Hospital

Weston County Health Services

Weston County Health Services in Newcastle, WY publishes cash prices for 223 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Wyoming median for 197 of 219 procedures and below it for 19. By typical cash price it ranks #12 of 12 Wyoming hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

"1124 Washington Blvd, Newcastle WY, 82701" Collected Sep 27, 2026 Source price file (307) 746-4491

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 531303 · CMS hospital register NPI 1154402972

The price file shows no self-pay discount

For 570 of the 570 prices listed here, the cash price in Weston County Health Services'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.

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 4 actions for a hospital named Weston County Health Services in Newcastle, WY:

Sep 17, 2024 Corrective action plan requested
Dec 23, 2024 Corrective action plan requested
Mar 28, 2025 Case closed
Jul 2, 2026 Warning notice

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 Radex Ankle Complete Minimum 3 Views	$406.00	$406.00	$251.72–$385.70	16% above	—
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 Radex Ankle Complete Minimum 3 Views	$406.00	$406.00	$251.72–$385.70	—	—
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Non-Invas Physiologic Std Extremity Art 2 Level	$357.00	$357.00	$221.34–$339.15	at median	—
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Non-Invas Physiologic Std Extremity Art 2 Level	$357.00	$357.00	$221.34–$339.15	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest W/Contrast/Noncontrast	$2,816.00	$2,816.00	$1,745.92–$2,675.20	54% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest W/Contrast/Noncontrast	$2,816.00	$2,816.00	$1,745.92–$2,675.20	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen & Pelvis W/O Contrast Material	$3,453.00	$3,453.00	$2,140.86–$3,280.35	22% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen & Pelvis W/O Contrast Material	$3,453.00	$3,453.00	$2,140.86–$3,280.35	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen & Pelvis W/Contrast Material	$4,716.00	$4,716.00	$2,923.92–$4,480.20	63% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen & Pelvis W/Contrast Material	$4,716.00	$4,716.00	$2,923.92–$4,480.20	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen & Pelvis W/O Contrst Followed by W Contrst 1/> Body Re	$5,001.00	$5,001.00	$3,100.62–$4,750.95	75% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen & Pelvis W/O Contrst Followed by W Contrst 1/> Body Re	$5,001.00	$5,001.00	$3,100.62–$4,750.95	—	—
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast Material	$2,680.00	$2,680.00	$1,661.60–$2,546.00	50% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W/Contrast Material	$2,680.00	$2,680.00	$1,661.60–$2,546.00	—	—
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast Material	$1,638.00	$1,638.00	$1,015.56–$1,556.10	7% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W/O Contrast Material	$1,638.00	$1,638.00	$1,015.56–$1,556.10	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial W/O Contrast Material	$1,638.00	$1,638.00	$1,015.56–$1,556.10	9% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial W/O Contrast Material	$1,638.00	$1,638.00	$1,015.56–$1,556.10	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT Head/Brain W/O Contrast Material	$1,905.00	$1,905.00	$1,181.10–$1,809.75	52% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head/Brain W/O Contrast Material	$1,905.00	$1,905.00	$1,181.10–$1,809.75	—	—
CT scan of the head with contrast CPT 70460 CT Head/Brain W/Contrast Material	$2,292.00	$2,292.00	$1,421.04–$2,177.40	67% above	—
CT scan of the head with contrast inpatient CPT 70460 CT Head/Brain W/Contrast Material	$2,292.00	$2,292.00	$1,421.04–$2,177.40	—	—
CT scan of the head without and with contrast CPT 70470 CT Head/Brain W/O & W/Contrast Material	$2,620.00	$2,620.00	$1,624.40–$2,489.00	57% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT Head/Brain W/O & W/Contrast Material	$2,620.00	$2,620.00	$1,624.40–$2,489.00	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Contrast Material	$1,786.00	$1,786.00	$1,107.32–$1,696.70	2% below	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W/O Contrast Material	$1,786.00	$1,786.00	$1,107.32–$1,696.70	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine W/O Contrast Material	$1,905.00	$1,905.00	$1,181.10–$1,809.75	1% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cervical Spine W/O Contrast Material	$1,905.00	$1,905.00	$1,181.10–$1,809.75	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast Material	$2,292.00	$2,292.00	$1,421.04–$2,177.40	15% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast Material	$2,292.00	$2,292.00	$1,421.04–$2,177.40	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Duplex Scan Extracranial Art Compl Bi Study	$894.00	$894.00	$554.28–$849.30	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 Duplex Scan Extracranial Art Compl Bi Study	$894.00	$894.00	$554.28–$849.30	—	—
Chest X-ray, 2 views CPT 71046 Radiologic Exam Chest 2 Views	$420.00	$420.00	$260.40–$399.00	38% above	—
Chest X-ray, 2 views inpatient CPT 71046 Radiologic Exam Chest 2 Views	$420.00	$420.00	$260.40–$399.00	—	—
Chest X-ray, single view CPT 71045 Radiologic Exam Chest Single View	$327.00	$327.00	$202.74–$310.65	75% above	—
Chest X-ray, single view inpatient CPT 71045 Radiologic Exam Chest Single View	$327.00	$327.00	$202.74–$310.65	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Real Time W/Image Complete	$595.00	$595.00	$368.90–$565.25	15% below	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Real Time W/Image Complete	$595.00	$595.00	$368.90–$565.25	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Study 1/> Sites Axial Skel	$694.00	$694.00	$430.28–$659.30	101% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA Bone Density Study 1/> Sites Axial Skel	$694.00	$694.00	$430.28–$659.30	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Diagnostic Computed Tomography Thorax W/O Cntrst	$1,786.00	$1,786.00	$1,107.32–$1,696.70	43% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 Diagnostic Computed Tomography Thorax W/O Cntrst	$1,786.00	$1,786.00	$1,107.32–$1,696.70	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Diagnostic Computed Tomography Thorax W/Contrast	$2,680.00	$2,680.00	$1,661.60–$2,546.00	62% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Diagnostic Computed Tomography Thorax W/Contrast	$2,680.00	$2,680.00	$1,661.60–$2,546.00	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study	$1,414.00	$1,414.00	$876.68–$1,343.30	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study	$1,414.00	$1,414.00	$876.68–$1,343.30	—	—
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Dup-Scan Xtr Veins Complete Bilateral Study	$952.00	$952.00	$590.24–$904.40	—	—
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Dup-Scan Xtr Veins Complete Bilateral Study	$952.00	$952.00	$590.24–$904.40	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo Tthrc R-T 2d W/Wom-Mode Compl Spec&Colr D	$2,381.00	$2,381.00	$1,476.22–$2,261.95	32% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo Tthrc R-T 2d W/Wom-Mode Compl Spec&Colr D	$2,381.00	$2,381.00	$1,476.22–$2,261.95	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd	$4,509.00	$4,509.00	$2,795.58–$4,283.55	10% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd	$4,509.00	$4,509.00	$2,795.58–$4,283.55	—	—
Knee X-ray, 3 views CPT 73562 Radiologic Examination Knee 3 Views	$357.00	$357.00	$221.34–$339.15	7% below	—
Knee X-ray, 3 views inpatient CPT 73562 Radiologic Examination Knee 3 Views	$357.00	$357.00	$221.34–$339.15	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdominal Real Time W/Image Limited	$714.00	$714.00	$442.68–$678.30	14% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdominal Real Time W/Image Limited	$714.00	$714.00	$442.68–$678.30	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$389.00	$389.00	$241.18–$369.55	3% above	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 Computed Tomography Thorax Lw Dose Lng Ca Scr C-	$389.00	$389.00	$241.18–$369.55	—	—
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl	$2,620.00	$2,620.00	$1,624.40–$2,489.00	5% above	—
