Hospital Sikeston, MO

Missouri Delta Medical Center

Missouri Delta Medical Center in Sikeston, MO publishes cash prices for 295 common procedures listed here, from its own machine-readable price file updated Aug 7, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 253 of 294 procedures and above it for 38. By typical cash price it ranks #7 of 60 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1008 N Main St, Sikeston, MO 63801 Collected Sep 27, 2026 Source price file (573) 472-7586

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 260113 · 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 3 actions for a hospital named Missouri Delta Medical Center in Sikeston, MO:

Nov 25, 2024 Warning notice
Feb 27, 2025 Corrective action plan requested
Mar 18, 2025 Case closed

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

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 Missouri	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 WC Doppler/tcom Single Level	$121.00	$484.00	$109.44–$387.20	65% below	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 ABI	$142.00	$568.00	$109.44–$454.40	58% below	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ABI	$152.75	$611.00	$109.44–$488.80	55% below	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 WC Doppler/tcom Single Level	$121.00	$484.00	$109.44–$387.20	—	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 ABI	$142.00	$568.00	$109.44–$454.40	—	75%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ABI	$152.75	$611.00	$109.44–$488.80	—	75%
Barium swallow (esophagus X-ray with contrast) CPT 74220 Contrast X-Ray Esophagus	$164.56	$658.25	$175.06–$526.60	62% below	75%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 Contrast X-Ray Esophagus	$164.56	$658.25	$175.06–$526.60	—	75%
Bone scan, whole body (nuclear medicine) CPT 78306 Bone Imaging Whole Body	$486.75	$1,947.00	$392.97–$1,557.60	67% below	75%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 Bone Imaging Whole Body	$486.75	$1,947.00	$392.97–$1,557.60	—	75%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angiography Chest W/Wo Contrast	$613.25	$2,453.00	$175.06–$1,962.40	68% below	75%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angiography Chest W/Wo Contrast	$613.25	$2,453.00	$175.06–$1,962.40	—	75%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen-Pelvis W/O Contrast	$1,094.94	$4,379.75	$233.47–$3,503.80	48% below	75%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen-Pelvis W/O Contrast	$1,094.94	$4,379.75	$233.47–$3,503.80	—	75%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen-Pelvis W/Contrast	$1,076.06	$4,304.25	$366.42–$3,443.40	55% below	75%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen-Pelvis W/Contrast	$1,076.06	$4,304.25	$366.42–$3,443.40	—	75%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen-Pelvis W/O W/Contrast	$1,220.69	$4,882.75	$366.42–$3,906.20	58% below	75%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen-Pelvis W/O W/Contrast	$1,220.69	$4,882.75	$366.42–$3,906.20	—	75%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen W/Contrast	$506.75	$2,027.00	$175.06–$1,621.60	68% below	75%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen W/Contrast	$506.75	$2,027.00	$175.06–$1,621.60	—	75%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast Dye	$525.75	$2,103.00	$104.75–$1,682.40	51% below	75%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen W/O Contrast Dye	$525.75	$2,103.00	$104.75–$1,682.40	—	75%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinuses W/O Contrast	$266.75	$1,067.00	$104.75–$853.60	75% below	75%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial-Sinuses W/O Contrast	$548.31	$2,193.25	$104.75–$1,754.60	49% below	75%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinuses W/O Contrast	$266.75	$1,067.00	$104.75–$853.60	—	75%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial-Sinuses W/O Contrast	$548.31	$2,193.25	$104.75–$1,754.60	—	75%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head W/O Contrast	$575.38	$2,301.50	$103.33–$1,841.20	54% below	75%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head W/O Contrast	$575.38	$2,301.50	$103.33–$1,841.20	—	75%
CT scan of the head with contrast CPT 70460 CT Head W/Contrast	$421.81	$1,687.25	$144.04–$1,349.80	71% below	75%
CT scan of the head with contrast CPT 70460 CT Venogram Head w/ Contrast	$642.56	$2,570.25	$144.04–$2,056.20	55% below	75%
CT scan of the head with contrast inpatient CPT 70460 CT Head W/Contrast	$421.81	$1,687.25	$144.04–$1,349.80	—	75%
CT scan of the head with contrast inpatient CPT 70460 CT Venogram Head w/ Contrast	$642.56	$2,570.25	$144.04–$2,056.20	—	75%
CT scan of the head without and with contrast CPT 70470 CT Head W/O W/Contrast	$569.56	$2,278.25	$169.97–$1,822.60	68% below	75%
CT scan of the head without and with contrast CPT 70470 CT Venogram Head w/ + w/o Contrast	$642.56	$2,570.25	$169.97–$2,056.20	64% below	75%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head W/O W/Contrast	$569.56	$2,278.25	$169.97–$1,822.60	—	75%
CT scan of the head without and with contrast inpatient CPT 70470 CT Venogram Head w/ + w/o Contrast	$642.56	$2,570.25	$169.97–$2,056.20	—	75%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar Spine W/O Contrast	$689.38	$2,757.50	$104.75–$2,206.00	50% below	75%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar Spine W/O Contrast	$689.38	$2,757.50	$104.75–$2,206.00	—	75%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical Spine W/O Contrast	$689.38	$2,757.50	$104.75–$2,206.00	58% below	75%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cervical Spine W/O Contrast	$689.38	$2,757.50	$104.75–$2,206.00	—	75%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W/Contrast	$569.56	$2,278.25	$175.06–$1,822.60	65% below	75%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis W/Contrast	$569.56	$2,278.25	$175.06–$1,822.60	—	75%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Head Trunk Vasc Imaging	$267.19	$1,068.75	$233.47–$855.00	68% below	75%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 Head Trunk Vasc Imaging	$267.19	$1,068.75	$233.47–$855.00	—	75%
Chest X-ray, 2 views CPT 71046 Chest Bucky Study	$87.13	$348.50	$86.58–$278.80	65% below	75%
Chest X-ray, 2 views CPT 71046 Chest Ap Lat	$107.44	$429.75	$86.58–$343.80	57% below	75%
Chest X-ray, 2 views CPT 71046 Chest Ap Lat With Fluoro	$139.25	$557.00	$86.58–$445.60	45% below	75%
Chest X-ray, 2 views inpatient CPT 71046 Chest Bucky Study	$87.13	$348.50	$86.58–$278.80	—	75%
Chest X-ray, 2 views inpatient CPT 71046 Chest Ap Lat	$107.44	$429.75	$86.58–$343.80	—	75%
Chest X-ray, 2 views inpatient CPT 71046 Chest Ap Lat With Fluoro	$139.25	$557.00	$86.58–$445.60	—	75%
Chest X-ray, single view CPT 71045 Chest Stereo Frontal	$87.13	$348.50	$81.12–$278.80	58% below	75%
Chest X-ray, single view CPT 71045 Chest 1 View Frontal	$87.13	$348.50	$81.12–$278.80	58% below	75%
Chest X-ray, single view inpatient CPT 71045 Chest Stereo Frontal	$87.13	$348.50	$81.12–$278.80	—	75%
