Hospital Dallas-Fort Worth-Arlington, TX

Medical City North Hills

Medical City North Hills in North Richland Hills, TX publishes cash prices for 228 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Texas median for 223 of 226 procedures and below it for 3. By typical cash price it ranks #256 of 305 Texas hospitals and #70 of 82 hospitals in the Dallas, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.

4401 Booth Calloway Road, North Richland Hills, TX, 76180 Collected Sep 28, 2026 Source price file (817) 255-1000

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 450087 · CMS hospital register NPI 1518911833

The price file shows no self-pay discount

For 782 of the 782 prices listed here, the cash price in Medical City North Hills's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Medical City North Hills in North Richland Hills, TX:

Oct 12, 2023 Met requirements
May 1, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V LT	$811.45	$811.45	$56.80–$811.45	115% above	—
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V RT	$811.45	$811.45	$56.80–$811.45	115% above	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP ART 1-2 LEVELS BIL	$907.81	$907.81	$63.55–$907.81	49% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$1,503.52	$1,503.52	$105.25–$1,503.52	200% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age 21+	$1,503.52	$1,503.52	$107.32	200% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age Under 21	$1,503.52	$1,503.52	$109.27	200% above	—
Barium swallow (esophagus X-ray with contrast) CPT 74220 Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study	$1,503.52	$1,503.52	$341.20–$401.74	200% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body Age Under 21	$7,776.02	$7,776.02	$308.74	348% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body Age 21+	$7,776.02	$7,776.02	$303.23	348% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body	$7,776.02	$7,776.02	$471.74–$848.52	348% above	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$7,776.02	$7,776.02	$544.32–$7,776.02	348% above	—
Breast ultrasound, complete, one breast CPT 76641 US BRST UNI W AX COMP	$1,326.44	$1,326.44	$92.85–$1,326.44	200% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI LT W AX COMP	$1,326.44	$1,326.44	$92.85–$1,326.44	200% above	—
Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI RT W AX COMP	$1,326.44	$1,326.44	$92.85–$1,326.44	200% above	—
Breast ultrasound, limited (one breast or one area) CPT 76642 US BRST UNI W AX LTD	$816.70	$816.70	$57.17–$816.70	119% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI LT W AX LTD	$816.70	$816.70	$57.17–$816.70	119% above	—
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI RT W AX LTD	$816.70	$816.70	$57.17–$816.70	119% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing	$7,143.02	$7,143.02	$341.20–$401.74	152% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$7,143.02	$7,143.02	$500.01–$7,143.02	152% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing Age 21+	$7,143.02	$7,143.02	$192.57	152% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing Age Under 21	$7,143.02	$7,143.02	$196.07	152% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Computed tomography, abdomen and pelvis; without contrast material Age 21+	$12,559.01	$12,559.01	$206.92	274% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Computed tomography, abdomen and pelvis; without contrast material Age Under 21	$12,559.01	$12,559.01	$210.68	274% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Computed tomography, abdomen and pelvis; without contrast material	$12,559.01	$12,559.01	$313.62–$517.79	274% above	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PELVIS W/O CONT	$12,559.01	$12,559.01	$879.13–$12,559.01	274% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Computed tomography, abdomen and pelvis; with contrast material(s)	$15,106.57	$15,106.57	$312.08–$1,630.50	288% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PELVIS W/CONT	$15,106.57	$15,106.57	$1,057.46–$15,106.57	288% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Computed tomography, abdomen and pelvis; with contrast material(s) Age 21+	$15,106.57	$15,106.57	$343.29	288% above	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Computed tomography, abdomen and pelvis; with contrast material(s) Age Under 21	$15,106.57	$15,106.57	$349.53	288% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions Age Under 21	$17,882.15	$17,882.15	$392.20	329% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions	$17,882.15	$17,882.15	$341.20–$828.27	329% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions Age 21+	$17,882.15	$17,882.15	$385.20	329% above	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS W&WO CONT	$17,882.15	$17,882.15	$1,251.75–$17,882.15	329% above	—
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT	$8,427.73	$8,427.73	$589.94–$8,427.73	223% above	—
CT scan of the abdomen with contrast CPT 74160 Computed tomography, abdomen; with contrast material(s)	$8,427.73	$8,427.73	$341.20–$401.74	223% above	—
CT scan of the abdomen with contrast CPT 74160 Computed tomography, abdomen; with contrast material(s) Age Under 21	$8,427.73	$8,427.73	$196.07	223% above	—
CT scan of the abdomen with contrast CPT 74160 Computed tomography, abdomen; with contrast material(s) Age 21+	$8,427.73	$8,427.73	$192.57	223% above	—
CT scan of the abdomen without contrast CPT 74150 Computed tomography, abdomen; without contrast material Age 21+	$7,106.17	$7,106.17	$115.23	247% above	—
CT scan of the abdomen without contrast CPT 74150 Computed tomography, abdomen; without contrast material	$7,106.17	$7,106.17	$104.75–$1,013.00	247% above	—
CT scan of the abdomen without contrast CPT 74150 Computed tomography, abdomen; without contrast material Age Under 21	$7,106.17	$7,106.17	$117.32	247% above	—
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$7,106.17	$7,106.17	$497.43–$7,106.17	247% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIFAC W/O CNT	$2,959.89	$2,959.89	$207.19–$2,959.89	78% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Computed tomography, maxillofacial area; without contrast material Age Under 21	$2,959.89	$2,959.89	$117.32	78% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Computed tomography, maxillofacial area; without contrast material Age 21+	$2,959.89	$2,959.89	$115.23	78% above	—
CT scan of the face and sinuses, no contrast dye CPT 70486 Computed tomography, maxillofacial area; without contrast material	$2,959.89	$2,959.89	$154.52–$245.18	78% above	—
CT scan of the head or brain, no contrast dye CPT 70450 Computed tomography, head or brain; without contrast material	$5,593.46	$5,593.46	$154.52–$245.18	193% above	—
CT scan of the head or brain, no contrast dye CPT 70450 Computed tomography, head or brain; without contrast material Age 21+	$5,593.46	$5,593.46	$115.23	193% above	—
CT scan of the head or brain, no contrast dye CPT 70450 Computed tomography, head or brain; without contrast material Age Under 21	$5,593.46	$5,593.46	$117.32	193% above	—
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT	$5,593.46	$5,593.46	$391.54–$5,593.46	193% above	—
CT scan of the head with contrast CPT 70460 Computed tomography, head or brain; with contrast material(s)	$6,590.10	$6,590.10	$152.36–$1,013.00	274% above	—
CT scan of the head with contrast CPT 70460 Computed tomography, head or brain; with contrast material(s) Age Under 21	$6,590.10	$6,590.10	$170.64	274% above	—
CT scan of the head with contrast CPT 70460 Computed tomography, head or brain; with contrast material(s) Age 21+	$6,590.10	$6,590.10	$167.60	274% above	—
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONT	$6,590.10	$6,590.10	$461.31–$6,590.10	274% above	—
CT scan of the head without and with contrast CPT 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections	$7,742.37	$7,742.37	$175.06–$1,013.00	236% above	—
CT scan of the head without and with contrast CPT 70470 CT HD/BR W&W/O CONT	$7,742.37	$7,742.37	$541.97–$7,742.37	236% above	—
CT scan of the head without and with contrast CPT 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections Age Under 21	$7,742.37	$7,742.37	$196.07	236% above	—
CT scan of the head without and with contrast CPT 70470 Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections Age 21+	$7,742.37	$7,742.37	$192.57	236% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Computed tomography, lumbar spine; without contrast material	$5,658.99	$5,658.99	$104.75–$1,013.00	175% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST	$5,658.99	$5,658.99	$396.13–$5,658.99	175% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Computed tomography, lumbar spine; without contrast material Age 21+	$5,658.99	$5,658.99	$115.23	175% above	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Computed tomography, lumbar spine; without contrast material Age Under 21	$5,658.99	$5,658.99	$117.32	175% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST	$5,658.99	$5,658.99	$396.13–$5,658.99	169% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Computed tomography, cervical spine; without contrast material	$5,658.99	$5,658.99	$154.52–$245.18	169% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Computed tomography, cervical spine; without contrast material Age 21+	$5,658.99	$5,658.99	$115.23	169% above	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Computed tomography, cervical spine; without contrast material Age Under 21	$5,658.99	$5,658.99	$117.32	169% above	—
CT scan of the pelvis, with contrast dye CPT 72193 Computed tomography, pelvis; with contrast material(s) Age 21+	$6,680.21	$6,680.21	$192.57	204% above	—
CT scan of the pelvis, with contrast dye CPT 72193 Computed tomography, pelvis; with contrast material(s)	$6,680.21	$6,680.21	$341.20–$401.74	204% above	—
CT scan of the pelvis, with contrast dye CPT 72193 Computed tomography, pelvis; with contrast material(s) Age Under 21	$6,680.21	$6,680.21	$196.07	204% above	—
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$6,680.21	$6,680.21	$467.61–$6,680.21	204% above	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex scan of extracranial arteries; complete bilateral study	$4,345.74	$4,345.74	$191.46–$929.00	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex scan of extracranial arteries; complete bilateral study Age 21+	$4,345.74	$4,345.74	$210.61	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex scan of extracranial arteries; complete bilateral study Age Under 21	$4,345.74	$4,345.74	$214.44	—	—
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUP EXTRACRANIAL BIL	$4,345.74	$4,345.74	$304.20–$4,345.74	221% above	—
Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 V	$1,187.71	$1,187.71	$83.14–$1,187.71	202% above	—
Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views	$1,187.71	$1,187.71	$83.86–$182.03	202% above	—
Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views Age 21+	$1,187.71	$1,187.71	$37.13	202% above	—
Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views Age Under 21	$1,187.71	$1,187.71	$37.80	202% above	—
Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view Age 21+	$757.05	$757.05	$28.30	134% above	—
Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view Age Under 21	$757.05	$757.05	$28.82	134% above	—
Chest X-ray, single view CPT 71045 CHEST XRAY 1 V	$757.05	$757.05	$52.99–$757.05	134% above	—
Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view	$757.05	$757.05	$83.86–$182.03	134% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COM	$2,033.62	$2,033.62	$142.35–$2,033.62	175% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete	$2,033.62	$2,033.62	$154.52–$245.18	175% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete Age Under 21	$2,033.62	$2,033.62	$117.32	175% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete Age 21+	$2,033.62	$2,033.62	$115.23	175% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)	$841.67	$841.67	$39.09–$156.61	102% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) Age 21+	$841.67	$841.67	$43.00	102% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) Age Under 21	$841.67	$841.67	$43.78	102% above	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$841.67	$841.67	$58.92–$841.67	102% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Computed tomography, thorax, diagnostic; without contrast material Age Under 21	$5,365.47	$5,365.47	$117.32	219% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Computed tomography, thorax, diagnostic; without contrast material Age 21+	$5,365.47	$5,365.47	$115.23	219% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Computed tomography, thorax, diagnostic; without contrast material	$5,365.47	$5,365.47	$154.52–$245.18	219% above	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$5,365.47	$5,365.47	$375.58–$5,365.47	219% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Computed tomography, thorax, diagnostic; with contrast material(s) Age 21+	$6,139.57	$6,139.57	$188.91	183% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Computed tomography, thorax, diagnostic; with contrast material(s) Age Under 21	$6,139.57	$6,139.57	$192.35	183% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST	$6,139.57	$6,139.57	$429.77–$6,139.57	183% above	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Computed tomography, thorax, diagnostic; with contrast material(s)	$6,139.57	$6,139.57	$341.20–$401.74	183% above	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG CAD BI	$1,367.01	$1,367.01	$95.69–$1,367.01	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral Other Outpatient	$1,367.01	$1,367.01	$114.38	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral	$1,367.01	$1,367.01	$118.73	—	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI RT	$1,176.37	$1,176.37	$82.35–$1,176.37	331% above	—
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI LT	$1,176.37	$1,176.37	$82.35–$1,176.37	331% above	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21	$4,345.74	$4,345.74	$261.54	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age 21+	$4,345.74	$4,345.74	$256.87	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	$4,345.74	$4,345.74	$233.52–$1,181.92	—	—
Duplex ultrasound of the leg arteries, both legs CPT 93925 DUP LE ART BIL	$4,345.74	$4,345.74	$304.20–$4,345.74	140% above	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	$4,345.74	$4,345.74	$188.79–$929.00	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age Under 21	$4,345.74	$4,345.74	$211.44	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age 21+	$4,345.74	$4,345.74	$207.67	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 DUP VEIN BIL	$4,345.74	$4,345.74	$304.20–$4,345.74	118% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D COMP W CF DOP	$8,660.97	$8,660.97	$606.27–$8,660.97	269% above	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, complete, with spectral Doppler echocardiography, and with color flow Doppler echoc	$8,660.97	$8,660.97	$372.65–$1,514.00	269% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPA IMAG INCL GB	$4,239.57	$4,239.57	$296.77–$4,239.57	165% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present;	$4,239.57	$4,239.57	$471.74–$848.52	165% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present; Age Under 21	$4,239.57	$4,239.57	$339.43	165% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present; Age 21+	$4,239.57	$4,239.57	$333.37	165% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V RT	$1,220.94	$1,220.94	$85.47–$1,220.94	202% above	—
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V LT	$1,220.94	$1,220.94	$85.47–$1,220.94	202% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD	$1,561.72	$1,561.72	$109.32–$1,561.72	148% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)	$1,561.72	$1,561.72	$87.21–$502.12	148% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) Age 21+	$1,561.72	$1,561.72	$95.93	148% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) Age Under 21	$1,561.72	$1,561.72	$97.68	148% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT LT	$8,521.13	$8,521.13	$596.48–$8,521.13	281% above	—
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT RT	$8,521.13	$8,521.13	$596.48–$8,521.13	281% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LW JNT W&WO CONT LT	$10,844.07	$10,844.07	$759.08–$10,844.07	242% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LW JNT W&WO CONT RT	$10,844.07	$10,844.07	$759.08–$10,844.07	242% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) Age 21+	$8,521.13	$8,521.13	$221.99	286% above	—
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT	$8,521.13	$8,521.13	$596.48–$8,521.13	286% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)	$8,521.13	$8,521.13	$313.62–$517.79	286% above	—
MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) Age Under 21	$8,521.13	$8,521.13	$226.03	286% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences	$10,844.07	$10,844.07	$616.10–$828.27	237% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONT	$10,844.07	$10,844.07	$759.08–$10,844.07	237% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences Age Under 21	$10,844.07	$10,844.07	$390.32	237% above	—
MRI of the abdomen, without and then with contrast dye CPT 74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences Age 21+	$10,844.07	$10,844.07	$383.35	237% above	—
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$7,289.34	$7,289.34	$510.25–$7,289.34	233% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material Age Under 21	$7,289.34	$7,289.34	$226.41	233% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material	$7,289.34	$7,289.34	$313.62–$517.79	233% above	—
MRI of the brain, no contrast dye CPT 70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material Age 21+	$7,289.34	$7,289.34	$222.37	233% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences Age 21+	$12,336.83	$12,336.83	$360.92	308% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences Age Under 21	$12,336.83	$12,336.83	$367.48	308% above	—
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONT	$12,336.83	$12,336.83	$863.58–$12,336.83	308% above	—
MRI of the brain, with and without contrast dye CPT 70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences	$12,336.83	$12,336.83	$328.11–$1,630.50	308% above	—
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT	$7,178.46	$7,178.46	$502.49–$7,178.46	214% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Age 21+	$7,178.46	$7,178.46	$216.85	214% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material Age Under 21	$7,178.46	$7,178.46	$220.80	214% above	—
MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material	$7,178.46	$7,178.46	$313.62–$517.79	214% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar	$11,386.28	$11,386.28	$616.10–$828.27	256% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar Age Under 21	$11,386.28	$11,386.28	$368.63	256% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar Age 21+	$11,386.28	$11,386.28	$362.04	256% above	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&W/O CONT	$11,386.28	$11,386.28	$797.04–$11,386.28	256% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material	$6,245.49	$6,245.49	$313.62–$517.79	191% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT	$6,245.49	$6,245.49	$437.18–$6,245.49	191% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material Age 21+	$6,245.49	$6,245.49	$215.75	191% above	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material Age Under 21	$6,245.49	$6,245.49	$219.68	191% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical Age Under 21	$12,336.83	$12,336.83	$369.36	278% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical Age 21+	$12,336.83	$12,336.83	$362.77	278% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical	$12,336.83	$12,336.83	$616.10–$828.27	278% above	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&W/O CONT	$12,336.83	$12,336.83	$863.58–$12,336.83	278% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT	$7,178.46	$7,178.46	$502.49–$7,178.46	210% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material Age 21+	$7,178.46	$7,178.46	$216.13	210% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material	$7,178.46	$7,178.46	$313.62–$517.79	210% above	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material Age Under 21	$7,178.46	$7,178.46	$220.06	210% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences Age 21+	$10,844.07	$10,844.07	$381.88	221% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences Age Under 21	$10,844.07	$10,844.07	$388.82	221% above	—
MRI of the pelvis without and with contrast CPT 72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences	$10,844.07	$10,844.07	$616.10–$828.27	221% above	—
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&WO CONT	$10,844.07	$10,844.07	$759.08–$10,844.07	221% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)	$7,316.38	$7,316.38	$313.62–$517.79	198% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) Age 21+	$7,316.38	$7,316.38	$256.82	198% above	—
MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) Age Under 21	$7,316.38	$7,316.38	$261.49	198% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT	$7,316.38	$7,316.38	$512.15–$7,316.38	198% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT LT	$8,521.13	$8,521.13	$596.48–$8,521.13	280% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT RT	$8,521.13	$8,521.13	$596.48–$8,521.13	280% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCRD SPECT R/S MULT	$11,733.37	$11,733.37	$821.34–$11,733.37	170% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat	$11,733.37	$11,733.37	$1,623.62–$2,938.37	170% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat Age 21+	$11,733.37	$11,733.37	$481.86	170% above	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantificat Age Under 21	$11,733.37	$11,733.37	$490.62	170% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) Age 21+	$1,892.98	$1,892.98	$55.87	292% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)	$1,892.98	$1,892.98	$154.52–$245.18	292% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) Age Under 21	$1,892.98	$1,892.98	$56.88	292% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD OR FU	$1,892.98	$1,892.98	$132.51–$1,892.98	292% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age 21+	$2,497.39	$2,497.39	$105.91	190% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete	$2,497.39	$2,497.39	$154.52–$245.18	190% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21	$2,497.39	$2,497.39	$107.83	190% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$2,497.39	$2,497.39	$174.82–$2,497.39	190% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRI	$2,497.39	$2,497.39	$174.82–$2,497.39	283% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation Age 21+	$2,497.39	$2,497.39	$115.23	283% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation Age Under 21	$2,497.39	$2,497.39	$117.32	283% above	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation	$2,497.39	$2,497.39	$104.75–$486.66	283% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation Age Under 21	$2,010.62	$2,010.62	$117.32	227% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation	$2,010.62	$2,010.62	$154.52–$245.18	227% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMTR	$2,010.62	$2,010.62	$140.74–$2,010.62	227% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation Age 21+	$2,010.62	$2,010.62	$115.23	227% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses Age 21+	$1,892.98	$1,892.98	$89.32	312% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD	$1,892.98	$1,892.98	$132.51–$1,892.98	312% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses Age Under 21	$1,892.98	$1,892.98	$90.94	312% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses	$1,892.98	$1,892.98	$154.52–$245.18	312% above	—
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR CAD BI	$653.09	$653.09	$45.72–$653.09	—	—
Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed Other Outpatient	$653.09	$653.09	$94.36	—	—
Screening mammogram, both breasts both sides CPT 77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed	$653.09	$653.09	$97.96	—	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V LT	$1,027.54	$1,027.54	$71.93–$1,027.54	198% above	—
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V RT	$1,027.54	$1,027.54	$71.93–$1,027.54	198% above	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or	$9,082.74	$9,082.74	$411.29–$1,514.00	234% above	—
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS W CONT ECG	$9,082.74	$9,082.74	$635.79–$9,082.74	234% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study Age 21+	$1,638.00	$1,638.00	$137.46	173% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study	$1,638.00	$1,638.00	$154.52–$401.74	173% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study Age Under 21	$1,638.00	$1,638.00	$139.96	173% above	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLW FUNC W/C&V	$1,638.00	$1,638.00	$114.66–$1,638.00	173% above	—
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$2,497.39	$2,497.39	$174.82–$2,497.39	288% above	—
Transvaginal pelvic ultrasound CPT 76830 Ultrasound, transvaginal Age Under 21	$2,497.39	$2,497.39	$117.32	288% above	—
Transvaginal pelvic ultrasound CPT 76830 Ultrasound, transvaginal Age 21+	$2,497.39	$2,497.39	$115.23	288% above	—
Transvaginal pelvic ultrasound CPT 76830 Ultrasound, transvaginal	$2,497.39	$2,497.39	$154.52–$245.18	288% above	—
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UT TRANSVAGINAL	$575.19	$575.19	$40.26–$575.19	12% above	—
Transvaginal ultrasound during pregnancy CPT 76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal	$575.19	$575.19	$92.89–$502.12	12% above	—
Transvaginal ultrasound during pregnancy CPT 76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal Age Under 21	$575.19	$575.19	$104.04	12% above	—
Transvaginal ultrasound during pregnancy CPT 76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal Age 21+	$575.19	$575.19	$102.18	12% above	—
Ultrasound of the abdomen, complete CPT 76700 Ultrasound, abdominal, real time with image documentation; complete	$2,497.39	$2,497.39	$104.75–$502.12	189% above	—
Ultrasound of the abdomen, complete CPT 76700 Ultrasound, abdominal, real time with image documentation; complete Age 21+	$2,497.39	$2,497.39	$115.23	189% above	—
Ultrasound of the abdomen, complete CPT 76700 Ultrasound, abdominal, real time with image documentation; complete Age Under 21	$2,497.39	$2,497.39	$117.32	189% above	—
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$2,497.39	$2,497.39	$174.82–$2,497.39	189% above	—
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CNTS	$2,183.71	$2,183.71	$152.86–$2,183.71	256% above	—
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound, scrotum and contents Age Under 21	$2,183.71	$2,183.71	$112.27	256% above	—
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound, scrotum and contents	$2,183.71	$2,183.71	$154.52–$245.18	256% above	—
Ultrasound of the scrotum and testicles CPT 76870 Ultrasound, scrotum and contents Age 21+	$2,183.71	$2,183.71	$110.26	256% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation Age 21+	$2,510.92	$2,510.92	$115.23	298% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation	$2,510.92	$2,510.92	$104.75–$502.12	298% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD AND NECK	$2,510.92	$2,510.92	$175.76–$2,510.92	298% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation Age Under 21	$2,510.92	$2,510.92	$117.32	298% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SNGL CONTRAST	$2,375.43	$2,375.43	$166.28–$2,375.43	223% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study	$2,375.43	$2,375.43	$341.20–$401.74	223% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age 21+	$2,375.43	$2,375.43	$135.26	223% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study Age Under 21	$2,375.43	$2,375.43	$137.72	223% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP VEIN UNI/LTD	$4,345.74	$4,345.74	$304.20–$4,345.74	441% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age 21+	$4,345.74	$4,345.74	$117.57	441% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age Under 21	$4,345.74	$4,345.74	$119.71	441% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	$4,345.74	$4,345.74	$106.88–$929.00	441% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V LT	$1,045.67	$1,045.67	$73.20–$1,045.67	172% above	—
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V RT	$1,045.67	$1,045.67	$73.20–$1,045.67	172% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP W PEL UN 2-3 VIEW	$1,508.06	$1,508.06	$105.56–$1,508.06	273% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W PEL UN 2-3 V LT	$1,508.06	$1,508.06	$105.56–$1,508.06	273% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP W PEL UN 2-3 V RT	$1,508.06	$1,508.06	$105.56–$1,508.06	273% above	—
X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view Age 21+	$619.54	$619.54	$33.44	83% above	—
X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view Age Under 21	$619.54	$619.54	$34.05	83% above	—
X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view	$619.54	$619.54	$83.86–$182.03	83% above	—
X-ray of the abdomen, 1 view CPT 74018 ABD XR 1V	$619.54	$619.54	$43.37–$619.54	83% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$1,169.58	$1,169.58	$81.87–$1,169.58	289% above	—
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$1,169.58	$1,169.58	$81.87–$1,169.58	289% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V LT	$692.08	$692.08	$48.45–$692.08	162% above	—
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V RT	$692.08	$692.08	$48.45–$692.08	162% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V RT	$847.72	$847.72	$59.34–$847.72	128% above	—
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V LT	$847.72	$847.72	$59.34–$847.72	128% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V RT	$847.72	$847.72	$59.34–$847.72	117% above	—
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V LT	$847.72	$847.72	$59.34–$847.72	117% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V LT	$921.76	$921.76	$64.52–$921.76	213% above	—
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V RT	$921.76	$921.76	$64.52–$921.76	213% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VIEWS	$1,349.40	$1,349.40	$94.46–$1,349.40	189% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination, spine, lumbosacral; 2 or 3 views	$1,349.40	$1,349.40	$154.52–$245.18	189% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination, spine, lumbosacral; 2 or 3 views Age 21+	$1,349.40	$1,349.40	$44.11	189% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21	$1,349.40	$1,349.40	$44.91	189% above	—
X-ray of the lower back, 4 or more views CPT 72110 Radiologic examination, spine, lumbosacral; minimum of 4 views Age Under 21	$1,702.98	$1,702.98	$58.39	172% above	—
X-ray of the lower back, 4 or more views CPT 72110 Radiologic examination, spine, lumbosacral; minimum of 4 views	$1,702.98	$1,702.98	$154.52–$245.18	172% above	—
X-ray of the lower back, 4 or more views CPT 72110 Radiologic examination, spine, lumbosacral; minimum of 4 views Age 21+	$1,702.98	$1,702.98	$57.34	172% above	—
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4 + VIEWS	$1,702.98	$1,702.98	$119.21–$1,702.98	172% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination, spine; thoracic, 2 views Age Under 21	$1,024.51	$1,024.51	$37.05	154% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS	$1,024.51	$1,024.51	$71.72–$1,024.51	154% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination, spine; thoracic, 2 views	$1,024.51	$1,024.51	$154.52–$245.18	154% above	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination, spine; thoracic, 2 views Age 21+	$1,024.51	$1,024.51	$36.39	154% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination, nasal bones, complete, minimum of 3 views Age 21+	$862.84	$862.84	$41.54	196% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination, nasal bones, complete, minimum of 3 views	$862.84	$862.84	$83.86–$182.03	196% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP	$862.84	$862.84	$60.40–$862.84	196% above	—
