–$142.00	1% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C ANTIBODY TEST	$27.00	$45.00	$14.27–$142.00	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Q91438HEPC AB QT PCR	$55.20	$92.00	$14.27–$142.00	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$55.20	$92.00	$29.23–$172.55	37% below	40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Q11348 HCV QT RT-PCR	$42.24	$70.40	$29.23–$172.55	52% below	40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 Q35645 HCV RNAQT RT-	$55.20	$92.00	$29.23–$172.55	37% below	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$55.20	$92.00	$29.23–$172.55	—	40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Q11348 HCV QT RT-PCR	$42.24	$70.40	$29.23–$172.55	—	40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 Q35645 HCV RNAQT RT-	$55.20	$92.00	$29.23–$172.55	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 Q90849HERPES SMP TP1	$5.07	$8.46	$13.19–$112.06	74% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$55.53	$92.56	$13.19–$112.06	187% above	40%
Herpes blood test, HSV-1 antibody CPT 86695 Q3636 HSV1 IGG IA	$55.53	$92.56	$13.19–$112.06	187% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Q90849HERPES SMP TP1	$5.07	$8.46	$13.19–$112.06	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Q3636 HSV1 IGG IA	$55.53	$92.56	$13.19–$112.06	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$55.53	$92.56	$13.19–$112.06	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$487.62	$812.70	$12.95–$812.70	724% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP,HIGHLY SENS	$487.62	$812.70	$12.95–$812.70	724% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$487.62	$812.70	$12.95–$812.70	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP,HIGHLY SENS	$487.62	$812.70	$12.95–$812.70	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$592.65	$987.75	$6.47–$987.75	919% above	40%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$592.65	$987.75	$6.47–$987.75	919% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$592.65	$987.75	$6.47–$987.75	—	40%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$592.65	$987.75	$6.47–$987.75	—	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$933.99	$1,556.65	$8.74–$1,556.65	1180% above	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACIT	$933.99	$1,556.65	$8.74–$1,556.65	1180% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACIT	$933.99	$1,556.65	$8.74–$1,556.65	—	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING TEST	$933.99	$1,556.65	$8.74–$1,556.65	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$1,098.45	$1,830.75	$8.68–$1,830.75	672% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$1,098.45	$1,830.75	$8.68–$1,830.75	—	40%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$35.56	$59.27	$11.56–$123.52	66% below	40%
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH)	$35.56	$59.27	$11.56–$123.52	—	40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$1,133.61	$1,889.35	$11.57–$1,889.35	749% above	40%
Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID	$1,133.61	$1,889.35	$11.57–$1,889.35	749% above	40%
Lactate (lactic acid) blood test inpatient CPT 83605 ASSAY OF LACTIC ACID	$1,133.61	$1,889.35	$11.57–$1,889.35	—	40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$1,133.61	$1,889.35	$11.57–$1,889.35	—	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME	$648.30	$1,080.50	$6.04–$1,080.50	1739% above	40%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROLDH	$648.30	$1,080.50	$6.04–$1,080.50	1739% above	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE (LD) (LDH) ENZYME	$648.30	$1,080.50	$6.04–$1,080.50	—	40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROLDH	$648.30	$1,080.50	$6.04–$1,080.50	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$676.83	$1,128.05	$6.89–$1,131.10	602% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$676.83	$1,128.05	$6.89–$1,131.10	602% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$676.83	$1,128.05	$6.89–$1,131.10	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$676.83	$1,128.05	$6.89–$1,131.10	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$772.02	$1,286.70	$8.17–$1,286.70	410% above	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PAN	$772.02	$1,286.70	$8.17–$1,286.70	410% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PAN	$772.02	$1,286.70	$8.17–$1,286.70	—	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$772.02	$1,286.70	$8.17–$1,286.70	—	40%
Magnesium blood test CPT 83735 Q10551 MG RBC ICP/MS	$5.29	$8.83	$6.70–$983.55	92% below	40%
Magnesium blood test CPT 83735 MAGNESIUM	$582.99	$971.65	$6.70–$983.55	833% above	40%
Magnesium blood test inpatient CPT 83735 Q10551 MG RBC ICP/MS	$5.29	$8.83	$6.70–$983.55	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$582.99	$971.65	$6.70–$983.55	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$39.45	$65.75	$12.41–$85.94	26% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$39.45	$65.75	$12.41–$85.94	26% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$39.45	$65.75	$12.41–$85.94	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$39.45	$65.75	$12.41–$85.94	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$415.53	$692.55	$5.18–$692.55	304% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREE	$415.53	$692.55	$5.18–$692.55	304% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREE	$415.53	$692.55	$5.18–$692.55	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN	$415.53	$692.55	$5.18–$692.55	—	40%
Mumps immunity blood test CPT 86735 Q8624 MUMPSAB IGG IA	$31.20	$52.00	$9.36–$87.96	95% above	40%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY	$31.20	$52.00	$9.36–$87.96	95% above	40%
Mumps immunity blood test inpatient CPT 86735 Q8624 MUMPSAB IGG IA	$31.20	$52.00	$9.36–$87.96	—	40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY	$31.20	$52.00	$9.36–$87.96	—	40%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$776.16	$1,293.60	$47.81–$1,293.60	238% above	40%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$776.16	$1,293.60	$47.81–$1,293.60	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$870.81	$1,451.35	$15.12–$1,455.85	1357% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$870.81	$1,451.35	$15.12–$1,455.85	1357% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$870.81	$1,451.35	$15.12–$1,455.85	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$870.81	$1,451.35	$15.12–$1,455.85	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 Q8837 PARATHORMONE P	$66.60	$111.00	$8.00–$275.28	39% below	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Q8837 PARATHORMONE P	$66.60	$111.00	$8.00–$275.28	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Q19872 THROMBOPLAST	$5.06	$8.44	$6.01–$491.44	92% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Q7079 THROMBOPLAST T	$7.35	$12.25	$6.01–$491.44	88% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$12.42	$20.70	$6.01–$491.44	80% below	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TIMEPTT	$270.03	$450.05	$6.01–$491.44	332% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Q19872 THROMBOPLAST	$5.06	$8.44	$6.01–$491.44	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Q7079 THROMBOPLAST T	$7.35	$12.25	$6.01–$491.44	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$12.42	$20.70	$6.01–$491.44	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TIMEPTT	$270.03	$450.05	$6.01–$491.44	—	40%
Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS	$646.02	$1,076.70	$4.74–$1,076.70	755% above	40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS, BLOOD	$646.02	$1,076.70	$4.74–$1,076.70	755% above	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 ASSAY OF PHOSPHORUS	$646.02	$1,076.70	$4.74–$1,076.70	—	40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS, BLOOD	$646.02	$1,076.70	$4.74–$1,076.70	—	40%
Potassium blood test CPT 84132 POTASSIUM SER PL WB	$547.26	$912.10	$4.76–$912.10	649% above	40%
Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM	$547.26	$912.10	$4.76–$912.10	649% above	40%
Potassium blood test inpatient CPT 84132 ASSAY OF SERUM POTASSIUM	$547.26	$912.10	$4.76–$912.10	—	40%
Potassium blood test inpatient CPT 84132 POTASSIUM SER PL WB	$547.26	$912.10	$4.76–$912.10	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Q92777 QNATAL ADV NX	$600.00	$1,000.00	$180.00–$2,622.21	65% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY	$600.00	$1,000.00	$180.00–$2,622.21	65% below	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Q92777 QNATAL ADV NX	$600.00	$1,000.00	$180.00–$2,622.21	—	40%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FETAL CHRMOML ANEUPLOIDY	$600.00	$1,000.00	$180.00–$2,622.21	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$93.09	$155.15	$4.29–$155.15	70% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$93.09	$155.15	$4.29–$155.15	—	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W-OP	$253.38	$422.30	$12.69–$422.30	236% above	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$253.38	$422.30	$12.69–$422.30	236% above	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$253.38	$422.30	$12.69–$422.30	—	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W-OP	$253.38	$422.30	$12.69–$422.30	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$460.35	$767.25	$10.03–$767.25	327% above	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W-OPTI	$460.35	$767.25	$10.03–$767.25	327% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$460.35	$767.25	$10.03–$767.25	—	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W-OPTI	$460.35	$767.25	$10.03–$767.25	—	40%
Rh blood typing CPT 86901 BLOOD TYPING RH D	$283.26	$472.10	$2.99–$472.10	409% above	40%
Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$283.26	$472.10	$2.99–$472.10	409% above	40%
Rh blood typing inpatient CPT 86901 BLOOD TYPING SEROLOGIC RH(D)	$283.26	$472.10	$2.99–$472.10	—	40%
Rh blood typing inpatient CPT 86901 BLOOD TYPING RH D	$283.26	$472.10	$2.99–$472.10	—	40%
Rubella antibody test (immunity check) CPT 86762 Q6444 RUBELLA AB IGG	$6.51	$10.85	$14.39–$773.43	87% below	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLLA ANTIBODY (IGM)	$9.10	$15.18	$14.39–$773.43	82% below	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$448.44	$747.40	$14.39–$773.43	784% above	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$448.44	$747.40	$14.39–$773.43	784% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 Q6444 RUBELLA AB IGG	$6.51	$10.85	$14.39–$773.43	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLLA ANTIBODY (IGM)	$9.10	$15.18	$14.39–$773.43	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$448.44	$747.40	$14.39–$773.43	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$448.44	$747.40	$14.39–$773.43	—	40%
Sodium blood test CPT 84295 SODIUM,SER PL OR WB	$594.93	$991.55	$4.81–$991.55	808% above	40%
Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM	$594.93	$991.55	$4.81–$991.55	808% above	40%
Sodium blood test inpatient CPT 84295 SODIUM,SER PL OR WB	$594.93	$991.55	$4.81–$991.55	—	40%
Sodium blood test inpatient CPT 84295 ASSAY OF SERUM SODIUM	$594.93	$991.55	$4.81–$991.55	—	40%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$27.87	$46.45	$8.88–$59.04	33% above	40%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$27.87	$46.45	$8.88–$59.04	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$296.31	$493.85	$4.19–$493.85	660% above	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCULT FECES 1-3	$296.31	$493.85	$4.19–$493.85	660% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCULT FECES 1-3	$296.31	$493.85	$4.19–$493.85	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$296.31	$493.85	$4.19–$493.85	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$30.09	$50.15	$9.02–$55.00	39% below	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Q14395 FECAL GLOB IC	$30.09	$50.15	$9.02–$55.00	39% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Q14395 FECAL GLOB IC	$30.09	$50.15	$9.02–$55.00	—	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL	$30.09	$50.15	$9.02–$55.00	—	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Q4112 FTA-ABS IFA	$3.60	$6.00	$4.32–$110.81	78% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$3.60	$6.00	$4.32–$110.81	78% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Q34323 T PALLAD AB	$3.60	$6.00	$4.32–$110.81	78% below	40%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREMPONEMA PALLIDUM	$7.20	$12.00	$4.32–$110.81	56% below	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Q4112 FTA-ABS IFA	$3.60	$6.00	$4.32–$110.81	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$3.60	$6.00	$4.32–$110.81	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Q34323 T PALLAD AB	$3.60	$6.00	$4.32–$110.81	—	40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREMPONEMA PALLIDUM	$7.20	$12.00	$4.32–$110.81	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Q4128 VDRL CSF SLDMF	$5.38	$8.98	$4.27–$706.49	60% below	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$415.53	$692.55	$4.27–$706.49	2996% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, QUAL	$415.53	$692.55	$4.27–$706.49	2996% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Q4128 VDRL CSF SLDMF	$5.38	$8.98	$4.27–$706.49	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, QUAL	$415.53	$692.55	$4.27–$706.49	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$415.53	$692.55	$4.27–$706.49	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Q36970 TB QFT PL 1TU	$20.40	$34.00	$12.24–$404.32	76% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Q16603 QUAN-TB