Good Samaritan Hospital
Good Samaritan Hospital in Los Gatos, CA publishes cash prices for 300 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 California median for 239 of 298 procedures and below it for 59. By typical cash price it ranks #213 of 213 California hospitals and #6 of 6 hospitals in the San Jose, CA area, cheapest first. Click a procedure to compare it with other hospitals nearby.
15891 Los Gatos Almaden Road, LOS GATOS, CA, 95032 Collected Sep 27, 2026 Source price file (408) 559-2011
Acute care hospital Emergency department CMS star rating 2 of 5 CCN 050380 · CMS hospital register NPI 1437103777
The price file shows no self-pay discount
For 514 of the 514 prices listed here, the cash price in Good Samaritan Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W&WO CONT | $28,397.71 | $28,397.71 | $4,259.66–$28,397.71 | 902% above | — |
| Abdominal CT scan without and with contrast CPT 74170 Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections | $28,397.71 | $28,397.71 | $3,626.41 | 902% above | — |
| Abdominal X-ray, 2 views CPT 74019 Radiologic examination, abdomen; 2 views | $2,206.89 | $2,206.89 | $251.58 | 412% above | — |
| Abdominal X-ray, 2 views CPT 74019 ABD XR 2V | $2,206.89 | $2,206.89 | $331.03–$2,206.89 | 412% above | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V LT | $3,000.03 | $3,000.03 | $450.00–$3,000.03 | 456% above | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 + V RT | $3,000.03 | $3,000.03 | $450.00–$3,000.03 | 456% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOP ART 1-2 LEVELS BIL | $1,495.13 | $1,495.13 | $224.27–$1,495.13 | 168% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREM W/O CONT LT | $17,869.95 | $17,869.95 | $2,680.49–$17,869.95 | 686% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UP EXTREM W/O CONT RT | $17,869.95 | $17,869.95 | $2,680.49–$17,869.95 | 686% 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 | $3,488.28 | $3,488.28 | $64.40–$506.50 | 481% above | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS | $3,488.28 | $3,488.28 | $523.24–$3,488.28 | 481% above | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY | $15,238.83 | $15,238.83 | $2,285.82–$15,238.83 | 618% above | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 Bone and/or joint imaging; whole body | $15,238.83 | $15,238.83 | $1,826.63 | 618% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI LT W AX COMP | $3,592.44 | $3,592.44 | $538.87–$3,592.44 | 399% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US BRST UNI RT W AX COMP | $3,592.44 | $3,592.44 | $538.87–$3,592.44 | 399% above | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI LT W AX LTD | $1,763.13 | $1,763.13 | $264.47–$1,763.13 | 227% above | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BRST UNI RT W AX LTD | $1,763.13 | $1,763.13 | $264.47–$1,763.13 | 227% above | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing | $33,658.87 | $33,658.87 | $5,578.52 | 522% above | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PEL W CONT | $33,658.87 | $33,658.87 | $5,048.83–$33,658.87 | 522% above | — |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD RAPIDAI TECH | $22,436.72 | $22,436.72 | $3,365.51–$22,436.72 | 624% above | — |
| CT angiography (CTA) of the head CPT 70496 CTA HEAD | $25,228.42 | $25,228.42 | $3,784.26–$25,228.42 | 714% above | — |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK RAPIDAI TECH | $22,436.72 | $22,436.72 | $3,365.51–$22,436.72 | 657% above | — |
| CT angiography (CTA) of the neck CPT 70498 CTA NECK | $22,436.72 | $22,436.72 | $3,365.51–$22,436.72 | 657% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST | $22,436.72 | $22,436.72 | $3,365.51–$22,436.72 | 564% 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 | $22,436.72 | $22,436.72 | $5,241.96 | 564% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and mo | $1,192.42 | $1,192.42 | $5,349.63 | 56% below | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT HEART W CN ART/GRAFTS | $1,192.42 | $1,192.42 | $178.86–$1,192.42 | 56% below | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium | $130.00 | $130.00 | $1,063.10 | 69% below | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO CN W QUAN CA | $130.00 | $130.00 | $19.50–$130.00 | 69% below | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 Computed tomography, abdomen and pelvis; without contrast material | $31,816.54 | $31,816.54 | $1,612.44 | 946% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PELVIS W/O CONT | $31,816.54 | $31,816.54 | $4,772.48–$31,816.54 | 946% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Computed tomography, abdomen and pelvis; with contrast material(s) | $44,564.21 | $44,564.21 | $3,077.35 | 983% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PELVIS W/CONT | $44,564.21 | $44,564.21 | $6,684.63–$44,564.21 | 983% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PELVIS W&WO CONT | $40,053.86 | $40,053.86 | $6,008.08–$40,053.86 | 796% 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 | $40,053.86 | $40,053.86 | $4,067.83 | 796% above | — |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONT | $23,995.86 | $23,995.86 | $3,599.38–$23,995.86 | 852% above | — |
| CT scan of the abdomen with contrast CPT 74160 Computed tomography, abdomen; with contrast material(s) | $23,995.86 | $23,995.86 | $2,926.60 | 852% above | — |
| CT scan of the abdomen without contrast CPT 74150 Computed tomography, abdomen; without contrast material | $22,084.09 | $22,084.09 | $77.43–$2,415.95 | 1057% above | — |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT | $22,084.09 | $22,084.09 | $3,312.61–$22,084.09 | 1057% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXIFAC W/O CNT | $17,754.94 | $17,754.94 | $2,663.24–$17,754.94 | 713% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT | $19,447.54 | $19,447.54 | $2,917.13–$19,447.54 | 750% above | — |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONT | $23,063.85 | $23,063.85 | $3,459.58–$23,063.85 | 753% above | — |
| CT scan of the head without and with contrast CPT 70470 CT HD/BR W&W/O CONT | $26,605.29 | $26,605.29 | $3,990.79–$26,605.29 | 771% above | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST | $21,070.70 | $21,070.70 | $3,160.61–$21,070.70 | 637% above | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST | $20,952.44 | $20,952.44 | $3,142.87–$20,952.44 | 620% above | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST | $20,570.52 | $20,570.52 | $3,085.58–$20,570.52 | 707% above | — |
| CT scan of the pelvis, with contrast dye CPT 72193 Computed tomography, pelvis; with contrast material(s) | $20,570.52 | $20,570.52 | $2,926.60 | 707% above | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 DUP EXTRACRANIAL BIL | $8,517.25 | $8,517.25 | $1,277.59–$8,517.25 | 624% above | — |
| Chest CT scan without and with contrast CPT 71270 Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections | $25,540.90 | $25,540.90 | $1,022.34–$3,781.86 | 724% above | — |
| Chest CT scan without and with contrast CPT 71270 CT CHEST W&W/O CONT | $25,540.90 | $25,540.90 | $3,831.14–$25,540.90 | 724% above | — |
| Chest X-ray, 2 views CPT 71046 Radiologic examination, chest; 2 views | $2,704.91 | $2,704.91 | $226.60 | 562% above | — |
| Chest X-ray, 2 views CPT 71046 CHEST XRAY 2 V | $2,704.91 | $2,704.91 | $405.74–$2,704.91 | 562% above | — |
| Chest X-ray, single view CPT 71045 Radiologic examination, chest; single view | $1,964.94 | $1,964.94 | $122.56 | 440% above | — |
