Hospital

Redington-Fairview General Hospital

Redington-Fairview General Hospital in Skowhegan, ME publishes cash prices for 254 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 below the Maine median for 130 of 253 procedures and above it for 112. By typical cash price it ranks #15 of 27 Maine hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

46 Fairview Ave Skowhegan, ME 04976 Collected Sep 27, 2026 Source price file (207) 474-5121

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 2 of 5 CCN 201314 · CMS hospital register

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 1 action for a hospital named Redington-Fairview General Hospital in Skowhegan, ME:

Jul 21, 2026 Warning notice

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 Maine	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDEX MEAS	$112.50	$162.00	$112.50–$162.00	63% below	31%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM COMPLETE	$248.25	$358.00	$248.25–$358.00	84% below	31%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY	$416.25	$600.00	$416.25–$600.00	81% above	31%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY	$416.25	$600.00	$416.25–$600.00	—	31%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$75.75	$109.00	$75.75–$109.00	82% below	31%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS	$97.50	$140.00	$97.50–$140.00	75% below	30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$84.75	$123.00	$84.75–$123.00	75% below	31%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$58.50	$84.00	$58.50–$84.00	63% below	30%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$85.50	$124.00	$85.50–$124.00	59% below	31%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$66.00	$96.00	$66.00–$96.00	67% below	31%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$149.25	$215.00	$149.25–$215.00	24% below	31%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT	$33.75	$49.00	$33.75–$49.00	3% above	31%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Liver Fibrosis Chron Hep-84460	$36.75	$53.00	$36.75–$53.00	12% above	31%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine amino (alt) (sgpt)	$51.00	$74.00	$51.00–$74.00	55% above	31%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT	$33.75	$49.00	$33.75–$49.00	—	31%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Liver Fibrosis Chron Hep-84460	$36.75	$53.00	$36.75–$53.00	—	31%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine amino (alt) (sgpt)	$51.00	$74.00	$51.00–$74.00	—	31%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST/SGOT	$33.00	$48.00	$33.00–$48.00	12% above	31%
AST (aspartate aminotransferase) enzyme test CPT 84450 Liver Fibrosis Chron Hep-84450	$36.00	$52.00	$36.00–$52.00	23% above	31%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT	$33.00	$48.00	$33.00–$48.00	—	31%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Liver Fibrosis Chron Hep-84450	$36.00	$52.00	$36.00–$52.00	—	31%
Allergy blood test, specific IgE, per allergen CPT 86003 Food/Tree Nut Allergy Panel-86	$5.25	$7.00	$5.25–$7.00	72% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Child/Tree Nut Allergy Panel-8	$5.25	$7.00	$5.25–$7.00	72% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 CHILD ALLERGY FD/ENV-86003	$6.00	$8.00	$6.00–$8.00	69% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 NORTHEAST ALLERGY EVAL-86003	$6.00	$8.00	$6.00–$8.00	69% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE-86003	$6.00	$8.00	$6.00–$8.00	69% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Seafood Grp Allergy Pan-86003	$7.50	$10.00	$7.50–$10.00	61% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 MOLD ALLERGY PANEL-86003	$8.25	$11.00	$8.25–$11.00	57% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy, Food Profile 13-86003	$12.00	$18.00	$12.00–$18.00	37% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ADULT FOOD ALLERGY PROFI-86003	$12.00	$18.00	$12.00–$18.00	37% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY SHELLFISH PANEL-86003	$13.50	$20.00	$13.50–$20.00	29% below	33%
Allergy blood test, specific IgE, per allergen CPT 86003 MOLLUSK ALLERGEN PANEL-86003	$14.25	$21.00	$14.25–$21.00	25% below	32%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergy Profile Region 1-86003	$15.00	$22.00	$15.00–$22.00	21% below	32%
Allergy blood test, specific IgE, per allergen CPT 86003 Nut Mix Allergry Panel - 86003	$15.00	$22.00	$15.00–$22.00	21% below	32%
Allergy blood test, specific IgE, per allergen CPT 86003 CRUSTACEA ALLERGEN PANEL-86003	$17.25	$25.00	$17.25–$25.00	10% below	31%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY PANEL 13 STING-86003	$20.25	$29.00	$20.25–$29.00	6% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergilllus fumigatus IgE	$23.25	$33.00	$23.25–$33.00	22% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus niger IgE	$23.25	$33.00	$23.25–$33.00	22% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN, INDIVIDUAL IGE	$32.25	$47.00	$32.25–$47.00	69% above	31%
Allergy blood test, specific IgE, per allergen CPT 86003 Seasonal Allergy Profile-86003	$32.25	$47.00	$32.25–$47.00	69% above	31%
Allergy blood test, specific IgE, per allergen CPT 86003 NON SEASON INHALE MAYO-86003	$45.00	$64.00	$45.00–$64.00	136% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT EPITHELIUM, IGE	$54.75	$79.00	$54.75–$79.00	187% above	31%
Allergy blood test, specific IgE, per allergen CPT 86003 NUTS ALLERGN PROFILEMAYO-86003	$72.00	$104.00	$72.00–$104.00	277% above	31%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Child/Tree Nut Allergy Panel-8	$5.25	$7.00	$5.25–$7.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food/Tree Nut Allergy Panel-86	$5.25	$7.00	$5.25–$7.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILD ALLERGY FD/ENV-86003	$6.00	$8.00	$6.00–$8.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NORTHEAST ALLERGY EVAL-86003	$6.00	$8.00	$6.00–$8.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE-86003	$6.00	$8.00	$6.00–$8.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Seafood Grp Allergy Pan-86003	$7.50	$10.00	$7.50–$10.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOLD ALLERGY PANEL-86003	$8.25	$11.00	$8.25–$11.00	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ADULT FOOD ALLERGY PROFI-86003	$12.00	$18.00	$12.00–$18.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy, Food Profile 13-86003	$12.00	$18.00	$12.00–$18.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY SHELLFISH PANEL-86003	$13.50	$20.00	$13.50–$20.00	—	33%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOLLUSK ALLERGEN PANEL-86003	$14.25	$21.00	$14.25–$21.00	—	32%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nut Mix Allergry Panel - 86003	$15.00	$22.00	$15.00–$22.00	—	32%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergy Profile Region 1-86003	$15.00	$22.00	$15.00–$22.00	—	32%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRUSTACEA ALLERGEN PANEL-86003	$17.25	$25.00	$17.25–$25.00	—	31%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGY PANEL 13 STING-86003	$20.25	$29.00	$20.25–$29.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus niger IgE	$23.25	$33.00	$23.25–$33.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergilllus fumigatus IgE	$23.25	$33.00	$23.25–$33.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN, INDIVIDUAL IGE	$32.25	$47.00	$32.25–$47.00	—	31%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Seasonal Allergy Profile-86003	$32.25	$47.00	$32.25–$47.00	—	31%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NON SEASON INHALE MAYO-86003	$45.00	$64.00	$45.00–$64.00	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT EPITHELIUM, IGE	$54.75	$79.00	$54.75–$79.00	—	31%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTS ALLERGN PROFILEMAYO-86003	$72.00	$104.00	$72.00–$104.00	—	31%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$99.00	$142.00	$99.00–$142.00	48% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP	$99.00	$142.00	$99.00–$142.00	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Multiplex, Panel 1-86038	$7.50	$10.00	$7.50–$10.00	84% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$14.25	$21.00	$14.25–$21.00	70% below	32%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CONNECT TISS DISEASE PAN-86038	$57.75	$83.00	$57.75–$83.00	22% above	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$75.00	$108.00	$75.00–$108.00	59% above	31%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Multiplex, Panel 1-86038	$7.50	$10.00	$7.50–$10.00	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$14.25	$21.00	$14.25–$21.00	—	32%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CONNECT TISS DISEASE PAN-86038	$57.75	$83.00	$57.75–$83.00	—	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$75.00	$108.00	$75.00–$108.00	—	31%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PROBNP	$173.25	$250.00	$173.25–$250.00	41% above	31%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PROBNP	$173.25	$250.00	$173.25–$250.00	—	31%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$165.00	$238.00	$165.00–$238.00	106% above	31%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$165.00	$238.00	$165.00–$238.00	—	31%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 DCPA LEVEL 4 TECHNICAL	$93.75	$135.00	$93.75–$135.00	34% below	31%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 DCPA LEVEL 4 TECHNICAL	$93.75	$135.00	$93.75–$135.00	—	31%
Blood culture for bacteria CPT 87040 DEEP WOUND CULTURE-87205	$27.00	$38.00	$27.00–$38.00	69% below	29%
Blood culture for bacteria CPT 87040 BLOOD CULTURE ROUTINE X 1	$67.50	$98.00	$67.50–$98.00	23% below	31%
Blood culture for bacteria inpatient CPT 87040 DEEP WOUND CULTURE-87205	$27.00	$38.00	$27.00–$38.00	—	29%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE ROUTINE X 1	$67.50	$98.00	$67.50–$98.00	—	31%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING BLOOD SPECIMEN	$14.25	$21.00	$14.25–$21.00	16% above	32%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD COLLECTION	$14.25	$21.00	$14.25–$21.00	16% above	32%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAWING BLOOD SPECIMEN	$14.25	$21.00	$14.25–$21.00	—	32%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD COLLECTION	$14.25	$21.00	$14.25–$21.00	—	32%
Blood glucose (sugar) test CPT 82947 GLUCOSE BY GLUCOMETER	$16.50	$24.00	$16.50–$24.00	29% below	31%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$25.50	$36.00	$25.50–$36.00	10% above	29%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BY GLUCOMETER	$16.50	$24.00	$16.50–$24.00	—	31%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$25.50	$36.00	$25.50–$36.00	—	29%
Blood lead test CPT 83655 LEAD	$45.00	$64.00	$45.00–$64.00	2% above	30%
Blood lead test inpatient CPT 83655 LEAD	$45.00	$64.00	$45.00–$64.00	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 B-HCG	$151.50	$218.00	$151.50–$218.00	268% above	31%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 B-HCG	$151.50	$218.00	$151.50–$218.00	—	31%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH AND ANTIBODY SCRN-86900	$7.50	$10.00	$7.50–$10.00	85% below	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO GROUP & RH TYPE-86900	$19.50	$28.00	$19.50–$28.00	60% below	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/RH AND ANTIBODY SCRN-86900	$7.50	$10.00	$7.50–$10.00	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO GROUP & RH TYPE-86900	$19.50	$28.00	$19.50–$28.00	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$47.25	$69.00	$47.25–$69.00	33% above	32%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$47.25	$69.00	$47.25–$69.00	—	32%
C. difficile toxin gene test (stool PCR) CPT 87493 C.DIF TOX DNA BY PCR	$180.75	$261.00	$180.75–$261.00	104% above	31%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C.DIF TOX DNA BY PCR	$180.75	$261.00	$180.75–$261.00	—	31%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$219.00	$316.00	$219.00–$316.00	395% above	31%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$219.00	$316.00	$219.00–$316.00	—	31%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA125	$98.25	$141.00	$98.25–$141.00	14% above	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA125	$98.25	$141.00	$98.25–$141.00	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 QUALITATIVE NAAT	$114.00	$164.00	$114.00–$164.00	104% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2	$139.50	$201.00	$139.50–$201.00	149% above	31%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 QUALITATIVE NAAT	$114.00	$164.00	$114.00–$164.00	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2	$139.50	$201.00	$139.50–$201.00	—	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC DNA-SDA-87491	$74.25	$107.00	$74.25–$107.00	11% above	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$78.00	$112.00	$78.00–$112.00	17% above	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA DNA/PCR URI-87491	$82.50	$119.00	$82.50–$119.00	23% above	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS RNA,TMA	$82.50	$119.00	$82.50–$119.00	23% above	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA DNA BY PCR-87491	$82.50	$119.00	$82.50–$119.00	23% above	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC DNA-SDA-87491	$74.25	$107.00	$74.25–$107.00	—	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$78.00	$112.00	$78.00–$112.00	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA DNA/PCR URI-87491	$82.50	$119.00	$82.50–$119.00	—	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 GC/CHLAMYDIA DNA BY PCR-87491	$82.50	$119.00	$82.50–$119.00	—	31%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS RNA,TMA	$82.50	$119.00	$82.50–$119.00	—	31%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 ADVANCED LIPID PANEL-86001	$14.25	$21.00	$14.25–$21.00	79% below	32%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Cardio IQ Lipid Panel	$23.25	$33.00	$23.25–$33.00	66% below	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE - 80061	$120.00	$173.00	$120.00–$173.00	73% above	31%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 ADVANCED LIPID PANEL-86001	$14.25	$21.00	$14.25–$21.00	—	32%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Cardio IQ Lipid Panel	$23.25	$33.00	$23.25–$33.00	—	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE - 80061	$120.00	$173.00	$120.00–$173.00	—	31%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF	$51.00	$74.00	$51.00–$74.00	21% above	31%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF W/SCAN	$51.00	$74.00	$51.00–$74.00	21% above	31%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF	$51.00	$74.00	$51.00–$74.00	—	31%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF W/SCAN	$51.00	$74.00	$51.00–$74.00	—	31%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$30.75	$45.00	$30.75–$45.00	at median	32%