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI Any Jt Lower Extrem W/O Contrast Matrl	$2,620.00	$2,620.00	$1,624.40–$2,489.00	—	—
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl	$3,929.00	$3,929.00	$2,435.98–$3,732.55	28% above	—
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI Any Jt Lower Extrem W/O & W/Contrast Matrl	$3,929.00	$3,929.00	$2,435.98–$3,732.55	—	—
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Contrast Material	$2,620.00	$2,620.00	$1,624.40–$2,489.00	7% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen W/O Contrast Material	$2,620.00	$2,620.00	$1,624.40–$2,489.00	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/O & W/Contrast Material	$4,286.00	$4,286.00	$2,657.32–$4,071.70	22% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen W/O & W/Contrast Material	$4,286.00	$4,286.00	$2,657.32–$4,071.70	—	—
MRI of the brain, no contrast dye CPT 70551 MRI Brain Brain Stem W/O Contrast Material	$2,858.00	$2,858.00	$1,771.96–$2,715.10	39% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Brain Stem W/O Contrast Material	$2,858.00	$2,858.00	$1,771.96–$2,715.10	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material	$3,929.00	$3,929.00	$2,435.98–$3,732.55	32% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain Brain Stem W/O W/Contrast Material	$3,929.00	$3,929.00	$2,435.98–$3,732.55	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material	$2,858.00	$2,858.00	$1,771.96–$2,715.10	44% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spinal Canal Lumbar W/O Contrast Material	$2,858.00	$2,858.00	$1,771.96–$2,715.10	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spinal Canal Lumbar W/O & W/Contr Matrl	$4,167.00	$4,167.00	$2,583.54–$3,958.65	65% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spinal Canal Lumbar W/O & W/Contr Matrl	$4,167.00	$4,167.00	$2,583.54–$3,958.65	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spinal Canal Thoracic W/O Contrast Matrl	$2,620.00	$2,620.00	$1,624.40–$2,489.00	52% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spinal Canal Thoracic W/O Contrast Matrl	$2,620.00	$2,620.00	$1,624.40–$2,489.00	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spinal Canal Cervical W/O & W/Contr Matrl	$3,929.00	$3,929.00	$2,435.98–$3,732.55	65% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spinal Canal Cervical W/O & W/Contr Matrl	$3,929.00	$3,929.00	$2,435.98–$3,732.55	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spinal Canal Cervical W/O Contrast Matrl	$2,858.00	$2,858.00	$1,771.96–$2,715.10	59% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spinal Canal Cervical W/O Contrast Matrl	$2,858.00	$2,858.00	$1,771.96–$2,715.10	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O & W/Contrast Material	$4,192.00	$4,192.00	$2,599.04–$3,982.40	65% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis W/O & W/Contrast Material	$4,192.00	$4,192.00	$2,599.04–$3,982.40	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Contrast Material	$2,751.00	$2,751.00	$1,705.62–$2,613.45	53% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis W/O Contrast Material	$2,751.00	$2,751.00	$1,705.62–$2,613.45	—	—
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Any Jt Upper Extremity W/O Contrast Matrl	$2,620.00	$2,620.00	$1,624.40–$2,489.00	12% above	—
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI Any Jt Upper Extremity W/O Contrast Matrl	$2,620.00	$2,620.00	$1,624.40–$2,489.00	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Nonobstetric Image Dcmtn Limited/F/U	$542.00	$542.00	$336.04–$514.90	65% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Nonobstetric Image Dcmtn Limited/F/U	$542.00	$542.00	$336.04–$514.90	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Nonobstetric Real-Time Image Complete	$1,092.00	$1,092.00	$677.04–$1,037.40	26% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Nonobstetric Real-Time Image Complete	$1,092.00	$1,092.00	$677.04–$1,037.40	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation	$755.00	$755.00	$468.10–$717.25	7% below	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Preg Uterus After 1st Trimest 1/1st Gestation	$755.00	$755.00	$468.10–$717.25	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat	$755.00	$755.00	$468.10–$717.25	18% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnant Uterus 14 Wk Transabdl 1/1st Gestat	$755.00	$755.00	$468.10–$717.25	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnant Uterus Limited 1/> Fetuses	$551.00	$551.00	$341.62–$523.45	31% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnant Uterus Limited 1/> Fetuses	$551.00	$551.00	$341.62–$523.45	—	—
Screening mammogram, both breasts both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad	$650.00	$650.00	$403.00–$617.50	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 Screening Mammography Bi 2-View Breast Inc Cad	$650.00	$650.00	$403.00–$617.50	—	—
Shoulder X-ray, complete, 2 or more views CPT 73030 Radex Shoulder Complete Minimum 2 Views	$468.00	$468.00	$290.16–$444.60	28% above	—
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 Radex Shoulder Complete Minimum 2 Views	$468.00	$468.00	$290.16–$444.60	—	—
Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$3,994.00	$3,994.00	$2,476.28–$3,794.30	1% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/>Yrs Sleep 4/> Addl Param Attnd	$3,994.00	$3,994.00	$2,476.28–$3,794.30	—	—
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$595.00	$595.00	$368.90–$565.25	7% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$595.00	$595.00	$368.90–$565.25	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US Preg Uterus Real Time W/Image Dcmtn Transvag	$641.00	$641.00	$397.42–$608.95	31% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Preg Uterus Real Time W/Image Dcmtn Transvag	$641.00	$641.00	$397.42–$608.95	—	—
Ultrasound of the abdomen, complete CPT 76700 US Abdominal Real Time W/Image Documentation	$1,072.00	$1,072.00	$664.64–$1,018.40	6% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal Real Time W/Image Documentation	$1,072.00	$1,072.00	$664.64–$1,018.40	—	—
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum & Contents	$827.00	$827.00	$512.74–$785.65	71% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum & Contents	$827.00	$827.00	$512.74–$785.65	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head & Neck Real Time Imge Docm	$548.00	$548.00	$339.76–$520.60	11% below	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Soft Tissue Head & Neck Real Time Imge Docm	$548.00	$548.00	$339.76–$520.60	—	—
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Dup-Scan Xtr Veins Unilateral/Limited Study	$894.00	$894.00	$554.28–$849.30	15% above	—
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 Dup-Scan Xtr Veins Unilateral/Limited Study	$894.00	$894.00	$554.28–$849.30	—	—
Wrist X-ray, complete, 3 or more views CPT 73110 Radex Wrist Complete Minimum 3 Views	$419.00	$419.00	$259.78–$398.05	36% above	—
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 Radex Wrist Complete Minimum 3 Views	$419.00	$419.00	$259.78–$398.05	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Radex Hip Unilateral With Pelvis 2-3 Views	$251.00	$251.00	$155.62–$238.45	5% below	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 Radex Hip Unilateral With Pelvis 2-3 Views	$251.00	$251.00	$155.62–$238.45	—	—
X-ray of the abdomen, 1 view CPT 74018 Radiologic Exam Abdomen 1 View	$352.00	$352.00	$218.24–$334.40	44% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 Radiologic Exam Abdomen 1 View	$352.00	$352.00	$218.24–$334.40	—	—
X-ray of the ankle, 2 views CPT 73600 Radiologic Examination Ankle 2 Views	$173.00	$173.00	$107.26–$164.35	33% below	—
X-ray of the ankle, 2 views inpatient CPT 73600 Radiologic Examination Ankle 2 Views	$173.00	$173.00	$107.26–$164.35	—	—
X-ray of the finger(s), 2 or more views CPT 73140 Radex Fingr Minimum 2 Views	$147.00	$147.00	$91.14–$139.65	33% below	—
X-ray of the finger(s), 2 or more views inpatient CPT 73140 Radex Fingr Minimum 2 Views	$147.00	$147.00	$91.14–$139.65	—	—
X-ray of the foot, 2 views CPT 73620 Radiologic Examination Foot 2 Views	$182.00	$182.00	$112.84–$172.90	15% below	—
X-ray of the foot, 2 views inpatient CPT 73620 Radiologic Examination Foot 2 Views	$182.00	$182.00	$112.84–$172.90	—	—
X-ray of the foot, complete, 3 or more views CPT 73630 Radex Foot Complete Minimum 3 Views	$435.00	$435.00	$269.70–$413.25	26% above	—