AU IA	$20.40	$34.00	$12.24–$404.32	76% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$20.40	$34.00	$12.24–$404.32	76% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Q36970 TB QFT PL 1TU	$20.40	$34.00	$12.24–$404.32	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$20.40	$34.00	$12.24–$404.32	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Q16603 QUAN-TB AU IA	$20.40	$34.00	$12.24–$404.32	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Q15038 LKM1 AB IGG	$16.69	$27.82	$8.00–$97.66	27% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$18.00	$30.00	$8.00–$97.66	21% below	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Q15038LKM1 AB IGG IA	$18.00	$30.00	$8.00–$97.66	21% below	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Q15038 LKM1 AB IGG	$16.69	$27.82	$8.00–$97.66	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$18.00	$30.00	$8.00–$97.66	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Q15038LKM1 AB IGG IA	$18.00	$30.00	$8.00–$97.66	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 NBS THYROID STIM TSH	$65.40	$109.00	$16.80–$1,560.35	29% below	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$870.81	$1,451.35	$16.80–$1,560.35	841% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM TSH	$870.81	$1,451.35	$16.80–$1,560.35	841% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NBS THYROID STIM TSH	$65.40	$109.00	$16.80–$1,560.35	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM TSH	$870.81	$1,451.35	$16.80–$1,560.35	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$870.81	$1,451.35	$16.80–$1,560.35	—	40%
Total IgE blood test CPT 82785 ASSAY OF IGE	$26.83	$44.72	$16.46–$187.94	57% below	40%
Total IgE blood test CPT 82785 PROFILE REGION XVII	$78.33	$130.56	$16.46–$187.94	25% above	40%
Total IgE blood test inpatient CPT 82785 ASSAY OF IGE	$26.83	$44.72	$16.46–$187.94	—	40%
Total IgE blood test inpatient CPT 82785 PROFILE REGION XVII	$78.33	$130.56	$16.46–$187.94	—	40%
Total cholesterol blood test CPT 82465 CHOLESTEROL TOTAL	$416.76	$694.60	$4.35–$694.60	892% above	40%
Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$416.76	$694.60	$4.35–$694.60	892% above	40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL TOTAL	$416.76	$694.60	$4.35–$694.60	—	40%
Total cholesterol blood test inpatient CPT 82465 ASSAY BLD/SERUM CHOLESTEROL	$416.76	$694.60	$4.35–$694.60	—	40%
Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE	$426.90	$711.50	$6.87–$711.50	989% above	40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE T4,TOTAL	$426.90	$711.50	$6.87–$711.50	989% above	40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE T4,TOTAL	$426.90	$711.50	$6.87–$711.50	—	40%
Total thyroxine (T4) blood test inpatient CPT 84436 ASSAY OF TOTAL THYROXINE	$426.90	$711.50	$6.87–$711.50	—	40%
Total triiodothyronine (T3) blood test CPT 84480 T3,TOTAL	$469.77	$782.95	$14.18–$782.95	502% above	40%
Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$469.77	$782.95	$14.18–$782.95	502% above	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 ASSAY TRIIODOTHYRONINE (T3)	$469.77	$782.95	$14.18–$782.95	—	40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3,TOTAL	$469.77	$782.95	$14.18–$782.95	—	40%
Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN	$125.10	$208.50	$12.76–$208.50	132% above	40%
Transferrin blood test CPT 84466 TRANSFERRIN	$125.10	$208.50	$12.76–$208.50	132% above	40%
Transferrin blood test inpatient CPT 84466 ASSAY OF TRANSFERRIN	$125.10	$208.50	$12.76–$208.50	—	40%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$125.10	$208.50	$12.76–$208.50	—	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$39.49	$65.82	$11.84–$134.74	60% below	40%
Trichomonas test (NAAT) CPT 87661 Q15509 T VAGINALIS A	$39.49	$65.82	$11.84–$134.74	60% below	40%
Trichomonas test (NAAT) inpatient CPT 87661 Q15509 T VAGINALIS A	$39.49	$65.82	$11.84–$134.74	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$39.49	$65.82	$11.84–$134.74	—	40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$456.96	$761.60	$5.74–$761.60	1012% above	40%
Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES	$456.96	$761.60	$5.74–$761.60	1012% above	40%
Triglycerides blood test inpatient CPT 84478 ASSAY OF TRIGLYCERIDES	$456.96	$761.60	$5.74–$761.60	—	40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$456.96	$761.60	$5.74–$761.60	—	40%
Troponin test, quantitative CPT 84484 TROPONIN, QUANTITATIVE	$27.12	$45.20	$12.15–$543.55	85% below	40%
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT	$299.01	$498.35	$12.15–$543.55	67% above	40%
Troponin test, quantitative CPT 84484 TROPONIN,QNT	$299.01	$498.35	$12.15–$543.55	67% above	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN, QUANTITATIVE	$27.12	$45.20	$12.15–$543.55	—	40%
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANT	$299.01	$498.35	$12.15–$543.55	—	40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN,QNT	$299.01	$498.35	$12.15–$543.55	—	40%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$648.30	$1,080.50	$4.52–$1,080.50	881% above	40%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$648.30	$1,080.50	$4.52–$1,080.50	881% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$648.30	$1,080.50	$4.52–$1,080.50	—	40%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$648.30	$1,080.50	$4.52–$1,080.50	—	40%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTO W-MICROSCOPE	$225.03	$375.05	$3.17–$375.05	172% above	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$225.03	$375.05	$3.17–$375.05	172% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTO W-MICROSCOPE	$225.03	$375.05	$3.17–$375.05	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$225.03	$375.05	$3.17–$375.05	—	40%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$17.88	$29.80	$3.70–$29.80	44% below	40%
Urinalysis with microscope exam, manual CPT 81000 UA, NONAUTO W-SCOPE	$17.88	$29.80	$3.70–$29.80	44% below	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W/SCOPE	$17.88	$29.80	$3.70–$29.80	—	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 UA, NONAUTO W-SCOPE	$17.88	$29.80	$3.70–$29.80	—	40%
Urinalysis without microscope exam, automated CPT 81003 UA,AUTO WITH OUT MICROSCOPE	$116.37	$193.95	$2.25–$193.95	108% above	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$116.37	$193.95	$2.25–$193.95	108% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA,AUTO WITH OUT MICROSCOPE	$116.37	$193.95	$2.25–$193.95	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$116.37	$193.95	$2.25–$193.95	—	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$23.43	$39.05	$3.08–$39.05	31% below	40%
