SelfPayRates
Hospital Bennington, VT

Southwestern Vermont Medical Center

Southwestern Vermont Medical Center in Bennington, VT publishes cash prices for 364 common procedures listed here, from its own machine-readable price file updated Oct 15, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Vermont median for 280 of 356 procedures and below it for 51. By typical cash price it ranks #11 of 11 Vermont hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.

100 Hospital Dr, Bennington, VT 05201 Collected Oct 25, 2026 Source price file Check a bill from this hospital (802) 442-6361

Acute care hospital Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 470012 · CMS hospital register NPI 1205865789

The price file shows no self-pay discount

For 1764 of the 1764 prices listed here, the cash price in Southwestern Vermont Medical Center'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.

Financial assistance

Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply

Southwestern Vermont Medical Center is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.

You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.

Source: IRS, section 501(r) requirements for nonprofit hospitals.

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Southwestern Vermont Medical Center in Bennington, VT:

  • Feb 13, 2024 Warning notice
  • May 16, 2024 Case closed
  • Jul 7, 2026 Warning notice

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

ProcedureCash priceList priceInsurers payvs VermontOff list
Abdominal CT scan without and with contrast CPT 74170 RENAL MASS PROTOCOL $4,450.25 $4,450.25 $2,225.12–$4,450.25 50% above —
Abdominal CT scan without and with contrast CPT 74170 ADRENAL MASS CT PROTOCOL $4,450.25 $4,450.25 $2,225.12–$4,450.25 50% above —
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W W/O CONTRAST LCD $4,450.25 $4,450.25 $2,225.12–$4,450.25 50% above —
Abdominal CT scan without and with contrast inpatient CPT 74170 RENAL MASS PROTOCOL $4,450.25 $4,450.25 $1,886.91–$4,316.74 — —
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W W/O CONTRAST LCD $4,450.25 $4,450.25 $1,886.91–$4,316.74 — —
Abdominal CT scan without and with contrast inpatient CPT 74170 ADRENAL MASS CT PROTOCOL $4,450.25 $4,450.25 $1,886.91–$4,316.74 — —
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEW $895.00 $895.00 $447.50–$895.00 42% above —
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS $895.00 $895.00 $447.50–$895.00 42% above —
Abdominal X-ray, 2 views CPT 74019 XBDOMEN 2 POSITIONAL $895.00 $895.00 $447.50–$895.00 42% above —
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEWS $895.00 $895.00 $379.48–$868.15 — —
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEW $895.00 $895.00 $379.48–$868.15 — —
Abdominal X-ray, 2 views inpatient CPT 74019 XBDOMEN 2 POSITIONAL $895.00 $895.00 $379.48–$868.15 — —
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LEFT MIN 3 VIEWS $665.00 $665.00 $332.50–$665.00 22% above —
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE LT ROUTINE 3-4 VIEWS $665.00 $665.00 $332.50–$665.00 22% above —
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RIGHT MIN 3 VIEWS $665.00 $665.00 $332.50–$665.00 22% above —
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE RT ROUTINE 3-4 VIEWS $665.00 $665.00 $332.50–$665.00 22% above —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE LT ROUTINE 3-4 VIEWS $665.00 $665.00 $281.96–$645.05 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE LEFT MIN 3 VIEWS $665.00 $665.00 $281.96–$645.05 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE RIGHT MIN 3 VIEWS $665.00 $665.00 $281.96–$645.05 — —
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE RT ROUTINE 3-4 VIEWS $665.00 $665.00 $281.96–$645.05 — —
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPPER EXT VASCULAR STUDY $130.00 $130.00 $65.00–$130.00 54% below —
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPPER EXT VASCULAR STUDY $130.00 $130.00 $55.12–$126.10 — —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 LEFT UPPER EXT. W/O CONTRAST $3,027.00 $3,027.00 $1,513.50–$3,027.00 43% above —
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 RIGHT UPPER EXT.W/O CONTRAST $3,027.00 $3,027.00 $1,513.50–$3,027.00 43% above —
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 RIGHT UPPER EXT.W/O CONTRAST $3,027.00 $3,027.00 $1,283.45–$2,936.19 — —
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 LEFT UPPER EXT. W/O CONTRAST $3,027.00 $3,027.00 $1,283.45–$2,936.19 — —
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY $2,707.50 $2,707.50 $1,353.75–$2,707.50 35% above —
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY $2,707.50 $2,707.50 $1,147.98–$2,626.28 — —
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST RT COMPLETE W/AXILLA $574.75 $574.75 $287.38–$574.75 at median —
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST LT COMPLETE W/AXILLA $574.75 $574.75 $287.38–$574.75 at median —
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST LT COMPLETE W/AXILLA $574.75 $574.75 $243.69–$557.51 — —
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST RT COMPLETE W/AXILLA $574.75 $574.75 $243.69–$557.51 — —
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT LIMITED $574.75 $574.75 $287.38–$574.75 at median —
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT LIMITED $574.75 $574.75 $287.38–$574.75 at median —
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT LIMITED $574.75 $574.75 $243.69–$557.51 — —
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT LIMITED $574.75 $574.75 $243.69–$557.51 — —
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN AND PELVIS $4,563.00 $4,563.00 $2,281.50–$4,563.00 16% above —
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN AND PELVIS $4,563.00 $4,563.00 $1,934.71–$4,426.11 — —
CT angiography (CTA) of the head CPT 70496 CTA HEAD $4,126.75 $4,126.75 $2,063.38–$4,126.75 19% above —
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD $4,126.75 $4,126.75 $1,749.74–$4,002.95 — —
CT angiography (CTA) of the neck CPT 70498 CTA NECK $3,603.50 $3,603.50 $1,801.75–$3,603.50 13% above —
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK $3,603.50 $3,603.50 $1,527.88–$3,495.40 — —
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORAX $3,874.25 $3,874.25 $1,937.12–$3,874.25 36% above —
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA THORAX $3,874.25 $3,874.25 $1,642.68–$3,758.02 — —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA CARDIAC W/ CONTRAST/W/3D $2,254.50 $2,254.50 $1,127.25–$2,254.50 at median —
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA CARDIAC W/ CONTRAST/W/3D $2,254.50 $2,254.50 $955.91–$2,186.86 — —
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORING $130.00 $130.00 $65.00–$130.00 19% below —
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORING $130.00 $130.00 $55.12–$126.10 — —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 RENAL STONE PROTOC ABD/PEL WO $4,152.25 $4,152.25 $2,076.12–$4,152.25 33% above —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ENTEROGRAPHY W/O IV $4,152.25 $4,152.25 $2,076.12–$4,152.25 33% above —
CT scan of abdomen and pelvis, no contrast dye CPT 74176 ABDOMEN PELVIS W/O IV CONTRAST $4,152.25 $4,152.25 $2,076.12–$4,152.25 33% above —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ENTEROGRAPHY W/O IV $4,152.25 $4,152.25 $1,760.55–$4,027.68 — —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 ABDOMEN PELVIS W/O IV CONTRAST $4,152.25 $4,152.25 $1,760.55–$4,027.68 — —
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 RENAL STONE PROTOC ABD/PEL WO $4,152.25 $4,152.25 $1,760.55–$4,027.68 — —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN PELVIS W/ IV CONTRAST $5,024.00 $5,024.00 $2,512.00–$5,024.00 19% above —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 APPENDIX PROTOCOL ABD/PEL W/CO $5,024.00 $5,024.00 $2,512.00–$5,024.00 19% above —
CT scan of abdomen and pelvis, with contrast dye CPT 74177 DIVERTICULITIS CT PROTOCOL $5,024.00 $5,024.00 $2,512.00–$5,024.00 19% above —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 APPENDIX PROTOCOL ABD/PEL W/CO $5,024.00 $5,024.00 $2,130.18–$4,873.28 — —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 DIVERTICULITIS CT PROTOCOL $5,024.00 $5,024.00 $2,130.18–$4,873.28 — —
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN PELVIS W/ IV CONTRAST $5,024.00 $5,024.00 $2,130.18–$4,873.28 — —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HEMATURIA PROTOCOL W/3D RECONS $6,802.00 $6,802.00 $3,401.00–$6,802.00 45% above —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDWO/PELW/WO IV CONTRAST $6,802.00 $6,802.00 $3,401.00–$6,802.00 45% above —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD W/WO+PELVIS W/IV CONTR $6,802.00 $6,802.00 $3,401.00–$6,802.00 45% above —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD W/WO+PELVIS W/O IV CONT $6,802.00 $6,802.00 $3,401.00–$6,802.00 45% above —
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W/WO IV CONTRAST $6,802.00 $6,802.00 $3,401.00–$6,802.00 45% above —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD W/WO+PELVIS W/O IV CONT $6,802.00 $6,802.00 $2,884.05–$6,597.94 — —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDWO/PELW/WO IV CONTRAST $6,802.00 $6,802.00 $2,884.05–$6,597.94 — —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HEMATURIA PROTOCOL W/3D RECONS $6,802.00 $6,802.00 $2,884.05–$6,597.94 — —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W/WO IV CONTRAST $6,802.00 $6,802.00 $2,884.05–$6,597.94 — —
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD W/WO+PELVIS W/IV CONTR $6,802.00 $6,802.00 $2,884.05–$6,597.94 — —
CT scan of the abdomen with contrast CPT 74160 CTSCAN ABDOMEN W/CONTRAST LCD $3,404.25 $3,404.25 $1,702.12–$3,404.25 25% above —
CT scan of the abdomen with contrast CPT 74160 LIVER MASS/ELEVATE LFT CT PROT $3,404.25 $3,404.25 $1,702.12–$3,404.25 25% above —
CT scan of the abdomen with contrast CPT 74160 PANCREAS CT PROTOCOL $3,404.25 $3,404.25 $1,702.12–$3,404.25 25% above —
CT scan of the abdomen with contrast CPT 74160 APPENDIX PROTOCOL ABDOMEN W/CO $3,404.25 $3,404.25 $1,702.12–$3,404.25 25% above —
CT scan of the abdomen with contrast inpatient CPT 74160 PANCREAS CT PROTOCOL $3,404.25 $3,404.25 $1,443.40–$3,302.12 — —
CT scan of the abdomen with contrast inpatient CPT 74160 CTSCAN ABDOMEN W/CONTRAST LCD $3,404.25 $3,404.25 $1,443.40–$3,302.12 — —
CT scan of the abdomen with contrast inpatient CPT 74160 APPENDIX PROTOCOL ABDOMEN W/CO $3,404.25 $3,404.25 $1,443.40–$3,302.12 — —
CT scan of the abdomen with contrast inpatient CPT 74160 LIVER MASS/ELEVATE LFT CT PROT $3,404.25 $3,404.25 $1,443.40–$3,302.12 — —
CT scan of the abdomen without contrast CPT 74150 CTSCAN ABDOMEN W/O CONTRASTLCD $3,031.50 $3,031.50 $1,515.75–$3,031.50 31% above —
CT scan of the abdomen without contrast inpatient CPT 74150 CTSCAN ABDOMEN W/O CONTRASTLCD $3,031.50 $3,031.50 $1,285.36–$2,940.56 — —
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN FACIAL W/O CONTRAST $2,626.00 $2,626.00 $1,313.00–$2,626.00 25% above —
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS SCAN W/O CONTRAST $2,626.00 $2,626.00 $1,313.00–$2,626.00 25% above —
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS SCAN W/O CONTRAST $2,626.00 $2,626.00 $1,113.42–$2,547.22 — —
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SCAN FACIAL W/O CONTRAST $2,626.00 $2,626.00 $1,113.42–$2,547.22 — —
CT scan of the head or brain, no contrast dye CPT 70450 CAT SCAN HEAD W/O CONTRAST LCD $2,634.75 $2,634.75 $1,317.38–$2,634.75 41% above —
CT scan of the head or brain, no contrast dye CPT 70450 HEAD CT W/O CONTRAST CRITICAL $2,634.75 $2,634.75 $1,317.38–$2,634.75 41% above —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD CT W/O CONTRAST CRITICAL $2,634.75 $2,634.75 $1,117.13–$2,555.71 — —
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CAT SCAN HEAD W/O CONTRAST LCD $2,634.75 $2,634.75 $1,117.13–$2,555.71 — —
CT scan of the head with contrast CPT 70460 CAT SCAN HEAD W/CONTRAST LCD $2,911.00 $2,911.00 $1,455.50–$2,911.00 27% above —
CT scan of the head with contrast inpatient CPT 70460 CAT SCAN HEAD W/CONTRAST LCD $2,911.00 $2,911.00 $1,234.26–$2,823.67 — —
CT scan of the head without and with contrast CPT 70470 CTSCAN HEAD W&W/O CONTRAST LCD $3,669.00 $3,669.00 $1,834.50–$3,669.00 32% above —
CT scan of the head without and with contrast inpatient CPT 70470 CTSCAN HEAD W&W/O CONTRAST LCD $3,669.00 $3,669.00 $1,555.66–$3,558.93 — —
CT scan of the lower back (lumbar spine) without contrast CPT 72131 LUMBAR SPINE W/O CONTRAST $3,027.00 $3,027.00 $1,513.50–$3,027.00 39% above —
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 LUMBAR SPINE W/O CONTRAST $3,027.00 $3,027.00 $1,283.45–$2,936.19 — —
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CERV SPINE W/O CONTRAST $3,027.00 $3,027.00 $1,513.50–$3,027.00 42% above —
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CERV SPINE W/O CONTRAST $3,027.00 $3,027.00 $1,283.45–$2,936.19 — —
CT scan of the pelvis, with contrast dye CPT 72193 LOWER ABDOMEN $3,466.75 $3,466.75 $1,733.38–$3,466.75 34% above —
CT scan of the pelvis, with contrast dye CPT 72193 APPENDIX PROTOCOL PELVIS W/CON $3,466.75 $3,466.75 $1,733.38–$3,466.75 34% above —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 LOWER ABDOMEN $3,466.75 $3,466.75 $1,469.90–$3,362.75 — —
CT scan of the pelvis, with contrast dye inpatient CPT 72193 APPENDIX PROTOCOL PELVIS W/CON $3,466.75 $3,466.75 $1,469.90–$3,362.75 — —
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US BILAT TEMPORAL ARTERY SCAN $1,228.50 $1,228.50 $614.25–$1,228.50 — —
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID COMPLETE $1,228.50 $1,228.50 $614.25–$1,228.50 82% above —
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID ULTRASOUND,BIL COMPLET $1,228.50 $1,228.50 $614.25–$1,228.50 82% above —
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US BILAT TEMPORAL ARTERY SCAN $1,228.50 $1,228.50 $520.88–$1,191.64 — —
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID ULTRASOUND,BIL COMPLET $1,228.50 $1,228.50 $520.88–$1,191.64 — —
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID COMPLETE $1,228.50 $1,228.50 $520.88–$1,191.64 — —
Chest CT scan without and with contrast CPT 71270 CHEST $3,778.50 $3,778.50 $1,889.25–$3,778.50 68% above —
Chest CT scan without and with contrast inpatient CPT 71270 CHEST $3,778.50 $3,778.50 $1,602.08–$3,665.14 — —
Chest X-ray, 2 views CPT 71046 XR CHEST PA/LAT 2V $711.75 $711.75 $355.88–$711.75 53% above —
Chest X-ray, 2 views CPT 71046 XR CHEST 2V-INSPIRATE/EXPIRATE $711.75 $711.75 $355.88–$711.75 53% above —
Chest X-ray, 2 views CPT 71046 CHEST OBLIQUES ONLY 2 VIEWS $711.75 $711.75 $355.88–$711.75 53% above —
Chest X-ray, 2 views CPT 71046 XR CHEST DECUBITUS VIEWS ONLY $711.75 $711.75 $355.88–$711.75 53% above —
Chest X-ray, 2 views inpatient CPT 71046 CHEST OBLIQUES ONLY 2 VIEWS $711.75 $711.75 $301.78–$690.40 — —
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2V-INSPIRATE/EXPIRATE $711.75 $711.75 $301.78–$690.40 — —
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA/LAT 2V $711.75 $711.75 $301.78–$690.40 — —
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST DECUBITUS VIEWS ONLY $711.75 $711.75 $301.78–$690.40 — —
Chest X-ray, single view CPT 71045 XR CHEST PORTABLE 1 VIEW $495.75 $495.75 $247.88–$495.75 37% above —
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW $495.75 $495.75 $247.88–$495.75 37% above —
Chest X-ray, single view inpatient CPT 71045 XR CHEST PORTABLE 1 VIEW $495.75 $495.75 $210.20–$480.88 — —
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW $495.75 $495.75 $210.20–$480.88 — —
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE LEFT $606.50 $606.50 $303.25–$606.50 20% above —
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE RIGHT $606.50 $606.50 $303.25–$606.50 20% above —
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE RT $606.50 $606.50 $303.25–$606.50 20% above —
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE LT $606.50 $606.50 $303.25–$606.50 20% above —
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RT $606.50 $606.50 $257.16–$588.30 — —
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LT $606.50 $606.50 $257.16–$588.30 — —
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE RIGHT $606.50 $606.50 $257.16–$588.30 — —
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE LEFT $606.50 $606.50 $257.16–$588.30 — —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RETROPERITONEUM ULTRASOUND $1,077.75 $1,077.75 $538.88–$1,077.75 49% above —
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL AND BLADDER ULTRASOUND $1,077.75 $1,077.75 $538.88–$1,077.75 49% above —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RETROPERITONEUM ULTRASOUND $1,077.75 $1,077.75 $456.97–$1,045.42 — —
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RENAL AND BLADDER ULTRASOUND $1,077.75 $1,077.75 $456.97–$1,045.42 — —
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA SCAN AXIAL ONLY $786.25 $786.25 $393.12–$786.25 20% above —
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA APPENDICULAR ONLY $786.25 $786.25 $393.12–$786.25 20% above —
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA SCAN AXIAL ONLY $786.25 $786.25 $333.37–$762.66 — —
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA APPENDICULAR ONLY $786.25 $786.25 $333.37–$762.66 — —
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR DEXA SCAN WRIST/HEEL $307.50 $307.50 $153.75–$307.50 14% below —
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA APPENDICULAR ONLY $307.50 $307.50 $153.75–$307.50 14% below —
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA APPENDICULAR ONLY $307.50 $307.50 $130.38–$298.27 — —
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 XR DEXA SCAN WRIST/HEEL $307.50 $307.50 $130.38–$298.27 — —
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CAT SCAN CHEST $3,027.00 $3,027.00 $1,513.50–$3,027.00 37% above —
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CAT SCAN CHEST $3,027.00 $3,027.00 $1,283.45–$2,936.19 — —
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CAT SCAN THORAX W/CONTRAST $3,398.25 $3,398.25 $1,699.12–$3,398.25 25% above —
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CAT SCAN THORAX W/CONTRAST $3,398.25 $3,398.25 $1,440.86–$3,296.30 — —
Diagnostic mammogram, both breasts both sides CPT 77066 DX BILAT MAMM0 DIGITAL W/CAD $900.25 $900.25 $450.12–$900.25 — —
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX BILAT MAMM0 DIGITAL W/CAD $900.25 $900.25 $381.71–$873.24 — —
Diagnostic mammogram, one breast one side CPT 77065 DX LT DIGITAL MAMMO /CAD $750.50 $750.50 $375.25–$750.50 41% above —
Diagnostic mammogram, one breast one side CPT 77065 DX RT DIGITAL MAMMO /CAD $750.50 $750.50 $375.25–$750.50 41% above —
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX RT DIGITAL MAMMO /CAD $750.50 $750.50 $318.21–$727.98 — —
Diagnostic mammogram, one breast inpatient one side CPT 77065 DX LT DIGITAL MAMMO /CAD $750.50 $750.50 $318.21–$727.98 — —
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 LOWER EXT BILATERAL ARTERIAL $1,183.50 $1,183.50 $591.75–$1,183.50 — —
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 LOWER EXT BILATERAL ARTERIAL $1,183.50 $1,183.50 $501.80–$1,147.99 — —
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS INSUFFICIECY BILAT $1,354.75 $1,354.75 $677.38–$1,354.75 — —
Duplex ultrasound of the leg veins, both legs CPT 93970 VENOUS COMP ULTRASOUND BILATER $1,354.75 $1,354.75 $677.38–$1,354.75 60% above —
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS INSUFFICIECY BILAT $1,354.75 $1,354.75 $574.41–$1,314.11 — —
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VENOUS COMP ULTRASOUND BILATER $1,354.75 $1,354.75 $574.41–$1,314.11 — —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAPHY W DOP&COLOR $3,041.75 $3,041.75 $1,520.88–$3,041.75 19% above —
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COLOR FLOW/DOPPLER $3,041.75 $3,041.75 $1,520.88–$3,041.75 19% above —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COLOR FLOW/DOPPLER $3,041.75 $3,041.75 $1,289.70–$2,950.50 — —
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAPHY W DOP&COLOR $3,041.75 $3,041.75 $1,289.70–$2,950.50 — —
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW LT 2 VIEWS $625.00 $625.00 $312.50–$625.00 54% above —
Elbow X-ray, 2 views one side CPT 73070 ELBOW RIGHT 2 VIEWS $625.00 $625.00 $312.50–$625.00 54% above —
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW RT 2 VIEWS $625.00 $625.00 $312.50–$625.00 54% above —
Elbow X-ray, 2 views one side CPT 73070 ELBOW LEFT 2 VIEWS $625.00 $625.00 $312.50–$625.00 54% above —
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW LT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW LEFT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW RT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW RIGHT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW RIGHT MIN 3 VIEWS $646.50 $646.50 $323.25–$646.50 13% above —
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW LT ROUTINE 3-4 VIEWS $646.50 $646.50 $323.25–$646.50 13% above —
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW LEFT MIN 3 VIEWS $646.50 $646.50 $323.25–$646.50 13% above —
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW RT ROUTINE 3-4 VIEWS $646.50 $646.50 $323.25–$646.50 13% above —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW RT ROUTINE 3-4 VIEWS $646.50 $646.50 $274.12–$627.10 — —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW LT ROUTINE 3-4 VIEWS $646.50 $646.50 $274.12–$627.10 — —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW LEFT MIN 3 VIEWS $646.50 $646.50 $274.12–$627.10 — —
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW RIGHT MIN 3 VIEWS $646.50 $646.50 $274.12–$627.10 — —
Eye socket (orbit) CT scan without contrast CPT 70480 ORBIT,SELLA,POSTFOSSA,EAR W/O $2,669.25 $2,669.25 $1,334.62–$2,669.25 20% above —
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 ORBIT,SELLA,POSTFOSSA,EAR W/O $2,669.25 $2,669.25 $1,131.76–$2,589.17 — —
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VIEWS $1,047.50 $1,047.50 $523.75–$1,047.50 69% above —
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES $1,047.50 $1,047.50 $523.75–$1,047.50 69% above —
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES $1,047.50 $1,047.50 $444.14–$1,016.08 — —
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 FACIAL BONES MIN 3 VIEWS $1,047.50 $1,047.50 $444.14–$1,016.08 — —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM LEFT $616.50 $616.50 $308.25–$616.50 33% above —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM RIGHT $616.50 $616.50 $308.25–$616.50 33% above —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM RT $616.50 $616.50 $308.25–$616.50 33% above —
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM LT $616.50 $616.50 $308.25–$616.50 33% above —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM LEFT $616.50 $616.50 $261.40–$598.00 — —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM LT $616.50 $616.50 $261.40–$598.00 — —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM RIGHT $616.50 $616.50 $261.40–$598.00 — —
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM RT $616.50 $616.50 $261.40–$598.00 — —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY DUCTAL SYSTEM $3,199.25 $3,199.25 $1,599.62–$3,199.25 85% above —
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY DUCTAL SYSTEM $3,199.25 $3,199.25 $1,356.48–$3,103.27 — —
Hand X-ray, 2 views one side CPT 73120 HAND RIGHT (2 VIEWS) $604.50 $604.50 $302.25–$604.50 26% above —
Hand X-ray, 2 views one side CPT 73120 XR HAND LT 2 VIEWS $604.50 $604.50 $302.25–$604.50 26% above —
Hand X-ray, 2 views one side CPT 73120 HAND LEFT (2 VIEWS) $604.50 $604.50 $302.25–$604.50 26% above —