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 Radex Foot Complete Minimum 3 Views	$435.00	$435.00	$269.70–$413.25	—	—
X-ray of the hand, 3 or more views CPT 73130 Radex Hand Minimum 3 Views	$198.00	$198.00	$122.76–$188.10	30% below	—
X-ray of the hand, 3 or more views inpatient CPT 73130 Radex Hand Minimum 3 Views	$198.00	$198.00	$122.76–$188.10	—	—
X-ray of the knee, 1 or 2 views CPT 73560 Radiologic Examination Knee 1/2 Views	$298.00	$298.00	$184.76–$283.10	4% below	—
X-ray of the knee, 1 or 2 views inpatient CPT 73560 Radiologic Examination Knee 1/2 Views	$298.00	$298.00	$184.76–$283.10	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Radex Spine Lumbosacral 2/3 Views	$567.00	$567.00	$351.54–$538.65	73% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Radex Spine Lumbosacral 2/3 Views	$567.00	$567.00	$351.54–$538.65	—	—
X-ray of the lower back, 4 or more views CPT 72110 Radex Spine Lumbosacral Minimum 4 Views	$617.00	$617.00	$382.54–$586.15	13% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 Radex Spine Lumbosacral Minimum 4 Views	$617.00	$617.00	$382.54–$586.15	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Radex Spine Thoracic 2 Views	$455.00	$455.00	$282.10–$432.25	31% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Radex Spine Thoracic 2 Views	$455.00	$455.00	$282.10–$432.25	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 Radex Nasal Bones Complete Minimum 3 Views	$174.00	$174.00	$107.88–$165.30	34% below	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Radex Nasal Bones Complete Minimum 3 Views	$174.00	$174.00	$107.88–$165.30	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Radex Spine Cervical 2 or 3 Views	$434.00	$434.00	$269.08–$412.30	22% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Radex Spine Cervical 2 or 3 Views	$434.00	$434.00	$269.08–$412.30	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 Radiologic Examination Pelvis 1/2 Views	$366.00	$366.00	$226.92–$347.70	47% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Radiologic Examination Pelvis 1/2 Views	$366.00	$366.00	$226.92–$347.70	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Radex Sacrum & Coccyx Minimum 2 Views	$256.00	$256.00	$158.72–$243.20	at median	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Radex Sacrum & Coccyx Minimum 2 Views	$256.00	$256.00	$158.72–$243.20	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
AST (aspartate aminotransferase) enzyme test CPT 84450 Sgot Ast	$80.00	$80.00	$49.60–$76.00	226% above	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Sgot Ast	$80.00	$80.00	$49.60–$76.00	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Acute Panel	$462.00	$462.00	$286.44–$438.90	113% above	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Acute Panel	$462.00	$462.00	$286.44–$438.90	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ref Food Panel	$51.00	$51.00	$31.62–$48.45	35% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ref Allergen Specific Ige	$51.00	$51.00	$31.62–$48.45	35% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ref Allergen Specific Ige	$51.00	$51.00	$31.62–$48.45	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ref Food Panel	$51.00	$51.00	$31.62–$48.45	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ref Cyclic Citrullinated Peptide (CCP)	$119.00	$119.00	$73.78–$113.05	108% above	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody	$119.00	$119.00	$73.78–$113.05	108% above	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Ref Cyclic Citrullinated Peptide (CCP)	$119.00	$119.00	$73.78–$113.05	—	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody	$119.00	$119.00	$73.78–$113.05	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC Ana (Antinuclear Antibodies), Screen W or W/O Reflex Mia	$110.00	$110.00	$68.20–$104.50	82% above	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anti Nuclear Ab	$160.00	$160.00	$99.20–$152.00	164% above	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC Ana (Antinuclear Antibodies), Screen W or W/O Reflex Mia	$110.00	$110.00	$68.20–$104.50	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Anti Nuclear Ab	$160.00	$160.00	$99.20–$152.00	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp B-Type Natriuetic Peptide	$383.00	$383.00	$237.46–$363.85	188% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Bnp B-Type Natriuetic Peptide	$383.00	$383.00	$237.46–$363.85	—	—
Basic metabolic panel (blood test) CPT 80048 Bmp W Total Calcium Panel	$165.00	$165.00	$102.30–$156.75	127% above	—
Basic metabolic panel (blood test) inpatient CPT 80048 Bmp W Total Calcium Panel	$165.00	$165.00	$102.30–$156.75	—	—
Blood culture for bacteria CPT 87040 Culture Bact Bld Aer Anaer	$251.00	$251.00	$155.62–$238.45	176% above	—
Blood culture for bacteria inpatient CPT 87040 Culture Bact Bld Aer Anaer	$251.00	$251.00	$155.62–$238.45	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection Venous Blood Venipuncture	$40.00	$40.00	$24.80–$38.00	31% above	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 PR Collection Venous Blood Venipuncture	$40.00	$40.00	$24.80–$38.00	31% above	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PR Collection Venous Blood Venipuncture	$40.00	$40.00	$24.80–$38.00	—	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Collection Venous Blood Venipuncture	$40.00	$40.00	$24.80–$38.00	—	—
Blood glucose (sugar) test CPT 82947 Glucose	$91.00	$91.00	$56.42–$86.45	168% above	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose	$91.00	$91.00	$56.42–$86.45	—	—
Blood lead test CPT 83655 Ref Heavy Metals Scrn UR Lead	$129.00	$129.00	$79.98–$122.55	433% above	—
Blood lead test CPT 83655 Heavy Metal Lead Wb	$133.00	$133.00	$82.46–$126.35	450% above	—
Blood lead test inpatient CPT 83655 Ref Heavy Metals Scrn UR Lead	$129.00	$129.00	$79.98–$122.55	—	—
Blood lead test inpatient CPT 83655 Heavy Metal Lead Wb	$133.00	$133.00	$82.46–$126.35	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg Qual Preg Test	$127.00	$127.00	$78.74–$120.65	187% above	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Hcg Qual Preg Test	$127.00	$127.00	$78.74–$120.65	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Type Serologic-OB Group	$72.00	$72.00	$44.64–$68.40	14% below	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Type Serologic	$72.00	$72.00	$44.64–$68.40	14% below	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Type Serologic-OB Group	$72.00	$72.00	$44.64–$68.40	—	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Abo Type Serologic	$72.00	$72.00	$44.64–$68.40	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Ractive Protein Quant	$103.00	$103.00	$63.86–$97.85	78% above	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Ractive Protein Quant	$103.00	$103.00	$63.86–$97.85	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Amplified Probe	$217.00	$217.00	$134.54–$206.15	95% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff Amplified Probe	$217.00	$217.00	$134.54–$206.15	—	—
CA 19-9 blood test (tumor marker) CPT 86301 Ref Ca Ag 19 9	$174.00	$174.00	$107.88–$165.30	133% above	—