Chest X-ray, single view inpatient CPT 71045 Chest 1 View Frontal	$87.13	$348.50	$81.12–$278.80	—	75%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroprnl Complete	$180.63	$722.50	$104.75–$578.00	68% below	75%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroprnl Complete	$180.63	$722.50	$104.75–$578.00	—	75%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Cont for Robotic Procedure	$535.94	$2,143.75	$104.75–$1,715.00	58% below	75%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Hi-Res w/o Contrast	$535.94	$2,143.75	$104.75–$1,715.00	58% below	75%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax W/O Contrast	$535.94	$2,143.75	$104.75–$1,715.00	58% below	75%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Hi-Res w/o Contrast	$535.94	$2,143.75	$104.75–$1,715.00	—	75%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax W/O Contrast	$535.94	$2,143.75	$104.75–$1,715.00	—	75%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Cont for Robotic Procedure	$535.94	$2,143.75	$104.75–$1,715.00	—	75%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax W/Contrast	$556.38	$2,225.50	$175.06–$1,780.40	66% below	75%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax W/Contrast	$556.38	$2,225.50	$175.06–$1,780.40	—	75%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Bilateral	$218.06	$872.25	$0.01–$697.80	—	75%
Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Bilateral Addl Views	$288.31	$1,153.25	$0.01–$922.60	—	75%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammogram Bilateral	$218.06	$872.25	$0.01–$697.80	—	75%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Mammogram Bilateral Addl Views	$288.31	$1,153.25	$0.01–$922.60	—	75%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US LE Art Duplex Bil	$811.25	$3,245.00	$233.47–$2,596.00	16% above	75%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US LE Art Duplex Bil	$811.25	$3,245.00	$233.47–$2,596.00	—	75%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Vein Mapping Bilateral Lower Extremity	$119.06	$476.25	$228.60–$470.41	—	75%
Duplex ultrasound of the leg veins, both legs CPT 93970 US LE Veins Duplex Bil	$518.56	$2,074.25	$233.47–$1,659.40	36% below	75%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 Vein Mapping Bilateral Lower Extremity	$119.06	$476.25	$228.60–$470.41	—	75%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US LE Veins Duplex Bil	$518.56	$2,074.25	$233.47–$1,659.40	—	75%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echocardiogram 2D (Cardiology)	$609.75	$2,439.00	$525.63–$1,951.20	60% below	75%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echocardiogram 2D (Cardiology)	$609.75	$2,439.00	$525.63–$1,951.20	—	75%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepato Billiary Scan	$546.50	$2,186.00	$392.97–$1,748.80	60% below	75%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 Hepato Billiary Scan	$546.50	$2,186.00	$392.97–$1,748.80	—	75%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Home Sleep Testing	$248.88	$995.50	$123.88–$796.40	62% below	75%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Home Sleep Testing	$248.88	$995.50	$123.88–$796.40	—	75%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Treatment Polysomnography	$1,595.31	$6,381.25	$800.91–$5,105.00	39% below	75%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Complex Polysomnography W/tx Int	$2,471.50	$9,886.00	$800.91–$7,908.80	6% below	75%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Treatment Polysomnography	$1,595.31	$6,381.25	$800.91–$5,105.00	—	75%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Complex Polysomnography W/tx Int	$2,471.50	$9,886.00	$800.91–$7,908.80	—	75%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Echography Abdominal Limit	$224.56	$898.25	$104.75–$718.60	55% below	75%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 Echography Abdominal Limit	$224.56	$898.25	$104.75–$718.60	—	75%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screening	$189.94	$759.75	$96.60–$1,258.00	56% below	75%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screening	$189.94	$759.75	$96.60–$1,258.00	—	75%
MRI of the abdomen without contrast CPT 74181 MRI MRCP	$707.19	$2,828.75	$233.47–$2,263.00	57% below	75%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Contrast	$735.38	$2,941.50	$233.47–$2,353.20	56% below	75%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP	$707.19	$2,828.75	$233.47–$2,263.00	—	75%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen W/O Contrast	$735.38	$2,941.50	$233.47–$2,353.20	—	75%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W/O W/Contrast	$863.00	$3,452.00	$366.42–$2,761.60	64% below	75%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen W/O W/Contrast	$863.00	$3,452.00	$366.42–$2,761.60	—	75%
MRI of the brain, no contrast dye CPT 70551 ER MRI Head Limited Study	$431.88	$1,727.50	$233.47–$1,828.00	73% below	75%
MRI of the brain, no contrast dye CPT 70551 MRI Brain Pituitary Gl W/O Contrast	$518.69	$2,074.75	$233.47–$1,828.00	68% below	75%
MRI of the brain, no contrast dye CPT 70551 MRI Brain W/O Contrast	$632.81	$2,531.25	$233.47–$2,025.00	61% below	75%
MRI of the brain, no contrast dye inpatient CPT 70551 ER MRI Head Limited Study	$431.88	$1,727.50	$233.47–$1,828.00	—	75%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain Pituitary Gl W/O Contrast	$518.69	$2,074.75	$233.47–$1,828.00	—	75%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain W/O Contrast	$632.81	$2,531.25	$233.47–$2,025.00	—	75%
MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary W/O W/Contrast	$881.38	$3,525.50	$366.42–$2,820.40	65% below	75%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W/O W/Contrast	$881.38	$3,525.50	$366.42–$2,820.40	65% below	75%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary W/O W/Contrast	$881.38	$3,525.50	$366.42–$2,820.40	—	75%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain W/O W/Contrast	$881.38	$3,525.50	$366.42–$2,820.40	—	75%
MRI of the lower back, no contrast dye CPT 72148 MRI Lumbar W/O Contrast	$707.06	$2,828.25	$233.47–$2,262.60	62% below	75%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Lumbar W/O Contrast	$707.06	$2,828.25	$233.47–$2,262.60	—	75%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Lumbar W/O W/Contrast	$924.13	$3,696.50	$366.42–$2,957.20	63% below	75%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Lumbar W/O W/Contrast	$924.13	$3,696.50	$366.42–$2,957.20	—	75%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Thoracic W/O Contrast	$707.06	$2,828.25	$233.47–$2,262.60	60% below	75%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Thoracic W/O Contrast	$707.06	$2,828.25	$233.47–$2,262.60	—	75%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Cervical W/O W/Contrast	$881.00	$3,524.00	$366.42–$2,819.20	65% below	75%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Cervical W/O W/Contrast	$881.00	$3,524.00	$366.42–$2,819.20	—	75%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Cervical W/O Contrast	$795.19	$3,180.75	$233.47–$2,544.60	60% below	75%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Cervical W/O Contrast	$795.19	$3,180.75	$233.47–$2,544.60	—	75%