X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21	$862.84	$862.84	$42.29	196% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radiologic examination, spine, cervical; 2 or 3 views	$1,134.82	$1,134.82	$83.86–$182.03	204% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS	$1,134.82	$1,134.82	$79.44–$1,134.82	204% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radiologic examination, spine, cervical; 2 or 3 views Age Under 21	$1,134.82	$1,134.82	$44.53	204% above	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radiologic examination, spine, cervical; 2 or 3 views Age 21+	$1,134.82	$1,134.82	$43.74	204% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic examination, pelvis; 1 or 2 views Age 21+	$884.00	$884.00	$30.87	138% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic examination, pelvis; 1 or 2 views Age Under 21	$884.00	$884.00	$31.43	138% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic examination, pelvis; 1 or 2 views	$884.00	$884.00	$154.52–$245.18	138% above	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS	$884.00	$884.00	$61.88–$884.00	138% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination, sacrum and coccyx, minimum of 2 views Age 21+	$998.82	$998.82	$36.03	205% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination, sacrum and coccyx, minimum of 2 views Age Under 21	$998.82	$998.82	$36.68	205% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination, sacrum and coccyx, minimum of 2 views	$998.82	$998.82	$83.86–$182.03	205% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 + V	$998.82	$998.82	$69.92–$998.82	205% above	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT) Age Under 21	$379.60	$379.60	$4.98	546% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT) Age 21+	$379.60	$379.60	$4.90	546% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT) Other Outpatient	$379.60	$379.60	$5.57	546% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Transferase; alanine amino (ALT) (SGPT)	$379.60	$379.60	$5.30	546% above	—
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$379.60	$379.60	$26.57–$379.60	546% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) Other Outpatient	$379.60	$379.60	$5.44	555% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$379.60	$379.60	$26.57–$379.60	555% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) Age 21+	$379.60	$379.60	$4.79	555% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) Age Under 21	$379.60	$379.60	$4.87	555% above	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT)	$379.60	$379.60	$5.18	555% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA	$1,312.97	$1,312.97	$47.63	239% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$1,312.97	$1,312.97	$91.91–$1,312.97	239% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA Other Outpatient	$1,312.97	$1,312.97	$50.01	239% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA Age 21+	$1,312.97	$1,312.97	$8.89	239% above	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsA Age Under 21	$1,312.97	$1,312.97	$9.05	239% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Age 21+	$321.55	$321.55	$4.82	1060% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each	$321.55	$321.55	$5.69	1060% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Age Under 21	$321.55	$321.55	$4.91	1060% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each Other Outpatient	$321.55	$321.55	$5.48	1060% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH	$321.55	$321.55	$22.51–$321.55	1060% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$473.38	$473.38	$33.14–$473.38	670% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Age Under 21	$473.38	$473.38	$12.19	670% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Age 21+	$473.38	$473.38	$11.97	670% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody Other Outpatient	$473.38	$473.38	$13.60	670% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody	$473.38	$473.38	$14.12	670% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BODY FLUID QL	$422.76	$422.76	$29.59–$422.76	378% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUAL SCREEN	$686.24	$686.24	$48.04–$686.24	676% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$1,574.95	$1,574.95	$110.25–$1,574.95	747% above	—
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium	$1,333.79	$1,333.79	$8.46	455% above	—
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium Other Outpatient	$1,333.79	$1,333.79	$8.88	455% above	—
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium Age Under 21	$1,333.79	$1,333.79	$10.91	455% above	—
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium Age 21+	$1,333.79	$1,333.79	$10.71	455% above	—
Basic metabolic panel (blood test) CPT 80048 BMP TOTAL CALCIUM	$1,333.79	$1,333.79	$93.37–$1,333.79	455% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level IV - Surgical pathology, gross and microscopic examination Abortion - spontaneous/missed Artery, biopsy Bone marrow, biopsy Bone exostosis Brain/meninges, other than for tumor resection Breast,	$1,225.12	$1,225.12	$49.76	312% above	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4	$1,225.12	$1,225.12	$85.76–$1,225.12	312% above	—
Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) Age 21+	$592.47	$592.47	$9.54	150% above	—
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$592.47	$592.47	$41.47–$592.47	150% above	—
Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)	$592.47	$592.47	$11.25	150% above	—
Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) Other Outpatient	$592.47	$592.47	$10.84	150% above	—
Blood culture for bacteria CPT 87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate) Age Under 21	$592.47	$592.47	$9.71	150% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture Other Outpatient	$62.52	$62.52	$9.81	216% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$62.52	$62.52	$4.38–$62.52	216% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection of venous blood by venipuncture	$62.52	$62.52	$3.00	216% above	—
Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip) Other Outpatient	$446.59	$446.59	$4.13	905% above	—
Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip) Age 21+	$446.59	$446.59	$3.63	905% above	—
Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN	$446.59	$446.59	$31.26–$446.59	905% above	—
Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip)	$446.59	$446.59	$3.93	905% above	—
Blood glucose (sugar) test CPT 82947 Glucose; quantitative, blood (except reagent strip) Age Under 21	$446.59	$446.59	$3.70	905% above	—
Blood lead test CPT 83655 LEAD BLOOD	$337.92	$337.92	$23.65–$337.92	537% above	—
Blood lead test CPT 83655 LEAD URINE	$918.47	$918.47	$64.29–$918.47	1632% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM	$774.08	$774.08	$54.19–$774.08	463% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin, chorionic (hCG); qualitative	$774.08	$774.08	$8.20	463% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin, chorionic (hCG); qualitative Age 21+	$774.08	$774.08	$6.95	463% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin, chorionic (hCG); qualitative Other Outpatient	$774.08	$774.08	$7.90	463% above	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Gonadotropin, chorionic (hCG); qualitative Age Under 21	$774.08	$774.08	$7.08	463% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO Other Outpatient	$282.86	$282.86	$3.14	220% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO Age Under 21	$282.86	$282.86	$2.81	220% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO Age 21+	$282.86	$282.86	$2.76	220% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$282.86	$282.86	$19.80–$282.86	220% above	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood typing, serologic; ABO	$282.86	$282.86	$3.26	220% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein; Age 21+	$330.47	$330.47	$4.79	467% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$330.47	$330.47	$23.13–$330.47	467% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein; Age Under 21	$330.47	$330.47	$4.87	467% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein; Other Outpatient	$330.47	$330.47	$5.44	467% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein;	$330.47	$330.47	$5.65	467% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX B NAP1 ST AMP	$797.91	$797.91	$55.85–$797.91	348% above	—
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE AMP PROB	$797.91	$797.91	$55.85–$797.91	348% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9	$418.30	$418.30	$22.68	208% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Other Outpatient	$418.30	$418.30	$21.85	208% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Age Under 21	$418.30	$418.30	$19.58	208% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay for tumor antigen, quantitative; CA 19-9 Age 21+	$418.30	$418.30	$19.23	208% above	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QN	$418.30	$418.30	$29.28–$418.30	208% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 FLUID QN	$455.52	$455.52	$31.89–$455.52	184% above	—
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QN	$989.92	$989.92	$69.29–$989.92	517% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 DNA/RNA AMP	$67.61	$67.61	$4.73–$67.61	24% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Age Under 21	$67.61	$67.61	$48.27	24% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Age 21+	$67.61	$67.61	$47.41	24% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique Other Outpatient	$67.61	$67.61	$53.88	24% below	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease ºCOVID-19»), amplified probe technique	$67.61	$67.61	$55.93	24% below	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other Outpatient	$599.91	$599.91	$36.84	376% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Age 21+	$599.91	$599.91	$32.43	376% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Age Under 21	$599.91	$599.91	$33.02	376% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE	$599.91	$599.91	$41.99–$599.91	376% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique	$599.91	$599.91	$38.25	376% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) Age Under 21	$1,245.97	$1,245.97	$8.58	539% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) Age 21+	$1,245.97	$1,245.97	$8.43	539% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$1,245.97	$1,245.97	$87.22–$1,245.97	539% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478) Other Outpatient	$1,245.97	$1,245.97	$14.06	539% above	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)	$1,245.97	$1,245.97	$13.39	539% above	—
Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) Other Outpatient	$766.65	$766.65	$6.79	703% above	—
Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED	$766.65	$766.65	$53.67–$766.65	703% above	—
Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)	$766.65	$766.65	$7.05	703% above	—
Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) Age Under 21	$766.65	$766.65	$6.08	703% above	—
Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) Age 21+	$766.65	$766.65	$5.97	703% above	—
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$1,673.20	$1,673.20	$117.12–$1,673.20	463% above	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8 Age 21+	$1,673.20	$1,673.20	$10.36	463% above	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8 Age Under 21	$1,673.20	$1,673.20	$10.55	463% above	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8	$1,673.20	$1,673.20	$10.56	463% above	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8 Other Outpatient	$1,673.20	$1,673.20	$11.09	463% above	—
D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products, D-dimer; quantitative Age 21+	$1,580.92	$1,580.92	$9.41	803% above	—
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$1,580.92	$1,580.92	$110.66–$1,580.92	803% above	—
D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products, D-dimer; quantitative Age Under 21	$1,580.92	$1,580.92	$9.58	803% above	—
D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products, D-dimer; quantitative Other Outpatient	$1,580.92	$1,580.92	$10.69	803% above	—
D-dimer blood test (blood clot marker) CPT 85379 Fibrin degradation products, D-dimer; quantitative	$1,580.92	$1,580.92	$10.18	803% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$1,990.25	$1,990.25	$139.32–$1,990.25	1194% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Age Under 21	$1,990.25	$1,990.25	$20.91	1194% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Age 21+	$1,990.25	$1,990.25	$20.54	1194% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S) Other Outpatient	$1,990.25	$1,990.25	$23.34	1194% above	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone-sulfate (DHEA-S)	$1,990.25	$1,990.25	$22.23	1194% above	—
Estradiol blood test CPT 82670 Estradiol; total Age 21+	$2,000.68	$2,000.68	$25.82	1279% above	—
Estradiol blood test CPT 82670 Estradiol; total Other Outpatient	$2,000.68	$2,000.68	$29.34	1279% above	—
Estradiol blood test CPT 82670 Estradiol; total	$2,000.68	$2,000.68	$30.45	1279% above	—
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$2,000.68	$2,000.68	$140.05–$2,000.68	1279% above	—
Estradiol blood test CPT 82670 Estradiol; total Age Under 21	$2,000.68	$2,000.68	$26.29	1279% above	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$1,574.95	$1,574.95	$110.25–$1,574.95	884% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Age 21+	$1,574.95	$1,574.95	$17.17	884% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Age Under 21	$1,574.95	$1,574.95	$17.48	884% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH)	$1,574.95	$1,574.95	$20.25	884% above	—
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin; follicle stimulating hormone (FSH) Other Outpatient	$1,574.95	$1,574.95	$19.51	884% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal Age Under 21	$672.86	$672.86	$18.47	215% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$672.86	$672.86	$47.10–$672.86	215% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal	$672.86	$672.86	$21.40	215% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal Other Outpatient	$672.86	$672.86	$20.61	215% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal Age 21+	$672.86	$672.86	$18.14	215% above	—
Ferritin blood test (iron stores) CPT 82728 Ferritin	$512.08	$512.08	$14.86	395% above	—
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$512.08	$512.08	$35.85–$512.08	395% above	—
Ferritin blood test (iron stores) CPT 82728 Ferritin Other Outpatient	$512.08	$512.08	$14.31	395% above	—
Ferritin blood test (iron stores) CPT 82728 Ferritin Age 21+	$512.08	$512.08	$12.60	395% above	—
Ferritin blood test (iron stores) CPT 82728 Ferritin Age Under 21	$512.08	$512.08	$12.82	395% above	—
Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) SER	$464.46	$464.46	$32.51–$464.46	391% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum Other Outpatient	$464.46	$464.46	$15.44	391% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum Age Under 21	$464.46	$464.46	$13.83	391% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum	$464.46	$464.46	$16.02	391% above	—
Folate (folic acid) blood test CPT 82746 Folic acid; serum Age 21+	$464.46	$464.46	$13.59	391% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Other Outpatient	$588.00	$588.00	$17.79	317% above	—
Free T3 thyroid hormone test CPT 84481 T3 FREE	$588.00	$588.00	$41.16–$588.00	317% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Age 21+	$588.00	$588.00	$15.65	317% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free Age Under 21	$588.00	$588.00	$15.94	317% above	—
Free T3 thyroid hormone test CPT 84481 Triiodothyronine T3; free	$588.00	$588.00	$16.94	317% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Age Under 21	$537.40	$537.40	$8.49	508% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Other Outpatient	$537.40	$537.40	$9.47	508% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$537.40	$537.40	$37.62–$537.40	508% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free	$537.40	$537.40	$9.83	508% above	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine; free Age 21+	$537.40	$537.40	$8.34	508% above	—
Free testosterone test CPT 84402 Testosterone; free Age Under 21	$943.77	$943.77	$23.96	754% above	—
Free testosterone test CPT 84402 Testosterone; free Age 21+	$943.77	$943.77	$23.53	754% above	—
Free testosterone test CPT 84402 Testosterone; free	$943.77	$943.77	$25.47	754% above	—
Free testosterone test CPT 84402 TESTOSTERONE FREE	$943.77	$943.77	$66.06–$943.77	754% above	—
Free testosterone test CPT 84402 Testosterone; free Other Outpatient	$943.77	$943.77	$26.74	754% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004)	$2,932.56	$2,932.56	$45.36	557% above	—
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GEN HEALTH PANEL	$2,932.56	$2,932.56	$2,199.42	557% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR W GLUCOLA	$613.33	$613.33	$42.93–$613.33	567% above	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HR W GLUCOLA	$613.33	$613.33	$42.93–$613.33	567% above	—
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$529.95	$529.95	$37.10–$529.95	249% above	—
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TT 1ST 3 SPEC	$1,180.46	$1,180.46	$82.63–$1,180.46	677% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique Other Outpatient	$599.91	$599.91	$36.84	324% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique	$599.91	$599.91	$35.09	324% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique Age 21+	$599.91	$599.91	$32.43	324% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique Age Under 21	$599.91	$599.91	$33.02	324% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE	$599.91	$599.91	$41.99–$599.91	324% above	—
H. pylori antibody blood test CPT 86677 H PYLORI AB QUAL	$285.83	$285.83	$20.01–$285.83	119% above	—
H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGA	$675.82	$675.82	$47.31–$675.82	417% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient	$1,296.57	$1,296.57	$15.10	1204% above	—
H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL	$1,296.57	$1,296.57	$90.76–$1,296.57	1204% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age Under 21	$1,296.57	$1,296.57	$13.53	1204% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$1,296.57	$1,296.57	$15.67	1204% above	—
H. pylori stool antigen test CPT 87338 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age 21+	$1,296.57	$1,296.57	$13.29	1204% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN	$2,852.17	$2,852.17	$199.65–$2,852.17	784% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed	$2,852.17	$2,852.17	$85.10	784% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Other Outpatient	$2,852.17	$2,852.17	$89.36	784% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Age Under 21	$2,852.17	$2,852.17	$80.06	784% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed Age 21+	$2,852.17	$2,852.17	$78.63	784% above	—
HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result Age 21+	$296.24	$296.24	$12.67	183% above	—
HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result	$296.24	$296.24	$14.94	183% above	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 AB QUAL	$296.24	$296.24	$20.74–$296.24	183% above	—
HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result Other Outpatient	$296.24	$296.24	$14.40	183% above	—
HIV-1 and HIV-2 antibody test CPT 86703 Antibody; HIV-1 and HIV-2, single result Age Under 21	$296.24	$296.24	$12.90	183% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age 21+	$296.24	$296.24	$22.25	110% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1AG HIV-1/2AB SINGLE	$296.24	$296.24	$20.74–$296.24	110% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age Under 21	$296.24	$296.24	$22.66	110% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient	$296.24	$296.24	$25.28	110% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$296.24	$296.24	$24.08	110% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$693.69	$693.69	$48.56–$693.69	653% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C) Age Under 21	$693.69	$693.69	$9.14	653% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C) Other Outpatient	$693.69	$693.69	$10.20	653% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C) Age 21+	$693.69	$693.69	$8.98	653% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin; glycosylated (A1C)	$693.69	$693.69	$10.58	653% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb) Age Under 21	$308.15	$308.15	$10.10	368% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb) Other Outpatient	$308.15	$308.15	$11.28	368% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUAL	$308.15	$308.15	$21.57–$308.15	368% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb) Age 21+	$308.15	$308.15	$9.92	368% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B surface antibody (HBsAb)	$308.15	$308.15	$10.74	368% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC	$308.15	$308.15	$10.33	295% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age 21+	$308.15	$308.15	$9.55	295% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Age Under 21	$308.15	$308.15	$9.72	295% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B S AG EIA QL	$308.15	$308.15	$21.57–$308.15	295% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent assay ºELISA», fluorescence immunoassay ºFIA», immunochemiluminometric assay ºIMC Other Outpatient	$308.15	$308.15	$10.85	295% above	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody;	$829.16	$829.16	$15.55	853% above	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody; Other Outpatient	$829.16	$829.16	$14.98	853% above	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody; Age Under 21	$829.16	$829.16	$13.43	853% above	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody; Age 21+	$829.16	$829.16	$13.19	853% above	—