Hand X-ray, 2 views one side CPT 73120 XR HAND RT 2 VIEWS $604.50 $604.50 $302.25–$604.50 26% above —
Hand X-ray, 2 views inpatient one side CPT 73120 HAND LEFT (2 VIEWS) $604.50 $604.50 $256.31–$586.36 — —
Hand X-ray, 2 views inpatient one side CPT 73120 HAND RIGHT (2 VIEWS) $604.50 $604.50 $256.31–$586.36 — —
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND RT 2 VIEWS $604.50 $604.50 $256.31–$586.36 — —
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND LT 2 VIEWS $604.50 $604.50 $256.31–$586.36 — —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS RIGHT $625.00 $625.00 $312.50–$625.00 60% above —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS LT $625.00 $625.00 $312.50–$625.00 60% above —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 CALCANEUS LEFT $625.00 $625.00 $312.50–$625.00 60% above —
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR CALCANEUS RT $625.00 $625.00 $312.50–$625.00 60% above —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS LT $625.00 $625.00 $265.00–$606.25 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR CALCANEUS RT $625.00 $625.00 $265.00–$606.25 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS RIGHT $625.00 $625.00 $265.00–$606.25 — —
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 CALCANEUS LEFT $625.00 $625.00 $265.00–$606.25 — —
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY WITH CPAP $8,519.00 $8,519.00 $4,259.50–$8,519.00 32% above —
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY WITH CPAP $8,519.00 $8,519.00 $3,612.06–$8,263.43 — —
Knee X-ray, 3 views one side CPT 73562 KNEE LEFT (PATELLA) 3 VIEWS $635.50 $635.50 $317.75–$635.50 7% above —
Knee X-ray, 3 views one side CPT 73562 XR KNEE OR PATELLA LT 3 VIEWS $635.50 $635.50 $317.75–$635.50 7% above —
Knee X-ray, 3 views one side CPT 73562 XR KNEE OR PATELLA RT 3 VIEWS $635.50 $635.50 $317.75–$635.50 7% above —
Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT (PATELLA) 3 VIEWS $635.50 $635.50 $317.75–$635.50 7% above —
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT (PATELLA) 3 VIEWS $635.50 $635.50 $269.45–$616.43 — —
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE OR PATELLA RT 3 VIEWS $635.50 $635.50 $269.45–$616.43 — —
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT (PATELLA) 3 VIEWS $635.50 $635.50 $269.45–$616.43 — —
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE OR PATELLA LT 3 VIEWS $635.50 $635.50 $269.45–$616.43 — —
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE LT ROUTINE VIEWS $901.50 $901.50 $450.75–$901.50 32% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE RIGHT COMPLETE MIN 4 VIEW $901.50 $901.50 $450.75–$901.50 32% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE LEFT COMPLETE MIN 4 VIEWS $901.50 $901.50 $450.75–$901.50 32% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE RIGHT COMPLETE 4 OR MORE $901.50 $901.50 $450.75–$901.50 32% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE RT ROUTINE VIEWS $901.50 $901.50 $450.75–$901.50 32% above —
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE LEFT COMPLETE 4 OR MORE V $901.50 $901.50 $450.75–$901.50 32% above —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE LEFT COMPLETE 4 OR MORE V $901.50 $901.50 $382.24–$874.46 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE LT ROUTINE VIEWS $901.50 $901.50 $382.24–$874.46 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE RIGHT COMPLETE MIN 4 VIEW $901.50 $901.50 $382.24–$874.46 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE RT ROUTINE VIEWS $901.50 $901.50 $382.24–$874.46 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE LEFT COMPLETE MIN 4 VIEWS $901.50 $901.50 $382.24–$874.46 — —
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE RIGHT COMPLETE 4 OR MORE $901.50 $901.50 $382.24–$874.46 — —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 LEFT LOWER EXT.W/O CONTRAST $2,876.25 $2,876.25 $1,438.12–$2,876.25 38% above —
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 RIGHT LOWER EXT.W/O CONTRAST $2,876.25 $2,876.25 $1,438.12–$2,876.25 38% above —
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 LEFT LOWER EXT.W/O CONTRAST $2,876.25 $2,876.25 $1,219.53–$2,789.96 — —
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 RIGHT LOWER EXT.W/O CONTRAST $2,876.25 $2,876.25 $1,219.53–$2,789.96 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ABDOMEN ULTRASOUND ED $918.75 $918.75 $459.38–$918.75 41% above —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ABDOMEN ULTRASOUND $918.75 $918.75 $459.38–$918.75 41% above —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 INFANT PYLORUS- LIMITED ABD US $918.75 $918.75 $459.38–$918.75 41% above —
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LOWER BACK SOFT TISSUE MASS $918.75 $918.75 $459.38–$918.75 41% above —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 INFANT PYLORUS- LIMITED ABD US $918.75 $918.75 $389.55–$891.19 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LOWER BACK SOFT TISSUE MASS $918.75 $918.75 $389.55–$891.19 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 LIMITED ABDOMEN ULTRASOUND $918.75 $918.75 $389.55–$891.19 — —
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 LIMITED ABDOMEN ULTRASOUND ED $918.75 $918.75 $389.55–$891.19 — —
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 U/S exam extremity $890.00 $890.00 $445.00–$890.00 56% above —
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 U/S EXTREMITY NONVASCULAR SDC $890.00 $890.00 $445.00–$890.00 56% above —
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 EXTREMITY US NON VASCULAR $890.00 $890.00 $445.00–$890.00 56% above —
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ULTRASOUND EXTREMITY LIMITED $890.00 $890.00 $445.00–$890.00 56% above —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 EXTREMITY RT NONVASCULAR U/S $890.00 $890.00 $445.00–$890.00 56% above —
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 EXTREMITY LT NONVASCULAR U/S $890.00 $890.00 $445.00–$890.00 56% above —
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ULTRASOUND EXTREMITY LIMITED $890.00 $890.00 $377.36–$863.30 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 U/S EXTREMITY NONVASCULAR SDC $890.00 $890.00 $377.36–$863.30 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 U/S exam extremity $890.00 $890.00 $377.36–$863.30 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 EXTREMITY US NON VASCULAR $890.00 $890.00 $377.36–$863.30 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 EXTREMITY LT NONVASCULAR U/S $890.00 $890.00 $377.36–$863.30 — —
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 EXTREMITY RT NONVASCULAR U/S $890.00 $890.00 $377.36–$863.30 — —
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LOW DOSE W/O $1,513.50 $1,513.50 $756.75–$1,513.50 at median —
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LOW DOSE W/O $1,513.50 $1,513.50 $641.72–$1,468.10 — —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER LEG LT $616.50 $616.50 $308.25–$616.50 30% above —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LOWER LEG RIGHT 2 VIEWS $616.50 $616.50 $308.25–$616.50 30% above —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 LOWER LEG LEFT 2 VIEWS $616.50 $616.50 $308.25–$616.50 30% above —
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER LEG RT $616.50 $616.50 $308.25–$616.50 30% above —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LOWER LEG LEFT 2 VIEWS $616.50 $616.50 $261.40–$598.00 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER LEG LT $616.50 $616.50 $261.40–$598.00 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 LOWER LEG RIGHT 2 VIEWS $616.50 $616.50 $261.40–$598.00 — —
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER LEG RT $616.50 $616.50 $261.40–$598.00 — —
MR angiography (MRA) of the head without contrast CPT 70544 MRI ANGIOGRAPHY HEAD W/O CONTR $4,471.75 $4,471.75 $2,235.88–$4,471.75 28% above —
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST MRI $4,471.75 $4,471.75 $2,235.88–$4,471.75 28% above —
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST MRI $4,471.75 $4,471.75 $1,896.02–$4,337.60 — —
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRI ANGIOGRAPHY HEAD W/O CONTR $4,471.75 $4,471.75 $1,896.02–$4,337.60 — —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 KNEE RIGHT MRI W/O CONTRAST $4,304.75 $4,304.75 $2,152.38–$4,304.75 28% above —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 KNEE LEFT MRI W/O CONTRAST $4,304.75 $4,304.75 $2,152.38–$4,304.75 28% above —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HIP RIGHT MRI W/O CONTRAST $4,304.75 $4,304.75 $2,152.38–$4,304.75 28% above —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HIP LEFT MRI W/O CONTRAST $4,304.75 $4,304.75 $2,152.38–$4,304.75 28% above —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 ANKLE LEFT MRI W/O CONTRAST $4,304.75 $4,304.75 $2,152.38–$4,304.75 28% above —
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 ANKLE RIGHT MRI W/O CONTRAST $4,304.75 $4,304.75 $2,152.38–$4,304.75 28% above —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 KNEE RIGHT MRI W/O CONTRAST $4,304.75 $4,304.75 $1,825.21–$4,175.61 — —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 ANKLE RIGHT MRI W/O CONTRAST $4,304.75 $4,304.75 $1,825.21–$4,175.61 — —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HIP LEFT MRI W/O CONTRAST $4,304.75 $4,304.75 $1,825.21–$4,175.61 — —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 ANKLE LEFT MRI W/O CONTRAST $4,304.75 $4,304.75 $1,825.21–$4,175.61 — —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HIP RIGHT MRI W/O CONTRAST $4,304.75 $4,304.75 $1,825.21–$4,175.61 — —
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 KNEE LEFT MRI W/O CONTRAST $4,304.75 $4,304.75 $1,825.21–$4,175.61 — —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HIP RIGHT MRI W & W/O CONTRAST $4,823.00 $4,823.00 $2,411.50–$4,823.00 2% above —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 ANKLE LEFT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,411.50–$4,823.00 2% above —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 ANKLE RIGHT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,411.50–$4,823.00 2% above —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HIP LEFT MRI W & W/O CONTRAST $4,823.00 $4,823.00 $2,411.50–$4,823.00 2% above —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 KNEE LEFT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,411.50–$4,823.00 2% above —
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 KNEE RIGHT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,411.50–$4,823.00 2% above —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 KNEE RIGHT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,044.95–$4,678.31 — —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 ANKLE LEFT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,044.95–$4,678.31 — —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 ANKLE RIGHT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,044.95–$4,678.31 — —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HIP LEFT MRI W & W/O CONTRAST $4,823.00 $4,823.00 $2,044.95–$4,678.31 — —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HIP RIGHT MRI W & W/O CONTRAST $4,823.00 $4,823.00 $2,044.95–$4,678.31 — —
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 KNEE LEFT MRI W&W/O CONTRAST $4,823.00 $4,823.00 $2,044.95–$4,678.31 — —
MRI of the abdomen without contrast CPT 74181 ABDOMEN W/O CONTRAST MRI $3,607.00 $3,607.00 $1,803.50–$3,607.00 26% above —
MRI of the abdomen without contrast CPT 74181 MRI ABD W/O HEMACHROMATOSIS $3,607.00 $3,607.00 $1,803.50–$3,607.00 26% above —
MRI of the abdomen without contrast CPT 74181 MRI ABD W/O CONTRAST $3,607.00 $3,607.00 $1,803.50–$3,607.00 26% above —
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN W/O CONTRAST MRI $3,607.00 $3,607.00 $1,529.37–$3,498.79 — —
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD W/O CONTRAST $3,607.00 $3,607.00 $1,529.37–$3,498.79 — —
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABD W/O HEMACHROMATOSIS $3,607.00 $3,607.00 $1,529.37–$3,498.79 — —
MRI of the abdomen, without and then with contrast dye CPT 74183 MRCP WITH AND WITHOUT CONTRAST $4,507.50 $4,507.50 $2,253.75–$4,507.50 13% above —
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN W/WO CONTRAST MRI $4,507.50 $4,507.50 $2,253.75–$4,507.50 13% above —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN W/WO CONTRAST MRI $4,507.50 $4,507.50 $1,911.18–$4,372.27 — —
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRCP WITH AND WITHOUT CONTRAST $4,507.50 $4,507.50 $1,911.18–$4,372.27 — —
MRI of the brain, no contrast dye CPT 70551 BRAIN WITHOUT CONTRAST MRI LCD $4,242.75 $4,242.75 $2,121.38–$4,242.75 30% above —
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN WITHOUT CONTRAST MRI LCD $4,242.75 $4,242.75 $1,798.93–$4,115.47 — —
MRI of the brain, with and without contrast dye CPT 70553 BRAIN W & W/O CONTRAST MRI LCD $4,611.50 $4,611.50 $2,305.75–$4,611.50 4% below —
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITARY W/WO CONTRAST $4,611.50 $4,611.50 $2,305.75–$4,611.50 4% below —
MRI of the brain, with and without contrast dye CPT 70553 IAC W/WO CONTRAST MRI LCD $4,611.50 $4,611.50 $2,305.75–$4,611.50 4% below —
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITARY W/WO CONTRAST $4,611.50 $4,611.50 $1,955.28–$4,473.16 — —
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W & W/O CONTRAST MRI LCD $4,611.50 $4,611.50 $1,955.28–$4,473.16 — —
MRI of the brain, with and without contrast dye inpatient CPT 70553 IAC W/WO CONTRAST MRI LCD $4,611.50 $4,611.50 $1,955.28–$4,473.16 — —
MRI of the lower back, no contrast dye CPT 72148 LSPINE MRI CRITICAL CORD COMPR $4,319.75 $4,319.75 $2,159.88–$4,319.75 21% above —
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE W/O CONTRAST MRI $4,319.75 $4,319.75 $2,159.88–$4,319.75 21% above —
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE W/O CONTRAST MRI $4,319.75 $4,319.75 $1,831.57–$4,190.16 — —
MRI of the lower back, no contrast dye inpatient CPT 72148 LSPINE MRI CRITICAL CORD COMPR $4,319.75 $4,319.75 $1,831.57–$4,190.16 — —
MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR SPINE W/WO CONTRAST MRI $4,729.00 $4,729.00 $2,364.50–$4,729.00 at median —
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR SPINE W/WO CONTRAST MRI $4,729.00 $4,729.00 $2,005.10–$4,587.13 — —
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC SPINE MRI WO CONTRAST $3,605.00 $3,605.00 $1,802.50–$3,605.00 1% above —
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 TSPINE MRI CRITICAL CORD COMPR $3,605.00 $3,605.00 $1,802.50–$3,605.00 1% above —
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC SPINE MRI WO CONTRAST $3,605.00 $3,605.00 $1,528.52–$3,496.85 — —
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 TSPINE MRI CRITICAL CORD COMPR $3,605.00 $3,605.00 $1,528.52–$3,496.85 — —
MRI of the neck (cervical spine) without and with contrast CPT 72156 CERV SPINE W/WO CONTRAST MRI $4,739.00 $4,739.00 $2,369.50–$4,739.00 1% below —
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERV SPINE W/WO CONTRAST MRI $4,739.00 $4,739.00 $2,009.34–$4,596.83 — —
MRI of the neck (cervical spine), no contrast dye CPT 72141 CSPINE MRI CRITICAL CORD COMPR $4,185.75 $4,185.75 $2,092.88–$4,185.75 22% above —
MRI of the neck (cervical spine), no contrast dye CPT 72141 CERV SPINE W/O CONTRAST MRI $4,185.75 $4,185.75 $2,092.88–$4,185.75 22% above —
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERV SPINE W/O CONTRAST MRI $4,185.75 $4,185.75 $1,774.76–$4,060.18 — —
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CSPINE MRI CRITICAL CORD COMPR $4,185.75 $4,185.75 $1,774.76–$4,060.18 — —
MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE SCAN W/WO CONTRAS $4,507.50 $4,507.50 $2,253.75–$4,507.50 5% above —
MRI of the pelvis without and with contrast CPT 72197 PELVIS W/WO CONTRAST MRI $4,507.50 $4,507.50 $2,253.75–$4,507.50 5% above —
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS W/WO CONTRAST MRI $4,507.50 $4,507.50 $1,911.18–$4,372.27 — —
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE SCAN W/WO CONTRAS $4,507.50 $4,507.50 $1,911.18–$4,372.27 — —
MRI of the pelvis, no contrast dye CPT 72195 MRI PROSTATE SCAN W/O CONTRAST $3,607.00 $3,607.00 $1,803.50–$3,607.00 53% above —
MRI of the pelvis, no contrast dye CPT 72195 PELVIS W/O CONTRAST MRI $3,607.00 $3,607.00 $1,803.50–$3,607.00 53% above —
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PROSTATE SCAN W/O CONTRAST $3,607.00 $3,607.00 $1,529.37–$3,498.79 — —
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS W/O CONTRAST MRI $3,607.00 $3,607.00 $1,529.37–$3,498.79 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 WRIST RIGHT MRI W/O CONTRAST $4,299.50 $4,299.50 $2,149.75–$4,299.50 33% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 ELBOW LEFT MRI W/O CONTRAST $4,299.50 $4,299.50 $2,149.75–$4,299.50 33% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 WRIST LEFT MRI W/O CONTRAST $4,299.50 $4,299.50 $2,149.75–$4,299.50 33% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 SHOULDER RT MRI W/O CONTRAST $4,299.50 $4,299.50 $2,149.75–$4,299.50 33% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 SHOULDER LEFT MRI W/O CONTRAST $4,299.50 $4,299.50 $2,149.75–$4,299.50 33% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 ELBOW RIGHT MRI W/O CONTRAST $4,299.50 $4,299.50 $2,149.75–$4,299.50 33% above —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 ELBOW RIGHT MRI W/O CONTRAST $4,299.50 $4,299.50 $1,822.99–$4,170.52 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 WRIST RIGHT MRI W/O CONTRAST $4,299.50 $4,299.50 $1,822.99–$4,170.52 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 WRIST LEFT MRI W/O CONTRAST $4,299.50 $4,299.50 $1,822.99–$4,170.52 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 SHOULDER RT MRI W/O CONTRAST $4,299.50 $4,299.50 $1,822.99–$4,170.52 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 SHOULDER LEFT MRI W/O CONTRAST $4,299.50 $4,299.50 $1,822.99–$4,170.52 — —
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 ELBOW LEFT MRI W/O CONTRAST $4,299.50 $4,299.50 $1,822.99–$4,170.52 — —
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CSPINE AP/LAT/FLEX/EXT $873.50 $873.50 $436.75–$873.50 25% above —
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE WITH FLEX/EXT $873.50 $873.50 $436.75–$873.50 25% above —
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERV SPINE W/OBLS OR FLEX/EXT $873.50 $873.50 $436.75–$873.50 25% above —
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERVICAL SPINE WITH FLEX/EXT $873.50 $873.50 $370.36–$847.30 — —
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 CERV SPINE W/OBLS OR FLEX/EXT $873.50 $873.50 $370.36–$847.30 — —
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CSPINE AP/LAT/FLEX/EXT $873.50 $873.50 $370.36–$847.30 — —
Neck soft tissue CT scan with contrast CPT 70491 CT SCAN NECK WITH CONTRAST $3,407.25 $3,407.25 $1,703.62–$3,407.25 42% above —
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SCAN NECK WITH CONTRAST $3,407.25 $3,407.25 $1,444.67–$3,305.03 — —
Neck soft tissue CT scan without contrast CPT 70490 CT SCAN NECK W/O CONTRAST $2,295.50 $2,295.50 $1,147.75–$2,295.50 11% above —
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SCAN NECK W/O CONTRAST $2,295.50 $2,295.50 $973.29–$2,226.63 — —
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK $449.50 $449.50 $224.75–$449.50 20% above —
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE VIEWS $449.50 $449.50 $224.75–$449.50 20% above —
Neck soft tissue X-ray inpatient CPT 70360 SOFT TISSUE NECK $449.50 $449.50 $190.59–$436.02 — —
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE VIEWS $449.50 $449.50 $190.59–$436.02 — —
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MPI 2 DAY FRAC/HRT WALL MOTION $6,680.00 $6,680.00 $3,340.00–$6,680.00 120% above —
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 THALLIUM MULTILPLE STUDIES $6,680.00 $6,680.00 $3,340.00–$6,680.00 120% above —
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 THALLIUM MULTILPLE STUDIES $6,680.00 $6,680.00 $2,832.32–$6,479.60 — —
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MPI 2 DAY FRAC/HRT WALL MOTION $6,680.00 $6,680.00 $2,832.32–$6,479.60 — —
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT PSMA FOR PROSTATE CA $6,910.75 $6,910.75 $3,455.38–$6,910.75 2% above —
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL BASE TO MIDTHIGH $6,910.75 $6,910.75 $3,455.38–$6,910.75 2% above —
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT GOZELLIX FOR PROSTATE CA $6,910.75 $6,910.75 $3,455.38–$6,910.75 2% above —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT PSMA FOR PROSTATE CA $6,910.75 $6,910.75 $2,930.16–$6,703.43 — —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT GOZELLIX FOR PROSTATE CA $6,910.75 $6,910.75 $2,930.16–$6,703.43 — —
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL BASE TO MIDTHIGH $6,910.75 $6,910.75 $2,930.16–$6,703.43 — —
Pelvic CT scan without contrast CPT 72192 PELVIS W/O CONTRAST LCD $3,027.00 $3,027.00 $1,513.50–$3,027.00 40% above —
Pelvic CT scan without contrast inpatient CPT 72192 PELVIS W/O CONTRAST LCD $3,027.00 $3,027.00 $1,283.45–$2,936.19 — —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BUTTOCK SOFT TISSUE MASS $840.00 $840.00 $420.00–$840.00 33% above —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC (NON-OB) LIMITED ED $840.00 $840.00 $420.00–$840.00 33% above —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC LTD-APPENDICITIS US $840.00 $840.00 $420.00–$840.00 33% above —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIC (NON-OB) LIMITED $840.00 $840.00 $420.00–$840.00 33% above —
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PERINEUM SOFT TISSUE MASS $840.00 $840.00 $420.00–$840.00 33% above —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC (NON-OB) LIMITED $840.00 $840.00 $356.16–$814.80 — —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC LTD-APPENDICITIS US $840.00 $840.00 $356.16–$814.80 — —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIC (NON-OB) LIMITED ED $840.00 $840.00 $356.16–$814.80 — —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BUTTOCK SOFT TISSUE MASS $840.00 $840.00 $356.16–$814.80 — —
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PERINEUM SOFT TISSUE MASS $840.00 $840.00 $356.16–$814.80 — —
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC (NON-OB) COMPLETE $1,169.75 $1,169.75 $584.88–$1,169.75 73% above —
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC (NON-OB) COMPLETE $1,169.75 $1,169.75 $495.97–$1,134.66 — —
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG >14 WEEKS SINGLE COMP. $1,193.50 $1,193.50 $596.75–$1,193.50 73% above —
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG >14 WEEKS SINGLE COMP. $1,193.50 $1,193.50 $506.04–$1,157.70 — —
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG <14 WKS SINGLE COMPLET $1,174.75 $1,174.75 $587.38–$1,174.75 51% above —
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG <14 WKS SINGLE COMPLET $1,174.75 $1,174.75 $498.09–$1,139.51 — —
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRA PREGNANT UTERUS LIMITED $740.50 $740.50 $370.25–$740.50 18% above —
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ULTRA PREGNANT UTERUS LIMIT ED $740.50 $740.50 $370.25–$740.50 18% above —
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRA PREGNANT UTERUS LIMIT ED $740.50 $740.50 $313.97–$718.28 — —
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ULTRA PREGNANT UTERUS LIMITED $740.50 $740.50 $313.97–$718.28 — —
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL LEFT 2 VIEWS $636.50 $636.50 $318.25–$636.50 21% above —