MRI of the pelvis without and with contrast CPT 72197 MRI Prostate w/ + w/o Cont	$506.31	$2,025.25	$366.42–$1,828.00	80% below	75%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W/O W/Contrast	$916.69	$3,666.75	$366.42–$2,933.40	64% below	75%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Prostate w/ + w/o Cont	$506.31	$2,025.25	$366.42–$1,828.00	—	75%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis W/O W/Contrast	$916.69	$3,666.75	$366.42–$2,933.40	—	75%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Contrast	$599.94	$2,399.75	$233.47–$1,919.80	68% below	75%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis W/O Contrast	$599.94	$2,399.75	$233.47–$1,919.80	—	75%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocard Perfusion Imaging	$1,797.63	$7,190.50	$1,352.93–$5,752.40	56% below	75%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 Myocard Perfusion Imaging	$1,797.63	$7,190.50	$1,352.93–$5,752.40	—	75%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Skull -High Imaging	$2,155.25	$8,621.00	$1,490.60–$6,896.80	53% below	75%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Skull -High Imaging	$2,155.25	$8,621.00	$1,490.60–$6,896.80	—	75%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Exam Pelvic Limited	$134.25	$537.00	$104.75–$429.60	67% below	75%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Exam Pelvic Limited	$134.25	$537.00	$104.75–$429.60	—	75%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non-OB	$243.88	$975.50	$104.75–$780.40	62% below	75%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Non-OB	$243.88	$975.50	$104.75–$780.40	—	75%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Echo Preg >14 Wks Single Fetus	$231.00	$924.00	$104.75–$739.20	59% below	75%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Echo Preg >14 Wks Single Fetus	$231.00	$924.00	$104.75–$739.20	—	75%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Echo Preg <14 Wks Single Fetus	$231.00	$924.00	$104.75–$739.20	55% below	75%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Echo Preg <14 Wks Single Fetus	$231.00	$924.00	$104.75–$739.20	—	75%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Pelvic Ultrasound	$204.06	$816.25	$104.75–$653.00	43% below	75%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Echo-Pregnant Uterus Limited	$228.63	$914.50	$104.75–$731.60	36% below	75%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Pelvic Ultrasound	$204.06	$816.25	$104.75–$653.00	—	75%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Echo-Pregnant Uterus Limited	$228.63	$914.50	$104.75–$731.60	—	75%
Screening mammogram, both breasts CPT 77067 Computer Screen Mammogram Add-On	$27.06	$108.25	$0.01–$224.96	84% below	75%
Screening mammogram, both breasts CPT 77067 Screening Mammogram	$113.56	$454.25	$0.01–$363.40	31% below	75%
Screening mammogram, both breasts CPT 77067 Screening Mammogram W/Implant	$166.81	$667.25	$0.01–$533.80	1% above	75%
Screening mammogram, both breasts inpatient CPT 77067 Computer Screen Mammogram Add-On	$27.06	$108.25	$0.01–$224.96	—	75%
Screening mammogram, both breasts inpatient CPT 77067 Screening Mammogram	$113.56	$454.25	$0.01–$363.40	—	75%
Screening mammogram, both breasts inpatient CPT 77067 Screening Mammogram W/Implant	$166.81	$667.25	$0.01–$533.80	—	75%
Sleep study in a lab (polysomnography) CPT 95810 95810 Diag Polysomnography-Limited	$902.19	$3,608.75	$762.74–$2,887.00	64% below	75%
Sleep study in a lab (polysomnography) CPT 95810 Diagnostic Polysomnography	$1,804.38	$7,217.50	$762.74–$5,774.00	29% below	75%
Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 Diag Polysomnography-Limited	$902.19	$3,608.75	$762.74–$2,887.00	—	75%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Diagnostic Polysomnography	$1,804.38	$7,217.50	$762.74–$5,774.00	—	75%
Swallow study (modified barium swallow, video X-ray) CPT 74230 Mod Bar Swallow	$186.13	$744.50	$175.06–$595.60	58% below	75%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 Mod Bar Swallow	$186.13	$744.50	$175.06–$595.60	—	75%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$217.75	$871.00	$104.75–$696.80	62% below	75%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$217.75	$871.00	$104.75–$696.80	—	75%
Transvaginal ultrasound during pregnancy CPT 76817 US Transvaginal Ob	$226.50	$906.00	$104.75–$724.80	52% below	75%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Transvaginal Ob	$226.50	$906.00	$104.75–$724.80	—	75%
Ultrasound of the abdomen, complete CPT 76700 US Abdominal Complete	$241.00	$964.00	$104.75–$771.20	69% below	75%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdominal Complete	$241.00	$964.00	$104.75–$771.20	—	75%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum	$236.19	$944.75	$104.75–$755.80	59% below	75%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum	$236.19	$944.75	$104.75–$755.80	—	75%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head Neck Thyroid	$217.75	$871.00	$104.75–$696.80	61% below	75%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$217.75	$871.00	$104.75–$696.80	61% below	75%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$217.75	$871.00	$104.75–$696.80	—	75%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head Neck Thyroid	$217.75	$871.00	$104.75–$696.80	—	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper GI W/O W/Contrast Delay	$224.56	$898.25	$175.06–$718.60	60% below	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Gastrointestinal W/Kub	$224.56	$898.25	$175.06–$718.60	60% below	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Upper GI BA Swallow	$242.88	$971.50	$175.06–$777.20	57% below	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI w/ SB	$301.63	$1,206.50	$175.06–$965.20	47% below	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Gastrointestinal W/Kub	$224.56	$898.25	$175.06–$718.60	—	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Upper GI W/O W/Contrast Delay	$224.56	$898.25	$175.06–$718.60	—	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 Upper GI BA Swallow	$242.88	$971.50	$175.06–$777.20	—	75%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI w/ SB	$301.63	$1,206.50	$175.06–$965.20	—	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Mapping Lt	$71.44	$285.75	$104.75–$301.93	87% below	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Venous Mapping Rt	$71.44	$285.75	$104.75–$301.93	87% below	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Mapping Lt	$71.44	$285.75	$104.75–$301.93	—	75%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Venous Mapping Rt	$71.44	$285.75	$104.75–$301.93	—	75%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 Hips Infant or Child 2 Views	$87.13	$348.50	$86.58–$278.80	63% below	75%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 Hips Infant or Child 2 Views	$87.13	$348.50	$86.58–$278.80	—	75%
X-ray of the abdomen, 1 view CPT 74018 Abdomen 1 View Upright	$87.13	$348.50	$86.58–$278.80	60% below	75%
X-ray of the abdomen, 1 view CPT 74018 Abdomen Ap View	$87.13	$348.50	$86.58–$278.80	60% below	75%
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen 1 View Upright	$87.13	$348.50	$86.58–$278.80	—	75%
X-ray of the abdomen, 1 view inpatient CPT 74018 Abdomen Ap View	$87.13	$348.50	$86.58–$278.80	—	75%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral Bending Only	$139.25	$557.00	$104.75–$445.60	53% below	75%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Lumbar Spine Ap Lat	$139.25	$557.00	$104.75–$445.60	53% below	75%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral Bending Only	$139.25	$557.00	$104.75–$445.60	—	75%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 Lumbar Spine Ap Lat	$139.25	$557.00	$104.75–$445.60	—	75%