Urinalysis without microscope exam, manual CPT 81002 UA NONAUTO W-O SCOPE	$23.43	$39.05	$3.08–$39.05	31% below	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$23.43	$39.05	$3.08–$39.05	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NONAUTO W-O SCOPE	$23.43	$39.05	$3.08–$39.05	—	40%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$659.07	$1,098.45	$8.07–$1,098.45	373% above	40%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE-COLONY CT	$659.07	$1,098.45	$8.07–$1,098.45	373% above	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT	$659.07	$1,098.45	$8.07–$1,098.45	—	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE-COLONY CT	$659.07	$1,098.45	$8.07–$1,098.45	—	40%
Urine microalbumin (albumin) test CPT 82043 MICROALB QNT	$634.38	$1,057.30	$5.78–$1,063.55	1628% above	40%
Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE	$634.38	$1,057.30	$5.78–$1,063.55	1628% above	40%
Urine microalbumin (albumin) test inpatient CPT 82043 UR ALBUMIN QUANTITATIVE	$634.38	$1,057.30	$5.78–$1,063.55	—	40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALB QNT	$634.38	$1,057.30	$5.78–$1,063.55	—	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST QL	$31.44	$52.40	$4.02–$52.40	64% below	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$31.44	$52.40	$4.02–$52.40	64% below	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST QL	$31.44	$52.40	$4.02–$52.40	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$31.44	$52.40	$4.02–$52.40	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$1,112.64	$1,854.40	$13.33–$1,854.40	1082% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$1,112.64	$1,854.40	$13.33–$1,854.40	—	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY	$1,112.10	$1,853.50	$38.50–$1,865.50	1541% above	40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 DIHYDROXY VITAMIN D	$1,112.10	$1,853.50	$38.50–$1,865.50	1541% above	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25-DIHYDROXY	$1,112.10	$1,853.50	$38.50–$1,865.50	—	40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 DIHYDROXY VITAMIN D	$1,112.10	$1,853.50	$38.50–$1,865.50	—	40%
Zinc blood test CPT 84630 ASSAY OF ZINC	$5.54	$9.24	$1.66–$75.97	50% below	40%
Zinc blood test CPT 84630 Q945 ZN ICP/MS AS	$5.54	$9.24	$1.66–$75.97	50% below	40%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$5.54	$9.24	$1.66–$75.97	—	40%
Zinc blood test inpatient CPT 84630 Q945 ZN ICP/MS AS	$5.54	$9.24	$1.66–$75.97	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$766.35	$1,277.25	$15.05–$1,277.25	328% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT	$766.35	$1,277.25	$15.05–$1,277.25	328% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT	$766.35	$1,277.25	$15.05–$1,277.25	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$766.35	$1,277.25	$15.05–$1,277.25	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$23,701.35	$39,502.25	$693.51–$39,502.25	83% above	40%
Cardiac catheterization with coronary angiogram CPT 93458 CC-L HRT ARTERY-VENT	$23,701.35	$39,502.25	$693.51–$39,502.25	83% above	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$23,701.35	$39,502.25	$693.51–$39,502.25	—	40%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CC-L HRT ARTERY-VENT	$23,701.35	$39,502.25	$693.51–$39,502.25	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI-CARDIOVERSION	$1,084.41	$1,807.35	$183.69–$5,909.05	43% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$2,461.02	$4,101.70	$183.69–$5,909.05	29% above	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI-CARDIOVERSION	$1,084.41	$1,807.35	$183.69–$5,909.05	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$2,461.02	$4,101.70	$183.69–$5,909.05	—	40%
Catheter ablation for atrial fibrillation CPT 93656 COMP EPS/ABLATION OF ATRIAL FIB	$48,828.12	$81,380.20	$1,116.69–$81,380.20	46% above	40%
Catheter ablation for atrial fibrillation CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB	$48,828.12	$81,380.20	$1,116.69–$81,380.20	46% above	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 COMP EPS/ABLATION OF ATRIAL FIB	$48,828.12	$81,380.20	$1,116.69–$81,380.20	—	40%
Catheter ablation for atrial fibrillation inpatient CPT 93656 COMPRE EP EVAL ABLTJ ATR FIB	$48,828.12	$81,380.20	$1,116.69–$81,380.20	—	40%
Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY	$5,140.38	$8,567.30	$1,995.21–$11,478.00	at median	40%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 CESAREAN DELIVERY	$5,140.38	$8,567.30	$1,995.21–$11,478.00	—	40%
Colonoscopy with endoscopic ultrasound CPT 45391 COLONOSCOPY W/ENDOSCOPE US	$2,393.37	$3,988.95	$214.09–$6,374.00	5% above	40%
Colonoscopy with endoscopic ultrasound inpatient CPT 45391 COLONOSCOPY W/ENDOSCOPE US	$2,393.37	$3,988.95	$214.09–$6,374.00	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$2,393.37	$3,988.95	$416.45–$4,963.00	3% above	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY	$2,393.37	$3,988.95	$416.45–$4,963.00	—	40%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$2,111.76	$3,519.60	$372.31–$4,963.00	2% above	40%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$2,111.76	$3,519.60	$372.31–$4,963.00	—	40%
Coronary stent placement, one artery CPT 92928 BMS CORONARY STENT	$22,617.12	$37,695.20	$724.58–$37,695.20	51% above	40%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$22,617.12	$37,695.20	$724.58–$37,695.20	51% above	40%
Coronary stent placement, one artery inpatient CPT 92928 BMS CORONARY STENT	$22,617.12	$37,695.20	$724.58–$37,695.20	—	40%
Coronary stent placement, one artery inpatient CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$22,617.12	$37,695.20	$724.58–$37,695.20	—	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$6,949.80	$11,583.00	$433.82–$10,223.00	6% below	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP I/HERN INIT REDUC >5 YR	$6,949.80	$11,583.00	$433.82–$10,223.00	—	40%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 TLH W/T/O 250 G OR LESS	$8,341.23	$13,902.05	$1,073.50–$12,699.00	41% below	40%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 TLH W/T/O 250 G OR LESS	$8,341.23	$13,902.05	$1,073.50–$12,699.00	—	40%
Left heart catheterization, diagnostic CPT 93452 CC-LHC VENT PUNC	$20,334.63	$33,891.05	$549.26–$33,891.05	105% above	40%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$20,334.63	$33,891.05	$549.26–$33,891.05	105% above	40%
Left heart catheterization, diagnostic inpatient CPT 93452 CC-LHC VENT PUNC	$20,334.63	$33,891.05	$549.26–$33,891.05	—	40%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HRT CATH W/VENTRCLGRPHY	$20,334.63	$33,891.05	$549.26–$33,891.05	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$6,550.92	$10,918.20	$315.61–$4,549.00	195% above	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$6,550.92	$10,918.20	$315.61–$4,549.00	—	40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$6,550.92	$10,918.20	$180.76–$4,549.00	221% above	40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRM EPI L/S 1	$6,550.92	$10,918.20	$180.76–$4,549.00	—	40%