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL RIGHT 2 VIEWS $636.50 $636.50 $318.25–$636.50 21% above —
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS LT $636.50 $636.50 $318.25–$636.50 21% above —
Rib X-ray, one side, 2 views one side CPT 71100 XR RIB RT $636.50 $636.50 $318.25–$636.50 21% above —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL LEFT 2 VIEWS $636.50 $636.50 $269.88–$617.40 — —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LT $636.50 $636.50 $269.88–$617.40 — —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 RIBS UNILATERAL RIGHT 2 VIEWS $636.50 $636.50 $269.88–$617.40 — —
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIB RT $636.50 $636.50 $269.88–$617.40 — —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS RIGHT UNI & PA CHEST 3 V $986.00 $986.00 $493.00–$986.00 52% above —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS LT W/PA CHEST ROUTINE $986.00 $986.00 $493.00–$986.00 52% above —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 RIBS LEFT UNI & PA CHEST 3 V $986.00 $986.00 $493.00–$986.00 52% above —
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS RT W/PA CHEST ROUTINE $986.00 $986.00 $493.00–$986.00 52% above —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS LEFT UNI & PA CHEST 3 V $986.00 $986.00 $418.06–$956.42 — —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS LT W/PA CHEST ROUTINE $986.00 $986.00 $418.06–$956.42 — —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS RT W/PA CHEST ROUTINE $986.00 $986.00 $418.06–$956.42 — —
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 RIBS RIGHT UNI & PA CHEST 3 V $986.00 $986.00 $418.06–$956.42 — —
Screening mammogram, both breasts both sides CPT 77067 SCREEN BILAT MAMMO DIGITAL/CAD $816.25 $816.25 $408.12–$816.25 — —
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREEN BILAT MAMMO DIGITAL/CAD $816.25 $816.25 $346.09–$791.76 — —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RT POSTRED 2 VIEW $890.00 $890.00 $445.00–$890.00 74% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LT POSTRED 2 VIEW $890.00 $890.00 $445.00–$890.00 74% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT MIN 2 VIEWS $890.00 $890.00 $445.00–$890.00 74% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RT ROUTINE/TRAUMA $890.00 $890.00 $445.00–$890.00 74% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT MIN 2 VIEWS $890.00 $890.00 $445.00–$890.00 74% above —
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LT ROUTINE/TRAUMA $890.00 $890.00 $445.00–$890.00 74% above —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT MIN 2 VIEWS $890.00 $890.00 $377.36–$863.30 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RT ROUTINE/TRAUMA $890.00 $890.00 $377.36–$863.30 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LT POSTRED 2 VIEW $890.00 $890.00 $377.36–$863.30 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RT POSTRED 2 VIEW $890.00 $890.00 $377.36–$863.30 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LT ROUTINE/TRAUMA $890.00 $890.00 $377.36–$863.30 — —
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT MIN 2 VIEWS $890.00 $890.00 $377.36–$863.30 — —
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES COMPLETE $979.25 $979.25 $489.62–$979.25 111% above —
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES ROUTINE $979.25 $979.25 $489.62–$979.25 111% above —
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES ROUTINE $979.25 $979.25 $415.20–$949.87 — —
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 SINUSES COMPLETE $979.25 $979.25 $415.20–$949.87 — —
Skull X-ray, fewer than 4 views CPT 70250 SKULL LIMITED < 4 VIEWS $877.75 $877.75 $438.88–$877.75 65% above —
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL LIMITED 1-3 VIEWS $877.75 $877.75 $438.88–$877.75 65% above —
Skull X-ray, fewer than 4 views inpatient CPT 70250 SKULL LIMITED < 4 VIEWS $877.75 $877.75 $372.17–$851.42 — —
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL LIMITED 1-3 VIEWS $877.75 $877.75 $372.17–$851.42 — —
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY $7,054.75 $7,054.75 $3,527.38–$7,054.75 20% above —
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY $7,054.75 $7,054.75 $2,991.21–$6,843.11 — —
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHO,TTE COMPLETE STRESS $3,053.50 $3,053.50 $1,526.75–$3,053.50 14% above —
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 DOBUTAMINE STRESS ECHO $3,053.50 $3,053.50 $1,526.75–$3,053.50 14% above —
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ECHOCARDIOGRAPHY WITH STRESS $3,053.50 $3,053.50 $1,526.75–$3,053.50 14% above —
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 DOBUTAMINE STRESS ECHO $3,053.50 $3,053.50 $1,294.68–$2,961.90 — —
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHO,TTE COMPLETE STRESS $3,053.50 $3,053.50 $1,294.68–$2,961.90 — —
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 ECHOCARDIOGRAPHY WITH STRESS $3,053.50 $3,053.50 $1,294.68–$2,961.90 — —
Swallow study (modified barium swallow, video X-ray) CPT 74230 VIDEOFLUORO SWALLOW FUNCTION $940.50 $940.50 $470.25–$940.50 25% above —
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 VIDEOFLUORO SWALLOW FUNCTION $940.50 $940.50 $398.77–$912.28 — —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR LT $616.50 $616.50 $308.25–$616.50 46% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR LEFT $616.50 $616.50 $308.25–$616.50 46% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR RT $616.50 $616.50 $308.25–$616.50 46% above —
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 FEMUR RIGHT $616.50 $616.50 $308.25–$616.50 46% above —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR RIGHT $616.50 $616.50 $261.40–$598.00 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR LT $616.50 $616.50 $261.40–$598.00 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 FEMUR LEFT $616.50 $616.50 $261.40–$598.00 — —
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR RT $616.50 $616.50 $261.40–$598.00 — —
Thoracic spine (mid back) CT scan without contrast CPT 72128 THORACIC SPINE W/O CONTRAST $3,030.00 $3,030.00 $1,515.00–$3,030.00 70% above —
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 THORACIC SPINE W/O CONTRAST $3,030.00 $3,030.00 $1,284.72–$2,939.10 — —
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) LT $596.50 $596.50 $298.25–$596.50 53% above —
Toe X-ray, 2 or more views one side CPT 73660 LEFT TOES $596.50 $596.50 $298.25–$596.50 53% above —
Toe X-ray, 2 or more views one side CPT 73660 XR TOE(S) RT $596.50 $596.50 $298.25–$596.50 53% above —
Toe X-ray, 2 or more views one side CPT 73660 RIGHT TOES $596.50 $596.50 $298.25–$596.50 53% above —
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) LT $596.50 $596.50 $252.92–$578.60 — —
Toe X-ray, 2 or more views inpatient one side CPT 73660 LEFT TOES $596.50 $596.50 $252.92–$578.60 — —
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) RT $596.50 $596.50 $252.92–$578.60 — —
Toe X-ray, 2 or more views inpatient one side CPT 73660 RIGHT TOES $596.50 $596.50 $252.92–$578.60 — —
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL ULTRASOUND $823.00 $823.00 $411.50–$823.00 at median —
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL ULTRASOUND ED $823.00 $823.00 $411.50–$823.00 at median —
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL ULTRASOUND ED $823.00 $823.00 $348.95–$798.31 — —
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL ULTRASOUND $823.00 $823.00 $348.95–$798.31 — —
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US PREG UTERUS $826.25 $826.25 $413.12–$826.25 15% above —
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US PREG UTERUS $826.25 $826.25 $350.33–$801.46 — —
Ultrasound of the abdomen, complete CPT 76700 ABDOMINAL COMPLETE ULTRASOUND $1,183.50 $1,183.50 $591.75–$1,183.50 30% above —
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMINAL COMPLETE ULTRASOUND $1,183.50 $1,183.50 $501.80–$1,147.99 — —
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM ULTRASOUND $1,169.75 $1,169.75 $584.88–$1,169.75 73% above —
Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM ULTRASOUND $1,169.75 $1,169.75 $495.97–$1,134.66 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SOFT TISSUE HEAD & NECK E.D. $1,098.00 $1,098.00 $549.00–$1,098.00 26% above —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US PARTOTID GLAND $1,098.00 $1,098.00 $549.00–$1,098.00 26% above —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID ULTRASOUND $1,098.00 $1,098.00 $549.00–$1,098.00 26% above —
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SOFT TISSUE HEAD & NECK U/S $1,098.00 $1,098.00 $549.00–$1,098.00 26% above —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 THYROID ULTRASOUND $1,098.00 $1,098.00 $465.55–$1,065.06 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SOFT TISSUE HEAD & NECK U/S $1,098.00 $1,098.00 $465.55–$1,065.06 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SOFT TISSUE HEAD & NECK E.D. $1,098.00 $1,098.00 $465.55–$1,065.06 — —
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US PARTOTID GLAND $1,098.00 $1,098.00 $465.55–$1,065.06 — —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI SINGLE CONTRAST W/O KUB $1,391.75 $1,391.75 $695.88–$1,391.75 19% above —
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI SINGLE CONTRAST W/O KUB $1,391.75 $1,391.75 $590.10–$1,350.00 — —
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMRTUS LT $890.00 $890.00 $445.00–$890.00 76% above —
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS LEFT $890.00 $890.00 $445.00–$890.00 76% above —
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS RT $890.00 $890.00 $445.00–$890.00 76% above —
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS RIGHT $890.00 $890.00 $445.00–$890.00 76% above —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS RT $890.00 $890.00 $377.36–$863.30 — —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMRTUS LT $890.00 $890.00 $377.36–$863.30 — —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS LEFT $890.00 $890.00 $377.36–$863.30 — —
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS RIGHT $890.00 $890.00 $377.36–$863.30 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN LIMITED STUDY $747.75 $747.75 $373.88–$747.75 11% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VENOUS COMPRESSION LIMITED $747.75 $747.75 $373.88–$747.75 11% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS INSUFFICIENCY LT $934.00 $934.00 $467.00–$934.00 39% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS INSUFFICIENCY RT $934.00 $934.00 $467.00–$934.00 39% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VEN COMP RT EXTREMITY $934.00 $934.00 $467.00–$934.00 39% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 VEN COMP LT EXTREMITY $934.00 $934.00 $467.00–$934.00 39% above —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX SCAN LIMITED STUDY $747.75 $747.75 $317.05–$725.32 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VENOUS COMPRESSION LIMITED $747.75 $747.75 $317.05–$725.32 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VEN COMP RT EXTREMITY $934.00 $934.00 $396.02–$905.98 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 VEN COMP LT EXTREMITY $934.00 $934.00 $396.02–$905.98 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS INSUFFICIENCY RT $934.00 $934.00 $396.02–$905.98 — —
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS INSUFFICIENCY LT $934.00 $934.00 $396.02–$905.98 — —
Wrist X-ray, 2 views one side CPT 73100 WRIST LEFT (2 VIEWS) $618.75 $618.75 $309.38–$618.75 28% above —
Wrist X-ray, 2 views one side CPT 73100 XR WRIST LT 2 VIEW $618.75 $618.75 $309.38–$618.75 28% above —
Wrist X-ray, 2 views one side CPT 73100 XR WRIST RT 2 VIEW $618.75 $618.75 $309.38–$618.75 28% above —
Wrist X-ray, 2 views one side CPT 73100 WRIST RIGHT (2 VIEWS) $618.75 $618.75 $309.38–$618.75 28% above —
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST RIGHT (2 VIEWS) $618.75 $618.75 $262.35–$600.19 — —
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST LT 2 VIEW $618.75 $618.75 $262.35–$600.19 — —
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST LEFT (2 VIEWS) $618.75 $618.75 $262.35–$600.19 — —
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST RT 2 VIEW $618.75 $618.75 $262.35–$600.19 — —
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST RT ROUTINE $775.75 $775.75 $387.88–$775.75 33% above —
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT MIN 3 VIEWS $775.75 $775.75 $387.88–$775.75 33% above —
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT MIN 3 VIEWS $775.75 $775.75 $387.88–$775.75 33% above —
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST LT ROUTINE $775.75 $775.75 $387.88–$775.75 33% above —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT MIN 3 VIEWS $775.75 $775.75 $328.92–$752.48 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT MIN 3 VIEWS $775.75 $775.75 $328.92–$752.48 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST RT ROUTINE $775.75 $775.75 $328.92–$752.48 — —
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST LT ROUTINE $775.75 $775.75 $328.92–$752.48 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT ROUTINE $856.50 $856.50 $428.25–$856.50 50% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT W/ AP PELVIS $856.50 $856.50 $428.25–$856.50 50% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT MIN 2 VIEWS $856.50 $856.50 $428.25–$856.50 50% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT ROUTINE $856.50 $856.50 $428.25–$856.50 50% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT MIN 2 VIEWS $856.50 $856.50 $428.25–$856.50 50% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT W/AP PELVIS $856.50 $856.50 $428.25–$856.50 50% above —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT ROUTINE $856.50 $856.50 $363.16–$830.80 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT W/AP PELVIS $856.50 $856.50 $363.16–$830.80 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT W/ AP PELVIS $856.50 $856.50 $363.16–$830.80 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT MIN 2 VIEWS $856.50 $856.50 $363.16–$830.80 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT ROUTINE $856.50 $856.50 $363.16–$830.80 — —
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT MIN 2 VIEWS $856.50 $856.50 $363.16–$830.80 — —
X-ray of the abdomen, 1 view CPT 74018 XR KUB ABDOMEN 1 VIEW $516.00 $516.00 $258.00–$516.00 30% above —
X-ray of the abdomen, 1 view CPT 74018 GASTROGRAFFIN CHALLENGE FOR SB $516.00 $516.00 $258.00–$516.00 30% above —
X-ray of the abdomen, 1 view inpatient CPT 74018 XR KUB ABDOMEN 1 VIEW $516.00 $516.00 $218.78–$500.52 — —
X-ray of the abdomen, 1 view inpatient CPT 74018 GASTROGRAFFIN CHALLENGE FOR SB $516.00 $516.00 $218.78–$500.52 — —
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE LEFT 2 VIEWS $625.00 $625.00 $312.50–$625.00 34% above —
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEWS $625.00 $625.00 $312.50–$625.00 34% above —
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE RT 2 VIEWS $625.00 $625.00 $312.50–$625.00 34% above —
X-ray of the ankle, 2 views one side CPT 73600 LEFT AP AND LAT ANKLE $625.00 $625.00 $312.50–$625.00 34% above —
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE LEFT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE RT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEWS $625.00 $625.00 $265.00–$606.25 — —
X-ray of the ankle, 2 views inpatient one side CPT 73600 LEFT AP AND LAT ANKLE $625.00 $625.00 $265.00–$606.25 — —
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) RT $606.50 $606.50 $303.25–$606.50 56% above —
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER(S) LT $606.50 $606.50 $303.25–$606.50 56% above —
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LEFT $606.50 $606.50 $303.25–$606.50 56% above —
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RIGHT $606.50 $606.50 $303.25–$606.50 56% above —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS RIGHT $606.50 $606.50 $257.16–$588.30 — —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) RT $606.50 $606.50 $257.16–$588.30 — —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS LEFT $606.50 $606.50 $257.16–$588.30 — —
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER(S) LT $606.50 $606.50 $257.16–$588.30 — —
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT (2 VIEWS) $614.50 $614.50 $307.25–$614.50 29% above —
X-ray of the foot, 2 views one side CPT 73620 XR FOOT LT 2 VIEWS $614.50 $614.50 $307.25–$614.50 29% above —
X-ray of the foot, 2 views one side CPT 73620 XR FOOT RT 2 VIEWS $614.50 $614.50 $307.25–$614.50 29% above —
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT (2 VIEWS) $614.50 $614.50 $307.25–$614.50 29% above —
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT LT 2 VIEWS $614.50 $614.50 $260.55–$596.06 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT (2 VIEWS) $614.50 $614.50 $260.55–$596.06 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT RT 2 VIEWS $614.50 $614.50 $260.55–$596.06 — —
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT (2 VIEWS) $614.50 $614.50 $260.55–$596.06 — —
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RIGHT COMPLETE MIN 3 VIEW $665.00 $665.00 $332.50–$665.00 30% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 LEFT FOOT MIN 3 VIEWS $665.00 $665.00 $332.50–$665.00 30% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT RT ROUTINE 3-4 VIEWS $665.00 $665.00 $332.50–$665.00 30% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LEFT COMPLETE MIN 3 VIEWS $665.00 $665.00 $332.50–$665.00 30% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT LT ROUTINE 3-4 VIEWS $665.00 $665.00 $332.50–$665.00 30% above —
X-ray of the foot, complete, 3 or more views one side CPT 73630 RIGHT FOOT MIN 3 VIEWS $665.00 $665.00 $332.50–$665.00 30% above —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 LEFT FOOT MIN 3 VIEWS $665.00 $665.00 $281.96–$645.05 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 RIGHT FOOT MIN 3 VIEWS $665.00 $665.00 $281.96–$645.05 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT LT ROUTINE 3-4 VIEWS $665.00 $665.00 $281.96–$645.05 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT LEFT COMPLETE MIN 3 VIEWS $665.00 $665.00 $281.96–$645.05 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT RT ROUTINE 3-4 VIEWS $665.00 $665.00 $281.96–$645.05 — —
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT RIGHT COMPLETE MIN 3 VIEW $665.00 $665.00 $281.96–$645.05 — —
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND RT ROUTINE 3-4 VIEWS $635.50 $635.50 $317.75–$635.50 26% above —
X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT COMPLETE MIN 3 VIEW $635.50 $635.50 $317.75–$635.50 26% above —
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND LT ROUTINE 3-4 VIEWS $635.50 $635.50 $317.75–$635.50 26% above —
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT COMPLETE MIN 3 VIEWS $635.50 $635.50 $317.75–$635.50 26% above —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT COMPLETE MIN 3 VIEW $635.50 $635.50 $269.45–$616.43 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND LT ROUTINE 3-4 VIEWS $635.50 $635.50 $269.45–$616.43 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND RT ROUTINE 3-4 VIEWS $635.50 $635.50 $269.45–$616.43 — —
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT COMPLETE MIN 3 VIEWS $635.50 $635.50 $269.45–$616.43 — —
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LT 1-2 VIEWS $566.50 $566.50 $283.25–$566.50 13% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RT 1-2 VIEWS $566.50 $566.50 $283.25–$566.50 13% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 OR 2 VIEWS $566.50 $566.50 $283.25–$566.50 13% above —
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS $566.50 $566.50 $283.25–$566.50 13% above —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RT 1-2 VIEWS $566.50 $566.50 $240.20–$549.50 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS $566.50 $566.50 $240.20–$549.50 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LT 1-2 VIEWS $566.50 $566.50 $240.20–$549.50 — —
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1 OR 2 VIEWS $566.50 $566.50 $240.20–$549.50 — —
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LSPINE 2-3 VIEWS $696.00 $696.00 $348.00–$696.00 5% above —
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 OR 3 VIEWS $696.00 $696.00 $348.00–$696.00 5% above —
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LSPINE 2-3 VIEWS $696.00 $696.00 $295.10–$675.12 — —
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 OR 3 VIEWS $696.00 $696.00 $295.10–$675.12 — —
X-ray of the lower back, 4 or more views CPT 72110 XR LSPINE W/OBLIQUES $811.50 $811.50 $405.75–$811.50 4% below —
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE WITH OBLIQUES $811.50 $811.50 $405.75–$811.50 4% below —
X-ray of the lower back, 4 or more views CPT 72110 XR LSPINE W/FLEX/EXT $811.50 $811.50 $405.75–$811.50 4% below —
X-ray of the lower back, 4 or more views CPT 72110 LSPINE WITH FLEX AND EXT $811.50 $811.50 $405.75–$811.50 4% below —
X-ray of the lower back, 4 or more views CPT 72110 L SPINE W BENDING $811.50 $811.50 $405.75–$811.50 4% below —
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LSPINE W/OBLIQUES $811.50 $811.50 $344.08–$787.16 — —
X-ray of the lower back, 4 or more views inpatient CPT 72110 LSPINE WITH FLEX AND EXT $811.50 $811.50 $344.08–$787.16 — —
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LSPINE W/FLEX/EXT $811.50 $811.50 $344.08–$787.16 — —
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE WITH OBLIQUES $811.50 $811.50 $344.08–$787.16 — —
X-ray of the lower back, 4 or more views inpatient CPT 72110 L SPINE W BENDING $811.50 $811.50 $344.08–$787.16 — —
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR TSPINE LIMITED 2 V $677.25 $677.25 $338.62–$677.25 31% above —
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS $677.25 $677.25 $338.62–$677.25 31% above —
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS $677.25 $677.25 $287.15–$656.93 — —
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR TSPINE LIMITED 2 V $677.25 $677.25 $287.15–$656.93 — —
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES $600.75 $600.75 $300.38–$600.75 8% above —
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES $600.75 $600.75 $300.38–$600.75 8% above —
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES $600.75 $600.75 $254.72–$582.73 — —
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES $600.75 $600.75 $254.72–$582.73 — —
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS $503.00 $503.00 $251.50–$503.00 at median —
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CSPINE AP/LAT 2-3 VIEWS $503.00 $503.00 $251.50–$503.00 at median —
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS $503.00 $503.00 $213.27–$487.91 — —
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CSPINE AP/LAT 2-3 VIEWS $503.00 $503.00 $213.27–$487.91 — —
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1-2 VIEWS $541.25 $541.25 $270.62–$541.25 24% above —
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS $541.25 $541.25 $270.62–$541.25 24% above —
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1 OR 2 VIEWS $541.25 $541.25 $229.49–$525.01 — —
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1-2 VIEWS $541.25 $541.25 $229.49–$525.01 — —
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX MIN 2 VIEWS $506.00 $506.00 $253.00–$506.00 at median —
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX $506.00 $506.00 $253.00–$506.00 at median —
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX $506.00 $506.00 $214.54–$490.82 — —
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX MIN 2 VIEWS $506.00 $506.00 $214.54–$490.82 — —