X-ray of the lower back, 4 or more views CPT 72110 Lumbar Spine Complete W/Oblique	$139.25	$557.00	$104.75–$445.60	67% below	75%
X-ray of the lower back, 4 or more views inpatient CPT 72110 Lumbar Spine Complete W/Oblique	$139.25	$557.00	$104.75–$445.60	—	75%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 Thoracic Spine 2 Views	$139.25	$557.00	$104.75–$445.60	47% below	75%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 Thoracic Spine 2 Views	$139.25	$557.00	$104.75–$445.60	—	75%
X-ray of the nasal bones, 3 or more views CPT 70160 Nasal Bones Complete	$87.13	$348.50	$86.58–$278.80	65% below	75%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 Nasal Bones Complete	$87.13	$348.50	$86.58–$278.80	—	75%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cerv Flex/Ext Only	$139.25	$557.00	$86.58–$445.60	54% below	75%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Cervical Spine Ap Lat Odt	$139.25	$557.00	$86.58–$445.60	54% below	75%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 Cervical Spine Ap Lat Odt	$139.25	$557.00	$86.58–$445.60	—	75%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cerv Flex/Ext Only	$139.25	$557.00	$86.58–$445.60	—	75%
X-ray of the pelvis, 1 or 2 views CPT 72170 Pelvis Ap View	$139.25	$557.00	$104.75–$445.60	38% below	75%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 Pelvis Ap View	$139.25	$557.00	$104.75–$445.60	—	75%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Sacrum Coccyx 2 View Min	$87.13	$348.50	$86.58–$278.80	67% below	75%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 Sacrum Coccyx 2 View Min	$87.13	$348.50	$86.58–$278.80	—	75%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt-Sgpt	$20.31	$81.25	$5.30–$65.00	58% below	75%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 FLFFT Alanine Amino (Alt)(Sgpt)	$22.63	$90.50	$5.30–$72.40	53% below	75%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NASH Fibrosure Part J	$27.94	$111.75	$5.30–$89.40	42% below	75%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alt-Sgpt	$20.31	$81.25	$5.30–$65.00	—	75%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 FLFFT Alanine Amino (Alt)(Sgpt)	$22.63	$90.50	$5.30–$72.40	—	75%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NASH Fibrosure Part J	$27.94	$111.75	$5.30–$89.40	—	75%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast-Sgot	$25.06	$100.25	$5.18–$80.20	46% below	75%
AST (aspartate aminotransferase) enzyme test CPT 84450 NASH Fibrosure Part H	$27.38	$109.50	$5.18–$87.60	41% below	75%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Ast-Sgot	$25.06	$100.25	$5.18–$80.20	—	75%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 NASH Fibrosure Part H	$27.38	$109.50	$5.18–$87.60	—	75%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Panel Hepatitis Acute	$148.06	$592.25	$47.63–$473.80	37% below	75%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Panel Hepatitis Acute	$148.06	$592.25	$47.63–$473.80	—	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F050-IgE Mackerel LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 W006-IgE Mugwort LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F041-IgE Salmon LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 E003-IgE Horse Dander LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 W020-IgE Nettle LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 W018-IgE Sheep Sorrel LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 T211-IgE Sweet Gum LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 C074-IgE Gelatin LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F329-IgE Watermelon LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(7) LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(5) Seafood LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(5) Nuts LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(5) Dairy LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 W016-IgE Rough Marshelder LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Chocolate/Cacao LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 M016-IgE Curvularia lunata LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Clam LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Aspergillus fumigatus LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Corn LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Tomato LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE Crayfish LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Strawberry LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Egg (Yolk) LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F210-IgE Pineapple LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F092-IgE Banana LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 W009-IgE Plantain, English LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(12) Fruits LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F338-IgE Scallop LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (9) Seeds/Nuts LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (5) Meats LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (4) Feathers LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy Grass LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (17) Fruits LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (16) Foods LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (13) Foodsw/CompRflx LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (12) Fruits LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (12) Fish/Shellfish LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Allergen	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 .Barbiturates, GC/MS Confirm LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 T037-IgE Bald Cypress LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 T012-IgE Willow LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Alpha-Gal IgE Panel LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 T003-IgE Common Silver Birch LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 G010-IgE Johnson Grass LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten IgE (F079) LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 F303-IgE Halibut LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(16)Foods/w CompRflx LC	$3.00	$12.00	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Regional Allergen Panel-LC	$3.13	$12.50	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Nut Allergen Panel-LC_LABCORP	$3.13	$12.50	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Meat Allergen Panel-LC	$3.13	$12.50	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Fish Allergen Panel-LC	$3.13	$12.50	$5.22–$21.80	86% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Respiratory Allergens, Region 8 (IA, IL, MO) CL	$4.13	$16.50	$5.22–$21.80	81% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Gelatin, IgE MAYO	$7.19	$28.75	$5.22–$23.00	67% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Rice, IgE MAYO	$7.19	$28.75	$5.22–$23.00	67% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Strawberry, IgE, Serum MAYO	$7.50	$30.00	$5.22–$24.00	66% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 NUTSP Sesame Seed, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 NUTSP Coconut, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Tomato, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Feather Panel # 2, Serum MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 NUTSP Almond, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Banana, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Scallop, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 NUTSP Peanut, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Willow, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg Yolk, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 NUTSP Pecan-Food, IgE MAYO	$7.81	$31.25	$5.22–$25.00	65% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Crab, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 English Plantain, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Curvularia lunata, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Crayfish, IgE MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Corn-Food, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Clam, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Cacao/Cocoa, IgE MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Bald Cypress, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Halibut, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Horse Dander, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson Grass, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Mackerel, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Mugwort, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Nettle, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Oyster, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Red Sorrel, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Silver Birch, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Sweet Gum, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Lobster, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Tuna, IgE Mayo	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE	$8.06	$32.25	$5.22–$25.80	64% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut, IgE. MAYO	$8.38	$33.50	$5.22–$26.80	62% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut-Food, IgE MAYO	$8.38	$33.50	$5.22–$26.80	62% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White, IgE, MAYO	$8.38	$33.50	$5.22–$26.80	62% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 FABP2 86003 Allergen SPEC IGE Crude XTRC EA_MAYO	$10.06	$40.25	$5.22–$32.20	54% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 RPR8 25 Allergens	$10.50	$42.00	$5.22–$33.60	52% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Stinging Insects Venom, IgE	$10.63	$42.50	$5.22–$34.00	52% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus fumigatus, IgE, Serum MAYO	$11.13	$44.50	$5.22–$35.60	50% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen (IgE) Nuts Profile CL	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Multi-Allergen (IgE), Feather Panel CL	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLERGEN (IgE) Nuts Profile CL_Corelabs	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLERGEN (IgE) Dairy Grain Profile CL_Corelab	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 allergen (IgE) Seafood Profile CL_Corelab	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Multi-Allergen (IgE) Feather Panel CL_Corelab	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen (IgE) Seafood Profile CL	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen (IgE) Dairy and Grain Profile CL	$12.88	$51.50	$5.22–$41.20	42% below	75%
Allergy blood test, specific IgE, per allergen CPT 86003 FAGPL Allergen Specific IgE	$22.00	$88.00	$5.22–$70.40	at median	75%
Allergy blood test, specific IgE, per allergen CPT 86003 AFAGPL Allergen Specific IgE	$23.13	$92.50	$5.22–$74.00	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Marsh Elder, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Pigweed, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 White Mulberry, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Russian Thistle, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut Tree, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 White Ash, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Turkey Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Tuna, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Sycamore, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Almond, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alernata, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigatus, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Chicken Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium Herbarum(Hormodendrum), IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Coconut, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Common Ragweed, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Crab, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Duck Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Elm, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Goose Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust (Hollister-Stier)(h2), IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust(Greer)(h1), IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Lobster, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Maple, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Milk, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Mountain Cedar, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Oak, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Oat, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan/Hickory Tree, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan-Food, IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicullium Chrysogenum(Penicillium Notatum), IgE CL	$23.25	$93.00	$5.22–$74.40	5% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Food-Nut Panel # 2 MAYO	$27.88	$111.50	$5.22–$89.20	26% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Nut Allergen Panel-LC	$28.13	$112.50	$5.22–$90.00	27% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 FSPII Allergen Specific IgE	$29.63	$118.50	$5.22–$94.80	34% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Food-Nut Panel # 1 MAYO	$31.50	$126.00	$5.22–$100.80	43% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Dairy and Grain Allergen Profile, Serum MAYO	$36.75	$147.00	$5.22–$117.60	66% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 APGAL 86003 ALLG SPEC IGE CRUDE XTRC EA_MAYO	$37.81	$151.25	$5.22–$121.00	71% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 FCRDE Carmine Dye/Red DyeCochineal (Dactylopius coccus) IgE	$43.75	$175.00	$5.22–$140.00	98% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Carmine Dye/Red Dye IgE MAYO	$43.75	$175.00	$5.22–$140.00	98% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 EAP_LC 86003 ALLG SPeC IGE CRUDE XTRC EA_LC	$49.94	$199.75	$5.22–$159.80	126% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill MOLD1 Mold Panel_MAYO	$50.13	$200.50	$5.22–$160.40	127% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 Food Panel	$50.13	$200.50	$5.22–$160.40	127% above	