Pacemaker implant (dual chamber) CPT 33208 PACEMAKER INSERTION DUAL LEADS	$22,286.91	$37,144.85	$939.00–$37,144.85	19% above	40%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$22,286.91	$37,144.85	$939.00–$37,144.85	19% above	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 PACEMAKER INSERTION DUAL LEADS	$22,286.91	$37,144.85	$939.00–$37,144.85	—	40%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSRT HEART PM ATRIAL & VENT	$22,286.91	$37,144.85	$939.00–$37,144.85	—	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$2,881.20	$4,802.00	$113.15–$14,670.10	57% above	40%
Paracentesis with imaging guidance CPT 49083 CT-ABD PARACEN W IMG	$2,881.20	$4,802.00	$113.15–$14,670.10	57% above	40%
Paracentesis with imaging guidance CPT 49083 IR-ABD PARACEN W IMG	$2,960.43	$4,934.05	$113.15–$14,670.10	61% above	40%
Paracentesis with imaging guidance CPT 49083 US-ABD PARACEN W IMG	$2,960.43	$4,934.05	$113.15–$14,670.10	61% above	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$2,881.20	$4,802.00	$113.15–$14,670.10	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 CT-ABD PARACEN W IMG	$2,881.20	$4,802.00	$113.15–$14,670.10	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 US-ABD PARACEN W IMG	$2,960.43	$4,934.05	$113.15–$14,670.10	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 IR-ABD PARACEN W IMG	$2,960.43	$4,934.05	$113.15–$14,670.10	—	40%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$5,560.83	$9,268.05	$110.33–$6,374.00	8% below	40%
Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE	$5,560.83	$9,268.05	$110.33–$6,374.00	—	40%
Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS SURG PRST8ECT RPBIC RAD	$9,730.23	$16,217.05	$1,201.92–$12,053.00	75% below	40%
Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 LAPS SURG PRST8ECT RPBIC RAD	$9,730.23	$16,217.05	$1,201.92–$12,053.00	—	40%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$231.18	$385.30	$302.26–$7,070.00	95% below	40%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION	$231.18	$385.30	$302.26–$7,070.00	—	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$276.18	$460.30	$605.06–$11,067.00	95% below	40%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$276.18	$460.30	$605.06–$11,067.00	—	40%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,043.73	$1,739.55	$116.44–$4,549.00	49% below	40%
Thoracentesis with imaging guidance CPT 32555 US-THORACNTSIS W IMG	$1,043.73	$1,739.55	$116.44–$4,549.00	49% below	40%
Thoracentesis with imaging guidance inpatient CPT 32555 US-THORACNTSIS W IMG	$1,043.73	$1,739.55	$116.44–$4,549.00	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,043.73	$1,739.55	$116.44–$4,549.00	—	40%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$5,560.83	$9,268.05	$212.68–$10,223.00	48% below	40%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS AND ADENOIDS	$5,560.83	$9,268.05	$212.68–$10,223.00	—	40%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$9,730.23	$16,217.05	$1,878.00–$11,478.00	6% above	40%
Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY	$9,730.23	$16,217.05	$1,878.00–$11,478.00	—	40%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$9,730.23	$16,217.05	$1,878.00–$17,492.00	62% below	40%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$9,730.23	$16,217.05	$1,878.00–$17,492.00	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$1,421.04	$2,368.40	$263.79–$6,374.00	56% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US-BRST BX LOC CLP W OR WO CLP	$1,421.04	$2,368.40	$263.79–$6,374.00	56% below	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US-BRST BX LOC CLP W OR WO CLP	$1,421.04	$2,368.40	$263.79–$6,374.00	—	40%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAG	$1,421.04	$2,368.40	$263.79–$6,374.00	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$2,393.37	$3,988.95	$295.32–$6,374.00	35% above	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$2,393.37	$3,988.95	$295.32–$6,374.00	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$2,111.76	$3,519.60	$282.64–$6,374.00	13% above	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSH WASH	$2,111.76	$3,519.60	$282.64–$6,374.00	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 0 2 HRS	$892.68	$1,487.80	$3,437.95–$19,099.90	2% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 2 4 HRS	$962.97	$1,604.95	$3,437.95–$19,099.90	10% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 4 6 HRS	$1,233.60	$2,056.00	$3,437.95–$19,099.90	41% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 6 8 HRS	$1,509.18	$2,515.30	$3,437.95–$19,099.90	73% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$1,543.80	$2,573.00	$3,437.95–$19,099.90	77% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 8 10 HR	$1,784.16	$2,973.60	$3,437.95–$19,099.90	104% above	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$1,784.16	$2,973.60	$3,437.95–$19,099.90	104% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 0 2 HRS	$892.68	$1,487.80	$3,437.95–$19,099.90	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 2 4 HRS	$962.97	$1,604.95	$3,437.95–$19,099.90	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 4 6 HRS	$1,233.60	$2,056.00	$3,437.95–$19,099.90	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 6 8 HRS	$1,509.18	$2,515.30	$3,437.95–$19,099.90	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$1,543.80	$2,573.00	$3,437.95–$19,099.90	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPNT	$1,784.16	$2,973.60	$3,437.95–$19,099.90	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 8 10 HR	$1,784.16	$2,973.60	$3,437.95–$19,099.90	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METANEB INAHALATION TREATMENT INITIAL	$233.04	$388.40	$12.76–$3,236.65	28% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT SUB	$238.59	$397.65	$12.76–$3,236.65	26% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 METANEB INHALATION TREATMENT SUBSEQUENT	$352.65	$587.75	$12.76–$3,236.65	9% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT INI	$437.10	$728.50	$12.76–$3,236.65	35% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$437.10	$728.50	$12.76–$3,236.65	35% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METANEB INAHALATION TREATMENT INITIAL	$233.04	$388.40	$12.76–$3,236.65	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT SUB	$238.59	$397.65	$12.76–$3,236.65	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 METANEB INHALATION TREATMENT SUBSEQUENT	$352.65	$587.75	$12.76–$3,236.65	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$437.10	$728.50	$12.76–$3,236.65	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT INI	$437.10	$728.50	$12.76–$3,236.65	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFU 1ST HR	$701.55	$1,169.25	$36.26–$1,745.01	20% below	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$701.55	$1,169.25	$36.26–$1,745.01	20% below	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$701.55	$1,169.25	$36.26–$1,745.01	—	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFU 1ST HR	$701.55	$1,169.25	$36.26–$1,745.01	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$5,494.05	$9,156.75	$132.67–$9,156.75	at median	40%