| Chest X-ray, single view CPT 71045 CHEST XRAY 1 V | $1,964.94 | $1,964.94 | $294.74–$1,964.94 | 440% above | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMP LT | $2,447.76 | $2,447.76 | $367.16–$2,447.76 | 406% above | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMP RT | $2,447.76 | $2,447.76 | $367.16–$2,447.76 | 406% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COM | $7,466.97 | $7,466.97 | $1,120.05–$7,466.97 | 776% above | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $991.69 | $991.69 | $148.75–$991.69 | 97% 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) | $991.69 | $991.69 | $335.69 | 97% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel) | $991.69 | $991.69 | $19.56–$5,074.00 | 258% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY PERIPHL | $991.69 | $991.69 | $148.75–$991.69 | 258% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Computed tomography, thorax, diagnostic; without contrast material | $22,591.87 | $22,591.87 | $2,526.02 | 1025% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST | $22,591.87 | $22,591.87 | $3,388.78–$22,591.87 | 1025% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST | $24,660.97 | $24,660.97 | $3,699.15–$24,660.97 | 751% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Computed tomography, thorax, diagnostic; with contrast material(s) | $24,660.97 | $24,660.97 | $106.69–$3,024.20 | 751% above | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG CAD BI | $1,739.26 | $1,739.26 | $260.89–$1,739.26 | — | — |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI RT | $1,568.91 | $1,568.91 | $235.34–$1,568.91 | 318% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIAG CAD UNI LT | $1,568.91 | $1,568.91 | $235.34–$1,568.91 | 318% 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 | $13,949.85 | $13,949.85 | $2,009.15 | — | — |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUP LE ART BIL | $13,949.85 | $13,949.85 | $2,092.48–$13,949.85 | 1260% 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 | $11,491.24 | $11,491.24 | $1,631.50 | — | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 DUP VEIN BIL | $11,491.24 | $11,491.24 | $1,723.69–$11,491.24 | 913% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO2D COMP W CF DOP | $4,552.66 | $4,552.66 | $682.90–$4,552.66 | 69% above | — |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT | $2,345.77 | $2,345.77 | $351.87–$2,345.77 | 496% above | — |
| Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT | $2,345.77 | $2,345.77 | $351.87–$2,345.77 | 496% above | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 + V LT | $3,079.23 | $3,079.23 | $461.88–$3,079.23 | 544% above | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 + V RT | $3,079.23 | $3,079.23 | $461.88–$3,079.23 | 544% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/IAC WO | $31,322.87 | $31,322.87 | $4,698.43–$31,322.87 | 1269% above | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT | $3,058.62 | $3,058.62 | $458.79–$3,058.62 | 667% above | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT | $3,058.62 | $3,058.62 | $458.79–$3,058.62 | 667% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary system imaging, including gallbladder when present; | $9,465.54 | $9,465.54 | $243.06–$5,074.00 | 415% above | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPA IMAG INCL GB | $9,465.54 | $9,465.54 | $1,419.83–$9,465.54 | 415% above | — |
| Hand X-ray, 2 views one side CPT 73120 XR HAND 2 V LT | $2,032.21 | $2,032.21 | $304.83–$2,032.21 | 399% above | — |
| Hand X-ray, 2 views one side CPT 73120 XR HAND 2 V RT | $2,032.21 | $2,032.21 | $304.83–$2,032.21 | 399% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2 + V RT | $1,931.30 | $1,931.30 | $289.69–$1,931.30 | 450% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS 2 + V LT | $1,931.30 | $1,931.30 | $289.69–$1,931.30 | 450% above | — |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V LT | $3,183.39 | $3,183.39 | $477.51–$3,183.39 | 593% above | — |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 V RT | $3,183.39 | $3,183.39 | $477.51–$3,183.39 | 593% above | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 + V LT | $3,983.04 | $3,983.04 | $597.46–$3,983.04 | 580% above | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 + V RT | $3,983.04 | $3,983.04 | $597.46–$3,983.04 | 580% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTRM W/O C LT | $20,355.69 | $20,355.69 | $3,053.35–$20,355.69 | 855% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOWER EXTRM W/O C RT | $20,355.69 | $20,355.69 | $3,053.35–$20,355.69 | 855% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD | $3,563.14 | $3,563.14 | $534.47–$3,563.14 | 330% above | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendonºs», muscleºs», nerveºs», other soft-tissue structureºs», or soft-tiss | $4,694.80 | $4,694.80 | $8.66–$155.95 | 833% above | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXTREM NON VASC LTD | $4,694.80 | $4,694.80 | $704.22–$4,694.80 | 833% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LUNG CA SCREEN WO CON | $529.48 | $529.48 | $79.42–$529.48 | 60% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s) | $529.48 | $529.48 | $82.88–$1,162.99 | 60% above | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 V LT | $3,270.19 | $3,270.19 | $490.53–$3,270.19 | 656% above | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 V RT | $3,270.19 | $3,270.19 | $490.53–$3,270.19 | 656% above | — |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA HD W/O CONT | $25,339.09 | $25,339.09 | $3,800.86–$25,339.09 | 763% above | — |
| MR angiography (MRA) of the head without contrast CPT 70544 Magnetic resonance angiography, head; without contrast material(s) | $25,339.09 | $25,339.09 | $4,788.39 | 763% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT LT | $25,339.10 | $25,339.10 | $3,800.86–$25,339.10 | 680% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LW JNT W/O CONT RT | $25,339.10 | $25,339.10 | $3,800.86–$25,339.10 | 680% 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 | $30,837.87 | $30,837.87 | $4,625.68–$30,837.87 | 559% 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 | $30,837.87 | $30,837.87 | $4,625.68–$30,837.87 | 559% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT | $21,995.12 | $21,995.12 | $3,299.27–$21,995.12 | 694% above | — |
| MRI of the abdomen without contrast CPT 74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) | $21,995.12 | $21,995.12 | $1,009.99–$4,762.13 | 694% 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 | $33,436.45 | $33,436.45 | $10,568.44 | 665% above | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W&WO CONT | $33,436.45 | $33,436.45 | $5,015.47–$33,436.45 | 665% above | — |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $20,680.10 | $20,680.10 | $3,102.01–$20,680.10 | 602% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W&WO CONT | $39,916.07 | $39,916.07 | $5,987.41–$39,916.07 | 810% above | — |