75%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Respiratory Allergens, Regions 8 (IA,IL,MO) CL_Corelab	$105.94	$423.75	$5.22–$339.00	379% above	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Clam LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alpha-Gal IgE Panel LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Aspergillus fumigatus LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (12) Fish/Shellfish LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (12) Fruits LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (13) Foodsw/CompRflx LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Allergen	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (16) Foods LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .Barbiturates, GC/MS Confirm LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (17) Fruits LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (4) Feathers LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F338-IgE Scallop LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (5) Meats LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (9) Seeds/Nuts LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(12) Fruits LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(16)Foods/w CompRflx LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(5) Dairy LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(5) Nuts LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(5) Seafood LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(7) LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Chocolate/Cacao LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T037-IgE Bald Cypress LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F092-IgE Banana LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gluten IgE (F079) LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W020-IgE Nettle LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T012-IgE Willow LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T003-IgE Common Silver Birch LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Egg (Yolk) LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G006-IgE Timothy Grass LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE Crayfish LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Strawberry LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Corn LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Tomato LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G010-IgE Johnson Grass LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W006-IgE Mugwort LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F050-IgE Mackerel LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W018-IgE Sheep Sorrel LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F210-IgE Pineapple LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W009-IgE Plantain, English LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F303-IgE Halibut LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W016-IgE Rough Marshelder LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F329-IgE Watermelon LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C074-IgE Gelatin LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T211-IgE Sweet Gum LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M016-IgE Curvularia lunata LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E003-IgE Horse Dander LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F041-IgE Salmon LC	$3.00	$12.00	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nut Allergen Panel-LC_LABCORP	$3.13	$12.50	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Meat Allergen Panel-LC	$3.13	$12.50	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fish Allergen Panel-LC	$3.13	$12.50	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Regional Allergen Panel-LC	$3.13	$12.50	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Respiratory Allergens, Region 8 (IA, IL, MO) CL	$4.13	$16.50	$5.22–$21.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gelatin, IgE MAYO	$7.19	$28.75	$5.22–$23.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rice, IgE MAYO	$7.19	$28.75	$5.22–$23.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Strawberry, IgE, Serum MAYO	$7.50	$30.00	$5.22–$24.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTSP Almond, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Feather Panel # 2, Serum MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTSP Sesame Seed, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTSP Pecan-Food, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTSP Peanut, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NUTSP Coconut, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Willow, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tomato, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Scallop, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Gluten, IgE MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Banana, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg Yolk, IgE, Serum MAYO	$7.81	$31.25	$5.22–$25.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crayfish, IgE MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Corn-Food, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Clam, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cacao/Cocoa, IgE MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oyster, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bald Cypress, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nettle, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lobster, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mugwort, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tuna, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mackerel, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson Grass, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Horse Dander, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Halibut, IgE, Serum MAYO	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish, IgE Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sweet Gum, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Silver Birch, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Red Sorrel, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 English Plantain, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Curvularia lunata, IgE, Serum Mayo	$8.06	$32.25	$5.22–$25.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White, IgE, MAYO	$8.38	$33.50	$5.22–$26.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut-Food, IgE MAYO	$8.38	$33.50	$5.22–$26.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut, IgE. MAYO	$8.38	$33.50	$5.22–$26.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FABP2 86003 Allergen SPEC IGE Crude XTRC EA_MAYO	$10.06	$40.25	$5.22–$32.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RPR8 25 Allergens	$10.50	$42.00	$5.22–$33.60	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stinging Insects Venom, IgE	$10.63	$42.50	$5.22–$34.