Lab tests

ProcedureCash priceList priceInsurers payvs VermontOff list
ACTH blood test CPT 82024 LABS-ACTH $244.50 $244.50 $122.25–$244.50 36% below —
ACTH blood test inpatient CPT 82024 LABS-ACTH $244.50 $244.50 $103.67–$237.16 — —
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LAB-ALT (SGPT) $84.75 $84.75 $42.38–$84.75 117% above —
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 LAB-ALT (SGPT) $84.75 $84.75 $35.93–$82.21 — —
AST (aspartate aminotransferase) enzyme test CPT 84450 LAB-AST (SGOT) $80.25 $80.25 $40.12–$80.25 27% above —
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 LAB-AST (SGOT) $80.25 $80.25 $34.03–$77.84 — —
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 LABS-ACUTE HEPATITIS PANEL $169.50 $169.50 $84.75–$169.50 62% below —
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 LABS-ACUTE HEPATITIS PANEL $169.50 $169.50 $71.87–$164.42 — —
Albumin blood test CPT 82040 LABS-SYN INDEX-ALBUMIN,SER $86.75 $86.75 $43.38–$86.75 102% above —
Albumin blood test CPT 82040 LAB-ALBUMIN BLOOD $86.75 $86.75 $43.38–$86.75 102% above —
Albumin blood test CPT 82040 LABS LYMEINDEX:ALBUMIN,SERUM $86.75 $86.75 $43.38–$86.75 102% above —
Albumin blood test inpatient CPT 82040 LABS-SYN INDEX-ALBUMIN,SER $86.75 $86.75 $36.78–$84.15 — —
Albumin blood test inpatient CPT 82040 LAB-ALBUMIN BLOOD $86.75 $86.75 $36.78–$84.15 — —
Albumin blood test inpatient CPT 82040 LABS LYMEINDEX:ALBUMIN,SERUM $86.75 $86.75 $36.78–$84.15 — —
Aldosterone blood test CPT 82088 LABS-ALDOSTERONE $472.50 $472.50 $236.25–$472.50 8% above —
Aldosterone blood test inpatient CPT 82088 LABS-ALDOSTERONE $472.50 $472.50 $200.34–$458.32 — —
Alkaline phosphatase (ALP) blood test CPT 84075 LAB-AP (ALK PHOS) $98.75 $98.75 $49.38–$98.75 119% above —
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 LAB-AP (ALK PHOS) $98.75 $98.75 $41.87–$95.79 — —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-WH FACED HORNET $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-CAT DANDER $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-DERM FARINAE $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-DOG EPITHELIAL $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-EGG WHITE $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-EGG YOLK $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-HORSE DANDER $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-MILK $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-CHICKEN FEATHERS $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-DUCK FEATHERS $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-GOOSE FEATHERS $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN TURKEY FEATHERS $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-OTHER $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-PEANUT $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS ALLERGEN RED MAPLE $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-SHRIMP $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-SOYBEAN $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-WHEAT $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-HONEY BEE $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-YELLOW JACKET $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-PAPER WASP $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen CPT 86003 LABS-ALLERGEN-YELLOW HORNET $110.25 $110.25 $55.12–$110.25 125% above —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-HONEY BEE $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-PEANUT $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS ALLERGEN RED MAPLE $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-SHRIMP $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-SOYBEAN $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-WHEAT $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-OTHER $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-YELLOW JACKET $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-PAPER WASP $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-YELLOW HORNET $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-WH FACED HORNET $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-CAT DANDER $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-DERM FARINAE $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-DOG EPITHELIAL $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-EGG WHITE $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-EGG YOLK $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-HORSE DANDER $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-MILK $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-CHICKEN FEATHERS $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-DUCK FEATHERS $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN-GOOSE FEATHERS $110.25 $110.25 $46.75–$106.94 — —
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LABS-ALLERGEN TURKEY FEATHERS $110.25 $110.25 $46.75–$106.94 — —
Alpha-fetoprotein (AFP) blood test CPT 82105 LABS AFPS ALPHA-FETOPROTEIN $182.25 $182.25 $91.12–$182.25 56% above —
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 LABS AFPS ALPHA-FETOPROTEIN $182.25 $182.25 $77.27–$176.78 — —
Ammonia blood test CPT 82140 LAB-AMMONIA $304.75 $304.75 $152.38–$304.75 130% above —
Ammonia blood test inpatient CPT 82140 LAB-AMMONIA $304.75 $304.75 $129.21–$295.61 — —
Amylase blood test CPT 82150 LABS-FLUID AMYLASE $68.75 $68.75 $34.38–$68.75 30% above —
Amylase blood test CPT 82150 LAB-AMYLASE $68.75 $68.75 $34.38–$68.75 30% above —
Amylase blood test inpatient CPT 82150 LAB-AMYLASE $68.75 $68.75 $29.15–$66.69 — —
Amylase blood test inpatient CPT 82150 LABS-FLUID AMYLASE $68.75 $68.75 $29.15–$66.69 — —
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 LABS-CYCLIC CITRULLINATED PEPT $286.50 $286.50 $143.25–$286.50 149% above —
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 LABS-CYCLIC CITRULLINATED PEPT $286.50 $286.50 $121.48–$277.90 — —
Antinuclear antibody (ANA) blood test, screen CPT 86038 LABS-ANTINUCLEAR AB $132.25 $132.25 $66.12–$132.25 28% above —
Antinuclear antibody (ANA) blood test, screen CPT 86038 LABS-ANA $132.25 $132.25 $66.12–$132.25 28% above —
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LABS-ANTINUCLEAR AB $132.25 $132.25 $56.07–$128.28 — —
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 LABS-ANA $132.25 $132.25 $56.07–$128.28 — —
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 LAB-B-TYPE NATRIURETIC PEPTIDE $333.25 $333.25 $166.62–$333.25 32% above —
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 LAB-B-TYPE NATRIURETIC PEPTIDE $333.25 $333.25 $141.30–$323.25 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LABS-PERTUSSIS CULTURE $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-CSF CULTURE/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-FOREIGN BODY CULTURE/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-SPT/TRA/BRC CULTURE/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-THROAT CULTURE INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-BODY FLUID CULTURE/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-TISSUE CULTURE/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-WOUND CULTURE/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-AUTOLOGOUS GRAFT CULT/INOC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LAB-NASAL/NASOPHARYNX CULT/INC $222.25 $222.25 $111.12–$222.25 164% above —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-THROAT CULTURE INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-BODY FLUID CULTURE/INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-TISSUE CULTURE/INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-WOUND CULTURE/INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-AUTOLOGOUS GRAFT CULT/INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-NASAL/NASOPHARYNX CULT/INC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LABS-PERTUSSIS CULTURE $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-CSF CULTURE/INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-FOREIGN BODY CULTURE/INOC $222.25 $222.25 $94.23–$215.58 — —
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LAB-SPT/TRA/BRC CULTURE/INOC $222.25 $222.25 $94.23–$215.58 — —
Basic metabolic panel (blood test) CPT 80048 LAB-BASIC METABOLIC PANEL $115.00 $115.00 $57.50–$115.00 24% above —
Basic metabolic panel (blood test) inpatient CPT 80048 LAB-BASIC METABOLIC PANEL $115.00 $115.00 $48.76–$111.55 — —
Bilirubin blood test, total CPT 82247 LAB-BILIRUBIN, NEWBORN $122.00 $122.00 $61.00–$122.00 139% above —
Bilirubin blood test, total CPT 82247 LAB-BILIRUBIN, TOTAL $122.00 $122.00 $61.00–$122.00 139% above —
Bilirubin blood test, total inpatient CPT 82247 LAB-BILIRUBIN, TOTAL $122.00 $122.00 $51.73–$118.34 — —
Bilirubin blood test, total inpatient CPT 82247 LAB-BILIRUBIN, NEWBORN $122.00 $122.00 $51.73–$118.34 — —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LAB-SP MICROSCOPIC EXAM LVL 4 $293.50 $293.50 $146.75–$293.50 12% above —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LAB-CYTOL CELL BLOCK $293.50 $293.50 $146.75–$293.50 12% above —
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LABS-PTH EXAM LVL 4 TC $293.50 $293.50 $146.75–$293.50 12% above —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LABS-PTH EXAM LVL 4 TC $293.50 $293.50 $124.44–$284.70 — —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LAB-CYTOL CELL BLOCK $293.50 $293.50 $124.44–$284.70 — —
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LAB-SP MICROSCOPIC EXAM LVL 4 $293.50 $293.50 $124.44–$284.70 — —
Blood culture for bacteria CPT 87040 LAB-BLOOD CULTURE/INOC $465.50 $465.50 $232.75–$465.50 242% above —
Blood culture for bacteria inpatient CPT 87040 LAB-BLOOD CULTURE/INOC $465.50 $465.50 $197.37–$451.54 — —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 NMC VENIPUNCTURE $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ROUTINE PBP $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW CLI $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 LAB-VENIPUNCTURE CHARGE-OUTPT $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 OCC HLTH - OUTPT PHLEBOTOMY $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DVHC VENIPUNCTURE $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SVRCC VENIPUNCTURE CHARGE $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only CPT 36415 POWNAL VENIPUNCTURE $30.25 $30.25 $15.12–$30.25 4% above —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 LAB-VENIPUNCTURE CHARGE-OUTPT $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 OCC HLTH - OUTPT PHLEBOTOMY $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 NMC VENIPUNCTURE $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ROUTINE PBP $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DVHC VENIPUNCTURE $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW CLI $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SVRCC VENIPUNCTURE CHARGE $30.25 $30.25 $12.83–$29.34 — —
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 POWNAL VENIPUNCTURE $30.25 $30.25 $12.83–$29.34 — —
Blood glucose (sugar) test CPT 82947 LAB-GLUCOSE $67.75 $67.75 $33.88–$67.75 65% above —
Blood glucose (sugar) test inpatient CPT 82947 LAB-GLUCOSE $67.75 $67.75 $28.73–$65.72 — —
Blood lead test CPT 83655 LABS-LEAD, URINE $109.00 $109.00 $54.50–$109.00 70% above —
Blood lead test CPT 83655 LABS-HM-LEAD, BLOOD $109.00 $109.00 $54.50–$109.00 70% above —
Blood lead test CPT 83655 LABS-LEAD, BLOOD $109.00 $109.00 $54.50–$109.00 70% above —
Blood lead test CPT 83655 LABS-LEAD, BLD Occupational $109.00 $109.00 $54.50–$109.00 70% above —
Blood lead test inpatient CPT 83655 LABS-LEAD, BLOOD $109.00 $109.00 $46.22–$105.73 — —
Blood lead test inpatient CPT 83655 LABS-HM-LEAD, BLOOD $109.00 $109.00 $46.22–$105.73 — —
Blood lead test inpatient CPT 83655 LABS-LEAD, URINE $109.00 $109.00 $46.22–$105.73 — —
Blood lead test inpatient CPT 83655 LABS-LEAD, BLD Occupational $109.00 $109.00 $46.22–$105.73 — —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 NMC URINE PREGNANCY TEST $185.00 $185.00 $92.50–$185.00 120% above —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 LAB-HCG QUAL $192.25 $192.25 $96.12–$192.25 128% above —
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 LAB ED-PREGNANCY TEST,URINE $192.25 $192.25 $96.12–$192.25 128% above —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 NMC URINE PREGNANCY TEST $185.00 $185.00 $78.44–$179.45 — —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 LAB ED-PREGNANCY TEST,URINE $192.25 $192.25 $81.51–$186.48 — —
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 LAB-HCG QUAL $192.25 $192.25 $81.51–$186.48 — —
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 LAB-BLOOD TYPING, ABO ONLY $140.50 $140.50 $70.25–$140.50 65% above —
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 LAB-BLOOD TYPING, ABO ONLY $140.50 $140.50 $59.57–$136.28 — —
Blood urea nitrogen (BUN) test CPT 84520 LAB-BLOOD UREA NITROGEN $80.25 $80.25 $40.12–$80.25 91% above —
Blood urea nitrogen (BUN) test CPT 84520 LAB URR RENAL $80.25 $80.25 $40.12–$80.25 91% above —
Blood urea nitrogen (BUN) test inpatient CPT 84520 LAB URR RENAL $80.25 $80.25 $34.03–$77.84 — —
Blood urea nitrogen (BUN) test inpatient CPT 84520 LAB-BLOOD UREA NITROGEN $80.25 $80.25 $34.03–$77.84 — —
C-peptide blood test CPT 84681 LABS-C-PEPTIDE $170.25 $170.25 $85.12–$170.25 9% below —
C-peptide blood test inpatient CPT 84681 LABS-C-PEPTIDE $170.25 $170.25 $72.19–$165.14 — —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LAB-C REACTIVE PROTEIN QUANT $91.75 $91.75 $45.88–$91.75 50% above —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LAB-C-REACTIVE PROTEIN $91.75 $91.75 $45.88–$91.75 50% above —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LABS- CRP QUANTITATIVE $91.75 $91.75 $45.88–$91.75 50% above —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LAB-C-REACTIVE PROTEIN $91.75 $91.75 $38.90–$89.00 — —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LAB-C REACTIVE PROTEIN QUANT $91.75 $91.75 $38.90–$89.00 — —
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LABS- CRP QUANTITATIVE $91.75 $91.75 $38.90–$89.00 — —
C. difficile toxin gene test (stool PCR) CPT 87493 LAB-CLOSTRIDIUM DIFFICILE PCR $307.50 $307.50 $153.75–$307.50 31% above —
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 LAB-CLOSTRIDIUM DIFFICILE PCR $307.50 $307.50 $130.38–$298.27 — —
CA 19-9 blood test (tumor marker) CPT 86301 LABS-CA 19-9 $214.00 $214.00 $107.00–$214.00 3% below —
CA 19-9 blood test (tumor marker) inpatient CPT 86301 LABS-CA 19-9 $214.00 $214.00 $90.74–$207.58 — —
CA-125 blood test (ovarian cancer marker) CPT 86304 LABS-CA 125 $190.50 $190.50 $95.25–$190.50 2% above —
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 LABS-CA 125 $190.50 $190.50 $80.77–$184.78 — —
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 LAB-COVID-19 PCR $120.50 $120.50 $60.25–$120.50 15% above —
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 LABS-COVID-19 PCR $120.50 $120.50 $60.25–$120.50 15% above —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 LABS-COVID-19 PCR $120.50 $120.50 $51.09–$116.88 — —
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 LAB-COVID-19 PCR $120.50 $120.50 $51.09–$116.88 — —
Calcium blood test, total CPT 82310 LAB CALCIUM, TOTAL RD $98.75 $98.75 $49.38–$98.75 184% above —
Calcium blood test, total CPT 82310 LAB-CALCIUM, TOTAL $98.75 $98.75 $49.38–$98.75 184% above —
Calcium blood test, total inpatient CPT 82310 LAB-CALCIUM, TOTAL $98.75 $98.75 $41.87–$95.79 — —
Calcium blood test, total inpatient CPT 82310 LAB CALCIUM, TOTAL RD $98.75 $98.75 $41.87–$95.79 — —
Carcinoembryonic antigen (CEA) test CPT 82378 LAB-CEA $310.00 $310.00 $155.00–$310.00 65% above —
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 LAB-CEA $310.00 $310.00 $131.44–$300.70 — —
Chickenpox (varicella) immunity blood test CPT 86787 LABS-VARICELLA ZOSTER IgM AB $122.00 $122.00 $61.00–$122.00 28% above —
Chickenpox (varicella) immunity blood test CPT 86787 LABS VARICELLA IGG AB SCREEN $122.00 $122.00 $61.00–$122.00 28% above —
Chickenpox (varicella) immunity blood test CPT 86787 LABS-VARICELLA ZOSTER IgG AB $122.00 $122.00 $61.00–$122.00 28% above —
Chickenpox (varicella) immunity blood test inpatient CPT 86787 LABS-VARICELLA ZOSTER IgG AB $122.00 $122.00 $51.73–$118.34 — —
Chickenpox (varicella) immunity blood test inpatient CPT 86787 LABS-VARICELLA ZOSTER IgM AB $122.00 $122.00 $51.73–$118.34 — —
Chickenpox (varicella) immunity blood test inpatient CPT 86787 LABS VARICELLA IGG AB SCREEN $122.00 $122.00 $51.73–$118.34 — —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 LAB-C. TRACHOMATIS PROBE $182.25 $182.25 $91.12–$182.25 50% above —
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 LAB-C. TRACHOMATIS PROBE $182.25 $182.25 $77.27–$176.78 — —
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LAB LIPID PANEL (ARP) $147.75 $147.75 $73.88–$147.75 51% above —
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LAB LIPID PANEL (ARP) $147.75 $147.75 $62.65–$143.32 — —
Complete blood count (CBC) with differential CPT 85025 LAB CBC+PLT W/DIFF (ELEC) $140.25 $140.25 $70.12–$140.25 102% above —
Complete blood count (CBC) with differential CPT 85025 SVRCC CBC+PLT w/DIFF (ELECTRON $140.25 $140.25 $70.12–$140.25 102% above —
Complete blood count (CBC) with differential inpatient CPT 85025 LAB CBC+PLT W/DIFF (ELEC) $140.25 $140.25 $59.47–$136.04 — —
Complete blood count (CBC) with differential inpatient CPT 85025 SVRCC CBC+PLT w/DIFF (ELECTRON $140.25 $140.25 $59.47–$136.04 — —
Complete blood count (CBC), no differential CPT 85027 LAB CBC W/ PLATELETS $79.75 $79.75 $39.88–$79.75 35% above —
Complete blood count (CBC), no differential inpatient CPT 85027 LAB CBC W/ PLATELETS $79.75 $79.75 $33.81–$77.36 — —
Comprehensive metabolic panel (blood test) CPT 80053 LAB-COMP METABOLIC PANEL $147.75 $147.75 $73.88–$147.75 5% above —
Comprehensive metabolic panel (blood test) inpatient CPT 80053 LAB-COMP METABOLIC PANEL $147.75 $147.75 $62.65–$143.32 — —
Cortisol blood test, total CPT 82533 LABS-CORTISOL TOTAL, SERUM $153.50 $153.50 $76.75–$153.50 26% above —
Cortisol blood test, total CPT 82533 LABS CORTISOL, SALIVA $153.50 $153.50 $76.75–$153.50 26% above —
Cortisol blood test, total CPT 82533 LAB-CORTISOL TOTAL, SERUM $153.50 $153.50 $76.75–$153.50 26% above —
Cortisol blood test, total inpatient CPT 82533 LAB-CORTISOL TOTAL, SERUM $153.50 $153.50 $65.08–$148.89 — —
Cortisol blood test, total inpatient CPT 82533 LABS CORTISOL, SALIVA $153.50 $153.50 $65.08–$148.89 — —
Cortisol blood test, total inpatient CPT 82533 LABS-CORTISOL TOTAL, SERUM $153.50 $153.50 $65.08–$148.89 — —
Creatine kinase (CK) blood test, total CPT 82550 LAB-CREATINE KINASE (CK) $138.75 $138.75 $69.38–$138.75 88% above —
Creatine kinase (CK) blood test, total inpatient CPT 82550 LAB-CREATINE KINASE (CK) $138.75 $138.75 $58.83–$134.59 — —
Creatinine blood test CPT 82565 LAB-CREATININE $80.25 $80.25 $40.12–$80.25 78% above —
Creatinine blood test CPT 82565 LAB-CREATININE RD $80.25 $80.25 $40.12–$80.25 78% above —
Creatinine blood test inpatient CPT 82565 LAB-CREATININE $80.25 $80.25 $34.03–$77.84 — —
Creatinine blood test inpatient CPT 82565 LAB-CREATININE RD $80.25 $80.25 $34.03–$77.84 — —
Cytomegalovirus (CMV) antibody test CPT 86644 LABS-CYTOMEGALOVIRUS IGG AB $173.75 $173.75 $86.88–$173.75 117% above —
Cytomegalovirus (CMV) antibody test CPT 86644 LABS CMV IGG ANTIBODY $173.75 $173.75 $86.88–$173.75 117% above —
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 LABS-CYTOMEGALOVIRUS IGG AB $173.75 $173.75 $73.67–$168.54 — —
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 LABS CMV IGG ANTIBODY $173.75 $173.75 $73.67–$168.54 — —
D-dimer blood test (blood clot marker) CPT 85379 LAB-D-DIMER $220.75 $220.75 $110.38–$220.75 134% above —
D-dimer blood test (blood clot marker) inpatient CPT 85379 LAB-D-DIMER $220.75 $220.75 $93.60–$214.13 — —
DHEA sulfate (DHEA-S) blood test CPT 82627 LABS-DHEA-SULFATE $201.00 $201.00 $100.50–$201.00 23% below —
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 LABS-DHEA-SULFATE $201.00 $201.00 $85.22–$194.97 — —
Drug screen by lab instrument (any number of drug classes) CPT 80307 LABS DRUGS OF ABUSE, MECONIUM $422.00 $422.00 $211.00–$422.00 154% above —
Drug screen by lab instrument (any number of drug classes) CPT 80307 LABS-DRUG SCREEN MULT CLASSES $422.00 $422.00 $211.00–$422.00 154% above —
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LABS DRUGS OF ABUSE, MECONIUM $422.00 $422.00 $178.93–$409.34 — —
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 LABS-DRUG SCREEN MULT CLASSES $422.00 $422.00 $178.93–$409.34 — —
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 LAB-ELECTROLYTE EVAL $98.75 $98.75 $49.38–$98.75 22% above —
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 LAB-ELECTROLYTE EVAL $98.75 $98.75 $41.87–$95.79 — —
Epstein-Barr virus (EBV) antibody test CPT 86665 LABS-EBV IGM AB TO VCA $112.00 $112.00 $56.00–$112.00 at median —
Epstein-Barr virus (EBV) antibody test CPT 86665 LABS-EBV IGG AB TO VCA $112.00 $112.00 $56.00–$112.00 at median —
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 LABS-EBV IGM AB TO VCA $112.00 $112.00 $47.49–$108.64 — —
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 LABS-EBV IGG AB TO VCA $112.00 $112.00 $47.49–$108.64 — —
Estradiol blood test CPT 82670 LABS-ESTRADIOL $214.00 $214.00 $107.00–$214.00 22% above —
Estradiol blood test CPT 82670 LABS ESTROG: ESTRADIOL $214.00 $214.00 $107.00–$214.00 22% above —
Estradiol blood test inpatient CPT 82670 LABS ESTROG: ESTRADIOL $214.00 $214.00 $90.74–$207.58 — —
Estradiol blood test inpatient CPT 82670 LABS-ESTRADIOL $214.00 $214.00 $90.74–$207.58 — —
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE $314.75 $314.75 $157.38–$314.75 61% above —
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE $314.75 $314.75 $133.45–$305.31 — —
Fecal calprotectin (stool inflammation test) CPT 83993 LABS-CALPROTECTIN, STOOL $387.00 $387.00 $193.50–$387.00 19% above —
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 LABS-CALPROTECTIN, STOOL $387.00 $387.00 $164.09–$375.39 — —
Ferritin blood test (iron stores) CPT 82728 LAB-FERRITIN $90.25 $90.25 $45.12–$90.25 28% below —
Ferritin blood test (iron stores) inpatient CPT 82728 LAB-FERRITIN $90.25 $90.25 $38.27–$87.54 — —
Fibrinogen blood test CPT 85384 LAB-FIBRINOGEN $164.00 $164.00 $82.00–$164.00 147% above —
Fibrinogen blood test inpatient CPT 85384 LAB-FIBRINOGEN $164.00 $164.00 $69.54–$159.08 — —
Folate (folic acid) blood test CPT 82746 LAB-FOLATE $123.75 $123.75 $61.88–$123.75 9% above —
Folate (folic acid) blood test inpatient CPT 82746 LAB-FOLATE $123.75 $123.75 $52.47–$120.04 — —
Free T3 thyroid hormone test CPT 84481 LABS-TRIIODOTHYRONINE, FREE $137.00 $137.00 $68.50–$137.00 10% below —
Free T3 thyroid hormone test CPT 84481 LAB - T3 FREE $137.00 $137.00 $68.50–$137.00 10% below —
Free T3 thyroid hormone test inpatient CPT 84481 LAB - T3 FREE $137.00 $137.00 $58.09–$132.89 — —
Free T3 thyroid hormone test inpatient CPT 84481 LABS-TRIIODOTHYRONINE, FREE $137.00 $137.00 $58.09–$132.89 — —
Free T4 (free thyroxine) thyroid blood test CPT 84439 LAB FREE T4 $181.25 $181.25 $90.62–$181.25 77% above —
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 LAB FREE T4 $181.25 $181.25 $76.85–$175.81 — —
Free testosterone test CPT 84402 LABS-TESTOSTERONE, FREE $201.00 $201.00 $100.50–$201.00 118% above —
Free testosterone test inpatient CPT 84402 LABS-TESTOSTERONE, FREE $201.00 $201.00 $85.22–$194.97 — —
Gamma-glutamyl transferase (GGT) blood test CPT 82977 LAB-GGT $100.00 $100.00 $50.00–$100.00 117% above —
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 LAB-GGT $100.00 $100.00 $42.40–$97.00 — —
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 LAB-GLUCOSE, PREG DIAB SCREEN $80.25 $80.25 $40.12–$80.25 48% above —