| MRI of the lower back, no contrast dye CPT 72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material | $22,182.83 | $22,182.83 | $116.68–$5,313.82 | 616% above | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT | $22,182.83 | $22,182.83 | $3,327.42–$22,182.83 | 616% 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 | $29,304.77 | $29,304.77 | $10,641.59 | 543% above | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W&W/O CONT | $29,304.77 | $29,304.77 | $4,395.72–$29,304.77 | 543% above | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT | $24,611.06 | $24,611.06 | $3,691.66–$24,611.06 | 712% 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 | $24,611.06 | $24,611.06 | $5,313.82 | 712% above | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W&W/O CONT | $25,664.59 | $25,664.59 | $3,849.69–$25,664.59 | 482% 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 | $25,664.59 | $25,664.59 | $204.59–$10,641.59 | 482% 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 | $22,079.75 | $22,079.75 | $4,788.39 | 622% above | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT | $22,079.75 | $22,079.75 | $3,311.96–$22,079.75 | 622% above | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W&WO CONT | $21,561.12 | $21,561.12 | $3,234.17–$21,561.12 | 405% 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 | $21,561.12 | $21,561.12 | $225.80–$10,568.44 | 405% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT | $21,033.81 | $21,033.81 | $3,155.07–$21,033.81 | 717% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) | $21,033.81 | $21,033.81 | $4,762.13 | 717% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT RT | $25,339.09 | $25,339.09 | $3,800.86–$25,339.09 | 847% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP JNT W/O CONT LT | $25,339.09 | $25,339.09 | $3,800.86–$25,339.09 | 847% above | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4-5 V | $3,154.10 | $3,154.10 | $473.12–$3,154.10 | 416% above | — |
| Neck soft tissue CT scan with contrast CPT 70491 CT NECK W/CONTRAST | $24,190.08 | $24,190.08 | $3,628.51–$24,190.08 | 839% above | — |
| Neck soft tissue CT scan with contrast CPT 70491 Computed tomography, soft tissue neck; with contrast material(s) | $24,190.08 | $24,190.08 | $2,415.95 | 839% above | — |
| Neck soft tissue CT scan without contrast CPT 70490 CT NECK W/O CONTRAST | $22,124.24 | $22,124.24 | $3,318.64–$22,124.24 | 983% above | — |
| Neck soft tissue CT scan without contrast CPT 70490 Computed tomography, soft tissue neck; without contrast material | $22,124.24 | $22,124.24 | $2,019.53 | 983% above | — |
| Neck soft tissue X-ray CPT 70360 Radiologic examination; neck, soft tissue | $2,321.90 | $2,321.90 | $174.38 | 623% above | — |
| Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE | $2,321.90 | $2,321.90 | $348.29–$2,321.90 | 623% 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 | $33,948.57 | $33,948.57 | $3,464.39 | 743% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCRD SPECT R/S MULT | $33,948.57 | $33,948.57 | $5,092.29–$33,948.57 | 743% above | — |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST | $8,347.99 | $8,347.99 | $1,252.20–$8,347.99 | 326% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LTD OR FU | $6,746.53 | $6,746.53 | $1,011.98–$6,746.53 | 1091% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE | $6,762.81 | $6,762.81 | $1,014.42–$6,762.81 | 619% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | $6,762.81 | $6,762.81 | $66.52–$651.33 | 619% 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 | $6,669.50 | $6,669.50 | $896.46 | 641% above | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRI | $6,669.50 | $6,669.50 | $1,000.42–$6,669.50 | 641% 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 | $2,468.38 | $2,468.38 | $64.70–$896.46 | 200% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1ST TRIMTR | $2,468.38 | $2,468.38 | $370.26–$2,468.38 | 200% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LTD | $6,640.20 | $6,640.20 | $996.03–$6,640.20 | 998% above | — |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI 2 V RT | $3,100.93 | $3,100.93 | $465.14–$3,100.93 | 570% above | — |
| Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNI 2 V LT | $3,100.93 | $3,100.93 | $465.14–$3,100.93 | 570% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI W/CXR 3+V RT | $3,802.93 | $3,802.93 | $570.44–$3,802.93 | 517% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNI W/CXR 3+V LT | $3,802.93 | $3,802.93 | $570.44–$3,802.93 | 517% above | — |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR CAD BI | $1,508.15 | $1,508.15 | $226.22–$1,508.15 | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V RT | $2,648.49 | $2,648.49 | $397.27–$2,648.49 | 371% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 + V LT | $2,648.49 | $2,648.49 | $397.27–$2,648.49 | 371% above | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES 3 + V | $4,341.09 | $4,341.09 | $651.16–$4,341.09 | 850% above | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 Radiologic examination, sinuses, paranasal, complete, minimum of 3 views | $4,341.09 | $4,341.09 | $338.16 | 850% above | — |
| Skull X-ray, fewer than 4 views CPT 70250 Radiologic examination, skull; less than 4 views | $2,183.02 | $2,183.02 | $265.52 | 415% above | — |
| Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 V | $2,183.02 | $2,183.02 | $327.45–$2,183.02 | 415% above | — |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO STRESS W CONT ECG | $6,236.58 | $6,236.58 | $935.49–$6,236.58 | 96% 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 | $6,236.58 | $6,236.58 | $123.65–$136.02 | 96% above | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWLW FUNC W/C&V | $4,657.91 | $4,657.91 | $698.69–$4,657.91 | 604% above | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 V RT | $2,692.97 | $2,692.97 | $403.95–$2,692.97 | 591% above | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 V LT | $2,692.97 | $2,692.97 | $403.95–$2,692.97 | 591% above | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE W/O CONTRAST | $12,949.48 | $12,949.48 | $1,942.42–$12,949.48 | 361% above | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2 + V LT | $1,462.58 | $1,462.58 | $219.39–$1,462.58 | 343% above | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) 2 + V RT | $1,462.58 | $1,462.58 | $219.39–$1,462.58 | 343% above | — |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $5,167.86 | $5,167.86 | $775.18–$5,167.86 | 621% above | — |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound, transvaginal | $5,167.86 | $5,167.86 | $651.33 | 621% above | — |
| Transvaginal ultrasound during pregnancy CPT 76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal | $5,167.86 | $5,167.86 | $51.98–$643.83 | 663% above | — |
| Transvaginal ultrasound during pregnancy CPT 76817 US PREG UT TRANSVAGINAL | $5,167.86 | $5,167.86 | $775.18–$5,167.86 | 663% above | — |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $7,061.18 | $7,061.18 | $1,059.18–$7,061.18 | 523% above | — |
| Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CNTS | $5,669.13 | $5,669.13 | $850.37–$5,669.13 | 537% above | — |
| Ultrasound of the scrotum and testicles CPT 76870 Ultrasound, scrotum and contents | $5,669.13 | $5,669.13 | $651.33 | 537% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD AND NECK | $7,141.47 | $7,141.47 | $1,071.22–$7,141.47 | 751% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI SNGL CONTRAST | $6,521.94 | $6,521.94 | $978.29–$6,521.94 | 959% 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 | $6,521.94 | $6,521.94 | $622.61 | 959% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 + V LT | $2,940.35 | $2,940.35 | $441.05–$2,940.35 | 588% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 + V RT | $2,940.35 | $2,940.35 | $441.05–$2,940.35 | 588% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUP VEIN UNI/LTD | $7,874.93 | $7,874.93 | $1,181.24–$7,874.93 | 781% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP VEIN UNI RT | $7,874.93 | $7,874.93 | $1,181.24–$7,874.93 | 781% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP VEIN UNI LT | $7,874.93 | $7,874.93 | $1,181.24–$7,874.93 | 781% above | — |
| Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT | $1,614.48 | $1,614.48 | $242.17–$1,614.48 | 316% above | — |
| Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT | $1,614.48 | $1,614.48 | $242.17–$1,614.48 | 316% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V LT | $2,733.12 | $2,733.12 | $409.97–$2,733.12 | 443% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 + V RT | $2,733.12 | $2,733.12 | $409.97–$2,733.12 | 443% 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 | $2,767.84 | $2,767.84 | $415.18–$2,767.84 | 557% 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 | $2,767.84 | $2,767.84 | $415.18–$2,767.84 | 557% above | — |
| X-ray of the abdomen, 1 view CPT 74018 ABD XR 1V | $1,549.38 | $1,549.38 | $232.41–$1,549.38 | 414% above | — |
| X-ray of the abdomen, 1 view CPT 74018 Radiologic examination, abdomen; 1 view | $1,549.38 | $1,549.38 | $209.96 | 414% above | — |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT | $1,677.41 | $1,677.41 | $251.61–$1,677.41 | 328% above | — |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT | $1,677.41 | $1,677.41 | $251.61–$1,677.41 | 328% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V RT | $2,026.78 | $2,026.78 | $304.02–$2,026.78 | 442% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) 2 + V LT | $2,026.78 | $2,026.78 | $304.02–$2,026.78 | 442% above | — |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT | $1,567.83 | $1,567.83 | $235.17–$1,567.83 | 287% above | — |
| X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT | $1,567.83 | $1,567.83 | $235.17–$1,567.83 | 287% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V LT | $3,007.62 | $3,007.62 | $451.14–$3,007.62 | 485% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 + V RT | $3,007.62 | $3,007.62 | $451.14–$3,007.62 | 485% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V LT | $2,623.53 | $2,623.53 | $393.53–$2,623.53 | 416% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3 + V RT | $2,623.53 | $2,623.53 | $393.53–$2,623.53 | 416% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V LT | $1,589.53 | $1,589.53 | $238.43–$1,589.53 | 316% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 V RT | $1,589.53 | $1,589.53 | $238.43–$1,589.53 | 316% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2/3 VIEWS | $3,202.92 | $3,202.92 | $480.44–$3,202.92 | 546% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radiologic examination, spine, lumbosacral; 2 or 3 views | $3,202.92 | $3,202.92 | $286.34 | 546% above | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radiologic examination, spine; thoracic, 2 views | $3,543.61 | $3,543.61 | $278.01 | 665% above | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS | $3,543.61 | $3,543.61 | $531.54–$3,543.61 | 665% above | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 Radiologic examination, nasal bones, complete, minimum of 3 views | $2,479.23 | $2,479.23 | $220.16 | 447% above | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMP | $2,479.23 | $2,479.23 | $371.88–$2,479.23 | 447% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2-3 VIEWS | $2,899.12 | $2,899.12 | $434.87–$2,899.12 | 537% above | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VIEWS | $2,092.97 | $2,092.97 | $313.95–$2,092.97 | 429% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radiologic examination, sacrum and coccyx, minimum of 2 views | $2,623.53 | $2,623.53 | $244.72 | 443% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2 + V | $2,623.53 | $2,623.53 | $393.53–$2,623.53 | 443% above | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH QN | $18.06 | $18.06 | $2.71–$18.06 | 73% below | — |
| ACTH blood test CPT 82024 Adrenocorticotropic hormone (ACTH) | $18.06 | $18.06 | $38.62–$401.60 | 73% below | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $990.25 | $990.25 | $148.54–$990.25 | 2196% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Transferase; aspartate amino (AST) (SGOT) | $990.25 | $990.25 | $5.18–$53.92 | 2083% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) | $990.25 | $990.25 | $148.54–$990.25 | 2083% above | — |
| Albumin blood test CPT 82040 ALBUMIN SERUM QN | $5.31 | $5.31 | $0.80–$5.31 | 79% below | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS (ALP) | $572.69 | $572.69 | $85.90–$572.69 | 1449% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH | $5.31 | $5.31 | $0.80–$5.31 | 36% below | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROT SERUM | $110.50 | $110.50 | $16.57–$110.50 | 17% above | — |
| Ammonia blood test CPT 82140 AMMONIA | $1,497.06 | $1,497.06 | $224.56–$1,497.06 | 727% above | — |
| Amylase blood test CPT 82150 AMYLASE ISOENZYMES PANC | $39.31 | $39.31 | $5.90–$39.31 | 41% below | — |
| Amylase blood test CPT 82150 AMYLASE | $1,382.31 | $1,382.31 | $207.35–$1,382.31 | 1978% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP | $12.75 | $12.75 | $1.91–$12.75 | 47% below | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic citrullinated peptide (CCP), antibody | $12.75 | $12.75 | $12.95–$134.72 | 47% below | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA QUAL SCREEN | $49.94 | $49.94 | $7.49–$49.94 | 4% below | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP QT | $91.38 | $91.38 | $13.71–$91.38 | 56% below | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE | $1,334.50 | $1,334.50 | $200.18–$1,334.50 | 539% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GASTRIC | $14.00 | $14.00 | $2.10–$14.00 | 89% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATHETER TIP | $14.00 | $14.00 | $2.10–$14.00 | 89% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT NASOPHARYNGEAL | $14.00 | $14.00 | $2.10–$14.00 | 89% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCHIAL | $14.00 | $14.00 | $2.10–$14.00 | 89% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE RESPIRATORY | $15.00 | $15.00 | $2.25–$15.00 | 89% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL | $15.94 | $15.94 | $2.39–$15.94 | 88% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SURGICAL SPEC | $59.50 | $59.50 | $8.93–$59.50 | 55% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID | $121.00 | $121.00 | $18.15–$121.00 | 9% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT THROAT | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BRONCH WASH | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ASPIRATE | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BONE MARROW | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE TISSUE | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1427% 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 | $2,184.50 | $2,184.50 | $8.46–$88.00 | 1031% above | — |
| Basic metabolic panel (blood test) CPT 80048 BMP TOTAL CALCIUM | $2,184.50 | $2,184.50 | $327.68–$2,184.50 | 1031% above | — |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOT FL | $13.81 | $13.81 | $2.07–$13.81 | 69% below | — |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOT BLD | $29.75 | $29.75 | $4.46–$29.75 | 34% below | — |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOT | $531.25 | $531.25 | $79.69–$531.25 | 1074% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL 4 | $523.81 | $523.81 | $78.57–$523.81 | 303% above | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CYTOLOGY CELL BLOCK | $745.88 | $745.88 | $111.88–$745.88 | 474% above | — |
| Blood culture for bacteria CPT 87040 CULTURE BLOOD | $13.81 | $13.81 | $2.07–$13.81 | 95% below | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $330.44 | $330.44 | $62.78–$330.44 | 1552% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN | $1,314.31 | $1,314.31 | $197.15–$1,314.31 | 3403% above | — |
| Blood lead test CPT 83655 LEAD BLOOD | $19.13 | $19.13 | $2.87–$19.13 | 59% above | — |