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus fumigatus, IgE, Serum MAYO	$11.13	$44.50	$5.22–$35.60	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen (IgE) Nuts Profile CL	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 ALLERGEN (IgE) Dairy Grain Profile CL_Corelab	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen (IgE) Dairy and Grain Profile CL	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Multi-Allergen (IgE), Feather Panel CL	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 allergen (IgE) Seafood Profile CL_Corelab	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 ALLERGEN (IgE) Nuts Profile CL_Corelabs	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Multi-Allergen (IgE) Feather Panel CL_Corelab	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen (IgE) Seafood Profile CL	$12.88	$51.50	$5.22–$41.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FAGPL Allergen Specific IgE	$22.00	$88.00	$5.22–$70.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AFAGPL Allergen Specific IgE	$23.13	$92.50	$5.22–$74.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan-Food, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sycamore, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Walnut Tree, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sesame Seed, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Russian Thistle, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Ash, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Pigweed, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Mulberry, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Marsh Elder, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicullium Chrysogenum(Penicillium Notatum), IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan/Hickory Tree, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oat, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tuna, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Turkey Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mountain Cedar, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Milk, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maple, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lobster, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust(Greer)(h1), IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust (Hollister-Stier)(h2), IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Goose Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Duck Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Crab, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Ragweed, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Coconut, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium Herbarum(Hormodendrum), IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chicken Feathers, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Dander, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda Grass, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Fumigatus, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Alernata, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Almond, IgE CL	$23.25	$93.00	$5.22–$74.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food-Nut Panel # 2 MAYO	$27.88	$111.50	$5.22–$89.20	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nut Allergen Panel-LC	$28.13	$112.50	$5.22–$90.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FSPII Allergen Specific IgE	$29.63	$118.50	$5.22–$94.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food-Nut Panel # 1 MAYO	$31.50	$126.00	$5.22–$100.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dairy and Grain Allergen Profile, Serum MAYO	$36.75	$147.00	$5.22–$117.60	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APGAL 86003 ALLG SPEC IGE CRUDE XTRC EA_MAYO	$37.81	$151.25	$5.22–$121.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Carmine Dye/Red Dye IgE MAYO	$43.75	$175.00	$5.22–$140.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FCRDE Carmine Dye/Red DyeCochineal (Dactylopius coccus) IgE	$43.75	$175.00	$5.22–$140.00	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EAP_LC 86003 ALLG SPeC IGE CRUDE XTRC EA_LC	$49.94	$199.75	$5.22–$159.80	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Food Panel	$50.13	$200.50	$5.22–$160.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bill MOLD1 Mold Panel_MAYO	$50.13	$200.50	$5.22–$160.40	—	75%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Respiratory Allergens, Regions 8 (IA,IL,MO) CL_Corelab	$105.94	$423.75	$5.22–$339.00	—	75%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC	$7.50	$30.00	$12.95–$54.11	91% below	75%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 504509 82600 CCP Antibody_LC	$20.75	$83.00	$12.95–$66.40	74% below	75%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab, S Mayo	$21.31	$85.25	$12.95–$68.20	73% below	75%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP_Cyclic Citrullinated Peptide Ab, S MAYO	$21.31	$85.25	$12.95–$68.20	73% below	75%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab, S MAYO	$91.19	$364.75	$12.95–$291.80	14% above	75%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC	$7.50	$30.00	$12.95–$54.11	—	75%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 504509 82600 CCP Antibody_LC	$20.75	$83.00	$12.95–$66.40	—	75%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP_Cyclic Citrullinated Peptide Ab, S MAYO	$21.31	$85.25	$12.95–$68.20	—	75%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab, S Mayo	$21.31	$85.25	$12.95–$68.20	—	75%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab, S MAYO	$91.19	$364.75	$12.95–$291.80	—	75%
Antinuclear antibody (ANA) blood test, screen CPT 86038 86038 Antinuclear Antibodies (ANA), Screen CL_Corelab	$9.50	$38.00	$12.09–$50.52	86% below	75%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies (ANA), Screen CL	$9.50	$38.00	$12.09–$50.52	86% below	75%
Antinuclear antibody (ANA) blood test, screen CPT 86038 382965 ANA by IFA, Reflex_LC	$19.31	$77.25	$12.09–$61.80	72% below	75%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab, S MAYO	$19.81	$79.25	$12.09–$63.40	71% below	75%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab, S Mayo	$19.81	$79.25	$12.09–$63.40	71% below	75%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies	$35.94	$143.75	$12.09–$115.00	47% below	75%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies (ANA), Screen CL	$9.50	$38.00	$12.09–$50.52	—	75%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 86038 Antinuclear Antibodies (ANA), Screen CL_Corelab	$9.50	$38.00	$12.09–$50.52	—	75%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 382965 ANA by IFA, Reflex_LC	$19.31	$77.25	$12.09–$61.80	—	75%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab, S Mayo	$19.81	$79.25	$12.09–$63.40	—	75%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab, S MAYO	$19.81	$79.25	$12.09–$63.40	—	75%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies	$35.94	$143.75	$12.09–$115.00	—	75%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Brain Natriuretic Peptide (BNP)	$120.94	$483.75	$39.26–$387.00	1% below	75%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT Pro-BNP	$125.81	$503.25	$39.26–$402.60	3% above	75%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Brain Natriuretic Peptide (BNP)	$120.94	$483.75	$39.26–$387.00	—	75%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT Pro-BNP	$125.81	$503.25	$39.26–$402.60	—	75%
Basic metabolic panel (blood test) CPT 80048 Chem 7	$55.00	$220.00	$8.46–$176.00	56% below	75%