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB QUAL	$829.16	$829.16	$58.04–$829.16	853% above	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C DNA QN	$291.79	$291.79	$20.43–$291.79	1% below	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QN	$2,008.13	$2,008.13	$140.57–$2,008.13	582% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB IGG	$397.46	$397.46	$27.82–$397.46	404% above	—
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB QL	$654.99	$654.99	$45.85–$654.99	731% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGG	$622.23	$622.23	$43.56–$622.23	590% above	—
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB QL	$654.99	$654.99	$45.85–$654.99	626% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$519.55	$519.55	$36.37–$519.55	552% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) Other Outpatient	$519.55	$519.55	$13.60	552% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP)	$519.55	$519.55	$12.95	552% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) Age Under 21	$519.55	$519.55	$12.19	552% above	—
High-sensitivity CRP (hs-CRP) test CPT 86141 C-reactive protein; high sensitivity (hsCRP) Age 21+	$519.55	$519.55	$11.97	552% above	—
Homocysteine blood test CPT 83090 Homocysteine Other Outpatient	$1,241.49	$1,241.49	$18.82	728% above	—
Homocysteine blood test CPT 83090 HOMOCYSTEINE QN	$1,241.49	$1,241.49	$86.90–$1,241.49	728% above	—
Homocysteine blood test CPT 83090 Homocysteine	$1,241.49	$1,241.49	$19.53	728% above	—
Homocysteine blood test CPT 83090 Homocysteine Age Under 21	$1,241.49	$1,241.49	$16.86	728% above	—
Homocysteine blood test CPT 83090 Homocysteine Age 21+	$1,241.49	$1,241.49	$16.56	728% above	—
Insulin blood test CPT 83525 INSULIN TOTAL	$468.92	$468.92	$32.82–$468.92	458% above	—
Insulin blood test CPT 83525 Insulin; total Other Outpatient	$468.92	$468.92	$12.00	458% above	—
Insulin blood test CPT 83525 Insulin; total Age Under 21	$468.92	$468.92	$10.75	458% above	—
Insulin blood test CPT 83525 Insulin; total Age 21+	$468.92	$468.92	$10.56	458% above	—
Insulin blood test CPT 83525 Insulin; total	$468.92	$468.92	$12.46	458% above	—
Iron blood test (serum iron) CPT 83540 IRON	$330.47	$330.47	$23.13–$330.47	280% above	—
Iron blood test (serum iron) CPT 83540 IRON LIVER TISSUE QN	$501.68	$501.68	$35.12–$501.68	477% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Age Under 21	$346.85	$346.85	$8.22	254% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity	$346.85	$346.85	$8.74	254% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Age 21+	$346.85	$346.85	$8.07	254% above	—
Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity Other Outpatient	$346.85	$346.85	$9.18	254% above	—
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING (TIBC)	$346.85	$346.85	$24.28–$346.85	254% above	—
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$1,475.21	$1,475.21	$103.26–$1,475.21	732% above	—
Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i	$1,475.21	$1,475.21	$9.46	732% above	—
Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i Age 21+	$1,475.21	$1,475.21	$6.61	732% above	—
Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i Age Under 21	$1,475.21	$1,475.21	$6.73	732% above	—
Kidney function blood test panel CPT 80069 Renal function panel This panel must include the following: Albumin (82040) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus i Other Outpatient	$1,475.21	$1,475.21	$9.11	732% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Age Under 21	$1,338.27	$1,338.27	$17.43	785% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Age 21+	$1,338.27	$1,338.27	$17.12	785% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH) Other Outpatient	$1,338.27	$1,338.27	$19.45	785% above	—
LH (luteinizing hormone) test CPT 83002 LH	$1,338.27	$1,338.27	$93.68–$1,338.27	785% above	—
LH (luteinizing hormone) test CPT 83002 Gonadotropin; luteinizing hormone (LH)	$1,338.27	$1,338.27	$20.19	785% above	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Age Under 21	$668.39	$668.39	$6.48	604% above	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$668.39	$668.39	$7.51	604% above	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Other Outpatient	$668.39	$668.39	$7.23	604% above	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Age 21+	$668.39	$668.39	$6.37	604% above	—
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$668.39	$668.39	$46.79–$668.39	604% above	—
Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani Age 21+	$1,613.65	$1,613.65	$6.61	647% above	—
Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani	$1,613.65	$1,613.65	$8.91	647% above	—
Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani Age Under 21	$1,613.65	$1,613.65	$6.73	647% above	—
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$1,613.65	$1,613.65	$112.96–$1,613.65	647% above	—
Liver function blood test panel CPT 80076 Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alani Other Outpatient	$1,613.65	$1,613.65	$8.58	647% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB IGG QL	$680.29	$680.29	$47.62–$680.29	723% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB IGM QL	$1,877.14	$1,877.14	$131.40–$1,877.14	2170% above	—
Lyme disease antibody test CPT 86618 LYME DISEASE AB QL	$2,165.93	$2,165.93	$151.62–$2,165.93	2519% above	—
Magnesium blood test CPT 83735 MAGNESIUM BLD	$340.92	$340.92	$23.86–$340.92	587% above	—
Magnesium blood test CPT 83735 MAGNESIUM OTHER	$340.92	$340.92	$23.86–$340.92	587% above	—
Magnesium blood test CPT 83735 MAGNESIUM URINE	$340.92	$340.92	$23.86–$340.92	587% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$1,016.73	$1,016.73	$71.17–$1,016.73	2666% above	—
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG	$1,262.34	$1,262.34	$88.36–$1,262.34	3334% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening Other Outpatient	$567.15	$567.15	$5.44	567% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE)	$567.15	$567.15	$39.70–$567.15	567% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening Age 21+	$567.15	$567.15	$4.79	567% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening Age Under 21	$567.15	$567.15	$4.87	567% above	—
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening	$567.15	$567.15	$5.18	567% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Other Outpatient	$372.16	$372.16	$19.31	230% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Age Under 21	$372.16	$372.16	$17.30	230% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free	$372.16	$372.16	$11.03–$98.54	230% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 PROS SPEC AG FREE	$372.16	$372.16	$26.05–$372.16	230% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate specific antigen (PSA); free Age 21+	$372.16	$372.16	$17.00	230% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total Age Under 21	$1,049.49	$1,049.49	$17.30	1074% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total Age 21+	$1,049.49	$1,049.49	$17.00	1074% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total Other Outpatient	$1,049.49	$1,049.49	$19.31	1074% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate specific antigen (PSA); total	$1,049.49	$1,049.49	$20.05	1074% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA) TOTAL	$1,049.49	$1,049.49	$73.46–$1,049.49	1074% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$574.61	$574.61	$40.22–$574.61	165% above	—
Parathyroid hormone (PTH) blood test CPT 83970 PTH C TERMINAL	$680.29	$680.29	$47.62–$680.29	214% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT); plasma or whole blood Age 21+	$668.39	$668.39	$5.56	1136% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$668.39	$668.39	$46.79–$668.39	1136% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT); plasma or whole blood	$668.39	$668.39	$6.01	1136% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT); plasma or whole blood Other Outpatient	$668.39	$668.39	$6.31	1136% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time, partial (PTT); plasma or whole blood Age Under 21	$668.39	$668.39	$5.66	1136% above	—
Progesterone blood test CPT 84144 PROGESTERONE	$1,393.35	$1,393.35	$97.53–$1,393.35	1111% above	—
Progesterone blood test CPT 84144 Progesterone	$1,393.35	$1,393.35	$20.86	1111% above	—
Progesterone blood test CPT 84144 Progesterone Age 21+	$1,393.35	$1,393.35	$19.27	1111% above	—
Progesterone blood test CPT 84144 Progesterone Other Outpatient	$1,393.35	$1,393.35	$21.90	1111% above	—
Progesterone blood test CPT 84144 Progesterone Age Under 21	$1,393.35	$1,393.35	$19.62	1111% above	—
Prolactin blood test CPT 84146 Prolactin Other Outpatient	$1,606.21	$1,606.21	$20.35	1285% above	—
Prolactin blood test CPT 84146 Prolactin Age 21+	$1,606.21	$1,606.21	$17.91	1285% above	—
Prolactin blood test CPT 84146 PROLACTIN	$1,606.21	$1,606.21	$112.43–$1,606.21	1285% above	—
Prolactin blood test CPT 84146 Prolactin Age Under 21	$1,606.21	$1,606.21	$18.23	1285% above	—
Prolactin blood test CPT 84146 Prolactin	$1,606.21	$1,606.21	$21.12	1285% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$163.75	$163.75	$11.46–$163.75	247% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR DOO MANUAL READ	$190.54	$190.54	$13.34–$190.54	56% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca Age Under 21	$190.54	$190.54	$11.85	56% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca	$190.54	$190.54	$7.56–$67.53	56% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca Other Outpatient	$190.54	$190.54	$13.23	56% above	—
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay ºeg, dipsticks, cups, ca Age 21+	$190.54	$190.54	$11.64	56% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS A AG OIA	$296.24	$296.24	$20.74–$296.24	211% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS B AG OIA	$296.24	$296.24	$20.74–$296.24	211% above	—
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS AG OIA	$588.00	$588.00	$41.16–$588.00	517% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A OPTICAL IA	$529.95	$529.95	$37.10–$529.95	432% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A	$529.95	$529.95	$16.53	432% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A Age Under 21	$529.95	$529.95	$15.56	432% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A Age 21+	$529.95	$529.95	$15.28	432% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A Other Outpatient	$529.95	$529.95	$17.36	432% above	—