Critical care, first 30 to 74 minutes one side CPT 99291 CRITICAL CARE LT 74M	$5,494.05	$9,156.75	$132.67–$9,156.75	at median	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$5,494.05	$9,156.75	$132.67–$9,156.75	—	40%
Critical care, first 30 to 74 minutes inpatient one side CPT 99291 CRITICAL CARE LT 74M	$5,494.05	$9,156.75	$132.67–$9,156.75	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE DROWSY	$1,768.74	$2,947.90	$39.30–$2,947.90	72% above	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$1,768.74	$2,947.90	$39.30–$2,947.90	72% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE DROWSY	$1,768.74	$2,947.90	$39.30–$2,947.90	—	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$1,768.74	$2,947.90	$39.30–$2,947.90	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NI-EKG, 12 LEADS	$850.50	$1,417.50	$7.43–$2,845.35	152% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$850.50	$1,417.50	$7.43–$2,845.35	152% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD ED STAFF	$856.71	$1,427.85	$7.43–$2,845.35	153% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$850.50	$1,417.50	$7.43–$2,845.35	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NI-EKG, 12 LEADS	$850.50	$1,417.50	$7.43–$2,845.35	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD ED STAFF	$856.71	$1,427.85	$7.43–$2,845.35	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 TRIAGE ONLY	$130.41	$217.35	$15.18–$5,045.00	69% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$429.30	$715.50	$15.18–$5,045.00	2% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF ED VISIT	$429.30	$715.50	$15.18–$5,045.00	2% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 TRIAGE ONLY	$130.41	$217.35	$15.18–$5,045.00	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF ED VISIT	$429.30	$715.50	$15.18–$5,045.00	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$429.30	$715.50	$15.18–$5,045.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED ED VISIT	$854.85	$1,424.75	$24.38–$5,045.00	2% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$854.85	$1,424.75	$24.38–$5,045.00	2% below	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$854.85	$1,424.75	$24.38–$5,045.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED ED VISIT	$854.85	$1,424.75	$24.38–$5,045.00	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMEDIATE ED VIST	$2,271.18	$3,785.30	$44.60–$5,300.00	51% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$2,271.18	$3,785.30	$44.60–$5,300.00	51% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMEDIATE ED VIST	$2,271.18	$3,785.30	$44.60–$5,300.00	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$2,271.18	$3,785.30	$44.60–$5,300.00	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED ED VISIT	$3,410.10	$5,683.50	$68.35–$5,683.50	26% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$3,410.10	$5,683.50	$68.35–$5,683.50	26% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED ED VISIT	$3,410.10	$5,683.50	$68.35–$5,683.50	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$3,410.10	$5,683.50	$68.35–$5,683.50	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$5,112.45	$8,520.75	$108.08–$8,520.75	44% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE ED VST	$5,112.45	$8,520.75	$108.08–$8,520.75	44% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$5,112.45	$8,520.75	$108.08–$8,520.75	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE ED VST	$5,112.45	$8,520.75	$108.08–$8,520.75	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$2,035.74	$3,392.90	$66.58–$3,392.90	44% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI-STRESS TEST	$2,035.74	$3,392.90	$66.58–$3,392.90	44% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$2,035.74	$3,392.90	$66.58–$3,392.90	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI-STRESS TEST	$2,035.74	$3,392.90	$66.58–$3,392.90	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$789.72	$1,316.20	$55.97–$6,181.70	59% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1 HR	$911.79	$1,519.65	$55.97–$6,181.70	83% above	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$789.72	$1,316.20	$55.97–$6,181.70	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1 HR	$911.79	$1,519.65	$55.97–$6,181.70	—	40%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$434.64	$724.40	$79.39–$4,854.75	26% below	40%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY DX 1 HR	$789.72	$1,316.20	$79.39–$4,854.75	35% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$434.64	$724.40	$79.39–$4,854.75	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DX 1 HR	$789.72	$1,316.20	$79.39–$4,854.75	—	40%
IV push of a medicine, first drug CPT 96374 INJECTION IV PUSH	$198.72	$331.20	$63.18–$7,708.60	44% below	40%
IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$535.74	$892.90	$63.18–$7,708.60	52% above	40%
IV push of a medicine, first drug CPT 96374 THERAPEUTIC IV PUSH	$864.81	$1,441.35	$63.18–$7,708.60	145% above	40%
IV push of a medicine, first drug CPT 96374 THERPEUTIC IV PUSH	$2,161.08	$3,601.80	$63.18–$7,708.60	511% above	40%
IV push of a medicine, first drug inpatient CPT 96374 INJECTION IV PUSH	$198.72	$331.20	$63.18–$7,708.60	—	40%
IV push of a medicine, first drug inpatient CPT 96374 THER/PROPH/DIAG INJ IV PUSH	$535.74	$892.90	$63.18–$7,708.60	—	40%
IV push of a medicine, first drug inpatient CPT 96374 THERAPEUTIC IV PUSH	$864.81	$1,441.35	$63.18–$7,708.60	—	40%
IV push of a medicine, first drug inpatient CPT 96374 THERPEUTIC IV PUSH	$2,161.08	$3,601.80	$63.18–$7,708.60	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$407.97	$679.95	$23.77–$2,367.45	128% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC DX SQ IM	$461.10	$768.50	$23.77–$2,367.45	157% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC 1 DX SQ IM	$464.46	$774.10	$23.77–$2,367.45	159% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$407.97	$679.95	$23.77–$2,367.45	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC DX SQ IM	$461.10	$768.50	$23.77–$2,367.45	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC 1 DX SQ IM	$464.46	$774.10	$23.77–$2,367.45	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO RE-ED-15 MIN	$163.98	$273.30	$15.50–$546.60	29% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$163.98	$273.30	$15.50–$546.60	29% above	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO RE-ED-15 MIN	$163.98	$273.30	$15.50–$546.60	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$163.98	