Complete blood count (CBC), no differential CPT 85027 CBC W/MANUAL DIFF - 85027	$42.75	$61.00	$42.75–$61.00	39% above	30%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$42.75	$61.00	$42.75–$61.00	39% above	30%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM W/SCAN	$65.25	$94.00	$65.25–$94.00	112% above	31%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$30.75	$45.00	$30.75–$45.00	—	32%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$42.75	$61.00	$42.75–$61.00	—	30%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/MANUAL DIFF - 85027	$42.75	$61.00	$42.75–$61.00	—	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM W/SCAN	$65.25	$94.00	$65.25–$94.00	—	31%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC P	$265.50	$354.00	$265.50–$354.00	137% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC P	$265.50	$354.00	$265.50–$354.00	—	25%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER-QUANTITATIVE	$54.75	$79.00	$54.75–$79.00	18% below	31%
D-dimer blood test (blood clot marker) CPT 85379 THROMBOPHILIA PROFILE-85379	$99.75	$144.00	$99.75–$144.00	49% above	31%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER-QUANTITATIVE	$54.75	$79.00	$54.75–$79.00	—	31%
D-dimer blood test (blood clot marker) inpatient CPT 85379 THROMBOPHILIA PROFILE-85379	$99.75	$144.00	$99.75–$144.00	—	31%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDRO-SULF	$243.00	$350.00	$243.00–$350.00	183% above	31%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDRO-SULF	$243.00	$350.00	$243.00–$350.00	—	31%
Estradiol blood test CPT 82670 Estradiol, Ultra	$28.98	$42.00	$28.98–$42.00	70% below	31%
Estradiol blood test CPT 82670 ESTRADIOL	$173.25	$250.00	$173.25–$250.00	77% above	31%
Estradiol blood test inpatient CPT 82670 Estradiol, Ultra	$28.98	$42.00	$28.98–$42.00	—	31%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$173.25	$250.00	$173.25–$250.00	—	31%
FSH (follicle-stimulating hormone) test CPT 83001 Egg Whole IgG4	$43.50	$62.00	$43.50–$62.00	45% below	30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH (S)	$87.00	$126.00	$87.00–$126.00	10% above	31%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Egg Whole IgG4	$43.50	$62.00	$43.50–$62.00	—	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH (S)	$87.00	$126.00	$87.00–$126.00	—	31%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN-STOOL	$173.25	$250.00	$173.25–$250.00	14% above	31%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN-STOOL	$173.25	$250.00	$173.25–$250.00	—	31%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$89.25	$129.00	$89.25–$129.00	28% above	31%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$89.25	$129.00	$89.25–$129.00	—	31%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$67.50	$98.00	$67.50–$98.00	1% below	31%
Folate (folic acid) blood test CPT 82746 FOLATE	$67.50	$98.00	$67.50–$98.00	1% below	31%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$67.50	$98.00	$67.50–$98.00	—	31%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$67.50	$98.00	$67.50–$98.00	—	31%
Free T3 thyroid hormone test CPT 84481 FREE T3	$245.25	$354.00	$245.25–$354.00	224% above	31%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$245.25	$354.00	$245.25–$354.00	—	31%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE, FREE	$39.00	$56.00	$39.00–$56.00	29% below	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$99.00	$142.00	$99.00–$142.00	80% above	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE, FREE	$39.00	$56.00	$39.00–$56.00	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$99.00	$142.00	$99.00–$142.00	—	30%
Free testosterone test CPT 84402 TESTOSTERONE - FREE	$228.75	$330.00	$228.75–$330.00	175% above	31%
Free testosterone test inpatient CPT 84402 TESTOSTERONE - FREE	$228.75	$330.00	$228.75–$330.00	—	31%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 1 HOUR PC	$37.50	$54.00	$37.50–$54.00	2% above	31%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 1 HOUR PC	$37.50	$54.00	$37.50–$54.00	—	31%
Glucose tolerance test, 3 samples CPT 82951 GTT 2 Hour	$55.50	$80.00	$55.50–$80.00	13% below	31%
Glucose tolerance test, 3 samples CPT 82951 GTT3G - 82591	$77.25	$111.00	$77.25–$111.00	21% above	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 2 Hour	$55.50	$80.00	$55.50–$80.00	—	31%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT3G - 82591	$77.25	$111.00	$77.25–$111.00	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC-URINE	$47.25	$69.00	$47.25–$69.00	14% below	32%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHLAMYDIA/GC DNA-SDA-87591	$74.25	$107.00	$74.25–$107.00	36% above	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA DNA BY PCR-87591	$82.50	$119.00	$82.50–$119.00	51% above	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE RNA, TMA	$82.50	$119.00	$82.50–$119.00	51% above	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA DNA/PCR URI-87591	$82.50	$119.00	$82.50–$119.00	51% above	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC-URINE	$47.25	$69.00	$47.25–$69.00	—	32%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHLAMYDIA/GC DNA-SDA-87591	$74.25	$107.00	$74.25–$107.00	—	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMYDIA DNA/PCR URI-87591	$82.50	$119.00	$82.50–$119.00	—	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE RNA, TMA	$82.50	$119.00	$82.50–$119.00	—	31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC/CHLAMYDIA DNA BY PCR-87591	$82.50	$119.00	$82.50–$119.00	—	31%
H. pylori antibody blood test CPT 86677 HELICOBACTERPYLORI AB	$70.50	$102.00	$70.50–$102.00	4% below	31%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTERPYLORI AB	$70.50	$102.00	$70.50–$102.00	—	31%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI AG, S	$183.00	$264.00	$183.00–$264.00	59% above	31%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI AG, S	$183.00	$264.00	$183.00–$264.00	—	31%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA (QUANT), PCR	$471.00	$679.00	$471.00–$679.00	150% above	31%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA (QUANT), PCR	$471.00	$679.00	$471.00–$679.00	—	31%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HTL-V3	$38.25	$55.00	$38.25–$55.00	at median	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/2 Ag/Ab, 4th Generation	$63.75	$92.00	$63.75–$92.00	67% above	31%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HTL-V3	$38.25	$55.00	$38.25–$55.00	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/2 Ag/Ab, 4th Generation	$63.75	$92.00	$63.75–$92.00	—	31%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 RECTAL	$40.50	$58.00	$40.50–$58.00	43% below	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 DCPA HPV DNA TEST	$69.75	$101.00	$69.75–$101.00	2% below	31%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 RECTAL	$40.50	$58.00	$40.50–$58.00	—	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 DCPA HPV DNA TEST	$69.75	$101.00	$69.75–$101.00	—	31%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Cardio IQ Hemoglobin A1c	$22.50	$32.00	$22.50–$32.00	44% below	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHGB	$63.75	$92.00	$63.75–$92.00	58% above	31%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN	$63.75	$92.00	$63.75–$92.00	58% above	31%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Cardio IQ Hemoglobin A1c	$22.50	$32.00	$22.50–$32.00	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHGB	$63.75	$92.00	$63.75–$92.00	—	31%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN	$63.75	$92.00	$63.75–$92.00	—	31%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURF ANTIGEN	$55.50	$80.00	$55.50–$80.00	19% above	31%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURF ANTIGEN	$55.50	$80.00	$55.50–$80.00	—	31%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$123.00	$178.00	$123.00–$178.00	81% above	31%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$123.00	$178.00	$123.00–$178.00	—	31%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL RNA BY PCR	$126.00	$182.00	$126.00–$182.00	27% below	31%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA PCR, QUANT	$377.25	$544.00	$377.25–$544.00	119% above	31%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL RNA BY PCR	$126.00	$182.00	$126.00–$182.00	—	31%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA PCR, QUANT	$377.25	$544.00	$377.25–$544.00	—	31%
Herpes blood test, HSV-1 antibody CPT 86695 Encephalitis Ab Panel CSF86695	$20.25	$29.00	$20.25–$29.00	57% below	30%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX-IGM-86695	$33.75	$49.00	$33.75–$49.00	28% below	31%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX IGG-86695	$69.00	$100.00	$69.00–$100.00	48% above	31%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Encephalitis Ab Panel CSF86695	$20.25	$29.00	$20.25–$29.00	—	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX-IGM-86695	$33.75	$49.00	$33.75–$49.00	—	31%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX IGG-86695	$69.00	$100.00	$69.00–$100.00	—	31%
Herpes blood test, HSV-2 antibody CPT 86696 Encephalitis Ab Panel CSF86696	$20.25	$29.00	$20.25–$29.00	67% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX-IGM-86696	$33.75	$49.00	$33.75–$49.00	46% below	31%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX IGG-86696	$69.00	$100.00	$69.00–$100.00	11% above	31%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG INHIBITION	$137.25	$198.00	$137.25–$198.00	121% above	31%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Encephalitis Ab Panel CSF86696	$20.25	$29.00	$20.25–$29.00	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX-IGM-86696	$33.75	$49.00	$33.75–$49.00	—	31%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX IGG-86696	$69.00	$100.00	$69.00–$100.00	—	31%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG INHIBITION	$137.25	$198.00	$137.25–$198.00	—	31%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP, HIGH SENSITIVITY	$74.25	$107.00	$74.25–$107.00	52% above	31%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP, HIGH SENSITIVITY	$74.25	$107.00	$74.25–$107.00	—	31%
Homocysteine blood test CPT 83090 THROMBOTIC RISK REFLX PL-83090	$28.50	$42.00	$28.50–$42.00	58% below	32%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$358.50	$517.00	$358.50–$517.00	434% above	31%
Homocysteine blood test inpatient CPT 83090 THROMBOTIC RISK REFLX PL-83090	$28.50	$42.00	$28.50–$42.00	—	32%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$358.50	$517.00	$358.50–$517.00	—	31%
Insulin blood test CPT 83525 Copper,Blood	$40.71	$59.00	$40.71–$59.00	18% below	31%
Insulin blood test CPT 83525 INSULIN	$69.75	$101.00	$69.75–$101.00	41% above	31%
Insulin blood test inpatient CPT 83525 Copper,Blood	$40.71	$59.00	$40.71–$59.00	—	31%
Insulin blood test inpatient CPT 83525 INSULIN	$69.75	$101.00	$69.75–$101.00	—	31%
Iron blood test (serum iron) CPT 83540 IRON	$42.75	$61.00	$42.75–$61.00	32% above	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$42.75	$61.00	$42.75–$61.00	—	30%
Kidney function blood test panel CPT 80069 KIDNEY PANEL	$113.25	$163.00	$113.25–$163.00	69% above	31%
Kidney function blood test panel inpatient CPT 80069 KIDNEY PANEL	$113.25	$163.00	$113.25–$163.00	—	31%
LH (luteinizing hormone) test CPT 83002 LH (S)	$99.00	$142.00	$99.00–$142.00	19% above	30%
LH (luteinizing hormone) test inpatient CPT 83002 LH (S)	$99.00	$142.00	$99.00–$142.00	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$45.75	$66.00	$45.75–$66.00	4% above	31%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-BODY FLUID	$52.50	$76.00	$52.50–$76.00	19% above	31%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$45.75	$66.00	$45.75–$66.00	—	31%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-BODY FLUID	$52.50	$76.00	$52.50–$76.00	—	31%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$83.25	$120.00	$83.25–$120.00	at median	31%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$83.25	$120.00	$83.25–$120.00	—	31%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODIES	$41.25	$59.00	$41.25–$59.00	42% below	30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODIES	$41.25	$59.00	$41.25–$59.00	—	30%
Magnesium blood test CPT 83735 STONE RISK DIAG PROFILE-83735	$10.50	$16.00	$10.50–$16.00	74% below	34%
Magnesium blood test CPT 83735 Magnesium, Urine 24 Hour	$30.00	$44.00	$30.00–$44.00	25% below	32%