| Blood lead test CPT 83655 LEAD URINE | $22.31 | $22.31 | $3.35–$22.31 | 86% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM | $673.63 | $673.63 | $101.04–$673.63 | 287% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE NEWBORN | $440.94 | $440.94 | $66.14–$440.94 | 320% above | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $440.94 | $440.94 | $66.14–$440.94 | 320% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $930.75 | $930.75 | $139.61–$930.75 | 2435% above | — |
| C-peptide blood test CPT 84681 C-PEPTIDE | $59.50 | $59.50 | $8.93–$59.50 | 7% below | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive protein; | $744.81 | $744.81 | $10.19–$53.92 | 983% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $744.81 | $744.81 | $111.72–$744.81 | 983% above | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, toxin gene(s), amplified probe technique | $776.69 | $776.69 | $25.78–$189.93 | 408% above | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOX GENE AMP PROB | $776.69 | $776.69 | $116.50–$776.69 | 408% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 FLUID QN | $49.94 | $49.94 | $7.49–$49.94 | 64% below | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 DNA/RNA AMP | $61.63 | $61.63 | $9.24–$61.63 | 33% 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 | $61.63 | $61.63 | $533.60 | 33% below | — |
| Calcium blood test, total CPT 82310 CALCIUM TOTAL | $892.50 | $892.50 | $133.88–$892.50 | 1342% above | — |
| Calcium blood test, total CPT 82310 Calcium; total | $892.50 | $892.50 | $5.16–$53.60 | 1342% above | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA | $19.13 | $19.13 | $2.87–$19.13 | 82% below | — |
| Chickenpox (varicella) immunity blood test CPT 86787 VARIC ZOSTER IGG | $13.81 | $13.81 | $2.07–$13.81 | 64% below | — |
| Chickenpox (varicella) immunity blood test CPT 86787 VARIC ZOSTER IGM | $13.81 | $13.81 | $2.07–$13.81 | 64% below | — |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB CSF | $142.38 | $142.38 | $21.36–$142.38 | 276% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE | $23.38 | $23.38 | $3.51–$23.38 | 57% below | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $1,408.88 | $1,408.88 | $211.33–$1,408.88 | 1131% above | — |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTOMATED | $1,039.13 | $1,039.13 | $155.87–$1,039.13 | 1095% above | — |
| Complete blood count (CBC), no differential CPT 85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) | $1,039.13 | $1,039.13 | $6.47–$67.36 | 1095% 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 | $3,215.13 | $3,215.13 | $10.56–$53.81 | 1159% above | — |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL | $3,215.13 | $3,215.13 | $482.27–$3,215.13 | 1159% above | — |
| Cortisol blood test, total CPT 82533 CORTISOL TOTAL | $45.69 | $45.69 | $6.85–$45.69 | 54% below | — |
| Creatine kinase (CK) blood test, total CPT 82550 CREAT KINASE (CK) TOTAL | $1,028.50 | $1,028.50 | $154.28–$1,028.50 | 1077% above | — |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine kinase (CK), (CPK); total | $1,028.50 | $1,028.50 | $12.83–$67.68 | 1077% above | — |
| Creatinine blood test CPT 82565 CREATININE BLD | $895.69 | $895.69 | $134.35–$895.69 | 1774% above | — |
| Creatinine blood test CPT 82565 Creatinine; blood | $895.69 | $895.69 | $5.12–$26.88 | 1774% above | — |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT | $24.44 | $24.44 | $3.67–$24.44 | 83% below | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S | $20.19 | $20.19 | $3.03–$20.19 | 80% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCR ANY NBR PER DOS | $45.69 | $45.69 | $6.85–$45.69 | 36% below | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $1,896.56 | $1,896.56 | $284.48–$1,896.56 | 2074% above | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGM QUAL | $12.75 | $12.75 | $1.91–$12.75 | 53% below | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EBV CAPSID IGG QUAL | $12.75 | $12.75 | $1.91–$12.75 | 53% below | — |
| Estradiol blood test CPT 82670 ESTRADIOL TOTAL | $24.44 | $24.44 | $3.67–$24.44 | 73% below | — |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $91.38 | $91.38 | $13.71–$91.38 | 12% below | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL | $268.81 | $268.81 | $40.32–$268.81 | 269% above | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, fecal | $268.81 | $268.81 | $38.66–$204.16 | 269% above | — |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $392.06 | $392.06 | $58.81–$392.06 | 266% above | — |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $1,262.25 | $1,262.25 | $189.34–$1,262.25 | 776% above | — |
| Folate (folic acid) blood test CPT 82746 Folic acid; serum | $330.44 | $330.44 | $14.70–$152.96 | 203% above | — |
| Folate (folic acid) blood test CPT 82746 FOLATE (FOLIC ACID) SER | $330.44 | $330.44 | $49.57–$330.44 | 203% above | — |
| Free T3 thyroid hormone test CPT 84481 T3 FREE | $484.50 | $484.50 | $72.67–$484.50 | 372% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE | $42.50 | $42.50 | $6.38–$42.50 | 38% below | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT | $31.88 | $31.88 | $4.78–$31.88 | 28% below | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose; post glucose dose (includes glucose) | $1,314.31 | $1,314.31 | $4.75–$24.94 | 2557% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR W GLUCOLA | $1,314.31 | $1,314.31 | $197.15–$1,314.31 | 2557% above | — |
| Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS | $2,423.56 | $2,423.56 | $363.53–$2,423.56 | 1666% above | — |
| Glucose tolerance test, 3 samples CPT 82951 Glucose; tolerance test (GTT), 3 specimens (includes glucose) | $2,423.56 | $2,423.56 | $25.37–$133.92 | 1666% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE | $100.94 | $100.94 | $15.14–$100.94 | 53% above | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGG | $11.69 | $11.69 | $1.75–$11.69 | 90% below | — |
| H. pylori antibody blood test CPT 86677 H PYLORI AB QL IGM | $11.69 | $11.69 | $1.75–$11.69 | 90% below | — |
| H. pylori stool antigen test CPT 87338 H PYLORI AG EIA STOOL | $37.19 | $37.19 | $5.58–$37.19 | 56% below | — |
| 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 | $37.19 | $37.19 | $14.38–$149.60 | 56% below | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 VIRAL LOAD | $124.31 | $124.31 | $18.65–$124.31 | 13% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN | $166.81 | $166.81 | $25.02–$166.81 | 52% above | — |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 AB QUAL | $931.81 | $931.81 | $139.77–$931.81 | 1460% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1AG HIV-1/2AB SINGLE | $51.00 | $51.00 | $7.65–$51.00 | 42% below | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1P24AG HIV-1/2AB SGL | $108.38 | $108.38 | $16.26–$108.38 | 24% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN | $18.06 | $18.06 | $2.71–$18.06 | 72% below | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $708.69 | $708.69 | $106.30–$708.69 | 986% above | — |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $296.44 | $296.44 | $44.47–$296.44 | 635% above | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QN | $110.50 | $110.50 | $16.57–$110.50 | 26% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB IGG | $24.44 | $24.44 | $3.67–$24.44 | 26% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX 1 AB IGM | $70.13 | $70.13 | $10.52–$70.13 | 262% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGG | $13.81 | $13.81 | $2.07–$13.81 | 42% below | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGM | $37.19 | $37.19 | $5.58–$37.19 | 55% above | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $12.75 | $12.75 | $1.91–$12.75 | 81% below | — |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE QN | $20.19 | $20.19 | $3.03–$20.19 | 72% below | — |