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 LAB-GLUCOSE TOL TEST, 2 HR $80.25 $80.25 $40.12–$80.25 48% above —
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 LAB-GLUCOSE TOL TEST, 2 HR $80.25 $80.25 $34.03–$77.84 — —
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 LAB-GLUCOSE, PREG DIAB SCREEN $80.25 $80.25 $34.03–$77.84 — —
Glucose tolerance test, 3 samples CPT 82951 LAB-GLUCOSE TOL, 5 HR $212.50 $212.50 $106.25–$212.50 41% above —
Glucose tolerance test, 3 samples CPT 82951 LAB-GLUCOSE TOL, 3 HR $212.50 $212.50 $106.25–$212.50 41% above —
Glucose tolerance test, 3 samples inpatient CPT 82951 LAB-GLUCOSE TOL, 3 HR $212.50 $212.50 $90.10–$206.12 — —
Glucose tolerance test, 3 samples inpatient CPT 82951 LAB-GLUCOSE TOL, 5 HR $212.50 $212.50 $90.10–$206.12 — —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 LAB-N. GONORRHOEAE PROBE $182.25 $182.25 $91.12–$182.25 16% above —
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 LAB-N. GONORRHOEAE PROBE $182.25 $182.25 $77.27–$176.78 — —
H. pylori antibody blood test CPT 86677 LABS H.PYLORI IgM AB $138.75 $138.75 $69.38–$138.75 149% above —
H. pylori antibody blood test CPT 86677 LABS-HELICOBACTER PYLORI AB $138.75 $138.75 $69.38–$138.75 149% above —
H. pylori antibody blood test inpatient CPT 86677 LABS-HELICOBACTER PYLORI AB $138.75 $138.75 $58.83–$134.59 — —
H. pylori antibody blood test inpatient CPT 86677 LABS H.PYLORI IgM AB $138.75 $138.75 $58.83–$134.59 — —
H. pylori stool antigen test CPT 87338 LAB-H.PYLORI AG,STOOL $172.75 $172.75 $86.38–$172.75 19% below —
H. pylori stool antigen test inpatient CPT 87338 LAB-H.PYLORI AG,STOOL $172.75 $172.75 $73.25–$167.57 — —
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 LABS-HIV1 RNA QUANT BY PCR $825.00 $825.00 $412.50–$825.00 123% above —
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 LABS-HIV1 RNA QUANT BY PCR $825.00 $825.00 $349.80–$800.25 — —
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LAB-HEMOGLOBIN A1C $187.25 $187.25 $93.62–$187.25 114% above —
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 LAB-HEMOGLOBIN A1C $187.25 $187.25 $79.39–$181.63 — —
Hemoglobin blood test CPT 85018 LAB HEMOGLOBIN $36.75 $36.75 $18.38–$36.75 63% above —
Hemoglobin blood test inpatient CPT 85018 LAB HEMOGLOBIN $36.75 $36.75 $15.58–$35.65 — —
Hepatitis B core antibody test (total) CPT 86704 LABS-HBcAB, TOTAL $122.00 $122.00 $61.00–$122.00 22% above —
Hepatitis B core antibody test (total) inpatient CPT 86704 LABS-HBcAB, TOTAL $122.00 $122.00 $51.73–$118.34 — —
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 LAB-HEPATITIS B SURF ANTIBODY $201.00 $201.00 $100.50–$201.00 109% above —
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 LAB-HEPATITIS B SURF ANTIBODY $201.00 $201.00 $85.22–$194.97 — —
Hepatitis B surface antigen (HBsAg) test CPT 87340 LAB-HEPATITIS B SURF ANTGEN $206.00 $206.00 $103.00–$206.00 122% above —
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 LAB-HEPATITIS B SURF ANTGEN $206.00 $206.00 $87.34–$199.82 — —
Hepatitis C antibody blood test (screening) CPT 86803 LAB - HEPATITIS C ANTIBODY $123.75 $123.75 $61.88–$123.75 12% above —
Hepatitis C antibody blood test (screening) inpatient CPT 86803 LAB - HEPATITIS C ANTIBODY $123.75 $123.75 $52.47–$120.04 — —
Hepatitis C viral load (HCV RNA) test CPT 87522 LABS-HEP C RNA BY PCR QT $1,180.50 $1,180.50 $590.25–$1,180.50 153% above —
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 LABS-HEP C RNA BY PCR QT $1,180.50 $1,180.50 $500.53–$1,145.08 — —
Herpes blood test, HSV-1 antibody CPT 86695 LABS HSV-1 IGG $199.00 $199.00 $99.50–$199.00 81% above —
Herpes blood test, HSV-1 antibody CPT 86695 LABS HSV-1 IGM $199.00 $199.00 $99.50–$199.00 81% above —
Herpes blood test, HSV-1 antibody inpatient CPT 86695 LABS HSV-1 IGG $199.00 $199.00 $84.38–$193.03 — —
Herpes blood test, HSV-1 antibody inpatient CPT 86695 LABS HSV-1 IGM $199.00 $199.00 $84.38–$193.03 — —
Herpes blood test, HSV-2 antibody CPT 86696 LABS HSV-2 IGG $199.00 $199.00 $99.50–$199.00 66% above —
Herpes blood test, HSV-2 antibody CPT 86696 LABS HSV-2 IGM $199.00 $199.00 $99.50–$199.00 66% above —
Herpes blood test, HSV-2 antibody inpatient CPT 86696 LABS HSV-2 IGG $199.00 $199.00 $84.38–$193.03 — —
Herpes blood test, HSV-2 antibody inpatient CPT 86696 LABS HSV-2 IGM $199.00 $199.00 $84.38–$193.03 — —
High-sensitivity CRP (hs-CRP) test CPT 86141 LABS CRP HIGHLY SENSITIVE $220.75 $220.75 $110.38–$220.75 130% above —
High-sensitivity CRP (hs-CRP) test CPT 86141 LAB CRP HIGHLY SENSITIVE $220.75 $220.75 $110.38–$220.75 130% above —
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 LAB CRP HIGHLY SENSITIVE $220.75 $220.75 $93.60–$214.13 — —
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 LABS CRP HIGHLY SENSITIVE $220.75 $220.75 $93.60–$214.13 — —
Homocysteine blood test CPT 83090 LABS-HOMOCYSTEINE,TOTAL PLASM $186.00 $186.00 $93.00–$186.00 8% below —
Homocysteine blood test inpatient CPT 83090 LABS-HOMOCYSTEINE,TOTAL PLASM $186.00 $186.00 $78.86–$180.42 — —
Insulin blood test CPT 83525 LABS-INSULIN, TOTAL $123.75 $123.75 $61.88–$123.75 20% above —
Insulin blood test inpatient CPT 83525 LABS-INSULIN, TOTAL $123.75 $123.75 $52.47–$120.04 — —
Iron blood test (serum iron) CPT 83540 LAB-IRON $89.25 $89.25 $44.62–$89.25 28% above —
Iron blood test (serum iron) inpatient CPT 83540 LAB-IRON $89.25 $89.25 $37.84–$86.57 — —
Iron-binding capacity (TIBC) test CPT 83550 LAB-TIBC $178.00 $178.00 $89.00–$178.00 118% above —
Iron-binding capacity (TIBC) test inpatient CPT 83550 LAB-TIBC $178.00 $178.00 $75.47–$172.66 — —
Kidney function blood test panel CPT 80069 LAB RENAL FUNCTION PANEL $106.50 $106.50 $53.25–$106.50 11% below —
Kidney function blood test panel inpatient CPT 80069 LAB RENAL FUNCTION PANEL $106.50 $106.50 $45.16–$103.30 — —
LH (luteinizing hormone) test CPT 83002 LAB-LUTEINIZING HORMONE $323.25 $323.25 $161.62–$323.25 102% above —
LH (luteinizing hormone) test inpatient CPT 83002 LAB-LUTEINIZING HORMONE $323.25 $323.25 $137.06–$313.55 — —
Lactate (lactic acid) blood test CPT 83605 LAB-LACTIC ACID $465.50 $465.50 $232.75–$465.50 308% above —
Lactate (lactic acid) blood test inpatient CPT 83605 LAB-LACTIC ACID $465.50 $465.50 $197.37–$451.54 — —
Lactate dehydrogenase (LDH) blood test CPT 83615 LABS-FLUID LD $83.25 $83.25 $41.62–$83.25 at median —
Lactate dehydrogenase (LDH) blood test CPT 83615 LAB-LD (LDH) $83.25 $83.25 $41.62–$83.25 at median —
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LAB-LD (LDH) $83.25 $83.25 $35.30–$80.75 — —
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LABS-FLUID LD $83.25 $83.25 $35.30–$80.75 — —
Lipase blood test (pancreas enzyme) CPT 83690 LAB-LIPASE $100.00 $100.00 $50.00–$100.00 104% above —
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LAB-LIPASE $100.00 $100.00 $42.40–$97.00 — —
Liver function blood test panel CPT 80076 LAB HEPATIC FUNCTION PANEL $127.25 $127.25 $63.62–$127.25 15% above —
Liver function blood test panel inpatient CPT 80076 LAB HEPATIC FUNCTION PANEL $127.25 $127.25 $53.95–$123.43 — —
Lyme disease antibody test CPT 86618 LAB-LYME DISEASE AB TOTAL $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS-LYME IgA $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS-LYME IgG $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS-LYME IgM $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS-LYME DIEASE AB TOTAL $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS LYMEINDEX:LYME IGG,BLOO $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS LYMEINDEX:LYME IGM,BLOO $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS LYMEINDEX:LYME IGG,CSF $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test CPT 86618 LABS LYMEINDEX:LYME IGM,CSF $78.25 $78.25 $39.12–$78.25 22% below —
Lyme disease antibody test inpatient CPT 86618 LABS LYMEINDEX:LYME IGM,BLOO $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS LYMEINDEX:LYME IGG,BLOO $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LAB-LYME DISEASE AB TOTAL $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS LYMEINDEX:LYME IGM,CSF $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS LYMEINDEX:LYME IGG,CSF $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS-LYME IgA $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS-LYME IgG $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS-LYME IgM $78.25 $78.25 $33.18–$75.90 — —
Lyme disease antibody test inpatient CPT 86618 LABS-LYME DIEASE AB TOTAL $78.25 $78.25 $33.18–$75.90 — —
Magnesium blood test CPT 83735 LAB-MAGNESIUM $130.50 $130.50 $65.25–$130.50 132% above —
Magnesium blood test CPT 83735 LABS-MAGNESIUM, RBC $130.50 $130.50 $65.25–$130.50 132% above —
Magnesium blood test inpatient CPT 83735 LABS-MAGNESIUM, RBC $130.50 $130.50 $55.33–$126.58 — —
Magnesium blood test inpatient CPT 83735 LAB-MAGNESIUM $130.50 $130.50 $55.33–$126.58 — —
Measles (rubeola) antibody test CPT 86765 LABS-RUBEOLA IgG AB $122.00 $122.00 $61.00–$122.00 52% above —
Measles (rubeola) antibody test inpatient CPT 86765 LABS-RUBEOLA IgG AB $122.00 $122.00 $51.73–$118.34 — —
Mono test (heterophile antibody, Monospot) CPT 86308 LAB-INFECTIOUS MONO TEST $109.00 $109.00 $54.50–$109.00 129% above —
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 LAB-INFECTIOUS MONO TEST $109.00 $109.00 $46.22–$105.73 — —
Mumps immunity blood test CPT 86735 LABS-MUMPS VIRUS IgG AB $183.75 $183.75 $91.88–$183.75 67% above —
Mumps immunity blood test CPT 86735 LABS-MUMPS VIRUS IgM AB $183.75 $183.75 $91.88–$183.75 67% above —
Mumps immunity blood test CPT 86735 LABS MUMPS IGG AB SCREEN $183.75 $183.75 $91.88–$183.75 67% above —
Mumps immunity blood test inpatient CPT 86735 LABS MUMPS IGG AB SCREEN $183.75 $183.75 $77.91–$178.24 — —
Mumps immunity blood test inpatient CPT 86735 LABS-MUMPS VIRUS IgG AB $183.75 $183.75 $77.91–$178.24 — —
Mumps immunity blood test inpatient CPT 86735 LABS-MUMPS VIRUS IgM AB $183.75 $183.75 $77.91–$178.24 — —
PSA (prostate-specific antigen) blood test, free CPT 84154 LABS-PROSTATE-SPECIFIC AG,FREE $142.50 $142.50 $71.25–$142.50 at median —
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 LABS-PROSTATE-SPECIFIC AG,FREE $142.50 $142.50 $60.42–$138.22 — —
PSA (prostate-specific antigen) blood test, total CPT 84153 LAB-PROSTATE ANTIGEN NON-SC $333.25 $333.25 $166.62–$333.25 148% above —
PSA (prostate-specific antigen) blood test, total CPT 84153 LABS-PROSTATE SPECIFIC AG,TOT $333.25 $333.25 $166.62–$333.25 148% above —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LABS-PROSTATE SPECIFIC AG,TOT $333.25 $333.25 $141.30–$323.25 — —
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 LAB-PROSTATE ANTIGEN NON-SC $333.25 $333.25 $141.30–$323.25 — —
Pap test (liquid-based, automated screening with review) CPT 88175 LABS-PAP SMEAR, DIAGNOSTIC $215.75 $215.75 $107.88–$215.75 122% above —
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 LABS-PAP SMEAR, DIAGNOSTIC $215.75 $215.75 $91.48–$209.28 — —
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 LAB THIN PREP PAP DIAGNOSTIC $216.25 $216.25 $108.12–$216.25 61% above —
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 LAB THIN PREP PAP DIAGNOSTIC $216.25 $216.25 $91.69–$209.76 — —
Parathyroid hormone (PTH) blood test CPT 83970 LABS-INTACT PTH $249.75 $249.75 $124.88–$249.75 at median —
Parathyroid hormone (PTH) blood test CPT 83970 LAB-PTH INTACT $249.75 $249.75 $124.88–$249.75 at median —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 LABS-INTACT PTH $249.75 $249.75 $105.89–$242.26 — —
Parathyroid hormone (PTH) blood test inpatient CPT 83970 LAB-PTH INTACT $249.75 $249.75 $105.89–$242.26 — —
Partial thromboplastin time (PTT) clotting test CPT 85730 LAB-PARTIAL THROMBOPLAST, TIME $125.25 $125.25 $62.62–$125.25 129% above —
Partial thromboplastin time (PTT) clotting test CPT 85730 LABS-APTT LUPUS ANTICOAG $125.25 $125.25 $62.62–$125.25 129% above —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LABS-APTT LUPUS ANTICOAG $125.25 $125.25 $53.11–$121.49 — —
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LAB-PARTIAL THROMBOPLAST, TIME $125.25 $125.25 $53.11–$121.49 — —
Phosphorus (phosphate) blood test CPT 84100 LAB-PHOSPHORUS $98.75 $98.75 $49.38–$98.75 119% above —
Phosphorus (phosphate) blood test CPT 84100 LAB-PHOSPHORUS RD $98.75 $98.75 $49.38–$98.75 119% above —
Phosphorus (phosphate) blood test inpatient CPT 84100 LAB-PHOSPHORUS $98.75 $98.75 $41.87–$95.79 — —
Phosphorus (phosphate) blood test inpatient CPT 84100 LAB-PHOSPHORUS RD $98.75 $98.75 $41.87–$95.79 — —
Potassium blood test CPT 84132 LAB-POTASSIUM $95.00 $95.00 $47.50–$95.00 128% above —
Potassium blood test CPT 84132 LAB-POTASSIUM RD $95.00 $95.00 $47.50–$95.00 128% above —
Potassium blood test inpatient CPT 84132 LAB-POTASSIUM RD $95.00 $95.00 $40.28–$92.15 — —
Potassium blood test inpatient CPT 84132 LAB-POTASSIUM $95.00 $95.00 $40.28–$92.15 — —
Progesterone blood test CPT 84144 LABS-PROGESTERONE $190.50 $190.50 $95.25–$190.50 8% above —
Progesterone blood test inpatient CPT 84144 LABS-PROGESTERONE $190.50 $190.50 $80.77–$184.78 — —
Prolactin blood test CPT 84146 LAB-PROLACTIN $359.50 $359.50 $179.75–$359.50 150% above —
Prolactin blood test inpatient CPT 84146 LAB-PROLACTIN $359.50 $359.50 $152.43–$348.72 — —
Prothrombin time (PT/INR) clotting test CPT 85610 SVRCC PROTIME-INR $43.00 $43.00 $21.50–$43.00 13% above —
Prothrombin time (PT/INR) clotting test CPT 85610 LAB-PROTHROMBIN TIME $43.00 $43.00 $21.50–$43.00 13% above —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 SVRCC PROTIME-INR $43.00 $43.00 $18.23–$41.71 — —
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LAB-PROTHROMBIN TIME $43.00 $43.00 $18.23–$41.71 — —
Rapid strep A antigen test from a throat swab, read visually CPT 87880 LAB-BETA STREP (EIA) $140.50 $140.50 $70.25–$140.50 110% above —
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 LAB-BETA STREP (EIA) $140.50 $140.50 $59.57–$136.28 — —
Renin blood test CPT 84244 LABS-RENIN $194.00 $194.00 $97.00–$194.00 6% below —
Renin blood test inpatient CPT 84244 LABS-RENIN $194.00 $194.00 $82.26–$188.18 — —
Rh blood typing CPT 86901 LAB-BLOOD TYPING, RH (D) ONLY $130.50 $130.50 $65.25–$130.50 169% above —
Rh blood typing inpatient CPT 86901 LAB-BLOOD TYPING, RH (D) ONLY $130.50 $130.50 $55.33–$126.58 — —
Rubella antibody test (immunity check) CPT 86762 LAB-RUBELLA SCREEN $190.50 $190.50 $95.25–$190.50 94% above —
Rubella antibody test (immunity check) inpatient CPT 86762 LAB-RUBELLA SCREEN $190.50 $190.50 $80.77–$184.78 — —
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 LAB-SEDIMENTATION RATE $80.75 $80.75 $40.38–$80.75 92% above —
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 LAB-SEDIMENTATION RATE $80.75 $80.75 $34.24–$78.33 — —
Semen analysis: volume, sperm count, motility and morphology CPT 89320 LAB-SEMEN ANALYSIS $192.25 $192.25 $96.12–$192.25 30% above —
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 LAB-SEMEN ANALYSIS $192.25 $192.25 $81.51–$186.48 — —
Sodium blood test CPT 84295 LAB-SODIUM $91.75 $91.75 $45.88–$91.75 104% above —
Sodium blood test inpatient CPT 84295 LAB-SODIUM $91.75 $91.75 $38.90–$89.00 — —
Stool ova and parasites exam CPT 87177 LABS-STOOL DIRECT SMEAR/CON/ID $180.50 $180.50 $90.25–$180.50 78% above —
Stool ova and parasites exam inpatient CPT 87177 LABS-STOOL DIRECT SMEAR/CON/ID $180.50 $180.50 $76.53–$175.08 — —
Stool test for hidden blood (guaiac FOBT) CPT 82270 LAB-OCCULT BLOOD SCREENING $65.00 $65.00 $32.50–$65.00 256% above —
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 LAB-OCCULT BLOOD SCREENING $65.00 $65.00 $27.56–$63.05 — —
Syphilis antibody test (Treponema pallidum) CPT 86780 LABS-SYPHILIS IgG AB $109.00 $109.00 $54.50–$109.00 88% above —
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 LABS-SYPHILIS IgG AB $109.00 $109.00 $46.22–$105.73 — —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LAB-RPR, SYPHILIS SEROLOGY $81.75 $81.75 $40.88–$81.75 14% above —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LABS-VDRL, CSF $81.75 $81.75 $40.88–$81.75 14% above —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 LABS-RAPID PLASMA REAGIN,S $81.75 $81.75 $40.88–$81.75 14% above —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LABS-RAPID PLASMA REAGIN,S $81.75 $81.75 $34.66–$79.30 — —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LABS-VDRL, CSF $81.75 $81.75 $34.66–$79.30 — —
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 LAB-RPR, SYPHILIS SEROLOGY $81.75 $81.75 $34.66–$79.30 — —
Testosterone blood test, total (not free testosterone) CPT 84403 LABS-TESTOSTERONE, TOTAL $201.00 $201.00 $100.50–$201.00 at median —
Testosterone blood test, total (not free testosterone) CPT 84403 LAB-TESTOSTERONE, TOTAL $201.00 $201.00 $100.50–$201.00 at median —
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 LAB-TESTOSTERONE, TOTAL $201.00 $201.00 $85.22–$194.97 — —
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 LABS-TESTOSTERONE, TOTAL $201.00 $201.00 $85.22–$194.97 — —
Thyroid peroxidase (TPO) antibody test CPT 86376 LABS LIVER/KIDNEY MICROSOME AB $153.50 $153.50 $76.75–$153.50 27% above —
Thyroid peroxidase (TPO) antibody test CPT 86376 LABS: THYROPEROXIDASE ANTIBODY $153.50 $153.50 $76.75–$153.50 27% above —
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LABS LIVER/KIDNEY MICROSOME AB $153.50 $153.50 $65.08–$148.89 — —
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LABS: THYROPEROXIDASE ANTIBODY $153.50 $153.50 $65.08–$148.89 — —
Thyroid-stimulating hormone (TSH) blood test CPT 84443 LAB-TSH $268.00 $268.00 $134.00–$268.00 41% above —
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LAB-TSH $268.00 $268.00 $113.63–$259.96 — —
Total IgE blood test CPT 82785 LABS-IgE, SERUM $152.50 $152.50 $76.25–$152.50 82% above —
Total IgE blood test inpatient CPT 82785 LABS-IgE, SERUM $152.50 $152.50 $64.66–$147.92 — —
Total cholesterol blood test CPT 82465 LAB-CHOLESTEROL, TOTAL $90.25 $90.25 $45.12–$90.25 121% above —
Total cholesterol blood test inpatient CPT 82465 LAB-CHOLESTEROL, TOTAL $90.25 $90.25 $38.27–$87.54 — —
Total thyroxine (T4) blood test CPT 84436 LAB-T4 (THYROXINE) $118.75 $118.75 $59.38–$118.75 108% above —
Total thyroxine (T4) blood test inpatient CPT 84436 LAB-T4 (THYROXINE) $118.75 $118.75 $50.35–$115.19 — —
Total triiodothyronine (T3) blood test CPT 84480 LABS-T3 TOTAL $123.75 $123.75 $61.88–$123.75 at median —
Total triiodothyronine (T3) blood test inpatient CPT 84480 LABS-T3 TOTAL $123.75 $123.75 $52.47–$120.04 — —
Transferrin blood test CPT 84466 LABS-TRANSFERRIN $123.75 $123.75 $61.88–$123.75 25% above —
Transferrin blood test inpatient CPT 84466 LABS-TRANSFERRIN $123.75 $123.75 $52.47–$120.04 — —
Trichomonas test (NAAT) CPT 87661 LAB-TRICH VAGINALIS RNA $133.75 $133.75 $66.88–$133.75 127% above —
Trichomonas test (NAAT) inpatient CPT 87661 LAB-TRICH VAGINALIS RNA $133.75 $133.75 $56.71–$129.74 — —
Triglycerides blood test CPT 84478 LAB-TRIGLYCERIDES $95.00 $95.00 $47.50–$95.00 136% above —
Triglycerides blood test CPT 84478 LABS-FLUID TRIGLYCERIDES $95.00 $95.00 $47.50–$95.00 136% above —
Triglycerides blood test inpatient CPT 84478 LABS-FLUID TRIGLYCERIDES $95.00 $95.00 $40.28–$92.15 — —
Triglycerides blood test inpatient CPT 84478 LAB-TRIGLYCERIDES $95.00 $95.00 $40.28–$92.15 — —
Troponin test, quantitative CPT 84484 LAB-TROPONIN-I $395.25 $395.25 $197.62–$395.25 140% above —
Troponin test, quantitative inpatient CPT 84484 LAB-TROPONIN-I $395.25 $395.25 $167.59–$383.39 — —
Uric acid blood test CPT 84550 LAB-URIC ACID $80.25 $80.25 $40.12–$80.25 23% above —
Uric acid blood test inpatient CPT 84550 LAB-URIC ACID $80.25 $80.25 $34.03–$77.84 — —
Urinalysis with microscope exam, automated CPT 81001 LAB-URINALYSIS W/SEDIMENT EXAM $149.00 $149.00 $74.50–$149.00 218% above —
Urinalysis with microscope exam, automated inpatient CPT 81001 LAB-URINALYSIS W/SEDIMENT EXAM $149.00 $149.00 $63.18–$144.53 — —
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS COMPLETE $22.75 $22.75 $11.38–$22.75 17% above —
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS COMPLETE $22.75 $22.75 $9.65–$22.07 — —
Urinalysis without microscope exam, automated CPT 81003 LAB-URINALYSIS, ROUTINE $147.75 $147.75 $73.88–$147.75 289% above —
Urinalysis without microscope exam, automated inpatient CPT 81003 LAB-URINALYSIS, ROUTINE $147.75 $147.75 $62.65–$143.32 — —
Urinalysis without microscope exam, manual CPT 81002 LAB-URINE SPECIFIC GRAVITY $59.75 $59.75 $29.88–$59.75 160% above —
Urinalysis without microscope exam, manual CPT 81002 SVRCC URINALYSIS, ROUTINE $59.75 $59.75 $29.88–$59.75 160% above —
Urinalysis without microscope exam, manual CPT 81002 LAB-URINE PH $59.75 $59.75 $29.88–$59.75 160% above —
Urinalysis without microscope exam, manual CPT 81002 LAB-ACETONE,URINE $59.75 $59.75 $29.88–$59.75 160% above —
Urinalysis without microscope exam, manual inpatient CPT 81002 SVRCC URINALYSIS, ROUTINE $59.75 $59.75 $25.33–$57.96 — —
Urinalysis without microscope exam, manual inpatient CPT 81002 LAB-URINE SPECIFIC GRAVITY $59.75 $59.75 $25.33–$57.96 — —
Urinalysis without microscope exam, manual inpatient CPT 81002 LAB-ACETONE,URINE $59.75 $59.75 $25.33–$57.96 — —
Urinalysis without microscope exam, manual inpatient CPT 81002 LAB-URINE PH $59.75 $59.75 $25.33–$57.96 — —
Urine culture for bacteria, with colony count CPT 87086 LAB-URINE CULTURE/INOC $145.25 $145.25 $72.62–$145.25 90% above —
Urine culture for bacteria, with colony count inpatient CPT 87086 LAB-URINE CULTURE/INOC $145.25 $145.25 $61.59–$140.89 — —
Urine microalbumin (albumin) test CPT 82043 LAB MICROALBUMIN, URINE $98.75 $98.75 $49.38–$98.75 96% above —
Urine microalbumin (albumin) test inpatient CPT 82043 LAB MICROALBUMIN, URINE $98.75 $98.75 $41.87–$95.79 — —
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST $24.75 $24.75 $12.38–$24.75 37% below —
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST $24.75 $24.75 $10.49–$24.01 — —
Vitamin B12 (cobalamin) blood test CPT 82607 LAB-B12 $122.00 $122.00 $61.00–$122.00 9% above —
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 LAB-B12 $122.00 $122.00 $51.73–$118.34 — —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LABS-VITAMIN D-25 $278.00 $278.00 $139.00–$278.00 31% above —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 LAB - VITAMIN D TOTAL $278.00 $278.00 $139.00–$278.00 31% above —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 LAB - VITAMIN D TOTAL $278.00 $278.00 $117.87–$269.66 — —
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 LABS-VITAMIN D-25 $278.00 $278.00 $117.87–$269.66 — —
Vitamin D, 1,25-dihydroxy blood test CPT 82652 LABS-VITAMIN D-1,25 $387.25 $387.25 $193.62–$387.25 11% above —
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 LABS-VITAMIN D-1,25 $387.25 $387.25 $164.19–$375.63 — —
Zinc blood test CPT 84630 LABS-ZINC, RBC $140.50 $140.50 $70.25–$140.50 9% below —
Zinc blood test CPT 84630 LABS-ZINC, SERUM $140.50 $140.50 $70.25–$140.50 9% below —
Zinc blood test inpatient CPT 84630 LABS-ZINC, RBC $140.50 $140.50 $59.57–$136.28 — —
Zinc blood test inpatient CPT 84630 LABS-ZINC, SERUM $140.50 $140.50 $59.57–$136.28 — —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LABS AFPS-GONADOTROPIN CHOR $316.50 $316.50 $158.25–$316.50 154% above —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LAB-HCG QUANT $316.50 $316.50 $158.25–$316.50 154% above —
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 LABS-HCG,TUMOR MARKER $316.50 $316.50 $158.25–$316.50 154% above —
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LABS AFPS-GONADOTROPIN CHOR $316.50 $316.50 $134.20–$307.00 — —
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LABS-HCG,TUMOR MARKER $316.50 $316.50 $134.20–$307.00 — —
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 LAB-HCG QUANT $316.50 $316.50 $134.20–$307.00 — —