$273.30	$15.50–$546.60	—	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW COMP	$614.04	$1,023.40	$109.81–$1,023.40	136% above	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$614.04	$1,023.40	$109.81–$1,023.40	136% above	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW COMP	$614.04	$1,023.40	$109.81–$1,023.40	—	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$614.04	$1,023.40	$109.81–$1,023.40	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$959.67	$1,599.45	$108.63–$1,599.45	145% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH COMP	$959.67	$1,599.45	$108.63–$1,599.45	145% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$959.67	$1,599.45	$108.63–$1,599.45	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH COMP	$959.67	$1,599.45	$108.63–$1,599.45	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$959.67	$1,599.45	$108.63–$1,599.45	306% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW COMP	$959.67	$1,599.45	$108.63–$1,599.45	306% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$959.67	$1,599.45	$108.63–$1,599.45	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW COMP	$959.67	$1,599.45	$108.63–$1,599.45	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD COMP	$959.67	$1,599.45	$108.63–$1,599.45	171% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$959.67	$1,599.45	$108.63–$1,599.45	171% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$959.67	$1,599.45	$108.63–$1,599.45	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD COMP	$959.67	$1,599.45	$108.63–$1,599.45	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THRPY-15 MIN	$205.05	$341.75	$28.17–$683.50	71% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$205.05	$341.75	$28.17–$683.50	71% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THRPY-15 MIN	$205.05	$341.75	$28.17–$683.50	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1/> REGIONS	$205.05	$341.75	$28.17–$683.50	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCS-15 MIN	$152.28	$253.80	$13.90–$626.35	18% above	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$152.28	$253.80	$13.90–$626.35	18% above	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES	$152.28	$253.80	$13.90–$626.35	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAP EXERCS-15 MIN	$152.28	$253.80	$13.90–$626.35	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHG SMOKE U 10	$80.10	$133.50	$15.62–$133.50	9% above	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$80.10	$133.50	$15.62–$133.50	9% above	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$80.10	$133.50	$15.62–$133.50	—	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHG SMOKE U 10	$80.10	$133.50	$15.62–$133.50	—	40%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$1,054.83	$1,758.05	$244.51–$1,758.05	131% above	40%
Speech and language evaluation CPT 92523 SP SOUND LANG COMP	$1,054.83	$1,758.05	$244.51–$1,758.05	131% above	40%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$1,054.83	$1,758.05	$244.51–$1,758.05	—	40%
Speech and language evaluation inpatient CPT 92523 SP SOUND LANG COMP	$1,054.83	$1,758.05	$244.51–$1,758.05	—	40%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$961.11	$1,601.85	$37.69–$1,601.85	246% above	40%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST	$961.11	$1,601.85	$37.69–$1,601.85	246% above	40%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST	$961.11	$1,601.85	$37.69–$1,601.85	—	40%
Speech therapy session, individual inpatient CPT 92507 TX SP LANG VOICE COMM INDIV	$961.11	$1,601.85	$37.69–$1,601.85	—	40%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$194.76	$324.60	$14.76–$324.60	49% below	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$194.76	$324.60	$14.76–$324.60	49% below	40%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$194.76	$324.60	$14.76–$324.60	—	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$194.76	$324.60	$14.76–$324.60	—	40%
Spirometry before and after a bronchodilator CPT 94060 BRONCHO EVAL PRE/PST	$1,137.27	$1,895.45	$27.02–$1,895.45	42% above	40%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$1,137.27	$1,895.45	$27.02–$1,895.45	42% above	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$1,137.27	$1,895.45	$27.02–$1,895.45	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHO EVAL PRE/PST	$1,137.27	$1,895.45	$27.02–$1,895.45	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$146.73	$244.55	$14.13–$489.10	7% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAP ACTVTS-15 MIN	$146.73	$244.55	$14.13–$489.10	7% above	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES	$146.73	$244.55	$14.13–$489.10	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAP ACTVTS-15 MIN	$146.73	$244.55	$14.13–$489.10	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUT	$249.06	$415.10	$20.80–$4,549.00	23% below	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$249.06	$415.10	$20.80–$4,549.00	23% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUT	$249.06	$415.10	$20.80–$4,549.00	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$249.06	$415.10	$20.80–$4,549.00	—	40%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CV STRESS TEST SUPVJ I&R	$2,097.33	$3,495.55	$84.06–$3,495.55	676% above	40%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 NI-STRESS TEST W/SUP,INTER & REPORT	$2,097.33	$3,495.55	$84.06–$3,495.55	676% above	40%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 NI-STRESS TEST W/SUP,INTER & REPORT	$2,097.33	$3,495.55	$84.06–$3,495.55	—	40%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CV STRESS TEST SUPVJ I&R	$2,097.33	$3,495.55	$84.06–$3,495.55	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIR VAC SC	$217.80	$363.00	$65.34–$363.00	30% below	40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ	$217.80	$363.00	$65.34–$363.00	30% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIR VAC SC	$217.80	$363.00	$65.34–$363.00	—	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VAR VACCINE LIVE SUBQ	$217.80	$363.00	$65.34–$363.00	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM	$65.40	$109.00	$19.62–$109.00	9% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPTH/TETA/PERT PED	$65.40	$109.00	$19.62–$109.00	9% below	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DIPTH/TETA/PERT PED	$65.40	$109.00	$19.62–$109.00	—	40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE < 7 YRS IM	$65.40	$109.00	$19.62–$109.00	—	40%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$159.00	$265.00	$47.70–$265.00	14% above	40%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VIRUS VACCINE	$159.00	$265.00	$47.70–$265.00	14% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPA VACCINE ADULT IM	$159.00	$265.00	$47.70–$265.00	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VIRUS VACCINE	