| Homocysteine blood test CPT 83090 Homocysteine | $20.19 | $20.19 | $17.92–$94.08 | 72% below | — |
| Iron blood test (serum iron) CPT 83540 IRON ATOMIC ABS | $139.19 | $139.19 | $20.88–$139.19 | 138% above | — |
| Iron blood test (serum iron) CPT 83540 IRON | $331.50 | $331.50 | $49.73–$331.50 | 467% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING | $930.75 | $930.75 | $139.61–$930.75 | 1158% above | — |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding capacity | $930.75 | $930.75 | $8.74–$90.88 | 1158% 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 | $2,602.06 | $2,602.06 | $8.68–$90.24 | 1729% above | — |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $2,602.06 | $2,602.06 | $390.31–$2,602.06 | 1729% above | — |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID BODY FL | $13.81 | $13.81 | $2.07–$13.81 | 90% below | — |
| Lactate (lactic acid) blood test CPT 83605 LACTIC ACID | $162.56 | $162.56 | $24.38–$162.56 | 15% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD) CSF | $36.13 | $36.13 | $5.42–$36.13 | 7% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD) BODY FLUID | $978.56 | $978.56 | $146.78–$978.56 | 2806% above | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH (LD) | $978.56 | $978.56 | $146.78–$978.56 | 2806% above | — |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $1,133.69 | $1,133.69 | $170.05–$1,133.69 | 929% above | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $2,030.44 | $2,030.44 | $304.57–$2,030.44 | 1243% 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 | $2,030.44 | $2,030.44 | $8.17–$84.96 | 1243% above | — |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB QL | $24.44 | $24.44 | $3.67–$24.44 | 5% above | — |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $7.44 | $7.44 | $1.12–$7.44 | 91% below | — |
| Magnesium blood test CPT 83735 MAGNESIUM RBC | $11.69 | $11.69 | $1.75–$11.69 | 85% below | — |
| Magnesium blood test CPT 83735 MAGNESIUM OTHER | $142.38 | $142.38 | $21.36–$142.38 | 79% above | — |
| Magnesium blood test CPT 83735 MAGNESIUM BLD | $1,151.75 | $1,151.75 | $172.76–$1,151.75 | 1351% above | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM | $34.00 | $34.00 | $5.10–$34.00 | 2% above | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA IGG | $117.94 | $117.94 | $17.69–$117.94 | 254% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile antibodies; screening | $978.56 | $978.56 | $5.18–$27.20 | 832% above | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE) | $978.56 | $978.56 | $146.78–$978.56 | 832% above | — |
| Mumps immunity blood test CPT 86735 MUMPS IGG QUAL | $11.69 | $11.69 | $1.75–$11.69 | 40% below | — |
| Mumps immunity blood test CPT 86735 MUMPS AB QUAL | $27.63 | $27.63 | $4.14–$27.63 | 42% above | — |
| Mumps immunity blood test CPT 86735 MUMPS IGM QUAL | $126.44 | $126.44 | $18.97–$126.44 | 551% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA) TOTAL | $27.63 | $27.63 | $4.14–$27.63 | 53% below | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PTH) | $29.75 | $29.75 | $4.46–$29.75 | 73% below | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $1,934.81 | $1,934.81 | $290.22–$1,934.81 | 1655% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $5.31 | $5.31 | $0.80–$5.31 | 92% below | — |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS OTHER | $99.88 | $99.88 | $14.98–$99.88 | 32% above | — |
| Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS BLD | $471.75 | $471.75 | $70.76–$471.75 | 524% above | — |
| Potassium blood test CPT 84132 POTASSIUM BLD | $895.69 | $895.69 | $134.35–$895.69 | 1123% above | — |
| Progesterone blood test CPT 84144 PROGESTERONE | $34.00 | $34.00 | $5.10–$34.00 | 60% below | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $38.25 | $38.25 | $5.74–$38.25 | 42% below | — |
| 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 | $2,097.38 | $2,097.38 | $21.09–$131.04 | 2374% above | — |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR DOO MANUAL READ | $2,097.38 | $2,097.38 | $314.61–$2,097.38 | 2374% above | — |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS B AG OIA | $818.13 | $818.13 | $122.72–$818.13 | 985% above | — |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS A AG OIA | $818.13 | $818.13 | $122.72–$818.13 | 985% above | — |
| Renin blood test CPT 84244 RENIN | $14.88 | $14.88 | $2.23–$14.88 | 40% below | — |
| Rh blood typing CPT 86901 RH TYPE | $484.50 | $484.50 | $72.67–$484.50 | 583% above | — |
| Rh blood typing CPT 86901 RH TYPE NEWBORN | $484.50 | $484.50 | $72.67–$484.50 | 583% above | — |
| Rheumatoid factor (RF) test CPT 86431 RA QN | $22.31 | $22.31 | $3.35–$22.31 | 69% above | — |
| Rheumatoid factor (RF) test CPT 86431 RA QN FL | $49.94 | $49.94 | $7.49–$49.94 | 278% above | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM | $12.75 | $12.75 | $1.91–$12.75 | 77% below | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO | $632.19 | $632.19 | $94.83–$632.19 | 1029% above | — |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation rate, erythrocyte; automated | $632.19 | $632.19 | $5.32–$28.16 | 1029% above | — |
| Sodium blood test CPT 84295 SODIUM BLD | $1,022.13 | $1,022.13 | $153.32–$1,022.13 | 1460% above | — |
| Stool ova and parasites exam CPT 87177 O&P SMEAR CONC ID | $30.81 | $30.81 | $4.62–$30.81 | 48% above | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD SCN 3 SPEC | $745.88 | $745.88 | $111.88–$745.88 | 1813% 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 | $745.88 | $745.88 | $4.38–$45.60 | 1813% above | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TP PA CONFIRMATION | $6.38 | $6.38 | $0.96–$6.38 | 72% below | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 MHA TP CONFIRM | $24.44 | $24.44 | $3.67–$24.44 | 8% above | — |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM AB | $330.44 | $330.44 | $49.57–$330.44 | 1365% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF QUAL | $5.31 | $5.31 | $0.80–$5.31 | 75% below | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GAMMA INTERFERON RESP | $59.50 | $59.50 | $8.93–$59.50 | 38% below | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL | $61.63 | $61.63 | $9.24–$61.63 | 25% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB | $14.88 | $14.88 | $2.23–$14.88 | 35% below | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICRO AB | $19.13 | $19.13 | $2.87–$19.13 | 16% below | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $1,900.81 | $1,900.81 | $285.12–$1,900.81 | 1649% above | — |
| Total IgE blood test CPT 82785 IGE | $54.19 | $54.19 | $8.13–$54.19 | 15% below | — |
| Total cholesterol blood test CPT 82465 CHOLESTEROL BLD | $1,174.06 | $1,174.06 | $176.11–$1,174.06 | 2562% above | — |
| Triglycerides blood test CPT 84478 TRIGLYCERIDES | $1,213.38 | $1,213.38 | $182.01–$1,213.38 | 2842% above | — |
| Troponin test, quantitative CPT 84484 Troponin, quantitative | $2,111.19 | $2,111.19 | $12.47–$129.76 | 1066% above | — |
| Troponin test, quantitative CPT 84484 TROPONIN QUANT | $2,111.19 | $2,111.19 | $316.68–$2,111.19 | 1066% above | — |
| Uric acid blood test CPT 84550 URIC ACID BLD | $950.94 | $950.94 | $142.64–$950.94 | 1356% above | — |
| Uric acid blood test CPT 84550 Uric acid; blood | $950.94 | $950.94 | $4.52–$47.04 | 1356% 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 | $1,073.13 | $1,073.13 | $6.25–$32.96 | 1195% above | — |
| Urinalysis with microscope exam, automated CPT 81001 UA W MICRO AUTO | $1,073.13 | $1,073.13 | $160.97–$1,073.13 | 1195% above | — |