Surgery and procedures

ProcedureCash priceList priceInsurers payvs VermontOff list
Botox injections for chronic migraine CPT 64615 CHEMONERVATION CHRONIC MIGRAIN $748.25 $748.25 $374.12–$748.25 83% above —
Botox injections for chronic migraine inpatient CPT 64615 CHEMONERVATION CHRONIC MIGRAIN $748.25 $748.25 $317.26–$725.80 — —
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BREAST BX RT,CLIP,SPECI MAMMO $3,430.50 $3,430.50 $1,715.25–$3,430.50 16% above —
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BREAST BX LT,CLIP,SPECI MAMMO $3,430.50 $3,430.50 $1,715.25–$3,430.50 16% above —
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BREAST BX LT,CLIP,SPECI MAMMO $3,430.50 $3,430.50 $1,454.53–$3,327.58 — —
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BREAST BX RT,CLIP,SPECI MAMMO $3,430.50 $3,430.50 $1,454.53–$3,327.58 — —
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSED DISTAL FIBULAR W/O MANIP $376.75 $376.75 $188.38–$376.75 19% below —
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSED DISTAL FIBULAR W/O MANIP $376.75 $376.75 $159.74–$365.45 — —
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Closed fx metatarsal fx $551.25 $551.25 $275.62–$551.25 41% above —
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 Closed fx metatarsal fx $551.25 $551.25 $233.73–$534.71 — —
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION,ELECTIVE ELECTRI $2,047.25 $2,047.25 $1,023.62–$2,047.25 34% above —
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion $2,047.25 $2,047.25 $1,023.62–$2,047.25 34% above —
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELEC CONV EXTERN $2,047.25 $2,047.25 $1,023.62–$2,047.25 34% above —
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELEC CONV EXTERN $2,047.25 $2,047.25 $868.03–$1,985.83 — —
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion $2,047.25 $2,047.25 $868.03–$1,985.83 — —
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION,ELECTIVE ELECTRI $2,047.25 $2,047.25 $868.03–$1,985.83 — —
Cervical biopsy CPT 57500 BIOPSY CERVIX $853.25 $853.25 $426.62–$853.25 at median —
Cervical biopsy inpatient CPT 57500 BIOPSY CERVIX $853.25 $853.25 $361.78–$827.65 — —
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREAT OF DISTAL RADIAL $1,407.75 $1,407.75 $703.88–$1,407.75 161% above —
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREAT OF DISTAL RADIAL $1,407.75 $1,407.75 $596.89–$1,365.52 — —
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY $2,020.25 $2,020.25 $1,010.12–$2,020.25 361% above —
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY $2,020.25 $2,020.25 $856.59–$1,959.64 — —
Earwax removal with instruments, one ear CPT 69210 Remove Impacted Cerumen $222.25 $222.25 $111.12–$222.25 34% above —
Earwax removal with instruments, one ear inpatient CPT 69210 Remove Impacted Cerumen $222.25 $222.25 $94.23–$215.58 — —
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Endometraial bx $323.25 $323.25 $161.62–$323.25 38% above —
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 Endometraial bx $323.25 $323.25 $137.06–$313.55 — —
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL EPIDURAL TRANSLAMINAR $2,856.00 $2,856.00 $1,428.00–$2,856.00 52% above —
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 TSPINE TRANSLAMINAR INJ $2,856.00 $2,856.00 $1,428.00–$2,856.00 52% above —
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 THORACIC EPIDURAL STEROID INJ $2,856.00 $2,856.00 $1,428.00–$2,856.00 52% above —
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CERVICAL EPIDURAL STEROID INJ $2,856.00 $2,856.00 $1,428.00–$2,856.00 52% above —
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL EPIDURAL STEROID INJ $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CERVICAL EPIDURAL TRANSLAMINAR $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 TSPINE TRANSLAMINAR INJ $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 THORACIC EPIDURAL STEROID INJ $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LS FACET INJ 1ST SITE W/CT GUI $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJECT LS FACET JT OR NERVE $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LS FACET INJ 1ST SITE W FLORO $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ.PARAVERTEBRAL LUMBAR SPINE $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ.PARAVERTEBRAL L/S ADD-ON $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 LUMBAR MEDIAL BRANCH INJ RT $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 LUMBAR MEDIAL BRANCH INJ LT $2,728.50 $2,728.50 $1,364.25–$2,728.50 18% above —
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ.PARAVERTEBRAL LUMBAR SPINE $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 LS FACET INJ 1ST SITE W FLORO $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ.PARAVERTEBRAL L/S ADD-ON $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJECT LS FACET JT OR NERVE $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 LS FACET INJ 1ST SITE W/CT GUI $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 LUMBAR MEDIAL BRANCH INJ RT $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 LUMBAR MEDIAL BRANCH INJ LT $2,728.50 $2,728.50 $1,156.88–$2,646.64 — —
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER OF HYSTEROGRAPHY $249.00 $249.00 $124.50–$249.00 33% below —
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJECT. HYSTEROSALPINGOGRAPHY $249.00 $249.00 $124.50–$249.00 33% below —
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJECT. HYSTEROSALPINGOGRAPHY $249.00 $249.00 $105.58–$241.53 — —
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETER OF HYSTEROGRAPHY $249.00 $249.00 $105.58–$241.53 — —
Incision and drainage of a simple or single skin abscess CPT 10060 I&D of abscess $462.25 $462.25 $231.12–$462.25 at median —
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D of abscess $462.25 $462.25 $195.99–$448.38 — —
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH $786.25 $786.25 $393.12–$786.25 175% above —
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH $786.25 $786.25 $333.37–$762.66 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JT/BURSA $177.00 $177.00 $88.50–$177.00 74% below —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JT.IN U/S $786.25 $786.25 $393.12–$786.25 15% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JT,INJ OR $786.25 $786.25 $393.12–$786.25 15% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATE/INJ LARGE JT OR BURSA $786.25 $786.25 $393.12–$786.25 15% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentisis Major Joint $786.25 $786.25 $393.12–$786.25 15% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS MAJ JT,INJ RT $786.25 $786.25 $393.12–$786.25 15% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHROCENTESIS MAJ JT,INJ LT $786.25 $786.25 $393.12–$786.25 15% above —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JT/BURSA $177.00 $177.00 $75.05–$171.69 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATE/INJ LARGE JT OR BURSA $786.25 $786.25 $333.37–$762.66 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentisis Major Joint $786.25 $786.25 $333.37–$762.66 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JT,INJ OR $786.25 $786.25 $333.37–$762.66 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JT.IN U/S $786.25 $786.25 $333.37–$762.66 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHROCENTESIS MAJ JT,INJ LT $786.25 $786.25 $333.37–$762.66 — —
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHROCENTESIS MAJ JT,INJ RT $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentisis Inter. Joint $786.25 $786.25 $393.12–$786.25 182% above —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS INTER. JT/BURSA $786.25 $786.25 $393.12–$786.25 182% above —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ MED JT OR BURSA W/ US $786.25 $786.25 $393.12–$786.25 182% above —
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATE/INJ MEDIUM JT/BURSA $786.25 $786.25 $393.12–$786.25 182% above —
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR PRE MR/CT LT ELBOW INJECT $786.25 $786.25 $393.12–$786.25 182% above —
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR PRE MR/CT RT ELBOW INJECT $786.25 $786.25 $393.12–$786.25 182% above —
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentisis Inter. Joint $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS INTER. JT/BURSA $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ MED JT OR BURSA W/ US $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATE/INJ MEDIUM JT/BURSA $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR PRE MR/CT RT ELBOW INJECT $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR PRE MR/CT LT ELBOW INJECT $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATE/INJECT SMALL JT/BURSA $786.25 $786.25 $393.12–$786.25 119% above —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTISIS SMALL JT/BURSA $786.25 $786.25 $393.12–$786.25 119% above —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/INJ SM JT OR BURSA W/ U.S. $786.25 $786.25 $393.12–$786.25 119% above —
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS SMALL JOINT $786.25 $786.25 $393.12–$786.25 119% above —
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS SMALL JOINT $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATE/INJECT SMALL JT/BURSA $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ SM JT OR BURSA W/ U.S. $786.25 $786.25 $333.37–$762.66 — —
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTISIS SMALL JT/BURSA $786.25 $786.25 $333.37–$762.66 — —
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR WOUNDS 2.5CM OR LESS $469.00 $469.00 $234.50–$469.00 3% above —
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR WOUNDS 2.5CM OR LESS $469.00 $469.00 $198.86–$454.93 — —
Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR INTERLAMINAR EPIDURAL $2,856.00 $2,856.00 $1,428.00–$2,856.00 37% above —
Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL LS TRANSLAMINAR CT IN $2,856.00 $2,856.00 $1,428.00–$2,856.00 37% above —
Lower-back epidural injection, with imaging guidance CPT 62323 CAUDAL EPIDURAL STEROID INJECT $2,856.00 $2,856.00 $1,428.00–$2,856.00 37% above —
Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR INTERLAMINAR EPID L2-3 $2,856.00 $2,856.00 $1,428.00–$2,856.00 37% above —
Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL LS TRANSLAMINAR INJ $2,856.00 $2,856.00 $1,428.00–$2,856.00 37% above —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL LS TRANSLAMINAR INJ $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR INTERLAMINAR EPIDURAL $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR INTERLAMINAR EPID L2-3 $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CAUDAL EPIDURAL STEROID INJECT $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL LS TRANSLAMINAR CT IN $2,856.00 $2,856.00 $1,210.94–$2,770.32 — —
Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 LS BILAT TRANSFORMAMINAL INJ $6,562.25 $6,562.25 $3,281.12–$6,562.25 — —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 XR GUIDE LS TRANSFORAMINAL INJ $4,399.75 $4,399.75 $2,199.88–$4,399.75 80% above —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPIDURAL LS TRANSFORAMINAL -CT $4,399.75 $4,399.75 $2,199.88–$4,399.75 80% above —
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPIDURAL LS TRANSFORAMINAL $4,399.75 $4,399.75 $2,199.88–$4,399.75 80% above —
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 LS TRANSFORAMINAL EPIDURAL LT $4,399.75 $4,399.75 $2,199.88–$4,399.75 80% above —
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 LS TRANSFORAMINAL EPIDURAL RT $4,399.75 $4,399.75 $2,199.88–$4,399.75 80% above —
Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 LS BILAT TRANSFORMAMINAL INJ $6,562.25 $6,562.25 $2,782.39–$6,365.38 — —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 XR GUIDE LS TRANSFORAMINAL INJ $4,399.75 $4,399.75 $1,865.49–$4,267.76 — —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 EPIDURAL LS TRANSFORAMINAL -CT $4,399.75 $4,399.75 $1,865.49–$4,267.76 — —
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 EPIDURAL LS TRANSFORAMINAL $4,399.75 $4,399.75 $1,865.49–$4,267.76 — —
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 LS TRANSFORAMINAL EPIDURAL LT $4,399.75 $4,399.75 $1,865.49–$4,267.76 — —
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 LS TRANSFORAMINAL EPIDURAL RT $4,399.75 $4,399.75 $1,865.49–$4,267.76 — —
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENIGN LESION 0.5CM LESS $871.50 $871.50 $435.75–$871.50 306% above —
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENIGN LESION 0.5CM LESS $871.50 $871.50 $369.52–$845.36 — —
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCIS. BENGN LSN FACE .5CM OR $445.00 $445.00 $222.50–$445.00 22% above —
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCIS. BENGN LSN FACE .5CM OR $445.00 $445.00 $188.68–$431.65 — —
Nail removal (partial or complete), one nail CPT 11730 Avulsion of nail plate $409.00 $409.00 $204.50–$409.00 at median —
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion of nail plate $409.00 $409.00 $173.42–$396.73 — —
Occipital nerve block (injection for headaches) one side CPT 64405 OCCIPITAL NERVE BLOCK GR-LEFT $1,239.00 $1,239.00 $619.50–$1,239.00 142% above —
Occipital nerve block (injection for headaches) one side CPT 64405 OCCIPITAL NERVE BLOCK GR RIGHT $1,239.00 $1,239.00 $619.50–$1,239.00 142% above —
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 OCCIPITAL NERVE BLOCK GR RIGHT $1,239.00 $1,239.00 $525.34–$1,201.83 — —
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 OCCIPITAL NERVE BLOCK GR-LEFT $1,239.00 $1,239.00 $525.34–$1,201.83 — —
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAG GUID $705.00 $705.00 $352.50–$705.00 at median —
Paracentesis with imaging guidance CPT 49083 USOUND GUIDED PARACENTESIS $2,704.75 $2,704.75 $1,352.38–$2,704.75 284% above —
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS INITIAL $2,704.75 $2,704.75 $1,352.38–$2,704.75 284% above —
Paracentesis with imaging guidance CPT 49083 CT GUIDED PARACENTESIS $2,704.75 $2,704.75 $1,352.38–$2,704.75 284% above —
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAG GUID $705.00 $705.00 $298.92–$683.85 — —
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS INITIAL $2,704.75 $2,704.75 $1,146.81–$2,623.61 — —
Paracentesis with imaging guidance inpatient CPT 49083 USOUND GUIDED PARACENTESIS $2,704.75 $2,704.75 $1,146.81–$2,623.61 — —
Paracentesis with imaging guidance inpatient CPT 49083 CT GUIDED PARACENTESIS $2,704.75 $2,704.75 $1,146.81–$2,623.61 — —
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL PERM NAIL PLATE $964.50 $964.50 $482.25–$964.50 6% above —
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL PERM NAIL PLATE $964.50 $964.50 $408.95–$935.56 — —
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 RF ABLATION LUMBAR SPINE RT $5,222.50 $5,222.50 $2,611.25–$5,222.50 36% above —
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 RF ABLATION LUMBAR SPINE LT $5,222.50 $5,222.50 $2,611.25–$5,222.50 36% above —
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 RF ABLATION LUMBAR SPINE RT $5,222.50 $5,222.50 $2,214.34–$5,065.82 — —
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 RF ABLATION LUMBAR SPINE LT $5,222.50 $5,222.50 $2,214.34–$5,065.82 — —
Removal of a foreign object under the skin, simple CPT 10120 Incis & removal foreign body $717.50 $717.50 $358.75–$717.50 46% above —
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incis & removal foreign body $717.50 $717.50 $304.22–$695.98 — —
Short arm cast (elbow to hand) CPT 29075 Application short arm cast $363.75 $363.75 $181.88–$363.75 10% below —
Short arm cast (elbow to hand) inpatient CPT 29075 Application short arm cast $363.75 $363.75 $154.23–$352.84 — —
Short arm splint (forearm and hand) CPT 29125 Application Short Arm Splint $449.50 $449.50 $224.75–$449.50 102% above —
Short arm splint (forearm and hand) inpatient CPT 29125 Application Short Arm Splint $449.50 $449.50 $190.59–$436.02 — —
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST $363.75 $363.75 $181.88–$363.75 1% above —
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST $363.75 $363.75 $154.23–$352.84 — —
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT $373.50 $373.50 $186.75–$373.50 10% above —
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT $373.50 $373.50 $158.36–$362.30 — —
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR 2.5cm OR LESS $601.75 $601.75 $300.88–$601.75 51% above —
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR 2.5cm OR LESS $601.75 $601.75 $255.14–$583.70 — —
Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REMOVAL $230.00 $230.00 $115.00–$230.00 17% above —
Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REMOVAL $230.00 $230.00 $97.52–$223.10 — —
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG $1,472.00 $1,472.00 $736.00–$1,472.00 74% above —
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINAL PUNCTURE DIAG. $1,472.00 $1,472.00 $736.00–$1,472.00 74% above —
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL FLUID TAP, DIAGNOSTIC $1,472.00 $1,472.00 $736.00–$1,472.00 74% above —
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR SPINAL PUNCTURE DIAG $1,472.00 $1,472.00 $736.00–$1,472.00 74% above —
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR SPINAL PUNCTURE DIAG $1,472.00 $1,472.00 $624.13–$1,427.84 — —
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAG $1,472.00 $1,472.00 $624.13–$1,427.84 — —
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL FLUID TAP, DIAGNOSTIC $1,472.00 $1,472.00 $624.13–$1,427.84 — —
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR SPINAL PUNCTURE DIAG. $1,472.00 $1,472.00 $624.13–$1,427.84 — —
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6cm to 7.5cm $636.50 $636.50 $318.25–$636.50 20% above —
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR 2.6cm to 7.5cm $636.50 $636.50 $269.88–$617.40 — —
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR FACE 2.5cm /less $581.50 $581.50 $290.75–$581.50 27% above —
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR FACE 2.5cm /less $581.50 $581.50 $246.56–$564.05 — —
Thoracentesis with imaging guidance CPT 32555 UB THORACENTESIS THERAPEUTIC $2,158.00 $2,158.00 $1,079.00–$2,158.00 72% above —
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS INITIAL/SUB CT $2,158.00 $2,158.00 $1,079.00–$2,158.00 72% above —
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS DX +THERAP $2,158.00 $2,158.00 $1,079.00–$2,158.00 72% above —
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS DIAGNOSTIC $2,158.00 $2,158.00 $1,079.00–$2,158.00 72% above —
Thoracentesis with imaging guidance inpatient CPT 32555 UB THORACENTESIS THERAPEUTIC $2,158.00 $2,158.00 $914.99–$2,093.26 — —
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS INITIAL/SUB CT $2,158.00 $2,158.00 $914.99–$2,093.26 — —
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS DX +THERAP $2,158.00 $2,158.00 $914.99–$2,093.26 — —
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS DIAGNOSTIC $2,158.00 $2,158.00 $914.99–$2,093.26 — —
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES $786.25 $786.25 $393.12–$786.25 36% above —
Trigger point injections, 1 or 2 muscles CPT 20552 PIRFORMIS MUSCLE INJECTION $786.25 $786.25 $393.12–$786.25 36% above —
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES $786.25 $786.25 $333.37–$762.66 — —
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PIRFORMIS MUSCLE INJECTION $786.25 $786.25 $333.37–$762.66 — —
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BREAST BX LT CLIP SPECIMEN $3,430.50 $3,430.50 $1,715.25–$3,430.50 33% above —
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US BREAST BX RT CLIP SPECIMEN $3,430.50 $3,430.50 $1,715.25–$3,430.50 33% above —
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US BREAST BX LT CLIP SPECIMEN $3,430.50 $3,430.50 $1,454.53–$3,327.58 — —
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US BREAST BX RT CLIP SPECIMEN $3,430.50 $3,430.50 $1,454.53–$3,327.58 — —
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY $1,966.50 $1,966.50 $983.25–$1,966.50 38% below —
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH BIOPSY $1,966.50 $1,966.50 $833.80–$1,907.50 — —
Upper endoscopy (EGD), diagnostic CPT 43235 Panendoscopy dx $2,379.50 $2,379.50 $1,189.75–$2,379.50 17% below —
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Panendoscopy dx $2,379.50 $2,379.50 $1,008.91–$2,308.11 — —
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION <14 $230.50 $230.50 $115.25–$230.50 44% above —
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESION <14 $230.50 $230.50 $97.73–$223.58 — —
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE/SUBQ tissue 1st 20CM> $485.75 $485.75 $242.88–$485.75 28% above —
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE/SUBQ tissue 1st 20CM> $485.75 $485.75 $205.96–$471.18 — —