Magnesium blood test CPT 83735 MAGNESIUM	$44.25	$63.00	$44.25–$63.00	10% above	30%
Magnesium blood test CPT 83735 MG RBC	$44.25	$63.00	$44.25–$63.00	10% above	30%
Magnesium blood test inpatient CPT 83735 STONE RISK DIAG PROFILE-83735	$10.50	$16.00	$10.50–$16.00	—	34%
Magnesium blood test inpatient CPT 83735 Magnesium, Urine 24 Hour	$30.00	$44.00	$30.00–$44.00	—	32%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$44.25	$63.00	$44.25–$63.00	—	30%
Magnesium blood test inpatient CPT 83735 MG RBC	$44.25	$63.00	$44.25–$63.00	—	30%
Measles (rubeola) antibody test CPT 86765 Encephalitis Ab Panel CSF86765	$20.25	$29.00	$20.25–$29.00	36% below	30%
Measles (rubeola) antibody test CPT 86765 MEASLES IGG AB	$47.25	$69.00	$47.25–$69.00	48% above	32%
Measles (rubeola) antibody test CPT 86765 MEASLES IGM AB	$102.75	$148.00	$102.75–$148.00	223% above	31%
Measles (rubeola) antibody test inpatient CPT 86765 Encephalitis Ab Panel CSF86765	$20.25	$29.00	$20.25–$29.00	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGG AB	$47.25	$69.00	$47.25–$69.00	—	32%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES IGM AB	$102.75	$148.00	$102.75–$148.00	—	31%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$33.00	$48.00	$33.00–$48.00	5% below	31%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$33.00	$48.00	$33.00–$48.00	—	31%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE & TOTAL-84154	$160.50	$232.00	$160.50–$232.00	82% above	31%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE & TOTAL-84154	$160.50	$232.00	$160.50–$232.00	—	31%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL DIAGNOSTIC	$78.00	$112.00	$78.00–$112.00	29% above	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, FREE & TOTAL-84153	$78.00	$112.00	$78.00–$112.00	29% above	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, FREE & TOTAL-84153	$78.00	$112.00	$78.00–$112.00	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL DIAGNOSTIC	$78.00	$112.00	$78.00–$112.00	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 DCPA SUREPATH PAP TEST	$65.25	$94.00	$65.25–$94.00	at median	31%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 DCPA SUREPATH PAP TEST	$65.25	$94.00	$65.25–$94.00	—	31%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR, LIQUID PREP	$65.25	$94.00	$65.25–$94.00	4% below	31%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR, LIQUID PREP	$65.25	$94.00	$65.25–$94.00	—	31%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$24.75	$35.00	$24.75–$35.00	73% below	29%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT W/O CALCIUM	$49.50	$72.00	$49.50–$72.00	46% below	31%
Parathyroid hormone (PTH) blood test CPT 83970 PTH	$369.00	$532.00	$369.00–$532.00	305% above	31%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$24.75	$35.00	$24.75–$35.00	—	29%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT W/O CALCIUM	$49.50	$72.00	$49.50–$72.00	—	31%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH	$369.00	$532.00	$369.00–$532.00	—	31%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOTIC RISK REFLX PL-85730	$28.50	$42.00	$28.50–$42.00	26% below	32%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT (HEPARIN)	$39.75	$57.00	$39.75–$57.00	3% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT	$39.75	$57.00	$39.75–$57.00	3% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG PROFILE-85730	$42.75	$61.00	$42.75–$61.00	10% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAG-85730	$44.25	$63.00	$44.25–$63.00	14% above	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$54.00	$78.00	$54.00–$78.00	40% above	31%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPHILIA PROFILE-85730	$99.75	$144.00	$99.75–$144.00	158% above	31%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOTIC RISK REFLX PL-85730	$28.50	$42.00	$28.50–$42.00	—	32%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT (HEPARIN)	$39.75	$57.00	$39.75–$57.00	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT	$39.75	$57.00	$39.75–$57.00	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG PROFILE-85730	$42.75	$61.00	$42.75–$61.00	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAG-85730	$44.25	$63.00	$44.25–$63.00	—	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$54.00	$78.00	$54.00–$78.00	—	31%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPHILIA PROFILE-85730	$99.75	$144.00	$99.75–$144.00	—	31%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 THROMBOPHILIA PROFILE-81420	$99.75	$144.00	$99.75–$144.00	91% below	31%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 QNATAL ADVANCED	$683.25	$985.00	$683.25–$985.00	35% below	31%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 THROMBOPHILIA PROFILE-81420	$99.75	$144.00	$99.75–$144.00	—	31%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 QNATAL ADVANCED	$683.25	$985.00	$683.25–$985.00	—	31%
Progesterone blood test CPT 84144 PROGESTERONE	$127.50	$184.00	$127.50–$184.00	47% above	31%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$127.50	$184.00	$127.50–$184.00	—	31%
Prolactin blood test CPT 84146 Macroprolactin-84146	$49.50	$72.00	$49.50–$72.00	33% below	31%
Prolactin blood test CPT 84146 PROLACTIN	$120.75	$174.00	$120.75–$174.00	64% above	31%
Prolactin blood test CPT 84146 PROLACTIN TTL & MONOMERIC	$129.00	$186.00	$129.00–$186.00	76% above	31%
Prolactin blood test inpatient CPT 84146 Macroprolactin-84146	$49.50	$72.00	$49.50–$72.00	—	31%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$120.75	$174.00	$120.75–$174.00	—	31%
Prolactin blood test inpatient CPT 84146 PROLACTIN TTL & MONOMERIC	$129.00	$186.00	$129.00–$186.00	—	31%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$25.50	$36.00	$25.50–$36.00	9% below	29%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME WITH INR	$25.50	$36.00	$25.50–$36.00	9% below	29%
Prothrombin time (PT/INR) clotting test CPT 85610 POINT OF CARE INR	$25.50	$36.00	$25.50–$36.00	9% below	29%
Prothrombin time (PT/INR) clotting test CPT 85610 THROMBOTIC RISK REFLX PL-85610	$28.50	$42.00	$28.50–$42.00	2% above	32%
Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAG PROFILE-85610	$42.75	$61.00	$42.75–$61.00	53% above	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$54.00	$78.00	$54.00–$78.00	93% above	31%
Prothrombin time (PT/INR) clotting test CPT 85610 THROMBOPHILIA PROFILE-85610	$99.75	$144.00	$99.75–$144.00	256% above	31%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME WITH INR	$25.50	$36.00	$25.50–$36.00	—	29%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$25.50	$36.00	$25.50–$36.00	—	29%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 POINT OF CARE INR	$25.50	$36.00	$25.50–$36.00	—	29%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 THROMBOTIC RISK REFLX PL-85610	$28.50	$42.00	$28.50–$42.00	—	32%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAG PROFILE-85610	$42.75	$61.00	$42.75–$61.00	—	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$54.00	$78.00	$54.00–$78.00	—	31%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 THROMBOPHILIA PROFILE-85610	$99.75	$144.00	$99.75–$144.00	—	31%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREPT SCREEN	$75.00	$108.00	$75.00–$108.00	89% above	31%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREPT SCREEN	$75.00	$108.00	$75.00–$108.00	—	31%
Rheumatoid factor (RF) test CPT 86431 ANA Multiplex, Panel 1-86431	$7.50	$10.00	$7.50–$10.00	77% below	25%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$49.50	$72.00	$49.50–$72.00	54% above	31%
Rheumatoid factor (RF) test inpatient CPT 86431 ANA Multiplex, Panel 1-86431	$7.50	$10.00	$7.50–$10.00	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$49.50	$72.00	$49.50–$72.00	—	31%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$95.25	$137.00	$95.25–$137.00	163% above	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$95.25	$137.00	$95.25–$137.00	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDRATE	$23.25	$33.00	$23.25–$33.00	25% below	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDRATE	$23.25	$33.00	$23.25–$33.00	—	30%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS FERTILITY	$78.00	$112.00	$78.00–$112.00	at median	30%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS FERTILITY	$78.00	$112.00	$78.00–$112.00	—	30%
Stool ova and parasites exam CPT 87177 OVA & PARASITES TOTAL X1-87177	$20.25	$29.00	$20.25–$29.00	36% below	30%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES TOTAL X1-87177	$20.25	$29.00	$20.25–$29.00	—	30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD STOOL 2-3	$21.75	$31.00	$21.75–$31.00	18% above	30%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD STOOL 2-3	$21.75	$31.00	$21.75–$31.00	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 IMMUNOCHEM FECAL OB	$37.50	$54.00	$37.50–$54.00	17% below	31%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 IMMUNOCHEM FECAL OB	$37.50	$54.00	$37.50–$54.00	—	31%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Screen	$27.00	$38.00	$27.00–$38.00	7% below	29%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$27.00	$38.00	$27.00–$38.00	7% below	29%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL-S	$45.00	$64.00	$45.00–$64.00	55% above	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Screen	$27.00	$38.00	$27.00–$38.00	—	29%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$27.00	$38.00	$27.00–$38.00	—	29%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL-S	$45.00	$64.00	$45.00–$64.00	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$162.75	$235.00	$162.75–$235.00	53% above	31%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$162.75	$235.00	$162.75–$235.00	—	31%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (S)	$34.50	$50.00	$34.50–$50.00	56% below	31%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, SERUM	$172.50	$249.00	$172.50–$249.00	121% above	31%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE (S)	$34.50	$50.00	$34.50–$50.00	—	31%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, SERUM	$172.50	$249.00	$172.50–$249.00	—	31%
Thyroid peroxidase (TPO) antibody test CPT 86376 CHRONIC URTICARIA PANEL-86376	$27.75	$40.00	$27.75–$40.00	62% below	31%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY	$87.00	$126.00	$87.00–$126.00	18% above	31%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LKM(LIVER/KIDNEY)MIC	$117.00	$168.00	$117.00–$168.00	58% above	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER CYTOSOL AUTOANTIBOD	$169.50	$244.00	$169.50–$244.00	129% above	31%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 CHRONIC URTICARIA PANEL-86376	$27.75	$40.00	$27.75–$40.00	—	31%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY	$87.00	$126.00	$87.00–$126.00	—	31%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-LKM(LIVER/KIDNEY)MIC	$117.00	$168.00	$117.00–$168.00	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER CYTOSOL AUTOANTIBOD	$169.50	$244.00	$169.50–$244.00	—	31%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHRONIC URITICARIA PANEL-84443	$27.75	$40.00	$27.75–$40.00	61% below	31%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMO	$110.25	$159.00	$110.25–$159.00	54% above	31%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHRONIC URITICARIA PANEL-84443	$27.75	$40.00	$27.75–$40.00	—	31%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMO	$110.25	$159.00	$110.25–$159.00	—	31%
Trichomonas test (NAAT) CPT 87661 VAGINITIS PANEL TMA-87661	$69.75	$101.00	$69.75–$101.00	18% below	31%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALS RNA	$138.00	$199.00	$138.00–$199.00	62% above	31%
Trichomonas test (NAAT) inpatient CPT 87661 VAGINITIS PANEL TMA-87661	$69.75	$101.00	$69.75–$101.00	—	31%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALS RNA	$138.00	$199.00	$138.00–$199.00	—	31%
Uric acid blood test CPT 84550 URIC ACID	$28.50	$42.00	$28.50–$42.00	at median	32%
Uric acid blood test inpatient CPT 84550 URIC ACID	$28.50	$42.00	$28.50–$42.00	—	32%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS	$6.75	$9.00	$6.75–$9.00	80% below	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS	$6.75	$9.00	$6.75–$9.00	—	25%
Urinalysis without microscope exam, automated CPT 81003 DIPSTICK URINE	$15.75	$23.00	$15.75–$23.00	17% below	32%
Urinalysis without microscope exam, automated inpatient CPT 81003 DIPSTICK URINE	$15.75	$23.00	$15.75–$23.00	—	32%
Urinalysis without microscope exam, manual CPT 81002 REDUCING SUBSTANCES URINE	$28.50	$42.00	$28.50–$42.00	81% above	32%
Urinalysis without microscope exam, manual inpatient CPT 81002 REDUCING SUBSTANCES URINE	$28.50	$42.00	$28.50–$42.00	—	32%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST, URINE	$42.00	$60.00	$42.00–$60.00	50% above	30%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST, URINE	$42.00	$60.00	$42.00–$60.00	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$97.50	$140.00	$97.50–$140.00	20% above	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$97.50	$140.00	$97.50–$140.00	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITROS 25-OH VITAMIN D	$183.75	$265.00	$183.75–$265.00	82% above	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYD-VIT D	$183.75	$265.00	$183.75–$265.00	82% above	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYD-VIT D	$183.75	$265.00	$183.75–$265.00	—	31%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITROS 25-OH VITAMIN D	$183.75	$265.00	$183.75–$265.00	—	31%
Zinc blood test CPT 84630 ZINC	$66.75	$97.00	$66.75–$97.00	81% above	31%
Zinc blood test CPT 84630 ZINC, RBC	$158.25	$228.00	$158.25–$228.00	329% above	31%