| Urinalysis without microscope exam, automated CPT 81003 UROBILINOGEN UR AUTO | $187.00 | $187.00 | $28.05–$187.00 | 234% above | — |
| Urinalysis without microscope exam, automated CPT 81003 BILIRUBIN UR AUTO | $187.00 | $187.00 | $28.05–$187.00 | 234% above | — |
| Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO | $895.69 | $895.69 | $134.35–$895.69 | 1499% above | — |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automate | $274.13 | $274.13 | $5.03–$36.16 | 683% above | — |
| Urinalysis without microscope exam, manual CPT 81002 SPEC GRAV UR MANUAL | $274.13 | $274.13 | $41.12–$274.13 | 683% above | — |
| Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR | $31.88 | $31.88 | $4.78–$31.88 | 77% below | — |
| Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN QN | $11.69 | $11.69 | $1.75–$11.69 | 67% below | — |
| Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL BY DOO | $686.38 | $686.38 | $102.96–$686.38 | 681% above | — |
| Urine pregnancy test, read by color change CPT 81025 Urine pregnancy test, by visual color comparison methods | $686.38 | $686.38 | $8.61–$89.60 | 681% above | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $22.31 | $22.31 | $3.35–$22.31 | 76% below | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH W/WO FRAC | $14.88 | $14.88 | $2.23–$14.88 | 77% below | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D3 25-OH | $472.81 | $472.81 | $70.92–$472.81 | 623% above | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1-25 W/WO FRAC | $18.06 | $18.06 | $2.71–$18.06 | 73% below | — |
| Zinc blood test CPT 84630 ZINC BLOOD | $6.38 | $6.38 | $0.96–$6.38 | 54% below | — |
| Zinc blood test CPT 84630 ZINC URINE | $15.94 | $15.94 | $2.39–$15.94 | 15% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE | $11.69 | $11.69 | $1.75–$11.69 | 93% below | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL | $6,895.18 | $6,895.18 | $1,310.08–$6,895.18 | 268% 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 | $236,168.12 | $236,168.12 | $5,950.00 | 606% above | — |
| Catheter ablation for atrial fibrillation CPT 93656 COM EP REPO CTH TX AFIB | $236,168.12 | $236,168.12 | $35,425.22–$236,168.12 | 606% above | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $4,770.00 | $4,770.00 | $906.30–$4,770.00 | 446% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INH TX AC AWY OBST | $710.36 | $710.36 | $106.55–$710.36 | 120% above | — |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV SING/IN DR 1 HR | $3,972.19 | $3,972.19 | $595.83–$3,972.19 | 355% above | — |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMP AUD THR EVAL/SP REC | $244.13 | $244.13 | $36.62–$244.13 | 56% below | — |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined) | $244.13 | $244.13 | $517.75 | 56% below | — |
| 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 | $25,592.00 | $25,592.00 | $8,726.00–$12,934.00 | 453% above | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MINS | $25,592.00 | $25,592.00 | $6,525.96–$25,592.00 | 453% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG REC AW & DROWSY | $4,675.27 | $4,675.27 | $701.29–$4,675.27 | 356% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram (EEG); including recording awake and drowsy | $4,675.27 | $4,675.27 | $1,134.09 | 356% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING ONLY | $2,128.77 | $2,128.77 | $319.32–$2,128.77 | 530% above | — |
| Electroconvulsive therapy (ECT), one session CPT 90870 ECT WITH MONITORING | $7,545.09 | $7,545.09 | $1,131.76–$7,545.09 | 214% above | — |
| Electroconvulsive therapy (ECT), one session CPT 90870 Electroconvulsive therapy (includes necessary monitoring) | $7,545.09 | $7,545.09 | $169.81 | 214% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LVL 1 EMER DEPT | $3,525.76 | $3,525.76 | $899.07–$3,525.76 | 738% 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 | $3,525.76 | $3,525.76 | $880.00–$1,676.00 | 738% 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 | $4,973.92 | $4,973.92 | $1,675.00–$2,221.00 | 470% above | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LVL 2 EMER DEPT | $4,973.92 | $4,973.92 | $1,268.35–$4,973.92 | 470% above | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LVL 3 EMER DEPT | $7,104.16 | $7,104.16 | $1,811.56–$7,104.16 | 366% 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 | $7,104.16 | $7,104.16 | $2,672.00–$6,902.00 | 366% 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 | $13,839.84 | $13,839.84 | $6,902.00–$10,186.00 | 410% above | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LVL 4 EMER DEPT | $13,839.84 | $13,839.84 | $3,529.16–$13,839.84 | 410% above | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LVL 5 EMER DEPT | $21,255.36 | $21,255.36 | $5,420.12–$21,255.36 | 500% 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 | $21,255.36 | $21,255.36 | $8,726.00–$12,934.00 | 500% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $2,800.39 | $2,800.39 | $420.06–$2,800.39 | 108% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 FAM W PT 50 MIN | $1,736.00 | $1,736.00 | $260.40–$1,736.00 | 407% above | — |
| Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes | $1,736.00 | $1,736.00 | $213.30 | 407% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 FAM WO PT 50 MIN | $1,736.00 | $1,736.00 | $260.40–$1,736.00 | 407% above | — |
| Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy (without the patient present), 50 minutes | $1,736.00 | $1,736.00 | $186.45 | 407% above | — |
| Group psychotherapy session CPT 90853 IOP PSY GRP (NOT FAMILY) | $1,448.48 | $1,448.48 | $217.27–$1,448.48 | 421% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INIT UP TO 1HR | $3,757.36 | $3,757.36 | $563.60–$3,757.36 | 660% above | — |
| IV infusion of a medicine, first hour CPT 96365 IV INITIAL UP TO 1 HOUR | $3,757.36 | $3,757.36 | $563.60–$3,757.36 | 540% above | — |
| IV push of a medicine, first drug CPT 96374 IVP SINGLE/INITIAL DRUG | $868.00 | $868.00 | $130.20–$868.00 | 145% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ | $1,153.36 | $1,153.36 | $173.00–$1,153.36 | 544% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSY DX EVAL | $1,448.48 | $1,448.48 | $217.27–$1,448.48 | 244% above | — |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric diagnostic evaluation | $1,448.48 | $1,448.48 | $128.08–$140.89 | 244% above | — |
| New patient office visit, about 30 minutes CPT 99203 OP VISIT LEVEL 3 NP | $2,235.10 | $2,235.10 | $335.26–$2,235.10 | 943% above | — |
| New patient office visit, about 45 minutes CPT 99204 OP VISIT LEVEL 4 NP | $2,957.71 | $2,957.71 | $443.66–$2,957.71 | 1107% above | — |
| New patient office visit, about 60 minutes CPT 99205 OP VISIT LEVEL 5 NP | $1,882.00 | $1,882.00 | $282.30–$1,882.00 | 538% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 BASIC CARE NP | $712.00 | $712.00 | $106.80–$712.00 | 386% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP VISIT LEVEL 2 NP | $1,071.98 | $1,071.98 | $160.80–$1,071.98 | 631% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INIT ASSESS EA 15MIN | $266.91 | $266.91 | $40.04–$266.91 | 168% above | — |
| Psychotherapy session, 30 minutes CPT 90832 INDIV SESSION 30MIN | $1,292.24 | $1,292.24 | $193.84–$1,292.24 | 306% above | — |
| Psychotherapy session, 45 minutes CPT 90834 INDIV SESSION 45MIN | $1,736.00 | $1,736.00 | $260.40–$1,736.00 | 446% above | — |