Doctor visits and therapy

ProcedureCash priceList priceInsurers payvs VermontOff list
Blood transfusion (giving blood or blood components) CPT 36430 PLATELET INFUSION $605.00 $605.00 $302.50–$605.00 10% below —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 2 HR CLINIC $686.00 $686.00 $343.00–$686.00 2% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 HR CLINIC $693.00 $693.00 $346.50–$693.00 3% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 3HRS CLINIC $767.00 $767.00 $383.50–$767.00 14% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 4HR CLINIC $850.00 $850.00 $425.00–$850.00 27% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 7 HRS $928.00 $928.00 $464.00–$928.00 39% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5HR CLINIC $933.00 $933.00 $466.50–$933.00 39% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 6HRS CLINIC $965.00 $965.00 $482.50–$965.00 44% above —
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 HOUR WEST WING $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 1HR $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 HOUR ICU $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 HOUR PEDS $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 1 HR $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 HOUR EAST WING $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 1 HOUR W&C $1,063.25 $1,063.25 $531.62–$1,063.25 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 8 HOURS $1,068.00 $1,068.00 $534.00–$1,068.00 59% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 2 HRS $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 2 HOURS W&C $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 2 HOURS PEDS $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 2 HOURS EAST WING $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 2 HOURS WEST WING $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 2 HOUR ICU $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 2HR $1,207.50 $1,207.50 $603.75–$1,207.50 80% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 3HR $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 3 HOURS EAST WING $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 3 HOURS WEST WING $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 3 HOURS ICU $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 3 HOURS PEDS $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 3 HRS $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 3 HOURS W&C $1,351.25 $1,351.25 $675.62–$1,351.25 102% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 4 HOURS WEST WING $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 4HR $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 4 HOURS EAST WING $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 4 HOUR ICU $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 4 HOURS W&C $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 4 HRS $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 4 HOURS PEDS $1,497.50 $1,497.50 $748.75–$1,497.50 124% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 5HR $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5 HOURS EAST WING $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5 HOURS PEDS $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5 HOURS W&C $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5 HOURS WEST WING $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5 HOURS $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 5 HOUR ICU $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 5 HRS $1,559.25 $1,559.25 $779.62–$1,559.25 133% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 6 HOURS EAST WING $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 6HR $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 6 HOURS W&C $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSUSION 6 HOURS $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 6 HRS $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 6 HOURS PEDS $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 6 HOURS WEST WING $1,698.75 $1,698.75 $849.38–$1,698.75 154% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 7 HOURS PEDS $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 7 HOURS ICU $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 7 HRS $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 7 HOURS W&C $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 7 HOURS WEST WING $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 7HR $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 7 HOURS EAST WING $1,834.50 $1,834.50 $917.25–$1,834.50 174% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 8 HOURS W&C $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 8 HOURS WEST WING $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 8 HRS $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 8 HOURS PEDS $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION RADIATION UNIT 8HR $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 8 HOURS EAST WING $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 8 HOUR ICU $1,971.75 $1,971.75 $985.88–$1,971.75 194% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 9 HRS $2,107.50 $2,107.50 $1,053.75–$2,107.50 215% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 9 HOURS W&C $2,107.50 $2,107.50 $1,053.75–$2,107.50 215% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 9 HOURS PEDS $2,107.50 $2,107.50 $1,053.75–$2,107.50 215% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 9 HOURS EAST WING $2,107.50 $2,107.50 $1,053.75–$2,107.50 215% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 9 HOURS WEST WING $2,107.50 $2,107.50 $1,053.75–$2,107.50 215% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSIONS 9 HRS ICU $2,107.50 $2,107.50 $1,053.75–$2,107.50 215% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 10 HOURS W&C $2,248.25 $2,248.25 $1,124.12–$2,248.25 236% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 10 HOURS WEST WING $2,248.25 $2,248.25 $1,124.12–$2,248.25 236% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 10 HOURS EAST WING $2,248.25 $2,248.25 $1,124.12–$2,248.25 236% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 10 HOURS PEDS $2,248.25 $2,248.25 $1,124.12–$2,248.25 236% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 10 HRS $2,248.25 $2,248.25 $1,124.12–$2,248.25 236% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 11+ HOURS EAST $2,337.50 $2,337.50 $1,168.75–$2,337.50 249% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 11+ HOURS PEDS $2,337.50 $2,337.50 $1,168.75–$2,337.50 249% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 11+ HOURS W&C $2,337.50 $2,337.50 $1,168.75–$2,337.50 249% above —
Blood transfusion (giving blood or blood components) CPT 36430 SDS - TRANSFUSION 11 HRS $2,337.50 $2,337.50 $1,168.75–$2,337.50 249% above —
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION 11+HOURS WEST WING $2,337.50 $2,337.50 $1,168.75–$2,337.50 249% above —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PLATELET INFUSION $605.00 $605.00 $256.52–$586.85 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 2 HR CLINIC $686.00 $686.00 $290.86–$665.42 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 1 HR CLINIC $693.00 $693.00 $293.83–$672.21 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 3HRS CLINIC $767.00 $767.00 $325.21–$743.99 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 4HR CLINIC $850.00 $850.00 $360.40–$824.50 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 7 HRS $928.00 $928.00 $393.47–$900.16 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5HR CLINIC $933.00 $933.00 $395.59–$905.01 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 6HRS CLINIC $965.00 $965.00 $409.16–$936.05 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 1 HOUR PEDS $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 1 HOUR EAST WING $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 1 HOUR W&C $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 1HR $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 1 HOUR WEST WING $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 1 HR $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 1 HOUR ICU $1,063.25 $1,063.25 $450.82–$1,031.35 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 8 HOURS $1,068.00 $1,068.00 $452.83–$1,035.96 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 2 HOURS W&C $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 2 HOURS PEDS $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 2 HRS $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 2 HOUR ICU $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 2 HOURS WEST WING $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 2 HOURS EAST WING $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 2HR $1,207.50 $1,207.50 $511.98–$1,171.27 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 3 HOURS WEST WING $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 3 HRS $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 3 HOURS W&C $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 3HR $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 3 HOURS ICU $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 3 HOURS EAST WING $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 3 HOURS PEDS $1,351.25 $1,351.25 $572.93–$1,310.71 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 4 HOURS EAST WING $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 4 HRS $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 4HR $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 4 HOURS W&C $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 4 HOURS PEDS $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 4 HOURS WEST WING $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 4 HOUR ICU $1,497.50 $1,497.50 $634.94–$1,452.58 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 5 HRS $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 5HR $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5 HOURS PEDS $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5 HOURS EAST WING $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5 HOURS WEST WING $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5 HOURS W&C $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5 HOURS $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 5 HOUR ICU $1,559.25 $1,559.25 $661.12–$1,512.47 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 6 HOURS WEST WING $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 6HR $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 6 HRS $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSUSION 6 HOURS $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 6 HOURS PEDS $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 6 HOURS W&C $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 6 HOURS EAST WING $1,698.75 $1,698.75 $720.27–$1,647.79 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 7 HOURS WEST WING $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 7HR $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 7 HOURS EAST WING $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 7 HOURS ICU $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 7 HRS $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 7 HOURS PEDS $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 7 HOURS W&C $1,834.50 $1,834.50 $777.83–$1,779.46 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 8 HOUR ICU $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 8 HRS $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 8 HOURS WEST WING $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 8 HOURS W&C $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 8 HOURS EAST WING $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION RADIATION UNIT 8HR $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 8 HOURS PEDS $1,971.75 $1,971.75 $836.02–$1,912.60 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 9 HOURS PEDS $2,107.50 $2,107.50 $893.58–$2,044.28 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 9 HRS $2,107.50 $2,107.50 $893.58–$2,044.28 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 9 HOURS W&C $2,107.50 $2,107.50 $893.58–$2,044.28 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 9 HOURS EAST WING $2,107.50 $2,107.50 $893.58–$2,044.28 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 9 HOURS WEST WING $2,107.50 $2,107.50 $893.58–$2,044.28 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSIONS 9 HRS ICU $2,107.50 $2,107.50 $893.58–$2,044.28 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 10 HOURS EAST WING $2,248.25 $2,248.25 $953.26–$2,180.80 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 10 HOURS PEDS $2,248.25 $2,248.25 $953.26–$2,180.80 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 10 HRS $2,248.25 $2,248.25 $953.26–$2,180.80 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 10 HOURS W&C $2,248.25 $2,248.25 $953.26–$2,180.80 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 10 HOURS WEST WING $2,248.25 $2,248.25 $953.26–$2,180.80 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 11+ HOURS PEDS $2,337.50 $2,337.50 $991.10–$2,267.38 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 SDS - TRANSFUSION 11 HRS $2,337.50 $2,337.50 $991.10–$2,267.38 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 11+ HOURS W&C $2,337.50 $2,337.50 $991.10–$2,267.38 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 11+ HOURS EAST $2,337.50 $2,337.50 $991.10–$2,267.38 — —
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION 11+HOURS WEST WING $2,337.50 $2,337.50 $991.10–$2,267.38 — —
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT SUBSEQUENT $149.00 $149.00 $74.50–$149.00 23% below —
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SM VOLUME NEBULIZER MECH VENT $149.00 $149.00 $74.50–$149.00 23% below —
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SMALL VOLUME NEBULIZER PEDS $149.00 $149.00 $74.50–$149.00 23% below —
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL RX SUBSEQUENT ADULT $149.00 $149.00 $74.50–$149.00 23% below —
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL RX INITIAL. $149.00 $149.00 $74.50–$149.00 23% below —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENT SUBSEQUENT $149.00 $149.00 $63.18–$144.53 — —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SM VOLUME NEBULIZER MECH VENT $149.00 $149.00 $63.18–$144.53 — —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL RX SUBSEQUENT ADULT $149.00 $149.00 $63.18–$144.53 — —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SMALL VOLUME NEBULIZER PEDS $149.00 $149.00 $63.18–$144.53 — —
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL RX INITIAL. $149.00 $149.00 $63.18–$144.53 — —
Chemotherapy IV infusion, first hour CPT 96413 CHEMO,INFUSION INT'L UP TO 1HR $478.00 $478.00 $239.00–$478.00 32% below —
Chemotherapy IV infusion, first hour CPT 96413 CHEMO,IV INFUSION 1HR 2E $937.00 $937.00 $468.50–$937.00 33% above —
Chemotherapy IV infusion, first hour CPT 96413 CHEMO,IV INFUSION WW 96413 $937.00 $937.00 $468.50–$937.00 33% above —
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION 1ST HR ICU $937.00 $937.00 $468.50–$937.00 33% above —
Chemotherapy IV infusion, first hour CPT 96413 Chemotherapy Infusion 1HR SDC $937.00 $937.00 $468.50–$937.00 33% above —
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO,INFUSION INT'L UP TO 1HR $478.00 $478.00 $202.67–$463.66 — —
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO,IV INFUSION 1HR 2E $937.00 $937.00 $397.29–$908.89 — —
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemotherapy Infusion 1HR SDC $937.00 $937.00 $397.29–$908.89 — —
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO,IV INFUSION WW 96413 $937.00 $937.00 $397.29–$908.89 — —
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION 1ST HR ICU $937.00 $937.00 $397.29–$908.89 — —
Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 AUDIOGRAM W/ INTERP $75.00 $75.00 $37.50–$75.00 30% below —
Comprehensive hearing test: tone and speech audiometry, both ears inpatient CPT 92557 AUDIOGRAM W/ INTERP $75.00 $75.00 $31.80–$72.75 — —
Critical care, first 30 to 74 minutes CPT 99291 EMERGENCY CRITICAL CARE $3,288.75 $3,288.75 $1,644.38–$3,288.75 88% above —
Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERGENCY CRITICAL CARE $3,288.75 $3,288.75 $1,394.43–$3,190.09 — —
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY $1,308.25 $1,308.25 $654.12–$1,308.25 141% above —
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE & DROWSY $1,308.25 $1,308.25 $554.70–$1,269.00 — —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 OCCH EKG TRACING $156.00 $156.00 $78.00–$156.00 5% below —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE EKG $212.75 $212.75 $106.38–$212.75 29% above —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 OCCH EKG TRACING $156.00 $156.00 $66.14–$151.32 — —
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ROUTINE EKG $212.75 $212.75 $90.21–$206.37 — —
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY LEVEL 1 $303.75 $303.75 $151.88–$303.75 14% above —
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY LEVEL 1 $303.75 $303.75 $128.79–$294.64 — —
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY LEVEL 2 $379.00 $379.00 $189.50–$379.00 10% below —
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY LEVEL 2 $379.00 $379.00 $160.70–$367.63 — —
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY LEVEL 3 $808.25 $808.25 $404.12–$808.25 11% above —
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY LEVEL 3 $808.25 $808.25 $342.70–$784.00 — —
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY LEVEL 4 $1,131.00 $1,131.00 $565.50–$1,131.00 17% above —
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY LEVEL 4 $1,131.00 $1,131.00 $479.54–$1,097.07 — —
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY LEVEL 5 $1,387.25 $1,387.25 $693.62–$1,387.25 3% above —
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY LEVEL 5 $1,387.25 $1,387.25 $588.19–$1,345.63 — —
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS EKG $1,024.50 $1,024.50 $512.25–$1,024.50 24% above —
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS EKG FOR ECHO $1,024.50 $1,024.50 $512.25–$1,024.50 24% above —
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST - TRACING ONLY $1,024.50 $1,024.50 $512.25–$1,024.50 24% above —
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS EKG $1,024.50 $1,024.50 $434.39–$993.76 — —
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST - TRACING ONLY $1,024.50 $1,024.50 $434.39–$993.76 — —
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS EKG FOR ECHO $1,024.50 $1,024.50 $434.39–$993.76 — —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAL 31-60MIN PBP $347.00 $347.00 $173.50–$347.00 52% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAL 31-60MIN ICU $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAL 31-60MINS ER $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAL 31-60MIN SDC $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAL,31-60MIN W&C $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAl 31-60MIN PED $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION,INITIAL 31-60MIN WW $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INF 31-60 MINS 2E $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes one side CPT 96360 HYDRATION,INITIAL 31-60MINS RT $641.75 $641.75 $320.88–$641.75 181% above —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAL 31-60MIN PBP $347.00 $347.00 $147.13–$336.59 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAL,31-60MIN W&C $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAl 31-60MIN PED $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INF 31-60 MINS 2E $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAL 31-60MIN WW $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAL 31-60MIN ICU $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAL 31-60MIN SDC $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION,INITIAL 31-60MINS ER $641.75 $641.75 $272.10–$622.50 — —
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient one side CPT 96360 HYDRATION,INITIAL 31-60MINS RT $641.75 $641.75 $272.10–$622.50 — —
IV infusion of a medicine, first hour CPT 96365 INFUSIONTHER PROPHY INIT 1HR $375.00 $375.00 $187.50–$375.00 20% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1HR ER $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT HR RENAL $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1 HR 2S $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1HR WW $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1 HR 2E $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INII 1HR W&C $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1HR PEDS $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THER INIT 1HR RAD TH $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1HR SDC $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1HR ENDO $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY INIT 1HR ICU $693.25 $693.25 $346.62–$693.25 121% above —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSIONTHER PROPHY INIT 1HR $375.00 $375.00 $159.00–$363.75 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1 HR 2S $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT HR RENAL $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1HR ER $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1HR SDC $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1HR ENDO $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THER INIT 1HR RAD TH $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1HR ICU $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1HR WW $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1 HR 2E $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INII 1HR W&C $693.25 $693.25 $293.94–$672.45 — —
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY INIT 1HR PEDS $693.25 $693.25 $293.94–$672.45 — —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL DRUGPBP $158.00 $158.00 $79.00–$158.00 34% below —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL DRUG 2E $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 INTRAVENOUS PUSH INITIAL DRUG $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL DRUG PE $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL DRUG WC $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INITIAL DRUGICU $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INIT'L DRUG SDC $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INIT'L DRUG END $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV SINGLE INITIAL SUBSTAN/DRUG $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE SUBSTANCE ECHO $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE/INIT DRUG EKG $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug one side CPT 96374 IV PUSH SINGLE INITIAL RT $293.50 $293.50 $146.75–$293.50 23% above —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL DRUGPBP $158.00 $158.00 $66.99–$153.26 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INIT DRUG EKG $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE SUBSTANCE ECHO $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV SINGLE INITIAL SUBSTAN/DRUG $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INIT'L DRUG END $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INIT'L DRUG SDC $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL DRUGICU $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL DRUG WC $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL DRUG PE $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 INTRAVENOUS PUSH INITIAL DRUG $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE/INITIAL DRUG 2E $293.50 $293.50 $124.44–$284.70 — —
IV push of a medicine, first drug inpatient one side CPT 96374 IV PUSH SINGLE INITIAL RT $293.50 $293.50 $124.44–$284.70 — —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAP INJ SUB OR IM PBP 96372 $43.00 $43.00 $21.50–$43.00 24% below —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM SDC $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM PAIN $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM ER $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM XR $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM SC INJECTION $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM 2E $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM WW $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM PED $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM W&C $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TREATMENT ROOM EAST WING $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJ SUB OR IM ICU $171.50 $171.50 $85.75–$171.50 202% above —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAP INJ SUB OR IM PBP 96372 $43.00 $43.00 $18.23–$41.71 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM PED $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM XR $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM ER $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM PAIN $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM SDC $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM SC INJECTION $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM ICU $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TREATMENT ROOM EAST WING $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM W&C $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM WW $171.50 $171.50 $72.72–$166.36 — —
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJ SUB OR IM 2E $171.50 $171.50 $72.72–$166.36 — —
Nerve conduction study, 7 or 8 nerve studies CPT 95910 7-8 NERVE CONDUCTION STUDIES $475.00 $475.00 $237.50–$475.00 43% above —
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 7-8 NERVE CONDUCTION STUDIES $475.00 $475.00 $201.40–$460.75 — —
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION $177.25 $177.25 $88.62–$177.25 38% above —
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDU/BAL 15MIN $177.25 $177.25 $88.62–$177.25 38% above —
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION $177.25 $177.25 $75.15–$171.93 — —
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDU/BAL 15MIN $177.25 $177.25 $75.15–$171.93 — —
New patient office visit, about 30 minutes CPT 99203 SVHC EMPLOYEE CLINIC NEW PT3 $212.25 $212.25 $106.12–$212.25 8% above —
New patient office visit, about 30 minutes inpatient CPT 99203 SVHC EMPLOYEE CLINIC NEW PT3 $212.25 $212.25 $89.99–$205.88 — —
New patient office visit, about 45 minutes CPT 99204 SVHC EMP CLINIC NEW PT L-4 $254.75 $254.75 $127.38–$254.75 1% above —
New patient office visit, about 45 minutes inpatient CPT 99204 SVHC EMP CLINIC NEW PT L-4 $254.75 $254.75 $108.01–$247.11 — —
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SVHC EMP CLINIC NE PT L-2 $150.25 $150.25 $75.12–$150.25 1% below —
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SVHC EMP CLINIC NE PT L-2 $150.25 $150.25 $63.71–$145.74 — —
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MAN. THERAPY TECH. 15 MINUTES $177.25 $177.25 $88.62–$177.25 38% above —
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY TECHNIQUES $177.25 $177.25 $88.62–$177.25 38% above —
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY TECHNIQUES $177.25 $177.25 $75.15–$171.93 — —
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MAN. THERAPY TECH. 15 MINUTES $177.25 $177.25 $75.15–$171.93 — —
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC PROCEDURE(SPEECH) $177.25 $177.25 $88.62–$177.25 41% above —
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC PROCEDURE(SPEECH) $177.25 $177.25 $75.15–$171.93 — —
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SVHC EMP CLINIC EST PT L-3 $175.50 $175.50 $87.75–$175.50 8% above —
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SVHC EMP CLINIC EST PT L-3 $175.50 $175.50 $74.41–$170.24 — —
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SVHC EMP CLINIC EST L-4 $212.25 $212.25 $106.12–$212.25 at median —
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SVHC EMP CLINIC EST L-4 $212.25 $212.25 $89.99–$205.88 — —
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SVHC EMP CLINIC EST PT L-2 $110.50 $110.50 $55.25–$110.50 at median —
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SVHC EMP CLINIC EST PT L-2 $110.50 $110.50 $46.85–$107.18 — —
Spirometry (breathing test) CPT 94010 SCREENING SPIROMETRY $424.00 $424.00 $212.00–$424.00 36% above —
Spirometry (breathing test) inpatient CPT 94010 SCREENING SPIROMETRY $424.00 $424.00 $179.78–$411.28 — —
Spirometry before and after a bronchodilator CPT 94060 DIAG SPIR W DILAT $794.25 $794.25 $397.12–$794.25 20% above —
Spirometry before and after a bronchodilator inpatient CPT 94060 DIAG SPIR W DILAT $794.25 $794.25 $336.76–$770.42 — —
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY $324.75 $324.75 $162.38–$324.75 47% above —
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 LAB-PHLEBOTOMY, THERAPEUTIC $324.75 $324.75 $162.38–$324.75 47% above —
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY $324.75 $324.75 $137.69–$315.01 — —
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 LAB-PHLEBOTOMY, THERAPEUTIC $324.75 $324.75 $137.69–$315.01 — —