Rheumatoid factor (RF) test CPT 86431 RA QN	$668.39	$668.39	$46.79–$668.39	1112% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Other Outpatient	$668.39	$668.39	$5.95	1112% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Age 21+	$668.39	$668.39	$5.24	1112% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative	$668.39	$668.39	$5.67	1112% above	—
Rheumatoid factor (RF) test CPT 86431 Rheumatoid factor; quantitative Age Under 21	$668.39	$668.39	$5.33	1112% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB QUAL	$418.30	$418.30	$29.28–$418.30	760% above	—
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM	$913.99	$913.99	$63.98–$913.99	1778% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated Age Under 21	$529.95	$529.95	$2.54	845% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated	$529.95	$529.95	$2.94	845% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$529.95	$529.95	$37.10–$529.95	845% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated Other Outpatient	$529.95	$529.95	$2.84	845% above	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated Age 21+	$529.95	$529.95	$2.50	845% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen analysis; volume, count, motility, and differential	$716.01	$716.01	$13.42	455% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS COMPLETE	$716.01	$716.01	$50.12–$716.01	455% above	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen analysis; volume, count, motility, and differential Other Outpatient	$716.01	$716.01	$12.93	455% above	—
Stool ova and parasites exam CPT 87177 Ova and parasites, direct smears, concentration and identification Age Under 21	$872.33	$872.33	$8.38	880% above	—
Stool ova and parasites exam CPT 87177 Ova and parasites, direct smears, concentration and identification	$872.33	$872.33	$8.90	880% above	—
Stool ova and parasites exam CPT 87177 O&P SMEAR CONC ID	$872.33	$872.33	$61.06–$872.33	880% above	—
Stool ova and parasites exam CPT 87177 Ova and parasites, direct smears, concentration and identification Age 21+	$872.33	$872.33	$8.23	880% above	—
Stool ova and parasites exam CPT 87177 Ova and parasites, direct smears, concentration and identification Other Outpatient	$872.33	$872.33	$9.35	880% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o Other Outpatient	$168.21	$168.21	$4.60	338% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD SCN 3 SPEC	$168.21	$168.21	$11.77–$168.21	338% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o	$168.21	$168.21	$4.77	338% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o Age Under 21	$168.21	$168.21	$4.12	338% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards o Age 21+	$168.21	$168.21	$4.05	338% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL BLD QUAL	$745.79	$745.79	$52.21–$745.79	1321% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$745.79	$745.79	$52.21–$745.79	1321% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF QUAL	$946.76	$946.76	$66.27–$946.76	1703% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon Age 21+	$791.96	$791.96	$57.27	287% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GAMMA INTERFERON RESP	$791.96	$791.96	$55.44–$791.96	287% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon Other Outpatient	$791.96	$791.96	$65.08	287% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon Age Under 21	$791.96	$791.96	$58.31	287% above	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon	$791.96	$791.96	$67.56	287% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$702.64	$702.64	$49.18–$702.64	594% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL UR	$2,733.08	$2,733.08	$191.32–$2,733.08	2598% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICRO AB	$562.70	$562.70	$39.39–$562.70	529% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL AB	$686.24	$686.24	$48.04–$686.24	667% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$833.62	$833.62	$58.35–$833.62	832% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH)	$622.23	$622.23	$18.31	406% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH) Age Under 21	$622.23	$622.23	$15.80	406% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH) Age 21+	$622.23	$622.23	$15.52	406% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid stimulating hormone (TSH) Other Outpatient	$622.23	$622.23	$17.64	406% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$622.23	$622.23	$43.56–$622.23	406% above	—
Trichomonas test (NAAT) CPT 87661 TRICH VAGINALIS AMP PRBE	$108.21	$108.21	$7.57–$108.21	24% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique	$108.21	$108.21	$38.25	24% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique Age Under 21	$108.21	$108.21	$33.02	24% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique Age 21+	$108.21	$108.21	$32.43	24% above	—
Trichomonas test (NAAT) CPT 87661 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique Other Outpatient	$108.21	$108.21	$36.84	24% above	—
Uric acid blood test CPT 84550 URIC ACID BLD	$529.95	$529.95	$37.10–$529.95	483% above	—
Uric acid blood test CPT 84550 Uric acid; blood	$529.95	$529.95	$4.52	483% above	—
Uric acid blood test CPT 84550 Uric acid; blood Other Outpatient	$529.95	$529.95	$4.75	483% above	—
Uric acid blood test CPT 84550 Uric acid; blood Age Under 21	$529.95	$529.95	$4.26	483% above	—
Uric acid blood test CPT 84550 Uric acid; blood Age 21+	$529.95	$529.95	$4.18	483% above	—
Urinalysis with microscope exam, automated CPT 81001 UA W MICRO AUTO	$562.70	$562.70	$39.39–$562.70	422% above	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w	$562.70	$562.70	$3.17	422% above	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w Age Under 21	$562.70	$562.70	$2.98	422% above	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w Age 21+	$562.70	$562.70	$2.93	422% above	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, w Other Outpatient	$562.70	$562.70	$3.33	422% above	—
Urinalysis without microscope exam, automated CPT 81003 PROTEIN UR QUAL AUTO	$150.34	$150.34	$10.52–$150.34	200% above	—
Urinalysis without microscope exam, automated CPT 81003 SPEC GRAV UR AUTO	$160.77	$160.77	$11.25–$160.77	221% above	—
Urinalysis without microscope exam, automated CPT 81003 KETONES UR AUTO	$190.54	$190.54	$13.34–$190.54	280% above	—
Urinalysis without microscope exam, automated CPT 81003 PH UR AUTO	$190.54	$190.54	$13.34–$190.54	280% above	—
Urinalysis without microscope exam, automated CPT 81003 BLOOD URINE AUTO	$190.54	$190.54	$13.34–$190.54	280% above	—
Urinalysis without microscope exam, automated CPT 81003 NITRITES UR AUTO	$190.54	$190.54	$13.34–$190.54	280% above	—
Urinalysis without microscope exam, automated CPT 81003 GLUC UR QUAL AUTO	$190.54	$190.54	$13.34–$190.54	280% above	—
Urinalysis without microscope exam, automated CPT 81003 LEUK EST UR AUTO	$190.54	$190.54	$13.34–$190.54	280% above	—
Urinalysis without microscope exam, automated CPT 81003 BILIRUBIN UR AUTO	$193.54	$193.54	$13.55–$193.54	286% above	—
Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO	$291.79	$291.79	$20.43–$291.79	482% above	—
Urinalysis without microscope exam, manual CPT 81002 UA W O MICRO MANUAL	$358.76	$358.76	$25.11–$358.76	902% above	—
Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine Age 21+	$549.31	$549.31	$7.46	295% above	—
Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR	$549.31	$549.31	$38.45–$549.31	295% above	—
Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine Age Under 21	$549.31	$549.31	$7.59	295% above	—
Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine Other Outpatient	$549.31	$549.31	$8.47	295% above	—
Urine culture for bacteria, with colony count CPT 87086 Culture, bacterial; quantitative colony count, urine	$549.31	$549.31	$8.07	295% above	—
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods Other Outpatient	$774.08	$774.08	$9.04	810% above	—
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods	$774.08	$774.08	$8.61	810% above	—
Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL BY DOO	$774.08	$774.08	$54.19–$774.08	810% above	—
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods Age 21+	$774.08	$774.08	$7.95	810% above	—
Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods Age Under 21	$774.08	$774.08	$8.10	810% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12);	$468.92	$468.92	$16.44	417% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Other Outpatient	$468.92	$468.92	$15.83	417% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Age 21+	$468.92	$468.92	$13.94	417% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 Cyanocobalamin (Vitamin B-12); Age Under 21	$468.92	$468.92	$14.19	417% above	—
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$468.92	$468.92	$32.82–$468.92	417% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D3 25-OH	$686.24	$686.24	$48.04–$686.24	457% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH W/WO FRAC	$1,384.40	$1,384.40	$96.91–$1,384.40	1024% above	—
Zinc blood test CPT 84630 Zinc Age Under 21	$282.86	$282.86	$10.72	310% above	—
Zinc blood test CPT 84630 Zinc Other Outpatient	$282.86	$282.86	$11.96	310% above	—
Zinc blood test CPT 84630 Zinc Age 21+	$282.86	$282.86	$10.53	310% above	—
Zinc blood test CPT 84630 ZINC BLOOD	$282.86	$282.86	$19.80–$282.86	310% above	—
Zinc blood test CPT 84630 Zinc	$282.86	$282.86	$11.39	310% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT TUMOR	$778.54	$778.54	$54.50–$778.54	594% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE	$1,436.51	$1,436.51	$100.56–$1,436.51	1181% above	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Cardiac catheterization with coronary angiogram CPT 93458 CTH PLC/INJ LHC & L VENT	$51,985.10	$51,985.10	$7,017.99–$51,985.10	340% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$1,831.20	$1,831.20	$247.21–$1,831.20	28% above	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion, elective, electrical conversion of arrhythmia; external	$4,071.30	$4,071.30	$3,293.00	185% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including	$75,897.72	$75,897.72	$7,668.00	110% above	—
Catheter ablation for atrial fibrillation CPT 93656 COM EP REPO CTH TX AFIB	$75,897.72	$75,897.72	$10,246.19–$75,897.72	110% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including with Cardiac Cath	$75,897.72	$75,897.72	$7,818.00	110% above	—