Zinc blood test inpatient CPT 84630 ZINC	$66.75	$97.00	$66.75–$97.00	—	31%
Zinc blood test inpatient CPT 84630 ZINC, RBC	$158.25	$228.00	$158.25–$228.00	—	31%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER	$21.75	$31.00	$21.75–$31.00	67% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 SEQ INTERGRATED SCRN PT2-84702	$36.00	$52.00	$36.00–$52.00	45% below	31%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QUAD SCREEN-84702	$46.50	$67.00	$46.50–$67.00	30% below	31%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 INTEGRATED SCREEN PART 2-84702	$72.00	$104.00	$72.00–$104.00	9% above	31%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 SEQ INT SCRN PART 1-84702	$81.75	$118.00	$81.75–$118.00	24% above	31%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG TOTAL	$98.25	$141.00	$98.25–$141.00	49% above	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER	$21.75	$31.00	$21.75–$31.00	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 SEQ INTERGRATED SCRN PT2-84702	$36.00	$52.00	$36.00–$52.00	—	31%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 QUAD SCREEN-84702	$46.50	$67.00	$46.50–$67.00	—	31%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 INTEGRATED SCREEN PART 2-84702	$72.00	$104.00	$72.00–$104.00	—	31%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 SEQ INT SCRN PART 1-84702	$81.75	$118.00	$81.75–$118.00	—	31%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG TOTAL	$98.25	$141.00	$98.25–$141.00	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRANE	$174.00	$251.00	$174.00–$251.00	at median	31%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HOSP TREATMENT OF ANKLE FRACT	$468.75	$676.00	$468.75–$676.00	70% above	31%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACT	$468.75	$676.00	$468.75–$676.00	70% above	31%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HOSP TREATMENT OF ANKLE FRACT	$468.75	$676.00	$468.75–$676.00	—	31%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HOSP TREAT METATARSAL FRAC FOO	$334.50	$483.00	$334.50–$483.00	44% above	31%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRAC FOOT	$334.50	$483.00	$334.50–$483.00	44% above	31%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HOSP TREAT METATARSAL FRAC FOO	$334.50	$483.00	$334.50–$483.00	—	31%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 HOSP CORRECTION HALLUX VALGUS	$1,261.50	$1,819.00	$1,261.50–$1,819.00	24% below	31%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 HOSP CORRECTION HALLUX VALGUS	$1,261.50	$1,819.00	$1,261.50–$1,819.00	—	31%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HOSP CARDIOVERSION ELECTRICEXT	$270.75	$390.00	$270.75–$390.00	43% below	31%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$487.50	$757.00	$487.50–$757.00	3% above	36%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HOSP CARDIOVERSION ELECTRICEXT	$270.75	$390.00	$270.75–$390.00	—	31%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$487.50	$757.00	$487.50–$757.00	—	36%
Carpal tunnel release, open surgery CPT 64721 HOSP CARPAL TUNNEL SURGERY	$1,271.25	$1,834.00	$1,271.25–$1,834.00	27% above	31%
Carpal tunnel release, open surgery inpatient CPT 64721 HOSP CARPAL TUNNEL SURGERY	$1,271.25	$1,834.00	$1,271.25–$1,834.00	—	31%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$132.00	$190.00	$132.00–$190.00	72% below	31%
Cervical biopsy CPT 57500 HOSP BIOPSY OF CERVIX	$132.00	$190.00	$132.00–$190.00	72% below	31%
Cervical biopsy inpatient CPT 57500 HOSP BIOPSY OF CERVIX	$132.00	$190.00	$132.00–$190.00	—	31%
Cesarean delivery, including prenatal and postpartum care CPT 59510 HOSP CESAREAN DELIVERY GLOBAL	$6,410.25	$9,245.00	$6,410.25–$9,245.00	76% above	31%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 HOSP CESAREAN DELIVERY GLOBAL	$6,410.25	$9,245.00	$6,410.25–$9,245.00	—	31%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 HOSP CIRCUMCISION >28 DAYS OLD	$297.75	$430.00	$297.75–$430.00	63% below	31%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 HOSP CIRCUMCISION >28 DAYS OLD	$297.75	$430.00	$297.75–$430.00	—	31%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGI BLOCK	$114.00	$164.00	$114.00–$164.00	60% below	30%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 HOSP CIRCUMCISION W/REG BLOCK	$251.25	$362.00	$251.25–$362.00	11% below	31%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 HOSP CIRCUMCISION W/REG BLOCK	$251.25	$362.00	$251.25–$362.00	—	31%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HOSP TREAT FX RADIUS/ULNA	$429.00	$619.00	$429.00–$619.00	65% above	31%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FX RADIUS/UNLA	$429.00	$619.00	$429.00–$619.00	65% above	31%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HOSP TREAT FX RADIUS/ULNA	$429.00	$619.00	$429.00–$619.00	—	31%
Colonoscopy with polyp removal CPT 45385 HOSP LESION REMOVAL COLONOSCOP	$1,716.75	$2,476.00	$1,716.75–$2,476.00	18% above	31%
Colonoscopy with polyp removal inpatient CPT 45385 HOSP LESION REMOVAL COLONOSCOP	$1,716.75	$2,476.00	$1,716.75–$2,476.00	—	31%
Colonoscopy with tissue sample CPT 45380 HOSP COLONOSCOPY AND BIOPSY	$1,526.25	$2,201.00	$1,526.25–$2,201.00	5% above	31%
Colonoscopy with tissue sample inpatient CPT 45380 HOSP COLONOSCOPY AND BIOPSY	$1,526.25	$2,201.00	$1,526.25–$2,201.00	—	31%
Colonoscopy, diagnostic CPT 45378 HOSP DIAGNOSTIC COLONOSCOPY	$1,263.75	$1,822.00	$1,263.75–$1,822.00	11% above	31%
Colonoscopy, diagnostic inpatient CPT 45378 HOSP DIAGNOSTIC COLONOSCOPY	$1,263.75	$1,822.00	$1,263.75–$1,822.00	—	31%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 HOSP BX OF CERVIX W/SCOPE,LEEP	$303.75	$438.00	$303.75–$438.00	55% below	31%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE,LEEP	$303.75	$438.00	$303.75–$438.00	55% below	31%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 HOSP BX OF CERVIX W/SCOPE,LEEP	$303.75	$438.00	$303.75–$438.00	—	31%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCO	$250.50	$361.00	$250.50–$361.00	25% above	31%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HOSP BX/CURETT CERVIX W/SCOPE	$250.50	$361.00	$250.50–$361.00	25% above	31%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HOSP BX/CURETT CERVIX W/SCOPE	$250.50	$361.00	$250.50–$361.00	—	31%
Cystoscopy with ureteral stent placement CPT 52332 HOSP CYSTOSCOPY AND TREATMENT	$723.75	$1,044.00	$723.75–$1,044.00	82% below	31%
Cystoscopy with ureteral stent placement inpatient CPT 52332 HOSP CYSTOSCOPY AND TREATMENT	$723.75	$1,044.00	$723.75–$1,044.00	—	31%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY OFFICE	$313.50	$452.00	$313.50–$452.00	32% below	31%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 HOSP CYSTOSCOPY	$313.50	$452.00	$313.50–$452.00	32% below	31%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 HOSP CYSTOSCOPY	$313.50	$452.00	$313.50–$452.00	—	31%
D&C (dilation and curettage), not related to pregnancy CPT 58120 HOSP DILATION & CURETTAGE	$807.75	$1,165.00	$807.75–$1,165.00	49% below	31%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 HOSP DILATION & CURETTAGE	$807.75	$1,165.00	$807.75–$1,165.00	—	31%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT 1ST PRE-MALG LES	$82.50	$146.00	$82.50–$146.00	10% below	43%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 CANALITH REPOSITIONING PROC	$82.80	$120.00	$82.80–$120.00	10% below	31%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 CANALITH REPOSITIONING PROC	$82.80	$120.00	$82.80–$120.00	—	31%
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR LAVAGE INDIRECT	$39.33	$57.00	$39.33–$57.00	13% below	31%
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR LAVAGE-NURSING	$39.75	$53.00	$39.75–$53.00	12% below	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR LAVAGE INDIRECT	$39.33	$57.00	$39.33–$57.00	—	31%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR LAVAGE-NURSING	$39.75	$53.00	$39.75–$53.00	—	25%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$150.75	$217.00	$150.75–$217.00	167% above	31%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HOSP BIOPSY OF UTERUS LINING	$153.00	$220.00	$153.00–$220.00	14% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY UTERUS LINING	$153.00	$220.00	$153.00–$220.00	14% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HOSP BIOPSY OF UTERUS LINING	$153.00	$220.00	$153.00–$220.00	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NERVE INJ INERLAMINAR C/T	$376.50	$543.00	$376.50–$543.00	53% below	31%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NERVE INJ INERLAMINAR C/T	$376.50	$543.00	$376.50–$543.00	53% below	31%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 EPIDURAL CER/THOR W/ FLUR	$1,353.00	$1,951.00	$1,353.00–$1,951.00	69% above	31%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NERVE INJ INERLAMINAR C/T	$376.50	$543.00	$376.50–$543.00	—	31%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 EPIDURAL CER/THOR W/ FLUR	$1,353.00	$1,951.00	$1,353.00–$1,951.00	—	31%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT JNT L/S 1 LV	$271.50	$391.00	$271.50–$391.00	70% below	31%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT JNT L/S 1 LV BIL	$271.50	$391.00	$271.50–$391.00	70% below	31%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ BACK FAC L/S PRIMARY	$1,393.50	$2,009.00	$1,393.50–$2,009.00	56% above	31%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT JNT L/S 1 LV BIL	$271.50	$391.00	$271.50–$391.00	—	31%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ BACK FAC L/S PRIMARY	$1,393.50	$2,009.00	$1,393.50–$2,009.00	—	31%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 HOSP RPR AA HRN 1ST 3-10 RDC	$1,698.75	$2,450.00	$1,698.75–$2,450.00	9% above	31%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 HOSP RPR AA HRN 1ST 3-10 RDC	$1,698.75	$2,450.00	$1,698.75–$2,450.00	—	31%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 HOSP RPR AA HRN 1ST > 10 RDC	$2,541.75	$3,666.00	$2,541.75–$3,666.00	51% above	31%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 HOSP RPR AA HRN 1ST > 10 RDC	$2,541.75	$3,666.00	$2,541.75–$3,666.00	—	31%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 HOSP RPR AA HRN 1ST < 3 CM RDC	$1,014.75	$1,463.00	$1,014.75–$1,463.00	15% above	31%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 HOSP RPR AA HRN 1ST < 3 CM RDC	$1,014.75	$1,463.00	$1,014.75–$1,463.00	—	31%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HOSP DIAGNOSTIC SIGMOIDOSCOPY	$435.00	$627.00	$435.00–$627.00	at median	31%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HOSP DIAGNOSTIC SIGMOIDOSCOPY	$435.00	$627.00	$435.00–$627.00	—	31%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTERO	$2,244.75	$3,238.00	$2,244.75–$3,238.00	at median	31%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTERO	$2,244.75	$3,238.00	$2,244.75–$3,238.00	—	31%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GR	$2,283.00	$3,293.00	$2,283.00–$3,293.00	39% above	31%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GR	$2,283.00	$3,293.00	$2,283.00–$3,293.00	—	31%
Gallbladder removal, open surgery through a larger incision CPT 47600 HOSP REMOVAL OF GALLBLADDER	$3,222.75	$4,648.00	$3,222.75–$4,648.00	24% above	31%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 HOSP REMOVAL OF GALLBLADDER	$3,222.75	$4,648.00	$3,222.75–$4,648.00	—	31%
Hammertoe correction surgery CPT 28285 HOSP REPAIR OF HAMMERTOE	$854.25	$1,232.00	$854.25–$1,232.00	12% below	31%
Hammertoe correction surgery inpatient CPT 28285 HOSP REPAIR OF HAMMERTOE	$854.25	$1,232.00	$854.25–$1,232.00	—	31%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOID BANDING	$413.25	$596.00	$413.25–$596.00	45% below	31%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOID BANDING	$413.25	$596.00	$413.25–$596.00	—	31%
Hemorrhoidectomy (internal and external), one area CPT 46255 HOSP HEMORRHOIDECTOMY	$1,443.00	$2,081.00	$1,443.00–$2,081.00	17% above	31%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HOSP HEMORRHOIDECTOMY	$1,443.00	$2,081.00	$1,443.00–$2,081.00	—	31%
Hysterectomy through an abdominal incision (total) CPT 58150 HOSP TOTAL HYSTERECTOMY	$3,127.50	$4,510.00	$3,127.50–$4,510.00	44% above	31%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 HOSP TOTAL HYSTERECTOMY	$3,127.50	$4,510.00	$3,127.50–$4,510.00	—	31%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HOSP CATHETER FOR HYSTEROGRAPH	$377.25	$544.00	$377.25–$544.00	63% above	31%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HOSP CATHETER FOR HYSTEROGRAPH	$377.25	$544.00	$377.25–$544.00	—	31%
Hysteroscopy with endometrial ablation CPT 58563 HOSP HYSTEROSCOPY, ABLATION	$2,682.75	$3,869.00	$2,682.75–$3,869.00	52% above	31%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HOSP HYSTEROSCOPY, ABLATION	$2,682.75	$3,869.00	$2,682.75–$3,869.00	—	31%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HOSP HYSTEROSCOPY, BIOPSY	$1,113.75	$1,606.00	$1,113.75–$1,606.00	at median	31%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$1,113.75	$1,606.00	$1,113.75–$1,606.00	at median	31%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HOSP HYSTEROSCOPY, BIOPSY	$1,113.75	$1,606.00	$1,113.75–$1,606.00	—	31%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS	$135.00	$228.00	$135.00–$228.00	10% below	41%