| Psychotherapy session, 60 minutes CPT 90837 INDIV SESSION 60MIN | $2,069.10 | $2,069.10 | $310.37–$2,069.10 | 463% 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 | $299.46 | $299.46 | $10.41–$11.45 | 308% above | — |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKECESS 3-10 MIN | $299.46 | $299.46 | $44.92–$299.46 | 308% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP VISIT LEVEL 5 EST | $2,767.84 | $2,767.84 | $415.18–$2,767.84 | 1165% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 EST | $1,755.53 | $1,755.53 | $263.33–$1,755.53 | 1112% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 EST | $1,313.72 | $1,313.72 | $197.06–$1,313.72 | 651% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 EST | $1,434.37 | $1,434.37 | $215.16–$1,434.37 | 1217% above | — |
| Spirometry (breathing test) CPT 94010 SPIROMETRY | $1,210.86 | $1,210.86 | $181.63–$1,210.86 | 242% above | — |
| Spirometry before and after a bronchodilator CPT 94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration | $3,243.07 | $3,243.07 | $435.74 | 305% above | — |
| Spirometry before and after a bronchodilator CPT 94060 BRONCH EV SPIR PRE/POST | $3,243.07 | $3,243.07 | $486.46–$3,243.07 | 305% above | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEB | $1,768.55 | $1,768.55 | $265.28–$1,768.55 | 445% above | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs California | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella virus vaccine (VAR), live, for subcutaneous use | $1,708.98 | $1,708.98 | $380.14 | 446% above | — |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX LIVE VAC SQ | $1,708.98 | $1,708.98 | $256.35–$1,708.98 | 446% above | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 INFANRIX < 7 YRS VAC IM | $526.57 | $526.57 | $78.99–$526.57 | 638% above | — |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DAPTACEL < 7 YRS VAC IM | $604.98 | $604.98 | $90.75–$604.98 | 748% above | — |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 Diphtheria, tetanus toxoids, acellular pertussis vaccine, Haemophilus influenzae type b, and inactivated poliovirus vaccine, (DTaP-IPV/Hib), for intramuscular use | $1,623.16 | $1,623.16 | $233.10 | 679% above | — |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 PENTACEL VAC IM | $1,623.16 | $1,623.16 | $243.47–$1,623.16 | 679% above | — |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRI PF IM | $108.23 | $108.23 | $16.23–$108.23 | 17% above | — |
| Flu shot, recombinant, egg-free (Flublok) CPT 90673 Influenza virus vaccine, trivalent (RIV3), derived from recombinant DNA, hemagglutinin (HA) protein only, preservative and antibiotic free, for intramuscular use | $108.23 | $108.23 | $161.96 | 17% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use | $28.19 | $28.19 | $23.22–$41.55 | 31% below | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRI 0.5 ML PF IM | $28.19 | $28.19 | $4.23–$28.19 | 31% below | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B vaccine (HepB), adult dosage, 3 dose schedule, for intramuscular use | $1,162.36 | $1,162.36 | $124.00 | 956% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX ADLT 10MCG IM | $1,162.36 | $1,162.36 | $174.35–$1,162.36 | 956% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 Hepatitis B vaccine (HepB), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use | $2,004.58 | $2,004.58 | $33.20–$58.77 | 3375% above | — |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 RECOMBIVAX PED 5MCG IM | $2,004.58 | $2,004.58 | $300.69–$2,004.58 | 3375% above | — |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ACTHIB 4 DOSE VAC IM | $837.01 | $837.01 | $125.55–$837.01 | 2155% 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 | $837.01 | $837.01 | $26.93 | 2155% above | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF IM | $108.23 | $108.23 | $16.23–$108.23 | 14% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza virus vaccine (IIV), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use | $108.23 | $108.23 | $161.96 | 14% below | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VAC LIVE SQ | $1,401.72 | $1,401.72 | $210.26–$1,401.72 | 993% above | — |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles, mumps and rubella virus vaccine (MMR), live, for subcutaneous use | $1,401.72 | $1,401.72 | $193.28 | 993% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA VAC IM | $2,305.48 | $2,305.48 | $345.82–$2,305.48 | 782% above | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, diphtheria toxoid carrier (MenACWY-D) or CRM197 carrier (MenACWY-CRM), for intramuscular use | $2,305.48 | $2,305.48 | $349.64 | 782% above | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENQUADFI VAC IM | $2,696.88 | $2,696.88 | $404.53–$2,696.88 | 910% above | — |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Meningococcal conjugate vaccine, serogroups A, C, W, Y, quadrivalent, tetanus toxoid carrier (MenACWY-TT), for intramuscular use | $2,696.88 | $2,696.88 | $350.43 | 910% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup B (MenB-4C), for intramuscular use | $3,474.11 | $3,474.11 | $497.34 | 976% above | — |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 BEXSERO VAC IM | $3,474.11 | $3,474.11 | $521.12–$3,474.11 | 976% above | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 Meningococcal recombinant lipoprotein vaccine, serogroup B (MenB-FHbp), 2 or 3 dose schedule, for intramuscular use | $3,041.74 | $3,041.74 | $447.05 | 1409% above | — |
| Meningococcal B vaccine (Trumenba) CPT 90621 TRUMENBA VAC IM | $3,041.74 | $3,041.74 | $456.26–$3,041.74 | 1409% above | — |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR-13 VAC IM | $2,075.57 | $2,075.57 | $311.34–$2,075.57 | 564% above | — |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 Pneumococcal conjugate vaccine, 15 valent (PCV15), for intramuscular use | $3,548.26 | $3,548.26 | $269.31–$482.60 | 756% above | — |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 VAXNEUVANCE VAC IM | $3,548.26 | $3,548.26 | $532.24–$3,548.26 | 756% 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 | $444.99 | $444.99 | $133.47–$246.52 | 175% above | — |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 VAC IMSQ | $444.99 | $444.99 | $66.75–$444.99 | 175% above | — |
| Polio vaccine, inactivated (IPV) CPT 90713 Poliovirus vaccine, inactivated (IPV), for subcutaneous or intramuscular use | $866.67 | $866.67 | $47.06–$94.19 | 856% above | — |
| Polio vaccine, inactivated (IPV) CPT 90713 IPOL VAC IMSQ | $866.67 | $866.67 | $130.00–$866.67 | 856% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use | $7,958.99 | $7,958.99 | $595.06–$1,171.00 | 722% above | — |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 BEYFORTUS 0.5 ML IM | $7,958.99 | $7,958.99 | $1,193.85–$7,958.99 | 722% above | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 ABRYSVO VAC IM | $5,383.34 | $5,383.34 | $807.50–$5,383.34 | 1642% above | — |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use | $5,383.34 | $5,383.34 | $312.94–$646.01 | 1642% above | — |
| Rabies vaccine, one dose CPT 90675 RABAVERT 1 ML VAC IM | $6,478.75 | $6,478.75 | $971.81–$6,478.75 | 817% above | — |
| Rabies vaccine, one dose CPT 90675 IMOVAX 1 ML VAC IM | $6,761.75 | $6,761.75 | $1,014.26–$6,761.75 | 857% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use | $502.20 | $502.20 | $63.94 | 523% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TENIVAC VAC >= 7 YRS IM | $502.20 | $502.20 | $75.33–$502.20 | 523% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL VAC >= 7 YRS IM | $730.00 | $730.00 | $109.50–$730.00 | 528% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN SGL | $483.84 | $483.84 | $72.58–$483.84 | 365% above | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZ ADMIN EA ADDTL | $1,282.40 | $1,282.40 | $192.36–$1,282.40 | 1558% above | — |