CA 19-9 blood test (tumor marker) CPT 86301 Ref Immunoassay, Tumor, Ca 19-9	$251.00	$251.00	$155.62–$238.45	237% above	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ref Ca Ag 19 9	$174.00	$174.00	$107.88–$165.30	—	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Ref Immunoassay, Tumor, Ca 19-9	$251.00	$251.00	$155.62–$238.45	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125	$259.00	$259.00	$160.58–$246.05	267% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125	$259.00	$259.00	$160.58–$246.05	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid-19 Pcr, High Throughput Technologies	$221.00	$221.00	$137.02–$209.95	116% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid Pcr Testing Asymptomatic Non-Covered- Self Pay Only	$221.00	$221.00	$137.02–$209.95	116% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid-19 Pcr	$221.00	$221.00	$137.02–$209.95	116% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid Test for the Biofire Pcr Panel	$221.00	$221.00	$137.02–$209.95	116% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 Ref Coronavirus With Cov-2 Rna, Qualitative Real-Time Rt-Pcr	$221.00	$221.00	$137.02–$209.95	116% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid Test for the Biofire Pcr Panel	$221.00	$221.00	$137.02–$209.95	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid-19 Pcr, High Throughput Technologies	$221.00	$221.00	$137.02–$209.95	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid-19 Pcr	$221.00	$221.00	$137.02–$209.95	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Covid Pcr Testing Asymptomatic Non-Covered- Self Pay Only	$221.00	$221.00	$137.02–$209.95	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 Ref Coronavirus With Cov-2 Rna, Qualitative Real-Time Rt-Pcr	$221.00	$221.00	$137.02–$209.95	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C Trachomatis Apmlified Probe	$218.00	$218.00	$135.16–$207.10	165% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Ref Chlamydia Trachomatis-Amplified Prob	$218.00	$218.00	$135.16–$207.10	165% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Ref Chlamydia Trachomatis-Amplified Prob	$218.00	$218.00	$135.16–$207.10	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C Trachomatis Apmlified Probe	$218.00	$218.00	$135.16–$207.10	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel Chol Tgl Ldl Hdl	$165.00	$165.00	$102.30–$156.75	214% above	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel Chol Tgl Ldl Hdl	$165.00	$165.00	$102.30–$156.75	—	—
Complete blood count (CBC) with differential CPT 85025 Complete Bl Count W Diff Auto	$133.00	$133.00	$82.46–$126.35	480% above	—
Complete blood count (CBC) with differential CPT 85025 PR Complete Bl Count W Diff Auto	$133.00	$133.00	$82.46–$126.35	480% above	—
Complete blood count (CBC) with differential inpatient CPT 85025 Complete Bl Count W Diff Auto	$133.00	$133.00	$82.46–$126.35	—	—
Complete blood count (CBC) with differential inpatient CPT 85025 PR Complete Bl Count W Diff Auto	$133.00	$133.00	$82.46–$126.35	—	—
Complete blood count (CBC), no differential CPT 85027 Complete Bl Count Automated	$99.00	$99.00	$61.38–$94.05	114% above	—
Complete blood count (CBC), no differential inpatient CPT 85027 Complete Bl Count Automated	$99.00	$99.00	$61.38–$94.05	—	—
Comprehensive metabolic panel (blood test) CPT 80053 Cmp Comprehensive Metabolic	$195.00	$195.00	$120.90–$185.25	121% above	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Cmp Comprehensive Metabolic	$195.00	$195.00	$120.90–$185.25	—	—
D-dimer blood test (blood clot marker) CPT 85379 D Dimer	$212.00	$212.00	$131.44–$201.40	129% above	—
D-dimer blood test (blood clot marker) CPT 85379 Ref D-Dimer, P-Aprol	$343.00	$343.00	$212.66–$325.85	271% above	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer	$212.00	$212.00	$131.44–$201.40	—	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 Ref D-Dimer, P-Aprol	$343.00	$343.00	$212.66–$325.85	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 Ref Dhea Sulfate	$286.00	$286.00	$177.32–$271.70	292% above	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Ref Dhea Sulfate	$286.00	$286.00	$177.32–$271.70	—	—
Estradiol blood test CPT 82670 Estradiol	$223.00	$223.00	$138.26–$211.85	114% above	—
Estradiol blood test inpatient CPT 82670 Estradiol	$223.00	$223.00	$138.26–$211.85	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$197.00	$197.00	$122.14–$187.15	215% above	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$197.00	$197.00	$122.14–$187.15	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 HC Calprotectin Fecal Stool	$252.00	$252.00	$156.24–$239.40	33% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Ref Calprotectin, F	$298.00	$298.00	$184.76–$283.10	57% above	—
Fecal calprotectin (stool inflammation test) CPT 83993 Assay for Calprotectin Fecal	$377.00	$377.00	$233.74–$358.15	99% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC Calprotectin Fecal Stool	$252.00	$252.00	$156.24–$239.40	—	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Ref Calprotectin, F	$298.00	$298.00	$184.76–$283.10	—	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Assay for Calprotectin Fecal	$377.00	$377.00	$233.74–$358.15	—	—
Ferritin blood test (iron stores) CPT 82728 Ferritin	$176.00	$176.00	$109.12–$167.20	158% above	—
Ferritin blood test (iron stores) CPT 82728 Ref Ferritin Serum	$340.00	$340.00	$210.80–$323.00	398% above	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin	$176.00	$176.00	$109.12–$167.20	—	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ref Ferritin Serum	$340.00	$340.00	$210.80–$323.00	—	—
Folate (folic acid) blood test CPT 82746 Folate Serum	$195.00	$195.00	$120.90–$185.25	261% above	—
Folate (folic acid) blood test inpatient CPT 82746 Folate Serum	$195.00	$195.00	$120.90–$185.25	—	—
Free T3 thyroid hormone test CPT 84481 T3 Triiodothyronine Free	$274.00	$274.00	$169.88–$260.30	296% above	—
Free T3 thyroid hormone test inpatient CPT 84481 T3 Triiodothyronine Free	$274.00	$274.00	$169.88–$260.30	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T 4	$145.00	$145.00	$89.90–$137.75	170% above	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T 4	$145.00	$145.00	$89.90–$137.75	—	—
Free testosterone test CPT 84402 Ref Testosterone, Free for Mayo Total and Free	$119.00	$119.00	$73.78–$113.05	85% above	—
Free testosterone test CPT 84402 Ref Testosterone Free for Mayo Total, Bio, Free	$119.00	$119.00	$73.78–$113.05	85% above	—
Free testosterone test inpatient CPT 84402 Ref Testosterone, Free for Mayo Total and Free	$119.00	$119.00	$73.78–$113.05	—	—
Free testosterone test inpatient CPT 84402 Ref Testosterone Free for Mayo Total, Bio, Free	$119.00	$119.00	$73.78–$113.05	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance OB	$69.00	$69.00	$42.78–$65.55	61% above	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance OB	$69.00	$69.00	$42.78–$65.55	—	—
Glucose tolerance test, 3 samples CPT 82951 Gtt 3 3hr Glucose Tolerance	$152.00	$152.00	$94.24–$144.40	106% above	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Gtt 3 3hr Glucose Tolerance	$152.00	$152.00	$94.24–$144.40	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrhoeae Amplified Probe	$222.00	$222.00	$137.64–$210.90	179% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N Gonorrhoeae Amplified Probe	$222.00	$222.00	$137.64–$210.90	—	—
H. pylori antibody blood test CPT 86677 Heliobacter Pylori Ab	$231.00	$231.00	$143.22–$219.45	177% above	—
H. pylori antibody blood test inpatient CPT 86677 Heliobacter Pylori Ab	$231.00	$231.00	$143.22–$219.45	—	—
H. pylori stool antigen test CPT 87338 Ref Stl for H Pylori	$180.00	$180.00	$111.60–$171.00	91% above	—
H. pylori stool antigen test inpatient CPT 87338 Ref Stl for H Pylori	$180.00	$180.00	$111.60–$171.00	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Ref Hiv 1 Rna by Ultra Sens Pcr Q	$238.00	$238.00	$147.56–$226.10	11% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Ref Hiv 1 Rna by Ultra Sens Pcr Q	$238.00	$238.00	$147.56–$226.10	—	—
HIV-1 and HIV-2 antibody test CPT 86703 Hiv I & II	$182.00	$182.00	$112.84–$172.90	181% above	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Hiv I & II	$182.00	$182.00	$112.84–$172.90	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1 and 2 Ag & Ab Screen	$249.00	$249.00	$154.38–$236.55	308% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Hiv 1 and 2 Ag & Ab Screen	$249.00	$249.00	$154.38–$236.55	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$114.00	$114.00	$70.68–$108.30	419% above	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$114.00	$114.00	$70.68–$108.30	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Ref Hep B Surface Antibody	$140.00	$140.00	$86.80–$133.00	207% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hbs Ab	$140.00	$140.00	$86.80–$133.00	207% above	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hbs Ab	$140.00	$140.00	$86.80–$133.00	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Ref Hep B Surface Antibody	$140.00	$140.00	$86.80–$133.00	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surface Ag	$87.00	$87.00	$53.94–$82.65	137% above	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Ref Hbs Ag	$87.00	$87.00	$53.94–$82.65	137% above	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Ref Hbs Ag	$87.00	$87.00	$53.94–$82.65	—	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hep B Surface Ag	$87.00	$87.00	$53.94–$82.65	—	—