Incision and drainage of a simple or single skin abscess CPT 10060 HOSP DRAINAGE OF SKIN ABSCESS	$135.00	$228.00	$135.00–$228.00	10% below	41%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HOSP DRAINAGE OF SKIN ABSCESS	$135.00	$228.00	$135.00–$228.00	—	41%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HOSP PRP I/HERN INIT REDUC >5	$1,562.25	$2,253.00	$1,562.25–$2,253.00	16% above	31%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HOSP PRP I/HERN INIT REDUC >5	$1,562.25	$2,253.00	$1,562.25–$2,253.00	—	31%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMEN	$102.75	$251.00	$102.75–$251.00	38% below	59%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON SHEATH/LIGAME	$102.75	$148.00	$102.75–$148.00	38% below	31%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HOSP INJ TENDON SHEATH/LIGAMNT	$102.75	$148.00	$102.75–$148.00	38% below	31%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HOSP INJ TENDON SHEATH/LIGAMNT	$102.75	$148.00	$102.75–$148.00	—	31%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON SHEATH/LIGAME	$102.75	$148.00	$102.75–$148.00	—	31%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JNT/BURSA W/O US LRG	$93.75	$135.00	$93.75–$135.00	51% below	31%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HOSP DRAIN/INJ JNT/BUR W/O U L	$93.75	$135.00	$93.75–$135.00	51% below	31%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$129.75	$187.00	$129.75–$187.00	32% below	31%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JNT/BURSA W/O US LRG	$187.50	$250.00	$187.50–$250.00	2% below	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HOSP DRAIN/INJ JNT/BUR W/O U L	$93.75	$135.00	$93.75–$135.00	—	31%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$129.75	$187.00	$129.75–$187.00	—	31%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JNT/BURSA W/O US LRG	$187.50	$250.00	$187.50–$250.00	—	25%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 HOSP INSERT DRUG DEL IMPLANT	$150.75	$217.00	$150.75–$217.00	37% above	31%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG DEL IMPLANT	$150.75	$217.00	$150.75–$217.00	37% above	31%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 HOSP INSERT DRUG DEL IMPLANT	$150.75	$217.00	$150.75–$217.00	—	31%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JNT/BURSA W/O US MED	$80.25	$115.00	$80.25–$115.00	56% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HOSP DRAIN/INJ JNT/BUR W/O U M	$80.25	$115.00	$80.25–$115.00	56% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HOSP DRAIN/INJ JNT/BUR W/O U M	$80.25	$115.00	$80.25–$115.00	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HOSP DRAIN/INJECT, JOINT/BURSA	$78.00	$118.00	$78.00–$118.00	61% below	34%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JNT/BURSA W/O US SML	$78.00	$118.00	$78.00–$118.00	61% below	34%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HOSP DRAIN/INJECT, JOINT/BURSA	$78.00	$118.00	$78.00–$118.00	—	34%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 HOSP KNEE ARTHROSCOPY/SURGERY	$1,410.75	$2,034.00	$1,410.75–$2,034.00	—	31%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 HOSP KNEE ARTHROSCOPY/SURGERY	$1,410.75	$2,034.00	$1,410.75–$2,034.00	—	31%
Knee arthroscopy with meniscus trim CPT 29881 HOSP KNEE ARTHROSCOPY/DRAINAGE	$1,965.00	$2,834.00	$1,965.00–$2,834.00	49% above	31%
Knee arthroscopy with meniscus trim inpatient CPT 29881 HOSP KNEE ARTHROSCOPY/DRAINAGE	$1,965.00	$2,834.00	$1,965.00–$2,834.00	—	31%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 HOSP KNEE ARTHROSCOPY/SURGERY	$2,119.50	$3,057.00	$2,119.50–$3,057.00	58% above	31%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 HOSP KNEE ARTHROSCOPY/SURGERY	$2,119.50	$3,057.00	$2,119.50–$3,057.00	—	31%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 HOSP KNEE ARTHROSCOPY/SURGERY	$1,876.50	$2,706.00	$1,876.50–$2,706.00	3% above	31%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 HOSP KNEE ARTHROSCOPY/SURGERY	$1,876.50	$2,706.00	$1,876.50–$2,706.00	—	31%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 HOSP LAPAROSCOPY-APPENDECTOMY	$1,794.75	$2,589.00	$1,794.75–$2,589.00	at median	31%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 HOSP LAPAROSCOPY-APPENDECTOMY	$1,794.75	$2,589.00	$1,794.75–$2,589.00	—	31%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 HOSP LAPRAOSCOPY-FUNDOPLASTY	$3,294.75	$4,752.00	$3,294.75–$4,752.00	67% above	31%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 HOSP LAPRAOSCOPY-FUNDOPLASTY	$3,294.75	$4,752.00	$3,294.75–$4,752.00	—	31%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 HOSP TLH-UTERUS 250g OR LESS	$2,449.50	$3,533.00	$2,449.50–$3,533.00	21% above	31%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 HOSP TLH-UTERUS 250g OR LESS	$2,449.50	$3,533.00	$2,449.50–$3,533.00	—	31%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 HOSP LAPARO HERNIA REPAIR-INT	$1,292.25	$1,864.00	$1,292.25–$1,864.00	34% above	31%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 HOSP LAPARO HERNIA REPAIR-INT	$1,292.25	$1,864.00	$1,292.25–$1,864.00	—	31%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP SURG RPR RECUR ING HERNIA	$1,665.75	$2,402.00	$1,665.75–$2,402.00	24% above	31%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP SURG RPR RECUR ING HERNIA	$1,665.75	$2,402.00	$1,665.75–$2,402.00	—	31%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 HOSP LAPAROSCOPY, REM ADNEX	$2,031.75	$2,930.00	$2,031.75–$2,930.00	16% above	31%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 HOSP LAPAROSCOPY, REM ADNEX	$2,031.75	$2,930.00	$2,031.75–$2,930.00	—	31%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAY CLOSE WOUND 2.5CM OR<	$222.75	$321.00	$222.75–$321.00	23% below	31%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HOSP LAY CLOSE WOUND 2.5CM OR<	$540.75	$780.00	$540.75–$780.00	88% above	31%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HOSP LAY CLOSE WOUND 2.5CM OR<	$540.75	$780.00	$540.75–$780.00	—	31%
Lower-back epidural injection, with imaging guidance CPT 62323 STELLATE GANG BLK W/FLURO	$920.25	$1,327.00	$920.25–$1,327.00	4% above	31%
Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL LUM/SAC W/FLURO	$1,250.25	$1,803.00	$1,250.25–$1,803.00	41% above	31%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 STELLATE GANG BLK W/FLURO	$920.25	$1,327.00	$920.25–$1,327.00	—	31%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL LUM/SAC W/FLURO	$1,250.25	$1,803.00	$1,250.25–$1,803.00	—	31%
Lower-back epidural injection, without imaging guidance CPT 62322 STELLATE GANGLION BLOCK	$208.50	$301.00	$208.50–$301.00	71% below	31%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$237.75	$343.00	$237.75–$343.00	67% below	31%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$237.75	$343.00	$237.75–$343.00	67% below	31%
Lower-back epidural injection, without imaging guidance CPT 62322 EPIDURAL LUMBAR/SACRAL	$538.50	$777.00	$538.50–$777.00	26% below	31%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 STELLATE GANGLION BLOCK	$208.50	$301.00	$208.50–$301.00	—	31%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$237.75	$343.00	$237.75–$343.00	—	31%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPIDURAL LUMBAR/SACRAL	$538.50	$777.00	$538.50–$777.00	—	31%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ-ANES/STERIOD EPIDURAL	$686.25	$990.00	$686.25–$990.00	21% below	31%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ-ANES/STERIOD EPIDURAL	$686.25	$990.00	$686.25–$990.00	21% below	31%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 EPIDURAL LUM/SAC TRANSFOR	$1,372.50	$1,979.00	$1,372.50–$1,979.00	57% above	31%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ-ANES/STERIOD EPIDURAL	$686.25	$990.00	$686.25–$990.00	—	31%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 EPIDURAL LUM/SAC TRANSFOR	$1,372.50	$1,979.00	$1,372.50–$1,979.00	—	31%
Lumpectomy (partial mastectomy) CPT 19301 HOSP MASTECTOMY PARTIAL	$1,899.00	$2,738.00	$1,899.00–$2,738.00	76% above	31%
Lumpectomy (partial mastectomy) inpatient CPT 19301 HOSP MASTECTOMY PARTIAL	$1,899.00	$2,738.00	$1,899.00–$2,738.00	—	31%
Mastectomy (total removal of the breast) CPT 19303 HOSP MASTECTOMY, SIMPLE,COMPLE	$2,940.75	$4,241.00	$2,940.75–$4,241.00	122% above	31%
Mastectomy (total removal of the breast) inpatient CPT 19303 HOSP MASTECTOMY, SIMPLE,COMPLE	$2,940.75	$4,241.00	$2,940.75–$4,241.00	—	31%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$590.25	$851.00	$590.25–$851.00	64% below	31%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$1,179.75	$1,700.00	$1,179.75–$1,700.00	28% below	31%
Miscarriage treatment with D&C, first trimester CPT 59820 HOSP CARE OF MISCARRIAGE	$1,180.50	$1,701.00	$1,180.50–$1,701.00	28% below	31%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$1,179.75	$1,700.00	$1,179.75–$1,700.00	—	31%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 HOSP CARE OF MISCARRIAGE	$1,180.50	$1,701.00	$1,180.50–$1,701.00	—	31%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION SKIN LESION	$87.00	$307.00	$87.00–$307.00	42% below	72%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HOSP EXC TR-EXT B9+MARG 0.5CM<	$87.00	$307.00	$87.00–$307.00	42% below	72%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HOSP EXC TR-EXT B9+MARG 0.5CM<	$87.00	$307.00	$87.00–$307.00	—	72%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HOSP EXC FACE-MM B9+MARG 0.5	$176.25	$254.00	$176.25–$254.00	27% below	31%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN LES-FACE 0.5/<	$176.25	$254.00	$176.25–$254.00	27% below	31%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HOSP EXC FACE-MM B9+MARG 0.5	$176.25	$254.00	$176.25–$254.00	—	31%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$123.00	$178.00	$123.00–$178.00	4% above	31%
Nail removal (partial or complete), one nail CPT 11730 HOSP REMOVAL OF NAIL PLATE	$123.00	$178.00	$123.00–$178.00	4% above	31%
Nail removal (partial or complete), one nail CPT 11730 NAIL REMOVAL	$280.50	$405.00	$280.50–$405.00	138% above	31%
Nail removal (partial or complete), one nail inpatient CPT 11730 HOSP REMOVAL OF NAIL PLATE	$123.00	$178.00	$123.00–$178.00	—	31%
Nail removal (partial or complete), one nail inpatient CPT 11730 NAIL REMOVAL	$280.50	$405.00	$280.50–$405.00	—	31%
Occipital nerve block (injection for headaches) both sides CPT 64405 NERVE BLK INJ OCCIPITAL BILAT	$163.50	$236.00	$163.50–$236.00	—	31%
Occipital nerve block (injection for headaches) CPT 64405 NERVE BLK INJ OCCIPITAL	$163.50	$236.00	$163.50–$236.00	29% below	31%
Occipital nerve block (injection for headaches) CPT 64405 N BLOCK INJ-OCCIPITAL	$163.50	$236.00	$163.50–$236.00	29% below	31%
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$230.25	$332.00	$230.25–$332.00	1% below	31%
Occipital nerve block (injection for headaches) inpatient both sides CPT 64405 NERVE BLK INJ OCCIPITAL BILAT	$163.50	$236.00	$163.50–$236.00	—	31%
Occipital nerve block (injection for headaches) inpatient CPT 64405 NERVE BLK INJ OCCIPITAL	$163.50	$236.00	$163.50–$236.00	—	31%
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$230.25	$332.00	$230.25–$332.00	—	31%
Paracentesis with imaging guidance CPT 49083 HOSP ABD PARACENTESIS W/IMAGIN	$387.75	$560.00	$387.75–$560.00	49% below	31%
Paracentesis with imaging guidance inpatient CPT 49083 HOSP ABD PARACENTESIS W/IMAGIN	$387.75	$560.00	$387.75–$560.00	—	31%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HOSP REMOVAL OF NAIL BED	$275.25	$397.00	$275.25–$397.00	2% below	31%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL NAIL BED	$275.25	$397.00	$275.25–$397.00	2% below	31%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HOSP REMOVAL OF NAIL BED	$275.25	$397.00	$275.25–$397.00	—	31%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$339.00	$489.00	$339.00–$489.00	54% below	31%
Prostate biopsy CPT 55700 HOSP BIOPSY OF PROSTATE	$339.00	$489.00	$339.00–$489.00	54% below	31%
Prostate biopsy CPT 55700 BIOPSY OF PROSTATE	$1,138.50	$1,642.00	$1,138.50–$1,642.00	55% above	31%
Prostate biopsy inpatient CPT 55700 HOSP BIOPSY OF PROSTATE	$339.00	$489.00	$339.00–$489.00	—	31%
Prostate biopsy inpatient CPT 55700 BIOPSY OF PROSTATE	$1,138.50	$1,642.00	$1,138.50–$1,642.00	—	31%
Removal of a breast lump, open surgery CPT 19120 HOSP REMOVAL OF BREAST LESION	$708.75	$1,022.00	$708.75–$1,022.00	41% below	31%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$708.75	$1,022.00	$708.75–$1,022.00	41% below	31%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$1,269.75	$1,831.00	$1,269.75–$1,831.00	5% above	31%
Removal of a breast lump, open surgery inpatient CPT 19120 HOSP REMOVAL OF BREAST LESION	$708.75	$1,022.00	$708.75–$1,022.00	—	31%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION	$1,269.75	$1,831.00	$1,269.75–$1,831.00	—	31%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY	$174.00	$623.00	$174.00–$623.00	1% below	72%
Removal of a foreign object under the skin, simple CPT 10120 HOSP REMOVAL FOREIGN BODY	$174.00	$623.00	$174.00–$623.00	1% below	72%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY	$346.50	$1,005.00	$346.50–$1,005.00	97% above	66%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$429.87	$623.00	$429.87–$623.00	145% above	31%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HOSP REMOVAL FOREIGN BODY	$174.00	$623.00	$174.00–$623.00	—	72%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY	$346.50	$1,005.00	$346.50–$1,005.00	—	66%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY	$429.87	$623.00	$429.87–$623.00	—	31%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCRN/HIGH RIS	$1,263.75	$1,822.00	$1,263.75–$1,822.00	32% above	31%
Short arm cast (elbow to hand) CPT 29075 APPLICATION-FOREARM CAST	$113.25	$163.00	$113.25–$163.00	38% below	31%
Short arm cast (elbow to hand) CPT 29075 HOSP APPLICATION-FOREARM CAST	$113.25	$163.00	$113.25–$163.00	38% below	31%
Short arm cast (elbow to hand) CPT 29075 FX - SHORT ARM	$423.00	$610.00	$423.00–$610.00	131% above	31%