Vaccines

ProcedureCash priceList priceInsurers payvs VermontOff list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC ADJUVANTED 0.5ML $84.00 $84.00 $42.00–$84.00 30% below —
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA FLUAD 0.5ML $84.00 $84.00 $42.00–$84.00 30% below —
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VACC(65+) TRIVAL 0.5 $84.00 $84.00 $42.00–$84.00 30% below —
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA FLUAD 0.5ML $84.00 $84.00 $35.62–$81.48 — —
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC ADJUVANTED 0.5ML $84.00 $84.00 $35.62–$81.48 — —
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VACC(65+) TRIVAL 0.5 $84.00 $84.00 $35.62–$81.48 — —
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 NDC: 8077701296 $165.00 $165.00 $82.50–$165.00 26% below —
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 SPIKEVAX MODERNA EMPH $165.00 $165.00 $82.50–$165.00 26% below —
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID19 MODERNA 12+ 50MCG/.5ML $165.00 $165.00 $82.50–$165.00 26% below —
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 SPIKEVAX MODERNA EMPH $165.00 $165.00 $69.96–$160.05 — —
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID19 MODERNA 12+ 50MCG/.5ML $165.00 $165.00 $69.96–$160.05 — —
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 NDC: 8077701296 $165.00 $165.00 $69.96–$160.05 — —
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACCINE $304.00 $304.00 $152.00–$304.00 at median —
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACCINE $304.00 $304.00 $128.90–$294.88 — —
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DIPH,PERTUS(ACEL),TET,POLIO/PF $183.84 $183.84 $91.92–$183.84 at median —
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DIPH,PERTUS(ACEL),TET,POLIO/PF $183.84 $183.84 $77.95–$178.32 — —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP PEDIATRIC VACCINE 0.5 ML $16.68 $16.68 $8.34–$16.68 — —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTaP Pediatric Vaccine 0.5 ml $21.99 $21.99 $11.00–$21.99 — —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE PEDIATRIC DOSE $50.50 $50.50 $25.25–$50.50 — —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP PEDIATRIC VACCINE 0.5 ML $16.68 $16.68 $7.07–$16.18 — —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTaP Pediatric Vaccine 0.5 ml $21.99 $21.99 $9.32–$21.33 — —
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTAP VACCINE PEDIATRIC DOSE $50.50 $50.50 $21.41–$48.98 — —
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Diphtheria Toxoid,Absorbed 0.5 $17.11 $17.11 $8.56–$17.11 77% below —
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DIPTH/TET OX/ACEL PERTUSIS/HEP $206.53 $206.53 $103.26–$206.53 175% above —
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 Diphtheria Toxoid,Absorbed 0.5 $17.11 $17.11 $7.25–$16.60 — —
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DIPTH/TET OX/ACEL PERTUSIS/HEP $206.53 $206.53 $87.57–$200.33 — —
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 TWINRIX (HEP A&B) VACCINE $136.50 $136.50 $68.25–$136.50 24% below —
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 TWINRIX (HEP A&B) VACCINE $136.50 $136.50 $57.88–$132.40 — —
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACC (ADULT) 1ML $50.50 $50.50 $25.25–$50.50 40% below —
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT $94.00 $94.00 $47.00–$94.00 13% above —
Hepatitis A vaccine, adult dose CPT 90632 HEPATT A VAC ADLT DOS INTRAMUS $134.00 $134.00 $67.00–$134.00 60% above —
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACC (ADULT) 1ML $50.50 $50.50 $21.41–$48.98 — —
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE ADULT $94.00 $94.00 $39.86–$91.18 — —
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATT A VAC ADLT DOS INTRAMUS $134.00 $134.00 $56.82–$129.98 — —
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEP A VACCINE PED/ADOL $38.50 $38.50 $19.25–$38.50 3% above —
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A VACCINE PED/ADOL $38.50 $38.50 $16.32–$37.34 — —
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 OCC HLTH - HBV VACCINE $62.50 $62.50 $31.25–$62.50 34% below —
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPAT B VAC ADL $89.00 $89.00 $44.50–$89.00 6% below —
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 OCC HLTH - HBV VACCINE $62.50 $62.50 $26.50–$60.62 — —
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPAT B VAC ADL $89.00 $89.00 $37.74–$86.33 — —
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VACC PED 10MCG/O.5 $16.75 $16.75 $8.38–$16.75 69% below —
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VACC PED 10MCG/O.5 $16.75 $16.75 $7.10–$16.25 — —
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HAEMOPHILUS B CONJ VACCINE 0.5 $6.00 $6.00 $3.00–$6.00 85% below —
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Adult HIB vaccine $103.00 $103.00 $51.50–$103.00 159% above —
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 HAEMOPHILUS B CONJ VACCINE 0.5 $6.00 $6.00 $2.54–$5.82 — —
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Adult HIB vaccine $103.00 $103.00 $43.67–$99.91 — —
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE VACCINE HIGH DOSE OCCH $60.00 $60.00 $30.00–$60.00 41% below —
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VACC HIGH DOSE .7ML $60.00 $60.00 $30.00–$60.00 41% below —
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE VACCINE HIGH DOSE $60.00 $60.00 $30.00–$60.00 41% below —
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VACC HIGH DOSE .7ML $60.00 $60.00 $25.44–$58.20 — —
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE VACCINE HIGH DOSE OCCH $60.00 $60.00 $25.44–$58.20 — —
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE VACCINE HIGH DOSE $60.00 $60.00 $25.44–$58.20 — —
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Japanese Encephalitis Adult $458.50 $458.50 $229.25–$458.50 — —
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 JAPANESE ENCEPHALITIS VAC PED $458.50 $458.50 $229.25–$458.50 — —
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 JAPANESE ENCEPHALITIS VAC PED $458.50 $458.50 $194.40–$444.74 — —
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Japanese Encephalitis Adult $458.50 $458.50 $194.40–$444.74 — —
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR $115.50 $115.50 $57.75–$115.50 26% below —
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE $165.00 $165.00 $82.50–$165.00 6% above —
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR $115.50 $115.50 $48.97–$112.04 — —
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE $165.00 $165.00 $69.96–$160.05 — —
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOC VAC (MENACTRA) 0.5 $80.69 $80.69 $40.34–$80.69 57% below —
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL A/C/Y/W 0.5MLKIT $95.83 $95.83 $47.92–$95.83 49% below —
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Menactra $148.50 $148.50 $74.25–$148.50 22% below —
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACOCCAL VACCINE $212.00 $212.00 $106.00–$212.00 12% above —
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VAC A/C/Y/W 135 $350.38 $350.38 $175.19–$350.38 85% above —
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOC VAC (MENACTRA) 0.5 $80.69 $80.69 $34.21–$78.27 — —
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL A/C/Y/W 0.5MLKIT $95.83 $95.83 $40.63–$92.96 — —
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Menactra $148.50 $148.50 $62.96–$144.04 — —
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACOCCAL VACCINE $212.00 $212.00 $89.89–$205.64 — —
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VAC A/C/Y/W 135 $350.38 $350.38 $148.56–$339.87 — —
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCCAL SEROGROUP B $407.00 $407.00 $203.50–$407.00 at median —
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCCAL SEROGROUP B $407.00 $407.00 $172.57–$394.79 — —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PREVNAR (PNEUMOCCAL)13 VALENT $263.75 $263.75 $131.88–$263.75 5% above —
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR (PNEUMOCCAL)13 VALENT $263.75 $263.75 $111.83–$255.84 — —
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 15 VAL CONJ .5ML $658.73 $658.73 $329.36–$658.73 35% above —
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20 VAL VACC 0.5ML $985.50 $985.50 $492.75–$985.50 102% above —
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 15 VAL CONJ .5ML $658.73 $658.73 $279.30–$638.97 — —
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20 VAL VACC 0.5ML $985.50 $985.50 $417.85–$955.94 — —
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PNEUMOCOCCAL 21 VAL CONJ VACC $738.73 $738.73 $369.36–$738.73 32% above —
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 PNEUMOCOCCAL 21 VAL CONJ VACC $738.73 $738.73 $313.22–$716.57 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONOCOCCAL 13 VAL CONJ VAC $122.78 $122.78 $61.39–$122.78 3% above —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE $154.00 $154.00 $77.00–$154.00 30% above —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX VACCINE $220.00 $220.00 $110.00–$220.00 85% above —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 0.5 ML VIAL $470.25 $470.25 $235.12–$470.25 296% above —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMONOCOCCAL 13 VAL CONJ VAC $122.78 $122.78 $52.06–$119.10 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE $154.00 $154.00 $65.30–$149.38 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX VACCINE $220.00 $220.00 $93.28–$213.40 — —
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 0.5 ML VIAL $470.25 $470.25 $199.39–$456.14 — —
Polio vaccine, inactivated (IPV) CPT 90713 Poliovac Inactiv 0.5 mL ea.dos $21.47 $21.47 $10.74–$21.47 74% below —
Polio vaccine, inactivated (IPV) CPT 90713 POLIO,INACTIVATED VACCINE $52.50 $52.50 $26.25–$52.50 37% below —
Polio vaccine, inactivated (IPV) CPT 90713 INACTIVE POLIOMYELITIS VACCINE $75.00 $75.00 $37.50–$75.00 11% below —
Polio vaccine, inactivated (IPV) inpatient CPT 90713 Poliovac Inactiv 0.5 mL ea.dos $21.47 $21.47 $9.10–$20.83 — —
Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIO,INACTIVATED VACCINE $52.50 $52.50 $22.26–$50.92 — —
Polio vaccine, inactivated (IPV) inpatient CPT 90713 INACTIVE POLIOMYELITIS VACCINE $75.00 $75.00 $31.80–$72.75 — —
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 NDC: 00069-0207-01 $500.00 $500.00 $250.00–$500.00 at median —
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV PREG, PREFA&PREFB/PF120MCG $842.71 $842.71 $421.36–$842.71 69% above —
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 NDC: 00069-0207-01 $500.00 $500.00 $212.00–$485.00 — —
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV PREG, PREFA&PREFB/PF120MCG $842.71 $842.71 $357.31–$817.43 — —
RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV 60+ PREF3 ANTIGEN/AS01E/PF $827.98 $827.98 $413.99–$827.98 103% above —
RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 RSV 60+ PREF3 ANTIGEN/AS01E/PF $827.98 $827.98 $351.06–$803.14 — —
Rabies vaccine, one dose CPT 90675 RABIES VAC-CHICK EMB CELL KIT $420.41 $420.41 $210.20–$420.41 at median —
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM $740.00 $740.00 $370.00–$740.00 76% above —
Rabies vaccine, one dose CPT 90675 RABIES VACCINE INTRAMUSCULAR $740.00 $740.00 $370.00–$740.00 76% above —
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC-CHICK EMB CELL KIT $420.41 $420.41 $178.25–$407.80 — —
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE INTRAMUSCULAR $740.00 $740.00 $313.76–$717.80 — —
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM $740.00 $740.00 $313.76–$717.80 — —
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 ROTAVIRUS VAC,LIVE ATTENUA 1.5 $353.12 $353.12 $176.56–$353.12 — —
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) inpatient CPT 90681 ROTAVIRUS VAC,LIVE ATTENUA 1.5 $353.12 $353.12 $149.72–$342.53 — —
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER 50MCG/.5ML $127.88 $127.88 $63.94–$127.88 69% below —
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER 50MCG/.5ML $127.88 $127.88 $54.22–$124.04 — —
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus/Diphtheria Tox, Adsorb $18.36 $18.36 $9.18–$18.36 57% below —
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIPHTHERIA VACCINE $32.00 $32.00 $16.00–$32.00 26% below —
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE 19YRS $46.00 $46.00 $23.00–$46.00 7% above —
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and Diphteria Vaccine $46.00 $46.00 $23.00–$46.00 7% above —
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus/Diphtheria Tox, Adsorb $18.36 $18.36 $7.78–$17.81 — —
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIPHTHERIA VACCINE $32.00 $32.00 $13.57–$31.04 — —
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE 19YRS $46.00 $46.00 $19.50–$44.62 — —
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus and Diphteria Vaccine $46.00 $46.00 $19.50–$44.62 — —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DTAP 0.5 ML $32.00 $32.00 $16.00–$32.00 43% below —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP(ADULT)VACCINE 0.5ML SYR $36.50 $36.50 $18.25–$36.50 35% below —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP $51.00 $51.00 $25.50–$51.00 9% below —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS DIPHTHERIA PERTUSSIS V $73.00 $73.00 $36.50–$73.00 30% above —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DTAP 0.5 ML $32.00 $32.00 $13.57–$31.04 — —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP(ADULT)VACCINE 0.5ML SYR $36.50 $36.50 $15.48–$35.40 — —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP $51.00 $51.00 $21.62–$49.47 — —
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS DIPHTHERIA PERTUSSIS V $73.00 $73.00 $30.95–$70.81 — —
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE $164.50 $164.50 $82.25–$164.50 — —
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID INTRAMUSCULAR INJ. $235.00 $235.00 $117.50–$235.00 — —
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE $164.50 $164.50 $69.75–$159.56 — —
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID INTRAMUSCULAR INJ. $235.00 $235.00 $99.64–$227.95 — —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN VACCINE OCCH SP $30.00 $30.00 $15.00–$30.00 38% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE SDC $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE 2EAST $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE W+C $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE WEST W $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1ST INJ $43.00 $43.00 $21.50–$43.00 10% below —
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION VACCINE OCCH $44.00 $44.00 $22.00–$44.00 8% below —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN VACCINE OCCH SP $30.00 $30.00 $12.72–$29.10 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE W+C $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1ST INJ $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE SDC $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE WEST W $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE 2EAST $43.00 $43.00 $18.23–$41.71 — —
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION VACCINE OCCH $44.00 $44.00 $18.66–$42.68 — —
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNI ADM EACH ADDITIONAL INJ $30.25 $30.25 $15.12–$30.25 at median —
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EACH ADDITIONAL VACCINE $31.50 $31.50 $15.75–$31.50 4% above —
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNI ADM EACH ADDITIONAL INJ $30.25 $30.25 $12.83–$29.34 — —
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 EACH ADDITIONAL VACCINE $31.50 $31.50 $13.36–$30.56 — —
Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE $248.50 $248.50 $124.25–$248.50 — —
Yellow fever vaccine, live inpatient CPT 90717 YELLOW FEVER VACCINE $248.50 $248.50 $105.36–$241.04 — —
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://svmc.org/222563241_Southwestern-Vermont-Medical-Center-Inc._standardcharges.zip