Hepatitis C antibody blood test (screening) CPT 86803 Hcv Ab	$221.00	$221.00	$137.02–$209.95	251% above	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hcv Ab	$221.00	$221.00	$137.02–$209.95	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Ref Hcv Viral Load	$268.00	$268.00	$166.16–$254.60	42% above	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Ref Hcv Viral Load	$268.00	$268.00	$166.16–$254.60	—	—
Herpes blood test, HSV-1 antibody CPT 86695 Hsv Type 1 Ab Igg	$139.00	$139.00	$86.18–$132.05	199% above	—
Herpes blood test, HSV-1 antibody CPT 86695 Ref Herpes Simplex Type 1	$197.00	$197.00	$122.14–$187.15	324% above	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Hsv Type 1 Ab Igg	$139.00	$139.00	$86.18–$132.05	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Ref Herpes Simplex Type 1	$197.00	$197.00	$122.14–$187.15	—	—
Herpes blood test, HSV-2 antibody CPT 86696 Hsv Type 2 Ab Igg	$176.00	$176.00	$109.12–$167.20	205% above	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 3	$196.00	$196.00	$121.52–$186.20	240% above	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Hsv Type 2 Ab Igg	$176.00	$176.00	$109.12–$167.20	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 3	$196.00	$196.00	$121.52–$186.20	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 Crpq C Reative Protein	$129.00	$129.00	$79.98–$122.55	103% above	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Crpq C Reative Protein	$129.00	$129.00	$79.98–$122.55	—	—
Homocysteine blood test CPT 83090 Ref Homocysteine Total Serum	$257.00	$257.00	$159.34–$244.15	323% above	—
Homocysteine blood test inpatient CPT 83090 Ref Homocysteine Total Serum	$257.00	$257.00	$159.34–$244.15	—	—
Insulin blood test CPT 83525 Ref Insulin	$204.00	$204.00	$126.48–$193.80	339% above	—
Insulin blood test inpatient CPT 83525 Ref Insulin	$204.00	$204.00	$126.48–$193.80	—	—
Iron blood test (serum iron) CPT 83540 Iron Serum	$70.00	$70.00	$43.40–$66.50	211% above	—
Iron blood test (serum iron) inpatient CPT 83540 Iron Serum	$70.00	$70.00	$43.40–$66.50	—	—
Iron-binding capacity (TIBC) test CPT 83550 Iron Bind Serum	$90.00	$90.00	$55.80–$85.50	285% above	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Bind Serum	$90.00	$90.00	$55.80–$85.50	—	—
Kidney function blood test panel CPT 80069 Renal Function Panel	$156.00	$156.00	$96.72–$148.20	68% above	—
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$156.00	$156.00	$96.72–$148.20	—	—
LH (luteinizing hormone) test CPT 83002 Ref Luteinzine Hormone (Lh)	$204.00	$204.00	$126.48–$193.80	224% above	—
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$204.00	$204.00	$126.48–$193.80	224% above	—
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$204.00	$204.00	$126.48–$193.80	—	—
LH (luteinizing hormone) test inpatient CPT 83002 Ref Luteinzine Hormone (Lh)	$204.00	$204.00	$126.48–$193.80	—	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$120.00	$120.00	$74.40–$114.00	73% above	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$120.00	$120.00	$74.40–$114.00	—	—
Liver function blood test panel CPT 80076 Hepatic Function Panel	$144.00	$144.00	$89.28–$136.80	101% above	—
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$144.00	$144.00	$89.28–$136.80	—	—
Lyme disease antibody test CPT 86618 Ref Lyme Disease Serology	$238.00	$238.00	$147.56–$226.10	230% above	—
Lyme disease antibody test CPT 86618 Ref Lyme Cns Inefection Igg With Antibody Index Reflex	$238.00	$238.00	$147.56–$226.10	230% above	—
Lyme disease antibody test inpatient CPT 86618 Ref Lyme Disease Serology	$238.00	$238.00	$147.56–$226.10	—	—
Lyme disease antibody test inpatient CPT 86618 Ref Lyme Cns Inefection Igg With Antibody Index Reflex	$238.00	$238.00	$147.56–$226.10	—	—
Magnesium blood test CPT 83735 Magnesium	$84.00	$84.00	$52.08–$79.80	131% above	—
Magnesium blood test inpatient CPT 83735 Magnesium	$84.00	$84.00	$52.08–$79.80	—	—
Measles (rubeola) antibody test CPT 86765 Rubeola	$214.00	$214.00	$132.68–$203.30	383% above	—
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola	$214.00	$214.00	$132.68–$203.30	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Heterophile Scr	$95.00	$95.00	$58.90–$90.25	94% above	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Heterophile Scr	$95.00	$95.00	$58.90–$90.25	—	—
Obstetric blood test panel CPT 80055 OB Panel	$411.00	$411.00	$254.82–$390.45	46% above	—
Obstetric blood test panel inpatient CPT 80055 OB Panel	$411.00	$411.00	$254.82–$390.45	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 HC Psa Free	$103.00	$103.00	$63.86–$97.85	127% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Ref Prostate Specific Antigen (Psa-Free)	$172.00	$172.00	$106.64–$163.40	278% above	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Ref Psa Free	$172.00	$172.00	$106.64–$163.40	278% above	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC Psa Free	$103.00	$103.00	$63.86–$97.85	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Ref Prostate Specific Antigen (Psa-Free)	$172.00	$172.00	$106.64–$163.40	—	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Ref Psa Free	$172.00	$172.00	$106.64–$163.40	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Ref Assay, Psa, Total	$176.00	$176.00	$109.12–$167.20	127% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Screening	$209.00	$209.00	$129.58–$198.55	170% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Diagnostic	$209.00	$209.00	$129.58–$198.55	170% above	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Ref Psa Total	$209.00	$209.00	$129.58–$198.55	170% above	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Ref Assay, Psa, Total	$176.00	$176.00	$109.12–$167.20	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Diagnostic	$209.00	$209.00	$129.58–$198.55	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Ref Psa Total	$209.00	$209.00	$129.58–$198.55	—	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Screening	$209.00	$209.00	$129.58–$198.55	—	—
Parathyroid hormone (PTH) blood test CPT 83970 Assay, Parathormone	$238.00	$238.00	$147.56–$226.10	116% above	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Assay, Parathormone	$238.00	$238.00	$147.56–$226.10	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ref Activated Partial Thrombopla Time, P (Mayo) Aathr Panel	$75.00	$75.00	$46.50–$71.25	112% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$101.00	$101.00	$62.62–$95.95	185% above	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Ref Activated Partial Thrombopla Time, P (Mayo) Alupp Panel	$122.00	$122.00	$75.64–$115.90	245% above	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ref Activated Partial Thrombopla Time, P (Mayo) Aathr Panel	$75.00	$75.00	$46.50–$71.25	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$101.00	$101.00	$62.62–$95.95	—	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Ref Activated Partial Thrombopla Time, P (Mayo) Alupp Panel	$122.00	$122.00	$75.64–$115.90	—	—
Progesterone blood test CPT 84144 Progesterone	$270.00	$270.00	$167.40–$256.50	441% above	—
Progesterone blood test inpatient CPT 84144 Progesterone	$270.00	$270.00	$167.40–$256.50	—	—
Prolactin blood test CPT 84146 Prolactin	$216.00	$216.00	$133.92–$205.20	229% above	—
Prolactin blood test inpatient CPT 84146 Prolactin	$216.00	$216.00	$133.92–$205.20	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 Ref Prothrombin Time (Pt), P-Aprol	$57.00	$57.00	$35.34–$54.15	88% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Ref Prothrombin Time (Pt),P (Mayo) Proct Panel	$82.00	$82.00	$50.84–$77.90	171% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Protime	$88.00	$88.00	$54.56–$83.60	191% above	—
Prothrombin time (PT/INR) clotting test CPT 85610 Ref Prothrombin Time (Pt),P Mayo Aathr Panel	$146.00	$146.00	$90.52–$138.70	383% above	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Ref Prothrombin Time (Pt), P-Aprol	$57.00	$57.00	$35.34–$54.15	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Ref Prothrombin Time (Pt),P (Mayo) Proct Panel	$82.00	$82.00	$50.84–$77.90	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Protime	$88.00	$88.00	$54.56–$83.60	—	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Ref Prothrombin Time (Pt),P Mayo Aathr Panel	$146.00	$146.00	$90.52–$138.70	—	—
Rapid flu test (influenza antigen) CPT 87804 Influenza a&B Waived	$105.00	$105.00	$65.10–$99.75	109% above	—
Rapid flu test (influenza antigen) CPT 87804 HC Influenza a Waived	$105.00	$105.00	$65.10–$99.75	109% above	—