Short arm cast (elbow to hand) inpatient CPT 29075 HOSP APPLICATION-FOREARM CAST	$113.25	$163.00	$113.25–$163.00	—	31%
Short arm cast (elbow to hand) inpatient CPT 29075 FX - SHORT ARM	$423.00	$610.00	$423.00–$610.00	—	31%
Short arm splint (forearm and hand) CPT 29125 HOSP APPLY FOREARM SPLINT	$76.50	$110.00	$76.50–$110.00	25% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$76.50	$110.00	$76.50–$110.00	25% below	30%
Short arm splint (forearm and hand) CPT 29125 SHORT ARM - SPLINT OCL	$280.50	$405.00	$280.50–$405.00	176% above	31%
Short arm splint (forearm and hand) inpatient CPT 29125 HOSP APPLY FOREARM SPLINT	$76.50	$110.00	$76.50–$110.00	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM - SPLINT OCL	$280.50	$405.00	$280.50–$405.00	—	31%
Short leg cast (below the knee) CPT 29405 HOSP APPLY SHORT LEG CAST	$121.50	$175.00	$121.50–$175.00	31% below	31%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$121.50	$175.00	$121.50–$175.00	31% below	31%
Short leg cast (below the knee) inpatient CPT 29405 HOSP APPLY SHORT LEG CAST	$121.50	$175.00	$121.50–$175.00	—	31%
Short leg splint (calf to foot) CPT 29515 HOSP APPLY-LOWER LEG SPLINT	$92.25	$133.00	$92.25–$133.00	8% below	31%
Short leg splint (calf to foot) CPT 29515 APPLY-LOWER LEG SPLINT	$92.25	$133.00	$92.25–$133.00	8% below	31%
Short leg splint (calf to foot) CPT 29515 SHORT LEG - SPLINT COL	$280.50	$405.00	$280.50–$405.00	179% above	31%
Short leg splint (calf to foot) inpatient CPT 29515 HOSP APPLY-LOWER LEG SPLINT	$92.25	$133.00	$92.25–$133.00	—	31%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG - SPLINT COL	$280.50	$405.00	$280.50–$405.00	—	31%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 HOSP SHOULDER ARTHROSCOPY/SURG	$583.50	$841.00	$583.50–$841.00	2% below	31%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 HOSP SHOULDER ARTHROSCOPY/SURG	$583.50	$841.00	$583.50–$841.00	—	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM REP/NON-FACE < 2.5 CM ADH	$187.50	$270.00	$187.50–$270.00	43% above	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIM REP/NON-FACE < 2.5 CM SUT	$219.00	$316.00	$219.00–$316.00	67% above	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HOSP REP SUPERFICIAL WOUND(S)	$435.75	$628.00	$435.75–$628.00	231% above	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$435.75	$628.00	$435.75–$628.00	231% above	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Rpr s/n/ax/gen/trnk 2.5cm/<	$648.75	$935.00	$648.75–$935.00	393% above	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM REP/NON-FACE < 2.5 CM ADH	$187.50	$270.00	$187.50–$270.00	—	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIM REP/NON-FACE < 2.5 CM SUT	$219.00	$316.00	$219.00–$316.00	—	31%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HOSP REP SUPERFICIAL WOUND(S)	$435.75	$628.00	$435.75–$628.00	—	31%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX OF SKIN SINGLE	$175.50	$253.00	$175.50–$253.00	20% below	31%
Skin biopsy, punch, one lesion CPT 11104 HOSP Punch bx of skin single	$175.50	$253.00	$175.50–$253.00	20% below	31%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX OF SKIN SINGLE	$175.50	$253.00	$175.50–$253.00	20% below	31%
Skin biopsy, punch, one lesion inpatient CPT 11104 HOSP Punch bx of skin single	$175.50	$253.00	$175.50–$253.00	—	31%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX OF SKIN SINGLE	$175.50	$253.00	$175.50–$253.00	—	31%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC LES TRK/ARM/LEG-0.5-<	$174.00	$271.00	$174.00–$271.00	43% below	36%
Skin tag removal, up to 15 tags CPT 11200 EXC SKIN TAGS-UP TO 15	$116.25	$167.00	$116.25–$167.00	at median	30%
Skin tag removal, up to 15 tags CPT 11200 HOSP REMOVAL OF SKIN TAGS	$116.25	$167.00	$116.25–$167.00	at median	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 HOSP REMOVAL OF SKIN TAGS	$116.25	$167.00	$116.25–$167.00	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$451.50	$651.00	$451.50–$651.00	at median	31%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$457.50	$659.00	$457.50–$659.00	1% above	31%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$457.50	$659.00	$457.50–$659.00	—	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM REP/NON-FACE 2.6-7.5 ADH	$375.00	$541.00	$375.00–$541.00	127% above	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIM REP/NON-FACE 2.6-7.5 SUT	$405.75	$586.00	$405.75–$586.00	145% above	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REP. SUPERFICIAL WOUND(S)	$498.00	$719.00	$498.00–$719.00	201% above	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HOSP REP SUPER WOUND 2.6-7.5CM	$498.00	$719.00	$498.00–$719.00	201% above	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM REP/NON-FACE 2.6-7.5 ADH	$375.00	$541.00	$375.00–$541.00	—	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIM REP/NON-FACE 2.6-7.5 SUT	$405.75	$586.00	$405.75–$586.00	—	31%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HOSP REP SUPER WOUND 2.6-7.5CM	$498.00	$719.00	$498.00–$719.00	—	31%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR SUPERFICIAL WOUNDS	$140.25	$202.00	$140.25–$202.00	8% below	31%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIM REP/FACE < 2.5 CM ADHESIVE	$280.50	$405.00	$280.50–$405.00	83% above	31%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIM REP/FACE < 2.5 CM SUTURE	$312.75	$451.00	$312.75–$451.00	104% above	31%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIM REP/FACE < 2.5 CM ADHESIVE	$280.50	$405.00	$280.50–$405.00	—	31%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIM REP/FACE < 2.5 CM SUTURE	$312.75	$451.00	$312.75–$451.00	—	31%
TURP (transurethral resection of the prostate) CPT 52601 HOSP PROSTATECTOMY (TURP)	$1,282.50	$1,849.00	$1,282.50–$1,849.00	32% below	31%
TURP (transurethral resection of the prostate) inpatient CPT 52601 HOSP PROSTATECTOMY (TURP)	$1,282.50	$1,849.00	$1,282.50–$1,849.00	—	31%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BX OF SKIN	$139.50	$201.00	$139.50–$201.00	19% below	31%
Thoracentesis with imaging guidance CPT 32555 HOSP APIRATE PLEURA W/IMAGING	$700.50	$1,010.00	$700.50–$1,010.00	8% above	31%
Thoracentesis with imaging guidance inpatient CPT 32555 HOSP APIRATE PLEURA W/IMAGING	$700.50	$1,010.00	$700.50–$1,010.00	—	31%
Total hip replacement CPT 27130 HOSP TOTAL HIP ARTHROPLASTY	$4,527.00	$6,528.00	$4,527.00–$6,528.00	79% above	31%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$4,527.00	$6,036.00	$4,527.00–$6,036.00	79% above	25%
Total hip replacement inpatient CPT 27130 HOSP TOTAL HIP ARTHROPLASTY	$4,527.00	$6,528.00	$4,527.00–$6,528.00	—	31%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$4,871.25	$7,025.00	$4,871.25–$7,025.00	52% above	31%
Total knee replacement CPT 27447 HOSP TOTAL KNEE ARTHROPLASTY	$4,871.25	$7,025.00	$4,871.25–$7,025.00	52% above	31%
Total knee replacement inpatient CPT 27447 HOSP TOTAL KNEE ARTHROPLASTY	$4,871.25	$7,025.00	$4,871.25–$7,025.00	—	31%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEA	$2,136.75	$3,082.00	$2,136.75–$3,082.00	121% above	31%
Trigger point injections, 1 or 2 muscles CPT 20552 SING/MULT TRIG PT/MUS-INJ	$87.00	$164.00	$87.00–$164.00	36% below	47%
Trigger point injections, 1 or 2 muscles CPT 20552 SING/MULT TRIG PT/MUS-INJ	$87.00	$126.00	$87.00–$126.00	36% below	31%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJ 1-2 MUSCLE	$111.00	$160.00	$111.00–$160.00	18% below	31%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$411.75	$594.00	$411.75–$594.00	203% above	31%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 SING/MULT TRIG PT/MUS-INJ	$87.00	$126.00	$87.00–$126.00	—	31%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJ 1-2 MUSCLE	$111.00	$160.00	$111.00–$160.00	—	31%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$411.75	$594.00	$411.75–$594.00	—	31%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 HOSP LAPAROSCOPY, TUBAL CAUTER	$1,157.25	$1,669.00	$1,157.25–$1,669.00	51% above	31%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 HOSP LAPAROSCOPY, TUBAL CAUTER	$1,157.25	$1,669.00	$1,157.25–$1,669.00	—	31%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 HOSP BREAST BX 1ST LESION US/I	$836.25	$1,206.00	$836.25–$1,206.00	49% below	31%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX 1ST LESION US/I	$836.25	$1,206.00	$836.25–$1,206.00	49% below	31%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 HOSP BREAST BX 1ST LESION US/I	$836.25	$1,206.00	$836.25–$1,206.00	—	31%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HOSP ESOPH ENDOSCOPY DILATION	$1,555.50	$2,243.00	$1,555.50–$2,243.00	43% above	31%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HOSP ESOPH ENDOSCOPY DILATION	$1,555.50	$2,243.00	$1,555.50–$2,243.00	—	31%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$609.00	$878.00	$609.00–$878.00	30% below	31%
Upper endoscopy (EGD) with biopsy CPT 43239 HOSP UPPR GI ENDOSCOPY-BIOPSY	$1,112.25	$1,604.00	$1,112.25–$1,604.00	27% above	31%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$609.00	$878.00	$609.00–$878.00	—	31%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HOSP UPPR GI ENDOSCOPY-BIOPSY	$1,112.25	$1,604.00	$1,112.25–$1,604.00	—	31%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HOSP UP GI SCOPE W/SUBMUC INJ	$312.00	$450.00	$312.00–$450.00	66% below	31%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HOSP UP GI SCOPE W/SUBMUC INJ	$312.00	$450.00	$312.00–$450.00	—	31%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HOSP UP ENDO W/SNARE REM LESIO	$720.75	$1,039.00	$720.75–$1,039.00	8% below	31%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HOSP UP ENDO W/SNARE REM LESIO	$720.75	$1,039.00	$720.75–$1,039.00	—	31%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 HOSP UPPR GI ENDO/GUIDE WIRE	$235.50	$340.00	$235.50–$340.00	50% below	31%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 HOSP UPPR GI ENDO/GUIDE WIRE	$235.50	$340.00	$235.50–$340.00	—	31%
Upper endoscopy (EGD), diagnostic CPT 43235 HOSP UPPER GI ENDOSCOPY-DIAGNO	$959.25	$1,383.00	$959.25–$1,383.00	28% above	31%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HOSP UPPER GI ENDOSCOPY-DIAGNO	$959.25	$1,383.00	$959.25–$1,383.00	—	31%
Vaginal delivery, including prenatal and postpartum care CPT 59400 HOSP OBSTETRICAL CARE	$5,687.25	$8,201.00	$5,687.25–$8,201.00	71% above	31%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 HOSP OBSTETRICAL CARE	$5,687.25	$8,201.00	$5,687.25–$8,201.00	—	31%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 HOSP VASECTOMY	$796.50	$1,148.00	$796.50–$1,148.00	57% above	31%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$796.50	$1,148.00	$796.50–$1,148.00	57% above	31%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 HOSP VASECTOMY	$796.50	$1,148.00	$796.50–$1,148.00	—	31%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION 1-14 LESIONS	$101.25	$233.00	$101.25–$233.00	16% below	57%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE	$123.00	$178.00	$123.00–$178.00	33% below	31%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HOSP DEBRIDE SKIN/TISSUE	$123.00	$178.00	$123.00–$178.00	33% below	31%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HOSP DEBRIDE SKIN/TISSUE	$123.00	$178.00	$123.00–$178.00	—	31%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 HOSP TREAT DISTAL RADIAL FX IN	$2,207.25	$3,183.00	$2,207.25–$3,183.00	40% above	31%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 HOSP TREAT DISTAL RADIAL FX IN	$2,207.25	$3,183.00	$2,207.25–$3,183.00	—	31%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$595.50	$859.00	$595.50–$859.00	21% above	31%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANS ADMIN. - 1 PER DAY	$595.50	$794.00	$595.50–$794.00	21% above	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANS ADMIN. - 1 PER DAY	$595.50	$794.00	$595.50–$794.00	—	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$595.50	$859.00	$595.50–$859.00	—	31%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMN	$25.50	$34.00	$25.50–$34.00	87% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TX/ PER TREATMENT	$88.50	$128.00	$88.50–$128.00	53% below	31%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TX/ PER TREATMENT	$88.50	$128.00	$88.50–$128.00	—	31%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV - UP TO 1 HR	$340.50	$454.00	$340.50–$454.00	19% below	25%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV - UP TO 1 HR	$340.50	$454.00	$340.50–$454.00	—	25%
Critical care, first 30 to 74 minutes CPT 99291 HOSP CRITICAL CARE-1ST HOUR	$299.25	$432.00	$299.25–$432.00	69% below	31%
Critical care, first 30 to 74 minutes CPT 99291 Prof Crit Care First 30-74m	$299.25	$432.00	$299.25–$432.00	69% below	31%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE-INIT-30-74M	$704.25	$1,016.00	$704.25–$1,016.00	28% below	31%