$159.00	$265.00	$47.70–$265.00	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$162.00	$270.00	$26.89–$270.00	32% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VAC ADULT IM	$162.00	$270.00	$26.89–$270.00	32% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$162.00	$270.00	$26.89–$270.00	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VAC ADULT IM	$162.00	$270.00	$26.89–$270.00	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$64.80	$108.00	$10.75–$222.00	12% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEP B VAC PED	$68.40	$114.00	$10.75–$222.00	19% above	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM	$64.80	$108.00	$10.75–$222.00	—	40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEP B VAC PED	$68.40	$114.00	$10.75–$222.00	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM	$73.80	$123.00	$22.14–$123.00	9% above	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HAEMO/MENIN VAC 0.5	$73.80	$123.00	$22.14–$123.00	9% above	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HAEMO/MENIN VAC 0.5	$73.80	$123.00	$22.14–$123.00	—	40%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HIB PRP-OMP VACC 3 DOSE IM	$73.80	$123.00	$22.14–$123.00	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC NOPRSV ANTIG	$106.20	$177.00	$17.62–$1,095.96	15% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM	$106.20	$177.00	$17.62–$1,095.96	15% below	40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE QUAD	$412.17	$686.96	$17.62–$1,095.96	229% above	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC NOPRSV ANTIG	$106.20	$177.00	$17.62–$1,095.96	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV NO PRSV INCREASED AG IM	$106.20	$177.00	$17.62–$1,095.96	—	40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE QUAD	$412.17	$686.96	$17.62–$1,095.96	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II INJ	$216.90	$361.50	$65.07–$361.50	55% above	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$216.90	$361.50	$65.07–$361.50	55% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II INJ	$216.90	$361.50	$65.07–$361.50	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE SC	$216.90	$361.50	$65.07–$361.50	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13 VACCINE IM	$445.80	$743.00	$74.00–$743.00	43% above	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOC 13-VAL IM	$445.80	$743.00	$74.00–$743.00	43% above	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PCV13 VACCINE IM	$445.80	$743.00	$74.00–$743.00	—	40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOC 13-VAL IM	$445.80	$743.00	$74.00–$743.00	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO-VAC 2YR-ADULT	$252.90	$421.50	$41.98–$421.50	56% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$252.90	$421.50	$41.98–$421.50	56% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMO-VAC 2YR-ADULT	$252.90	$421.50	$41.98–$421.50	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$252.90	$421.50	$41.98–$421.50	—	40%
Polio vaccine, inactivated (IPV) CPT 90713 POLIO VACCINE 0.5ML	$102.90	$171.50	$30.87–$171.50	13% above	40%
Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM	$102.90	$171.50	$30.87–$171.50	13% above	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS IPV SC/IM	$102.90	$171.50	$30.87–$171.50	—	40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIO VACCINE 0.5ML	$102.90	$171.50	$30.87–$171.50	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VAC IM	$665.70	$1,109.50	$313.68–$2,435.50	6% below	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$795.60	$1,326.00	$313.68–$2,435.50	13% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC IM	$665.70	$1,109.50	$313.68–$2,435.50	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$795.60	$1,326.00	$313.68–$2,435.50	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 ROTAVIR VAC PENT 2ML	$230.40	$384.00	$69.12–$384.00	28% above	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL	$230.40	$384.00	$69.12–$384.00	28% above	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 RV5 VACC 3 DOSE LIVE ORAL	$230.40	$384.00	$69.12–$384.00	—	40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIR VAC PENT 2ML	$230.40	$384.00	$69.12–$384.00	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD IM NO PRSRV GE 7Y	$98.70	$164.50	$29.61–$164.50	21% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$98.70	$164.50	$29.61–$164.50	21% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$98.70	$164.50	$29.61–$164.50	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD IM NO PRSRV GE 7Y	$98.70	$164.50	$29.61–$164.50	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH/TET/ACPERT .5ML	$109.50	$182.50	$40.62–$361.50	5% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$109.50	$182.50	$40.62–$361.50	5% below	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH/TET/ACPERT .5ML	$109.50	$182.50	$40.62–$361.50	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$109.50	$182.50	$40.62–$361.50	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$62.52	$104.20	$4.46–$375.35	40% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADD INJ SINGLE	$80.73	$134.55	$4.46–$375.35	23% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE	$81.96	$136.60	$4.46–$375.35	22% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$62.52	$104.20	$4.46–$375.35	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADD INJ SINGLE	$80.73	$134.55	$4.46–$375.35	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE	$81.96	$136.60	$4.46–$375.35	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EA ADD VACC	$37.59	$62.65	$38.73–$215.25	53% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM INJ EA ADD	$37.89	$63.15	$38.73–$215.25	53% below	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EACH ADD VACC	$53.67	$89.45	$38.73–$215.25	33% below	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM EA ADD VACC	$37.59	$62.65	$38.73–$215.25	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM INJ EA ADD	$37.89	$63.15	$38.73–$215.25	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM EACH ADD VACC	$53.67	$89.45	$38.73–$215.25	—	40%

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

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

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

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

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

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

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

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

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

Source file: https://s3.amazonaws.com/ycubaa-production-marlin-1-charge-management-public/facilities/e21d6544-b3b7-44c8-8df0-60cd8284ed13/911894113_WATSONVILLE-COMMUNITY-HOSPITAL_standardcharges.zip