Rapid flu test (influenza antigen) CPT 87804 HC Influenza B Waived	$105.00	$105.00	$65.10–$99.75	109% above	—
Rapid flu test (influenza antigen) inpatient CPT 87804 HC Influenza B Waived	$105.00	$105.00	$65.10–$99.75	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza a&B Waived	$105.00	$105.00	$65.10–$99.75	—	—
Rapid flu test (influenza antigen) inpatient CPT 87804 HC Influenza a Waived	$105.00	$105.00	$65.10–$99.75	—	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC Strep a Pcr	$61.00	$61.00	$37.82–$57.95	31% above	—
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep Screen Group a Waived	$114.00	$114.00	$70.68–$108.30	144% above	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC Strep a Pcr	$61.00	$61.00	$37.82–$57.95	—	—
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep Screen Group a Waived	$114.00	$114.00	$70.68–$108.30	—	—
Rheumatoid factor (RF) test CPT 86431 Ra Quan	$90.00	$90.00	$55.80–$85.50	143% above	—
Rheumatoid factor (RF) test inpatient CPT 86431 Ra Quan	$90.00	$90.00	$55.80–$85.50	—	—
Rubella antibody test (immunity check) CPT 86762 Rubella	$108.00	$108.00	$66.96–$102.60	105% above	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella	$108.00	$108.00	$66.96–$102.60	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Westergren Esr	$70.00	$70.00	$43.40–$66.50	127% above	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Westergren Esr	$70.00	$70.00	$43.40–$66.50	—	—
Stool ova and parasites exam CPT 87177 Ref Ova & Parasite Examination	$127.00	$127.00	$78.74–$120.65	374% above	—
Stool ova and parasites exam inpatient CPT 87177 Ref Ova & Parasite Examination	$127.00	$127.00	$78.74–$120.65	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood, Occult: Feces Screening 1-3	$26.00	$26.00	$16.12–$24.70	60% above	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Fecal Occult Blood Nonmedicare	$40.00	$40.00	$24.80–$38.00	146% above	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Blood, Occult: Feces Screening 1-3	$26.00	$26.00	$16.12–$24.70	—	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Fecal Occult Blood Nonmedicare	$40.00	$40.00	$24.80–$38.00	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occ Bl Test Ifob Diag	$127.00	$127.00	$78.74–$120.65	186% above	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Bl Test Ifob Scrn	$131.00	$131.00	$81.22–$124.45	195% above	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occ Bl Test Ifob Diag	$127.00	$127.00	$78.74–$120.65	—	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Bl Test Ifob Scrn	$131.00	$131.00	$81.22–$124.45	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$65.00	$65.00	$40.30–$61.75	52% above	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$65.00	$65.00	$40.30–$61.75	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB Gold	$289.00	$289.00	$179.18–$274.55	104% above	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB Gold	$289.00	$289.00	$179.18–$274.55	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 Ref Testosterone, Total for Mayo Total, Bio, and Free	$224.00	$224.00	$138.88–$212.80	339% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$232.00	$232.00	$143.84–$220.40	355% above	—
Testosterone blood test, total (not free testosterone) CPT 84403 Ref Testosterone Total, for Mayo Total and Free	$232.00	$232.00	$143.84–$220.40	355% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Ref Testosterone, Total for Mayo Total, Bio, and Free	$224.00	$224.00	$138.88–$212.80	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$232.00	$232.00	$143.84–$220.40	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Ref Testosterone Total, for Mayo Total and Free	$232.00	$232.00	$143.84–$220.40	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies	$183.00	$183.00	$113.46–$173.85	249% above	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Ref Liver Kidney Microsomal Antibo	$197.00	$197.00	$122.14–$187.15	276% above	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Antibodies	$183.00	$183.00	$113.46–$173.85	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Ref Liver Kidney Microsomal Antibo	$197.00	$197.00	$122.14–$187.15	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$209.00	$209.00	$129.58–$198.55	203% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Ref Tsh	$214.00	$214.00	$132.68–$203.30	210% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$209.00	$209.00	$129.58–$198.55	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Ref Tsh	$214.00	$214.00	$132.68–$203.30	—	—
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Amplfied	$184.00	$184.00	$114.08–$174.80	42% above	—
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis Amplfied	$184.00	$184.00	$114.08–$174.80	—	—
Uric acid blood test CPT 84550 Uric Acid Blood	$97.00	$97.00	$60.14–$92.15	241% above	—
Uric acid blood test inpatient CPT 84550 Uric Acid Blood	$97.00	$97.00	$60.14–$92.15	—	—
Urinalysis with microscope exam, automated CPT 81001 Urine Auto With Micro	$80.00	$80.00	$49.60–$76.00	119% above	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urine Auto With Micro	$80.00	$80.00	$49.60–$76.00	—	—
Urinalysis with microscope exam, manual CPT 81000 Urine Dip W Micro08012012	$80.00	$80.00	$49.60–$76.00	181% above	—
Urinalysis with microscope exam, manual inpatient CPT 81000 Urine Dip W Micro08012012	$80.00	$80.00	$49.60–$76.00	—	—
Urinalysis without microscope exam, automated CPT 81003 Urine Auto WO Micro	$37.00	$37.00	$22.94–$35.15	150% above	—
Urinalysis without microscope exam, automated CPT 81003 Urine Auto WO Micro Waived	$37.00	$37.00	$22.94–$35.15	150% above	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Auto WO Micro	$37.00	$37.00	$22.94–$35.15	—	—
Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Auto WO Micro Waived	$37.00	$37.00	$22.94–$35.15	—	—
Urinalysis without microscope exam, manual CPT 81002 Urine Dip POC	$37.00	$37.00	$22.94–$35.15	73% above	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dip POC	$37.00	$37.00	$22.94–$35.15	—	—
Urine culture for bacteria, with colony count CPT 87086 Ref Urine Culture Quant Cc	$105.00	$105.00	$65.10–$99.75	493% above	—
Urine culture for bacteria, with colony count inpatient CPT 87086 Ref Urine Culture Quant Cc	$105.00	$105.00	$65.10–$99.75	—	—
Urine pregnancy test, read by color change CPT 81025 Hcg Urine	$104.00	$104.00	$64.48–$98.80	149% above	—
Urine pregnancy test, read by color change CPT 81025 Hcg Urine Waived	$104.00	$104.00	$64.48–$98.80	149% above	—
Urine pregnancy test, read by color change inpatient CPT 81025 Hcg Urine Waived	$104.00	$104.00	$64.48–$98.80	—	—
Urine pregnancy test, read by color change inpatient CPT 81025 Hcg Urine	$104.00	$104.00	$64.48–$98.80	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vit B12 Serum	$193.00	$193.00	$119.66–$183.35	245% above	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vit B12 Serum	$193.00	$193.00	$119.66–$183.35	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Ref Vit D 25 Hydroxy W Fractions	$379.00	$379.00	$234.98–$360.05	359% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vit D 25 Hydroxy W Fractions	$379.00	$379.00	$234.98–$360.05	359% above	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vit D 25 Hydroxy W Fractions	$379.00	$379.00	$234.98–$360.05	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Ref Vit D 25 Hydroxy W Fractions	$379.00	$379.00	$234.98–$360.05	—	—
Zinc blood test CPT 84630 Ref Zinc Serum	$119.00	$119.00	$73.78–$113.05	379% above	—
Zinc blood test inpatient CPT 84630 Ref Zinc Serum	$119.00	$119.00	$73.78–$113.05	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Ref Bhcg CSF	$170.00	$170.00	$105.40–$161.50	167% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Quant Preg Test	$210.00	$210.00	$130.20–$199.50	230% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Ref Bhcg CSF	$170.00	$170.00	$105.40–$161.50	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg Quant Preg Test	$210.00	$210.00	$130.20–$199.50	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Earwax removal with instruments, one ear one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$218.00	$218.00	$135.16–$207.10	114% above	—