Critical care, first 30 to 74 minutes CPT 99291 ED CRITICAL CARE 30-74 MN	$1,876.50	$2,706.00	$1,876.50–$2,706.00	93% above	31%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Prof Crit Care First 30-74m	$299.25	$432.00	$299.25–$432.00	—	31%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HOSP CRITICAL CARE-1ST HOUR	$299.25	$432.00	$299.25–$432.00	—	31%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE-INIT-30-74M	$704.25	$1,016.00	$704.25–$1,016.00	—	31%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED CRITICAL CARE 30-74 MN	$1,876.50	$2,706.00	$1,876.50–$2,706.00	—	31%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG-AWAKE AND DROWSY	$394.50	$569.00	$394.50–$569.00	12% below	31%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG TRACING/INTERPRETATION	$153.75	$221.00	$153.75–$221.00	80% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$112.50	$162.00	$112.50–$162.00	5% above	31%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$112.50	$162.00	$112.50–$162.00	—	31%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL by Physician	$60.00	$86.00	$60.00–$86.00	34% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF VISIT	$60.00	$86.00	$60.00–$86.00	34% below	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HOSP EMERGENCY DEPT VISIT I	$66.75	$97.00	$66.75–$97.00	27% below	31%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY RM SERVICES I	$117.00	$168.00	$117.00–$168.00	29% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE REMOVAL by Nurse	$117.00	$168.00	$117.00–$168.00	29% above	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE REMOVAL by Physician	$60.00	$86.00	$60.00–$86.00	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF VISIT	$60.00	$86.00	$60.00–$86.00	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HOSP EMERGENCY DEPT VISIT I	$66.75	$97.00	$66.75–$97.00	—	31%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE REMOVAL by Nurse	$117.00	$168.00	$117.00–$168.00	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY RM SERVICES I	$117.00	$168.00	$117.00–$168.00	—	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Prof Emergency Dept Visit	$110.25	$159.00	$110.25–$159.00	38% below	31%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HOSP EMERGENCY DEPT VISIT II	$120.00	$173.00	$120.00–$173.00	32% below	31%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED VISIT	$120.00	$173.00	$120.00–$173.00	32% below	31%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY RM SERVICES II	$211.50	$305.00	$211.50–$305.00	19% above	31%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Prof Emergency Dept Visit	$110.25	$159.00	$110.25–$159.00	—	31%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED VISIT	$120.00	$173.00	$120.00–$173.00	—	31%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HOSP EMERGENCY DEPT VISIT II	$120.00	$173.00	$120.00–$173.00	—	31%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY RM SERVICES II	$211.50	$305.00	$211.50–$305.00	—	31%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HOSP EMERGENCY DEPT VISIT III	$324.00	$467.00	$324.00–$467.00	3% below	31%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMEDIATE VISIT	$324.00	$467.00	$324.00–$467.00	3% below	31%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY RM SVCS III	$446.25	$644.00	$446.25–$644.00	33% above	31%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMEDIATE VISIT	$324.00	$467.00	$324.00–$467.00	—	31%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HOSP EMERGENCY DEPT VISIT III	$324.00	$467.00	$324.00–$467.00	—	31%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY RM SVCS III	$446.25	$644.00	$446.25–$644.00	—	31%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED VISIT	$477.00	$687.00	$477.00–$687.00	22% below	31%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY RM SERVICES IV	$939.00	$1,354.00	$939.00–$1,354.00	54% above	31%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED VISIT	$477.00	$687.00	$477.00–$687.00	—	31%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY RM SERVICES IV	$939.00	$1,354.00	$939.00–$1,354.00	—	31%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE VISIT	$837.00	$1,207.00	$837.00–$1,207.00	15% below	31%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY RM SERVICES V	$1,478.25	$2,132.00	$1,478.25–$2,132.00	50% above	31%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE VISIT	$837.00	$1,207.00	$837.00–$1,207.00	—	31%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY RM SERVICES V	$1,478.25	$2,132.00	$1,478.25–$2,132.00	—	31%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST EKG	$455.25	$656.00	$455.25–$656.00	19% below	31%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST EKG	$455.25	$656.00	$455.25–$656.00	—	31%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP IV HYDRATION - 1 HR	$147.75	$213.00	$147.75–$213.00	28% below	31%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 MEDS(HYDRATE) IV UPTO 1HR	$172.50	$230.00	$172.50–$230.00	16% below	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OP IV HYDRATION - 1 HR	$147.75	$213.00	$147.75–$213.00	—	31%
IV infusion of a medicine, first hour CPT 96365 OP IV THERAPY - 1 HR	$147.75	$213.00	$147.75–$213.00	54% below	31%
IV infusion of a medicine, first hour CPT 96365 ED IV THERAPY - 1 HR.	$147.75	$213.00	$147.75–$213.00	54% below	31%
IV infusion of a medicine, first hour CPT 96365 MEDS(THERAPY) IV UPTO 1HR	$172.50	$230.00	$172.50–$230.00	46% below	25%
IV infusion of a medicine, first hour inpatient CPT 96365 OP IV THERAPY - 1 HR	$147.75	$213.00	$147.75–$213.00	—	31%
IV infusion of a medicine, first hour inpatient CPT 96365 ED IV THERAPY - 1 HR.	$147.75	$213.00	$147.75–$213.00	—	31%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 NON-CHEMO INJECTION	$51.75	$69.00	$51.75–$69.00	23% below	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED THERAPEUTIC INJECTION	$51.75	$75.00	$51.75–$75.00	23% below	31%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC INJECTION	$51.75	$75.00	$51.75–$75.00	23% below	31%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC INJECTION	$51.75	$75.00	$51.75–$75.00	—	31%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED THERAPEUTIC INJECTION	$51.75	$75.00	$51.75–$75.00	—	31%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 MOTOR/SENS 7-8 NRV CONDJ	$228.75	$330.00	$228.75–$330.00	16% below	31%
New patient office visit, about 30 minutes CPT 99203 Prof New Patient - Level 3	$110.25	$263.00	$110.25–$263.00	3% above	58%
New patient office visit, about 30 minutes CPT 99203 NB OB F/U New Patient Level 3	$113.85	$165.00	$113.85–$165.00	6% above	31%
New patient office visit, about 30 minutes CPT 99203 PRENATAL New Patient Level 3	$182.25	$272.00	$182.25–$272.00	70% above	33%
New patient office visit, about 30 minutes CPT 99203 Prof New Patient - Level 3	$184.50	$387.00	$184.50–$387.00	72% above	52%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT - DETAILED	$189.00	$272.00	$189.00–$272.00	76% above	31%
New patient office visit, about 30 minutes CPT 99203 ONCO Prof New PAT - LVL 3	$249.75	$360.00	$249.75–$360.00	133% above	31%
New patient office visit, about 30 minutes CPT 99203 ONCO Prof New PAT - LVL 3	$455.25	$657.00	$455.25–$657.00	324% above	31%
New patient office visit, about 30 minutes inpatient CPT 99203 NB OB F/U New Patient Level 3	$113.85	$165.00	$113.85–$165.00	—	31%
New patient office visit, about 30 minutes inpatient CPT 99203 PRENATAL New Patient Level 3	$182.25	$272.00	$182.25–$272.00	—	33%
New patient office visit, about 30 minutes inpatient CPT 99203 ONCO Prof New PAT - LVL 3	$249.75	$360.00	$249.75–$360.00	—	31%
New patient office visit, about 30 minutes inpatient CPT 99203 ONCO Prof New PAT - LVL 3	$455.25	$657.00	$455.25–$657.00	—	31%
New patient office visit, about 45 minutes CPT 99204 Prof New Patient - Level 4	$186.00	$449.00	$186.00–$449.00	14% above	59%
New patient office visit, about 45 minutes CPT 99204 NEW PAT-COMPREHEN/COMPLEX	$273.75	$395.00	$273.75–$395.00	68% above	31%
New patient office visit, about 45 minutes CPT 99204 PRENATAL New Patient Level 4	$311.25	$415.00	$311.25–$415.00	91% above	25%
New patient office visit, about 45 minutes CPT 99204 ONCO Prof New PAT - LVL 4	$370.50	$535.00	$370.50–$535.00	128% above	31%
New patient office visit, about 45 minutes inpatient CPT 99204 PRENATAL New Patient Level 4	$311.25	$415.00	$311.25–$415.00	—	25%
New patient office visit, about 45 minutes inpatient CPT 99204 ONCO Prof New PAT - LVL 4	$370.50	$535.00	$370.50–$535.00	—	31%
New patient office visit, about 60 minutes CPT 99205 Prof New Patient - Level 5	$247.50	$590.00	$247.50–$590.00	1% above	58%
New patient office visit, about 60 minutes CPT 99205 NEW PAT-COMPRE HIGH COMPL	$348.00	$517.00	$348.00–$517.00	42% above	33%
New patient office visit, about 60 minutes CPT 99205 PRENATAL New Patient Level 5	$408.75	$545.00	$408.75–$545.00	67% above	25%
New patient office visit, about 60 minutes CPT 99205 ONCO Prof New PAT - LVL 5	$464.25	$670.00	$464.25–$670.00	90% above	31%
New patient office visit, about 60 minutes inpatient CPT 99205 PRENATAL New Patient Level 5	$408.75	$545.00	$408.75–$545.00	—	25%
New patient office visit, about 60 minutes inpatient CPT 99205 ONCO Prof New PAT - LVL 5	$464.25	$670.00	$464.25–$670.00	—	31%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Prof New Patient - Level 2	$65.25	$158.00	$65.25–$158.00	at median	59%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PRENATAL New Patient Level 2	$109.50	$188.00	$109.50–$188.00	68% above	42%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT-EXPAND PROBLE	$128.25	$187.00	$128.25–$187.00	96% above	31%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NB OB F/U New Patient Level 2	$129.72	$188.00	$129.72–$188.00	99% above	31%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ONCO Prof New PAT - LVL 2	$180.75	$261.00	$180.75–$261.00	177% above	31%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PRENATAL New Patient Level 2	$109.50	$188.00	$109.50–$188.00	—	42%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NB OB F/U New Patient Level 2	$129.72	$188.00	$129.72–$188.00	—	31%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ONCO Prof New PAT - LVL 2	$180.75	$261.00	$180.75–$261.00	—	31%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TELE NUTRI EDUC INIT 15M	$11.25	$17.00	$11.25–$17.00	76% below	34%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 NUTRI EDUC-INIT IND-15MIN	$19.50	$28.00	$19.50–$28.00	58% below	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TDESP PRE-ASSESSMENT	$87.00	$126.00	$87.00–$126.00	88% above	31%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TDES+CVD PRE-ASSESSMENT	$132.00	$190.00	$132.00–$190.00	184% above	31%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TELE NUTRI EDUC INIT 15M	$11.25	$17.00	$11.25–$17.00	—	34%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 NUTRI EDUC-INIT IND-15MIN	$19.50	$28.00	$19.50–$28.00	—	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TDESP PRE-ASSESSMENT	$87.00	$126.00	$87.00–$126.00	—	31%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TDES+CVD PRE-ASSESSMENT	$132.00	$190.00	$132.00–$190.00	—	31%
Preventive checkup, new patient aged 18–39 CPT 99385 PHP 18-39	$219.00	$316.00	$219.00–$316.00	100% above	31%
Preventive checkup, new patient aged 40–64 CPT 99386 PHP 40-64	$232.50	$335.00	$232.50–$335.00	69% above	31%
Preventive checkup, new patient aged 65 or older CPT 99387 NEW PATIENT 65+ YEARS	$246.75	$356.00	$246.75–$356.00	143% above	31%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39	$174.00	$264.00	$174.00–$264.00	66% above	34%
Preventive checkup, returning patient aged 40–64 CPT 99396 PHP 40-64	$186.00	$291.00	$186.00–$291.00	78% above	36%
Preventive checkup, returning patient aged 65 or older CPT 99397 PHP EST PT 65+	$203.25	$340.00	$203.25–$340.00	82% above	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MI	$20.70	$30.00	$20.70–$30.00	16% below	31%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MI	$22.50	$30.00	$22.50–$30.00	9% below	25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10MIN	$22.50	$30.00	$22.50–$30.00	9% below	25%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10 MI	$20.70	$30.00	$20.70–$30.00	—	31%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10MIN	$22.50	$30.00	$22.50–$30.00	—	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Prof OV Estab Pat Lvl 5 40-54m	$182.25	$263.00	$182.25–$263.00	39% above	31%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Prof Estab Patient - Level 5	$182.25	$414.00	$182.25–$414.00	39% above	56%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PAT-COMPRE HIGH COMPL	$241.50	$381.00	$241.50–$381.00	84% above	37%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PRENATAL Estab Patient Level 5	$287.25	$414.00	$287.25–$414.00	119% above	31%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ONCO Prof Estab PAT - LVL 5	$338.25	$488.00	$338.25–$488.00	157% above	31%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL V	$342.75	$488.00	$342.75–$488.00	161% above	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 DSMT CLINIC LEVEL V	$356.25	$514.00	$356.25–$514.00	171% above	31%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HOSP OFF/OP CON NEW/EST HI 55	$363.75	$485.00	$363.75–$485.00	177% above	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PROF OFF/OP CON NEW/EST HI 55	$389.25	$519.00	$389.25–$519.00	196% above	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PROF OFF/OP CON NEW/EST HI 55	$389.25	$519.00	$389.25–$519.00	196% above	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFF/OP CONSLTJ NEW/EST HI 55	$445.50	$594.00	$445.50–$594.00	239% above	25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ONCO OFF/OP CON NEW/EST HI 55	$693.75	$925.00	$693.75–$925.00	428% above	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Prof OV Estab Pat Lvl 5 40-54m	$182.25	$263.00	$182.25–$263.00	—	31%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PRENATAL Estab Patient Level 5	$287.25	$414.00	$287.25–$414.00	—	31%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ONCO Prof Estab PAT - LVL 5	$338.25	$488.00	$338.25–$488.00	—	31%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 DSMT CLINIC LEVEL V	$356.25	$514.00	