Catheter ablation for atrial fibrillation CPT 93656 Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including without Cardiac Cath	$75,897.72	$75,897.72	$5,591.00	110% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTH JNTBRS MJR WO US RT	$4,432.03	$4,432.03	$598.32–$4,432.03	574% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTH JNTBRS MJR WO US LT	$4,432.03	$4,432.03	$598.32–$4,432.03	574% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance Age Under 21	$1,585.11	$1,585.11	$26.36	168% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance Age 21+	$1,585.11	$1,585.11	$25.89	168% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance	$1,585.11	$1,585.11	$2,152.00–$5,442.00	168% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTH JNT BRS INT WO US	$1,585.11	$1,585.11	$213.99–$1,585.11	168% above	—
Left heart catheterization, diagnostic one side CPT 93452 CATH HRT LT/INJ L VENT	$51,985.10	$51,985.10	$7,017.99–$51,985.10	443% above	—
Pacemaker implant (dual chamber) CPT 33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular	$70,294.90	$70,294.90	$6,773.44–$85,680.00	270% above	—
Pacemaker implant (dual chamber) CPT 33208 INS PACEMAKER ATR/VENT	$70,294.90	$70,294.90	$9,489.81–$70,294.90	270% above	—
Pacemaker implant (dual chamber) CPT 33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular Age Under 21	$70,294.90	$70,294.90	$7,225.01	270% above	—
Pacemaker implant (dual chamber) CPT 33208 Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular Age 21+	$70,294.90	$70,294.90	$7,095.99	270% above	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$3,728.11	$3,728.11	$260.97–$3,728.11	324% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HYP SPUTUM	$461.82	$461.82	$32.33–$461.82	127% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INH TX AC AWY OBST	$876.67	$876.67	$61.37–$876.67	331% above	—
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MINS	$7,553.72	$7,553.72	$1,019.75–$7,553.72	192% above	—
Critical care, first 30 to 74 minutes CPT 99291 Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes	$7,553.72	$7,553.72	$800.00–$8,280.00	192% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram (EEG); including recording awake and drowsy	$1,421.09	$1,421.09	$854.32–$1,662.03	45% above	—
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AW & DROWSY	$1,421.09	$1,421.09	$99.48–$1,421.09	45% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY	$1,314.44	$1,314.44	$92.01–$1,314.44	363% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional ER	$1,445.74	$1,445.74	$110.30	452% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional	$1,445.74	$1,445.74	$140.00–$1,118.00	452% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LVL 1 EMER DEPT	$1,445.74	$1,445.74	$195.17–$1,445.74	452% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LVL 2 EMER DEPT	$2,282.72	$2,282.72	$308.17–$2,282.72	386% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making	$2,282.72	$2,282.72	$140.00–$1,123.00	386% above	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making ER	$2,282.72	$2,282.72	$200.85	386% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making	$2,792.87	$2,792.87	$200.00–$2,931.00	239% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LVL 3 EMER DEPT	$2,792.87	$2,792.87	$377.04–$2,792.87	239% above	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making ER	$2,792.87	$2,792.87	$357.08	239% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making ER	$3,586.63	$3,586.63	$545.81	174% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making	$3,586.63	$3,586.63	$320.00–$4,206.00	174% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LVL 4 EMER DEPT	$3,586.63	$3,586.63	$484.20–$3,586.63	174% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making	$5,174.15	$5,174.15	$363.00–$8,280.00	158% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LVL 5 EMER DEPT	$5,174.15	$5,174.15	$698.51–$5,174.15	158% above	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making ER	$5,174.15	$5,174.15	$779.00	158% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$5,399.43	$5,399.43	$377.96–$5,399.43	321% above	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation an	$5,399.43	$5,399.43	$696.02–$1,514.00	321% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INIT UP TO 1HR	$792.97	$792.97	$55.51–$792.97	76% above	—
IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HOUR	$792.97	$792.97	$55.51–$792.97	69% above	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ	$181.91	$181.91	$12.73–$181.91	20% above	—
New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NP	$485.36	$485.36	$364.02	129% above	—
New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NP	$593.95	$593.95	$445.46	85% above	—
New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NP	$728.03	$728.03	$546.02	117% above	—
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT LEVEL 2 NP	$404.75	$404.75	$54.64–$404.75	137% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes	$199.19	$199.19	$33.91	245% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INIT ASSESS EA 15MIN	$199.19	$199.19	$13.94–$199.19	245% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes Other Outpatient	$199.19	$199.19	$32.67	245% above	—
Occupational therapy evaluation, low complexity CPT 97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or Other Outpatient	$679.93	$679.93	$105.28	180% above	—
Occupational therapy evaluation, low complexity CPT 97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or	$679.93	$679.93	$109.29	180% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination	$1,345.03	$1,345.03	$106.43	341% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination Other Outpatient	$1,345.03	$1,345.03	$102.52	341% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st	$679.93	$679.93	$106.43	239% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using st Other Outpatient	$679.93	$679.93	$102.52	239% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o	$1,013.16	$1,013.16	$94.70–$462.72	301% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination o Other Outpatient	$1,013.16	$1,013.16	$102.52	301% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKECESS 3-10 MIN	$117.48	$117.48	$8.22–$117.48	166% above	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes	$117.48	$117.48	$34.68–$67.46	166% above	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 EST	$451.00	$451.00	$31.57–$451.00	46% above	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 EST	$485.36	$485.36	$65.52–$485.36	137% above	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 EST	$398.00	$398.00	$27.86–$398.00	85% above	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 EST	$150.00	$150.00	$112.50	9% below	—
Spirometry (breathing test) CPT 94010 SPIROMETRY	$1,494.54	$1,494.54	$104.62–$1,494.54	319% above	—
Spirometry (breathing test) CPT 94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation	$1,494.54	$1,494.54	$380.46–$740.17	319% above	—
Spirometry before and after a bronchodilator CPT 94060 BRONCH EV SPIR PRE/POST	$2,389.42	$2,389.42	$167.26–$2,389.42	302% above	—
Spirometry before and after a bronchodilator CPT 94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration	$2,389.42	$2,389.42	$129.83–$252.57	302% above	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEB	$568.46	$568.46	$39.79–$568.46	139% above	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Texas	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VAC LIVE SQ	$1,435.01	$1,435.01	$1,076.26	190% above	—
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella virus vaccine (VAR), live, for subcutaneous use	$1,435.01	$1,435.01	$380.14	190% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRI 0.5 ML PF IM	$157.02	$157.02	$10.99–$157.02	229% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX ADLT 10MCG IM	$523.17	$523.17	$36.62–$523.17	191% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use	$523.17	$523.17	$124.00	191% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use Other Outpatient	$523.17	$523.17	—	191% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Haemophilus influenzae type b vaccine (Hib), PRP-T conjugate, 4 dose schedule, for intramuscular use	$288.33	$288.33	$26.93	514% above	—
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB 4 DOSE VAC IM	$288.33	$288.33	$216.25	514% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF IM	$369.60	$369.60	$25.87–$369.60	148% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC LIVE SQ	$1,058.88	$1,058.88	$74.12–$1,058.88	328% above	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use	$1,058.88	$1,058.88	$193.28	328% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI VAC IM	$992.01	$992.01	$69.44–$992.01	39% above	—
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use	$992.01	$992.01	$350.43	39% above	—
Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use	$1,269.40	$1,269.40	$447.05	63% above	—
Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA VAC IM	$1,269.40	$1,269.40	$88.86–$1,269.40	63% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use	$1,314.41	$1,314.41	$444.36	23% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAXNEUVANCE VAC IM	$1,314.41	$1,314.41	$92.01–$1,314.41	23% above	—
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use Other Outpatient	$1,314.41	$1,314.41	—	23% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR-20 VAC IM	$1,547.02	$1,547.02	$108.29–$1,547.02	175% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use Other Outpatient	$1,547.02	$1,547.02	—	175% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal conjugate vaccine, 20 valent (PCV20), for intramuscular use	$1,547.02	$1,547.02	$516.29	175% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use	$370.04	$370.04	$220.23	46% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VAC IMSQ	$370.04	$370.04	$25.90–$370.04	46% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use Other Outpatient	$370.04	$370.04	—	46% above	—
Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VAC IM	$2,460.63	$2,460.63	$172.24–$2,460.63	140% above	—
Rabies vaccine, one dose CPT 90675 Rabies vaccine, for intramuscular use	$2,460.63	$2,460.63	$520.11	140% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use	$867.79	$867.79	$65.14	470% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VAC >=7YRS IM	$867.79	$867.79	$650.84	470% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN SGL	$122.32	$122.32	$8.56–$122.32	64% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition	$92.09	$92.09	$35.67–$69.39	72% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDTL	$92.09	$92.09	$6.45–$92.09	72% above	—

Source file: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682205_MEDICAL-CITY-NORTH-HILLS_standardcharges.json?si=dpx-pt-json-access-policy&spr=https&sv=2026-02-06&sr=c&sig=ks%2BgfAjyEHlZmeP2PYJ%2F9NpMuCoRStjTb2bhIy9Y6LM%3D