Earwax removal with instruments, one ear inpatient one side CPT 69210 Removal Impacted Cerumen Instrumentation Unilat	$218.00	$218.00	$135.16–$207.10	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 Drain Skin Abscess Simple	$463.00	$463.00	$287.06–$439.85	233% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 Incision & Drainage Abscess Simple/Single	$477.00	$477.00	$295.74–$453.15	243% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drain Skin Abscess Simple	$463.00	$463.00	$287.06–$439.85	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Incision & Drainage Abscess Simple/Single	$477.00	$477.00	$295.74–$453.15	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US	$408.00	$408.00	$252.96–$387.60	36% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Aspir&/Inj Major Jt/Bursa W/O US	$408.00	$408.00	$252.96–$387.60	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$342.00	$342.00	$212.04–$324.90	28% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Aspir&/Inj Interm Jt/Burs W/O US	$342.00	$342.00	$212.04–$324.90	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Repair Intermediate S/a/T/E 2.5 Cm/<	$669.00	$669.00	$414.78–$635.55	16% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Repair Intermediate S/a/T/E 2.5 Cm/<	$669.00	$669.00	$414.78–$635.55	—	—
Paracentesis with imaging guidance CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging Guidance	$834.00	$834.00	$517.08–$792.30	9% below	—
Paracentesis with imaging guidance inpatient CPT 49083 Abdom Paracentesis Dx/Ther W/Imaging Guidance	$834.00	$834.00	$517.08–$792.30	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of Nail Bed	$542.00	$542.00	$336.04–$514.90	18% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Removal of Nail Bed	$542.00	$542.00	$336.04–$514.90	—	—
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple	$600.00	$600.00	$372.00–$570.00	165% above	—
Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body Simple	$627.00	$627.00	$388.74–$595.65	177% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple	$600.00	$600.00	$372.00–$570.00	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Remove Foreign Body Simple	$627.00	$627.00	$388.74–$595.65	—	—
Short arm splint (forearm and hand) CPT 29125 Application Short Arm Splint Forearm-Hand Static	$350.00	$350.00	$217.00–$332.50	52% above	—
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint,Static	$350.00	$350.00	$217.00–$332.50	52% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint,Static	$350.00	$350.00	$217.00–$332.50	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Application Short Arm Splint Forearm-Hand Static	$350.00	$350.00	$217.00–$332.50	—	—
Short leg cast (below the knee) CPT 29405 Application Short Leg Cast Below Knee-Toe	$539.00	$539.00	$334.18–$512.05	46% above	—
Short leg cast (below the knee) inpatient CPT 29405 Application Short Leg Cast Below Knee-Toe	$539.00	$539.00	$334.18–$512.05	—	—
Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint	$281.00	$281.00	$174.22–$266.95	38% above	—
Short leg splint (calf to foot) CPT 29515 Application Short Leg Splint Calf Foot	$284.00	$284.00	$176.08–$269.80	39% above	—
Short leg splint (calf to foot) inpatient CPT 29515 Apply Lower Leg Splint	$281.00	$281.00	$174.22–$266.95	—	—
Short leg splint (calf to foot) inpatient CPT 29515 Application Short Leg Splint Calf Foot	$284.00	$284.00	$176.08–$269.80	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Scalp/Neck/Ax/Genit/Trunk 2.5cm/<	$714.00	$714.00	$442.68–$678.30	216% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Resuperf Wnd Body <2.5cm	$749.00	$749.00	$464.38–$711.55	232% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Simple Repair Scalp/Neck/Ax/Genit/Trunk 2.5cm/<	$714.00	$714.00	$442.68–$678.30	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Resuperf Wnd Body <2.5cm	$749.00	$749.00	$464.38–$711.55	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Smpl Repair Scalp/Neck/Ax/Genit/Trunk 2.6-7.5cm	$775.00	$775.00	$480.50–$736.25	184% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Resup Npterf Wnd Body 2.6-7.5 Cm	$906.00	$906.00	$561.72–$860.70	232% 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 Smpl Repair Scalp/Neck/Ax/Genit/Trunk 2.6-7.5cm	$775.00	$775.00	$480.50–$736.25	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Resup Npterf Wnd Body 2.6-7.5 Cm	$906.00	$906.00	$561.72–$860.70	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simple Repair F/E/E/N/L/M 2.5cm/<	$714.00	$714.00	$442.68–$678.30	162% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Resuperf Wnd Face <2.5 Cm	$906.00	$906.00	$561.72–$860.70	233% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Simple Repair F/E/E/N/L/M 2.5cm/<	$714.00	$714.00	$442.68–$678.30	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Resuperf Wnd Face <2.5 Cm	$906.00	$906.00	$561.72–$860.70	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 Inject Trigger Point, 1 or 2	$335.00	$335.00	$207.70–$318.25	78% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Inject Trigger Point, 1 or 2	$335.00	$335.00	$207.70–$318.25	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Transfusion, Blood or Blood Components	$595.00	$595.00	$368.90–$565.25	13% below	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfusion, Blood or Blood Components	$595.00	$595.00	$368.90–$565.25	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Pressurized/Nonpressurized Inhalation Treatment	$222.00	$222.00	$137.64–$210.90	57% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Pressurized/Nonpressurized Inhalation Treatment	$222.00	$222.00	$137.64–$210.90	—	—
Chemotherapy IV infusion, first hour CPT 96413 Chemotx Admn IV Nfs Tq Up 1 Hr 1/1st Sbst/Drug	$737.00	$737.00	$456.94–$700.15	66% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemotx Admn IV Nfs Tq Up 1 Hr 1/1st Sbst/Drug	$737.00	$737.00	$456.94–$700.15	—	—
Critical care, first 30 to 74 minutes CPT 99291 Critical Care, E/M 30-74 Minutes	$2,381.00	$2,381.00	$1,476.22–$2,261.95	56% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care, E/M 30-74 Minutes	$2,381.00	$2,381.00	$1,476.22–$2,261.95	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ecg Routine Ecg W/Least 12 Lds Trcg Only W/O I&R	$156.00	$156.00	$96.72–$148.20	23% below	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Ecg Routine Ecg W/Least 12 Lds Trcg Only W/O I&R	$156.00	$156.00	$96.72–$148.20	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PR Emergency Department Visit Limited/Minor Prob	$402.00	$402.00	$249.24–$381.90	89% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PR Emergency Department Visit Limited/Minor Prob	$402.00	$402.00	$249.24–$381.90	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PR Emergency Department Visit Low/Moder Severity	$544.00	$544.00	$337.28–$516.80	58% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PR Emergency Department Visit Low/Moder Severity	$544.00	$544.00	$337.28–$516.80	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PR ED Visit Low Mdm	$819.00	$819.00	$507.78–$778.05	22% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PR ED Visit Low Mdm	$819.00	$819.00	$507.78–$778.05	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PR ED Visit Mod Severity	$1,222.00	$1,222.00	$757.64–$1,160.90	19% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PR ED Visit Mod Severity	$1,222.00	$1,222.00	$757.64–$1,160.90	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PR ED Visit High Mdm	$1,824.00	$1,824.00	$1,130.88–$1,732.80	13% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PR ED Visit High Mdm	$1,824.00	$1,824.00	$1,130.88–$1,732.80	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Cv Strs Tst Xers&/or Rx Cont Ecg Trcg Only	$568.00	$568.00	$352.16–$539.60	31% below	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cv Strs Tst Xers&/or Rx Cont Ecg Trcg Only	$568.00	$568.00	$352.16–$539.60	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infusion Hydration Initial 31 Min-1 Hour	$441.00	$441.00	$273.42–$418.95	65% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Infusion Hydration Initial 31 Min-1 Hour	$441.00	$441.00	$273.42–$418.95	—	—
IV infusion of a medicine, first hour CPT 96365 IV Infusion Therapy/Prophylaxis /Dx 1st to 1 Hr	$441.00	$441.00	$273.42–$418.95	32% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 IV Infusion Therapy/Prophylaxis /Dx 1st to 1 Hr	$441.00	$441.00	$273.42–$418.95	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic Prophylactic/Dx Injection Subq/Im	$96.00	$96.00	$59.52–$91.20	2% below	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Therapeutic Prophylactic/Dx Injection Subq/Im	$96.00	$96.00	$59.52–$91.20	—	—