$356.25–$514.00	—	31%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HOSP OFF/OP CON NEW/EST HI 55	$363.75	$485.00	$363.75–$485.00	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PROF OFF/OP CON NEW/EST HI 55	$389.25	$519.00	$389.25–$519.00	—	25%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ONCO OFF/OP CON NEW/EST HI 55	$693.75	$925.00	$693.75–$925.00	—	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 BIRTH CTR EST PAT/NURSE ONLY	$51.00	$73.00	$51.00–$73.00	23% below	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Prof OV Estab Pat Lvl 3 29-30m	$65.25	$115.00	$65.25–$115.00	2% below	43%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Prof Estab Patient- Level 3	$65.25	$175.00	$65.25–$175.00	2% below	63%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HOSP PRENATAL Estab Pat Lvl 3	$79.35	$115.00	$79.35–$115.00	19% above	31%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 NB OB F/U Est Patient Level 3	$79.35	$115.00	$79.35–$115.00	19% above	31%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PAT-EXPAND PROB FOCUS	$104.25	$187.00	$104.25–$187.00	57% above	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PRENATAL Estab Patient Level 3	$121.50	$175.00	$121.50–$175.00	82% above	31%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Prof Estab Patient- Level 3	$129.72	$188.00	$129.72–$188.00	95% above	31%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONCO Prof Estab PAT- LVL 3	$139.50	$201.00	$139.50–$201.00	109% above	31%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OTHER OP CONSULT LEV 3	$176.25	$235.00	$176.25–$235.00	165% above	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PROF OFF/OP CON NEW/EST LOW 30	$176.25	$235.00	$176.25–$235.00	165% above	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PROF OFF/OP CON NEW/EST LOW 30	$176.25	$235.00	$176.25–$235.00	165% above	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFF/OP CNSLTJ NEW/EST LOW 30	$241.50	$322.00	$241.50–$322.00	263% above	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HOSP OFF/OP CON NEW/EST LOW 30	$250.50	$334.00	$250.50–$334.00	276% above	25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONCO OFF/OP CON NEW/EST LOW 30	$366.00	$488.00	$366.00–$488.00	450% above	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 BIRTH CTR EST PAT/NURSE ONLY	$51.00	$73.00	$51.00–$73.00	—	30%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Prof OV Estab Pat Lvl 3 29-30m	$65.25	$115.00	$65.25–$115.00	—	43%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HOSP PRENATAL Estab Pat Lvl 3	$79.35	$115.00	$79.35–$115.00	—	31%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NB OB F/U Est Patient Level 3	$79.35	$115.00	$79.35–$115.00	—	31%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PRENATAL Estab Patient Level 3	$121.50	$175.00	$121.50–$175.00	—	31%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Prof Estab Patient- Level 3	$129.72	$188.00	$129.72–$188.00	—	31%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONCO Prof Estab PAT- LVL 3	$139.50	$201.00	$139.50–$201.00	—	31%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PROF OFF/OP CON NEW/EST LOW 30	$176.25	$235.00	$176.25–$235.00	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HOSP OFF/OP CON NEW/EST LOW 30	$250.50	$334.00	$250.50–$334.00	—	25%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONCO OFF/OP CON NEW/EST LOW 30	$366.00	$488.00	$366.00–$488.00	—	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HOSP PRENATAL Estab Pat Lvl 4	$113.16	$164.00	$113.16–$164.00	23% above	31%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NB OB F/U Est Patient Level 4	$113.16	$164.00	$113.16–$164.00	23% above	31%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Prof OV Estab Pat Lvl 4 30-39m	$114.00	$164.00	$114.00–$164.00	24% above	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Prof Estab Patient - Level 4	$114.00	$293.00	$114.00–$293.00	24% above	61%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PAT-DETAILED,MOD COMP	$164.25	$255.00	$164.25–$255.00	79% above	36%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PRENATAL Estab Patient Level 4	$203.25	$293.00	$203.25–$293.00	121% above	31%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONCO Prof Estab PAT - LVL 4	$212.25	$306.00	$212.25–$306.00	131% above	31%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PROF OFF/OP CON NEW/EST MOD 40	$215.25	$287.00	$215.25–$287.00	134% above	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PROF OFF/OP CON NEW/EST MOD 40	$215.25	$293.00	$215.25–$293.00	134% above	27%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HOSP OFF/OP CON NEW/EST MOD 40	$215.25	$293.00	$215.25–$293.00	134% above	27%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 DSMT CLINIC LEVEL IV	$306.00	$441.00	$306.00–$441.00	233% above	31%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFF/OP CNSLTJ NEW/EST MOD 40	$342.75	$457.00	$342.75–$457.00	273% above	25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONCO OFF/OP CON NEW/EST MOD 40	$514.50	$686.00	$514.50–$686.00	460% above	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HOSP PRENATAL Estab Pat Lvl 4	$113.16	$164.00	$113.16–$164.00	—	31%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NB OB F/U Est Patient Level 4	$113.16	$164.00	$113.16–$164.00	—	31%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Prof OV Estab Pat Lvl 4 30-39m	$114.00	$164.00	$114.00–$164.00	—	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PRENATAL Estab Patient Level 4	$203.25	$293.00	$203.25–$293.00	—	31%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONCO Prof Estab PAT - LVL 4	$212.25	$306.00	$212.25–$306.00	—	31%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HOSP OFF/OP CON NEW/EST MOD 40	$215.25	$293.00	$215.25–$293.00	—	27%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PROF OFF/OP CON NEW/EST MOD 40	$215.25	$287.00	$215.25–$287.00	—	25%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 DSMT CLINIC LEVEL IV	$306.00	$441.00	$306.00–$441.00	—	31%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONCO OFF/OP CON NEW/EST MOD 40	$514.50	$686.00	$514.50–$686.00	—	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prof OV Estab Pat Lvl 2 10-19m	$33.00	$79.00	$33.00–$79.00	35% below	58%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HOSP PRENATAL Estab Pat Lvl 2	$54.51	$79.00	$54.51–$79.00	8% above	31%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NB OB F/U Est Patient Level 2	$54.51	$79.00	$54.51–$79.00	8% above	31%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prof Estab Patient - Level 2	$54.75	$142.00	$54.75–$142.00	9% above	61%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONCO Prof Estab PAT - LVL 2	$70.50	$102.00	$70.50–$102.00	40% above	31%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PAT-PROB FOCUS,BASIC	$75.75	$132.00	$75.75–$132.00	50% above	43%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prof Estab Patient - Level 2	$91.08	$132.00	$91.08–$132.00	81% above	31%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prof Pat Cons-Level 1	$91.08	$132.00	$91.08–$132.00	81% above	31%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CONSULT-PROB FOCUS,BASIC	$98.25	$132.00	$98.25–$132.00	95% above	26%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PRENATAL Estab Patient Level 2	$98.25	$142.00	$98.25–$142.00	95% above	31%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HOSP Prof Pat Cons-Level 1	$111.00	$148.00	$111.00–$148.00	120% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prof Othr OP Consult Lvl 1 15m	$117.75	$157.00	$117.75–$157.00	134% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Prof Pat Cons-Level 1	$117.75	$157.00	$117.75–$157.00	134% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PROF OFF/OP CONS NEW/EST SF 20	$144.00	$192.00	$144.00–$192.00	186% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PROF OFF/OP CONS NEW/EST SF 20	$144.75	$193.00	$144.75–$193.00	187% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONCO Prof Pat Cons-Level 1	$180.75	$241.00	$180.75–$241.00	259% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFF/OP CONSLTJ NEW/EST SF 20	$182.25	$243.00	$182.25–$243.00	262% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HOSP OFF/OP CONS NEW/EST SF 20	$223.50	$298.00	$223.50–$298.00	343% above	25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONCO OFF/OP CONS NEW/EST SF 20	$281.25	$375.00	$281.25–$375.00	458% above	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Prof OV Estab Pat Lvl 2 10-19m	$33.00	$79.00	$33.00–$79.00	—	58%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HOSP PRENATAL Estab Pat Lvl 2	$54.51	$79.00	$54.51–$79.00	—	31%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NB OB F/U Est Patient Level 2	$54.51	$79.00	$54.51–$79.00	—	31%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONCO Prof Estab PAT - LVL 2	$70.50	$102.00	$70.50–$102.00	—	31%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Prof Estab Patient - Level 2	$91.08	$132.00	$91.08–$132.00	—	31%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Prof Pat Cons-Level 1	$91.08	$132.00	$91.08–$132.00	—	31%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PRENATAL Estab Patient Level 2	$98.25	$142.00	$98.25–$142.00	—	31%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HOSP Prof Pat Cons-Level 1	$111.00	$148.00	$111.00–$148.00	—	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Prof Othr OP Consult Lvl 1 15m	$117.75	$157.00	$117.75–$157.00	—	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PROF OFF/OP CONS NEW/EST SF 20	$144.75	$193.00	$144.75–$193.00	—	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONCO Prof Pat Cons-Level 1	$180.75	$241.00	$180.75–$241.00	—	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HOSP OFF/OP CONS NEW/EST SF 20	$223.50	$298.00	$223.50–$298.00	—	25%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONCO OFF/OP CONS NEW/EST SF 20	$281.25	$375.00	$281.25–$375.00	—	25%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION TEST	$57.00	$76.00	$57.00–$76.00	62% below	25%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$60.75	$87.00	$60.75–$87.00	59% below	30%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$60.75	$87.00	$60.75–$87.00	59% below	30%
Spirometry (breathing test) CPT 94010 INCENTIVE SPIROMETER	$124.50	$180.00	$124.50–$180.00	17% below	31%
Spirometry (breathing test) CPT 94010 PFT	$208.50	$301.00	$208.50–$301.00	39% above	31%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$60.75	$87.00	$60.75–$87.00	—	30%
Spirometry (breathing test) inpatient CPT 94010 INCENTIVE SPIROMETER	$124.50	$180.00	$124.50–$180.00	—	31%
Spirometry (breathing test) inpatient CPT 94010 PFT	$208.50	$301.00	$208.50–$301.00	—	31%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$108.75	$157.00	$108.75–$157.00	70% below	31%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$108.75	$157.00	$108.75–$157.00	70% below	31%
Spirometry before and after a bronchodilator CPT 94060 PFT W/BRONCHODILATOR	$355.50	$513.00	$355.50–$513.00	3% below	31%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$108.75	$157.00	$108.75–$157.00	—	31%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT W/BRONCHODILATOR	$355.50	$513.00	$355.50–$513.00	—	31%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$38.25	$55.00	$38.25–$55.00	74% below	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$63.00	$90.00	$63.00–$90.00	58% below	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$38.25	$55.00	$38.25–$55.00	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Maine	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE	$213.00	$381.00	$213.00–$381.00	37% above	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Trivalent Flu Shot	$15.00	$20.00	$15.00–$20.00	32% below	25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE TRIVALENT	$15.00	$20.00	$15.00–$20.00	32% below	25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE TRIVALENT	$15.00	$20.00	$15.00–$20.00	—	25%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A & B COMBO VACCINE	$128.12	$170.82	$128.12–$170.82	18% below	25%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE	$85.68	$114.24	$85.68–$114.24	7% above	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B ENERGIX 3 DOSE IM	$64.46	$85.94	$64.46–$85.94	19% above	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$64.46	$85.94	$64.46–$85.94	19% above	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$64.46	$85.94	$64.46–$85.94	—	25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High Dose Trivalent	$45.00	$65.00	$45.00–$65.00	61% below	31%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES/MUMPS/RUBELLA VACCINE	$119.67	$159.56	$119.67–$159.56	15% above	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VAC	$101.57	$135.42	$101.57–$135.42	12% above	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL 23 POLYVALENT VAC	$101.57	$135.42	$101.57–$135.42	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$37.01	$49.34	$37.01–$49.34	11% below	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$37.01	$49.34	$37.01–$49.34	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACC 7 YRS/>IM (BOOSTRIX)	$48.60	$64.80	$48.60–$64.80	15% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET-DIPTH-PERT VACCINE	$48.60	$64.80	$48.60–$64.80	15% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACC 7 YRS/>IM (BOOSTRIX)	$48.60	$64.80	$48.60–$64.80	—	25%

Source file: https://cdn.sanity.io/files/c10j53hh/production/dced876dd63bcd9b5cff85a8059a2ac045fd14ea.csv