Neuromuscular re-education, 15 minutes CPT 97112 Ther Px 1/> Areas Each 15 Min Neuromusc Reeduca	$120.00	$120.00	$74.40–$114.00	19% above	—
Neuromuscular re-education, 15 minutes inpatient CPT 97112 Ther Px 1/> Areas Each 15 Min Neuromusc Reeduca	$120.00	$120.00	$74.40–$114.00	—	—
Occupational therapy evaluation, low complexity CPT 97165 Ot Eval Low Complexity	$253.00	$253.00	$156.86–$240.35	51% above	—
Occupational therapy evaluation, low complexity inpatient CPT 97165 Ot Eval Low Complexity	$253.00	$253.00	$156.86–$240.35	—	—
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Eval Visit High Complexity	$314.00	$314.00	$194.68–$298.30	35% above	—
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Pt Eval Visit High Complexity	$314.00	$314.00	$194.68–$298.30	—	—
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Eval Visit Low Complexity	$253.00	$253.00	$156.86–$240.35	32% above	—
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Pt Eval Visit Low Complexity	$253.00	$253.00	$156.86–$240.35	—	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Eval Visit Moderate Complex	$285.00	$285.00	$176.70–$270.75	33% above	—
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Pt Eval Visit Moderate Complex	$285.00	$285.00	$176.70–$270.75	—	—
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Tqs 1/> Regions Each 15 Minutes	$127.00	$127.00	$78.74–$120.65	18% above	—
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Tqs 1/> Regions Each 15 Minutes	$127.00	$127.00	$78.74–$120.65	—	—
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Px 1/> Areas Each 15 Min Exercises	$125.00	$125.00	$77.50–$118.75	35% above	—
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Px 1/> Areas Each 15 Min Exercises	$125.00	$125.00	$77.50–$118.75	—	—
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes	$70.00	$70.00	$43.40–$66.50	146% above	—
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Tobacco Use Cessation Intermediate 3-10 Minutes	$70.00	$70.00	$43.40–$66.50	—	—
Speech and language evaluation CPT 92523 Eval Speech Sound Product Language Comprehension	$477.00	$477.00	$295.74–$453.15	73% above	—
Speech and language evaluation inpatient CPT 92523 Eval Speech Sound Product Language Comprehension	$477.00	$477.00	$295.74–$453.15	—	—
Speech therapy session, individual CPT 92507 Tx Speech Lang Voice Commj &/Auditory Proc Ind	$231.00	$231.00	$143.22–$219.45	17% above	—
Speech therapy session, individual inpatient CPT 92507 Tx Speech Lang Voice Commj &/Auditory Proc Ind	$231.00	$231.00	$143.22–$219.45	—	—
Spirometry (breathing test) CPT 94010 Spmtry W/Vc Expiratory Flo W/WO Mxml Vol Vntj	$160.00	$160.00	$99.20–$152.00	22% below	—
Spirometry (breathing test) inpatient CPT 94010 Spmtry W/Vc Expiratory Flo W/WO Mxml Vol Vntj	$160.00	$160.00	$99.20–$152.00	—	—
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeut Actvity Direct Pt Contact Each 15 Min	$103.00	$103.00	$63.86–$97.85	21% above	—
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeut Actvity Direct Pt Contact Each 15 Min	$103.00	$103.00	$63.86–$97.85	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic Separate Procedure	$204.00	$204.00	$126.48–$193.80	29% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic Separate Procedure	$204.00	$204.00	$126.48–$193.80	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Wyoming	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$107.48	$107.48	$66.64–$102.11	352% above	—
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACCINE TS 2024-25(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE	$107.48	$107.48	$66.64–$102.11	—	—
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS VACCINE RECOM (PF) 20 MCG/ML INTRAMUSCULAR WRAPPER	$330.74	$330.74	$205.06–$314.20	134% above	—
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VIRUS VACCINE RECOM (PF) 20 MCG/ML INTRAMUSCULAR WRAPPER	$330.74	$330.74	$205.06–$314.20	—	—
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$334.61	$334.61	$207.46–$317.88	198% above	—
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACCINE TS2024-25(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE	$334.61	$334.61	$207.46–$317.88	—	—
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$352.24	$352.24	$218.39–$334.63	106% above	—
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$352.24	$352.24	$218.39–$334.63	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$623.00	$623.00	$386.26–$591.85	5% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE	$623.00	$623.00	$386.26–$591.85	—	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$669.01	$669.01	$414.79–$635.56	50% above	—
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$669.01	$669.01	$414.79–$635.56	—	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$364.11	$364.11	$225.75–$345.90	69% above	—
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE	$364.11	$364.11	$225.75–$345.90	—	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$458.00	$458.00	$283.96–$435.10	at median	—
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION	$458.00	$458.00	$283.96–$435.10	—	—
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$1,063.91	$1,063.91	$659.62–$1,010.71	76% above	—
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP	$1,063.91	$1,063.91	$659.62–$1,010.71	—	—
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 VARICELLA-ZOSTER VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT	$547.90	$547.90	$339.70–$520.51	15% above	—
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 VARICELLA-ZOSTER VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT	$547.90	$547.90	$339.70–$520.51	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$172.60	$172.60	$107.01–$163.97	128% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$172.60	$172.60	$107.01–$163.97	128% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SUSP	$172.60	$172.60	$107.01–$163.97	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE	$172.60	$172.60	$107.01–$163.97	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$227.14	$227.14	$140.83–$215.78	215% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$227.58	$227.58	$141.10–$216.20	215% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$227.14	$227.14	$140.83–$215.78	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPHTH,PERTUS(AC)TETANUS(PF)2 LF-(2.5-5-3-5MCG)-5 LF/0.5 ML IM SYRINGE	$227.58	$227.58	$141.10–$216.20	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Im Adm Prq ID Subq/Im Njxs 1 Vaccine	$75.00	$75.00	$46.50–$71.25	61% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of Influenza Virus Vaccine	$75.00	$75.00	$46.50–$71.25	61% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of Pneumococcal Vaccine	$75.00	$75.00	$46.50–$71.25	61% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Administration of Hepatitis B Vaccine	$75.00	$75.00	$46.50–$71.25	61% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Im Adm Prq ID Subq/Im Njxs 1 Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration of Hepatitis B Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration of Influenza Virus Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Administration of Pneumococcal Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Im Adm Prq ID Subq/Im Njxs Ea Vaccine	$75.00	$75.00	$46.50–$71.25	221% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Subsequent Administration of Hepatitis B Vaccine	$75.00	$75.00	$46.50–$71.25	221% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Subsequent Administration of Pneumococcal Vaccine	$75.00	$75.00	$46.50–$71.25	221% above	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Subsequent Administration of Influenza Virus Vaccine	$75.00	$75.00	$46.50–$71.25	221% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Im Adm Prq ID Subq/Im Njxs Ea Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Subsequent Administration of Pneumococcal Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Subsequent Administration of Influenza Virus Vaccine	$75.00	$75.00	$46.50–$71.25	—	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Subsequent Administration of Hepatitis B Vaccine	$75.00	$75.00	$46.50–$71.25	—	—

Source file: https://783f2ce5-aaa6-4179-b159-820a2909766e.usrfiles.com/ugd/783f2c_c5e66d3fd4114f7bb54c6bd65d593345.csv