Basic metabolic panel (blood test) inpatient CPT 80048 Chem 7	$55.00	$220.00	$8.46–$176.00	—	75%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEV4P Level 4 Gross and Microscopic Exam Bill Only	$76.50	$306.00	$51.63–$244.80	63% below	75%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Path: Tissue Group IV	$135.38	$541.50	$51.63–$433.20	34% below	75%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Level 4 Gross and Miscroscopic, RB_MAYO	$284.81	$1,139.25	$51.63–$911.40	40% above	75%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEV4P Level 4 Gross and Microscopic Exam Bill Only	$76.50	$306.00	$51.63–$244.80	—	75%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Path: Tissue Group IV	$135.38	$541.50	$51.63–$433.20	—	75%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Level 4 Gross and Miscroscopic, RB_MAYO	$284.81	$1,139.25	$51.63–$911.40	—	75%
Blood culture for bacteria CPT 87040 Culture Blood For Bacteria	$30.44	$121.75	$10.32–$97.40	73% below	75%
Blood culture for bacteria inpatient CPT 87040 Culture Blood For Bacteria	$30.44	$121.75	$10.32–$97.40	—	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 BLOOD DRAW FEE - POC	$7.38	$29.50	$0.01–$23.60	56% below	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 InfCtr Blood Draw	$7.63	$30.50	$0.01–$24.40	55% below	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw By Venipuncture 2H	$7.63	$30.50	$0.01–$24.40	55% below	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood Draw By Venipuncture	$7.94	$31.75	$0.01–$25.40	53% below	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$7.94	$31.75	$0.01–$25.40	53% below	75%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ER Blood Drawing Fee	$8.69	$34.75	$0.01–$27.80	48% below	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 BLOOD DRAW FEE - POC	$7.38	$29.50	$0.01–$23.60	—	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Draw By Venipuncture 2H	$7.63	$30.50	$0.01–$24.40	—	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 InfCtr Blood Draw	$7.63	$30.50	$0.01–$24.40	—	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood Draw By Venipuncture	$7.94	$31.75	$0.01–$25.40	—	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$7.94	$31.75	$0.01–$25.40	—	75%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ER Blood Drawing Fee	$8.69	$34.75	$0.01–$27.80	—	75%
Blood glucose (sugar) test CPT 82947 Glucose - Random	$20.31	$81.25	$3.93–$65.00	38% below	75%
Blood glucose (sugar) test CPT 82947 .GTT Fasting Glucose	$21.44	$85.75	$3.93–$68.60	34% below	75%
Blood glucose (sugar) test CPT 82947 NASH Fibrosure Part D	$22.75	$91.00	$3.93–$72.80	30% below	75%
Blood glucose (sugar) test inpatient CPT 82947 Glucose - Random	$20.31	$81.25	$3.93–$65.00	—	75%
Blood glucose (sugar) test inpatient CPT 82947 .GTT Fasting Glucose	$21.44	$85.75	$3.93–$68.60	—	75%
Blood glucose (sugar) test inpatient CPT 82947 NASH Fibrosure Part D	$22.75	$91.00	$3.93–$72.80	—	75%
Blood lead test CPT 83655 Lead, B, HMS MAYO	$9.44	$37.75	$12.11–$50.59	83% below	75%
Blood lead test CPT 83655 Lead Urine	$23.13	$92.50	$12.11–$74.00	58% below	75%
Blood lead test CPT 83655 Led, Blood Add-On Charge	$26.13	$104.50	$12.11–$83.60	52% below	75%
Blood lead test CPT 83655 PBDB_Lead with Demographics, B MAYO	$39.81	$159.25	$12.11–$127.40	27% below	75%
Blood lead test CPT 83655 HMHA 83655 ASSAY OF LEAD_MAYO	$139.25	$557.00	$12.11–$445.60	155% above	75%
Blood lead test inpatient CPT 83655 Lead, B, HMS MAYO	$9.44	$37.75	$12.11–$50.59	—	75%
Blood lead test inpatient CPT 83655 Lead Urine	$23.13	$92.50	$12.11–$74.00	—	75%
Blood lead test inpatient CPT 83655 Led, Blood Add-On Charge	$26.13	$104.50	$12.11–$83.60	—	75%
Blood lead test inpatient CPT 83655 PBDB_Lead with Demographics, B MAYO	$39.81	$159.25	$12.11–$127.40	—	75%
Blood lead test inpatient CPT 83655 HMHA 83655 ASSAY OF LEAD_MAYO	$139.25	$557.00	$12.11–$445.60	—	75%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta Hcg Qualitative	$27.31	$109.25	$7.52–$87.40	49% below	75%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta Hcg Qualitative	$27.31	$109.25	$7.52–$87.40	—	75%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Newborn ABO/Rh	$96.00	$384.00	$1.67–$307.20	33% above	75%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type Abo	$99.88	$399.50	$1.67–$319.60	38% above	75%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood Type Abo	$100.69	$402.75	$1.67–$322.20	40% above	75%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh	$100.69	$402.75	$1.67–$322.20	40% above	75%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Newborn ABO/Rh	$96.00	$384.00	$1.67–$307.20	—	75%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Type Abo	$99.88	$399.50	$1.67–$319.60	—	75%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh	$100.69	$402.75	$1.67–$322.20	—	75%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood Type Abo	$100.69	$402.75	$1.67–$322.20	—	75%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 FIBDD C-Reactive Protein	$15.88	$63.50	$5.18–$50.80	73% below	75%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 FIBDD C-Reactive Protein	$15.88	$63.50	$5.18–$50.80	—	75%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile PCR	$52.56	$210.25	$37.27–$168.20	63% below	75%
C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Difficile PCR	$52.56	$210.25	$37.27–$168.20	63% below	75%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile PCR	$52.56	$210.25	$37.27–$168.20	—	75%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium Difficile PCR	$52.56	$210.25	$37.27–$168.20	—	75%
CA 19-9 blood test (tumor marker) CPT 86301 Immunoassay Tumor Ca 19-9	$39.69	$158.75	$20.81–$127.00	64% below	75%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Immunoassay Tumor Ca 19-9	$39.69	$158.75	$20.81–$127.00	—	75%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$39.69	$158.75	$20.81–$127.00	64% below	75%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$39.69	$158.75	$20.81–$127.00	—	75%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID - POC	$78.88	$315.50	$51.31–$252.40	21% below	75%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID POC hospital	$78.88	$315.50	$51.31–$252.40	21% below	75%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 Lab Test	$78.88	$315.50	$51.31–$252.40	21% below	75%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS Coronavirus RNA PCR Mayo	$87.00	$348.00	$51.31–$278.40	13% below	75%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 87635 - SARS-COV-2 COVID-19 AMP PRB	$161.50	$646.00	$51.31–$516.80	62% above	75%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID POC hospital	$78.88	$315.50	$51.31–$252.40	—	75%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 Lab Test	$78.88	$315.50	$51.31–$252.40	—	75%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID - POC	$78.88	$315.50	$51.31–$252.40	—	75%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS Coronavirus RNA PCR Mayo	$87.00	$348.00	$51.31–$278.40	—	75%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 87635 - SARS-COV-2 COVID-19 AMP PRB	$161.50	$646.00	$51.31–$516.80	—	75%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CTRNA Chlamydia trachomatis Amp RNA	$26.25	$105.00	$35.09–$117.56	71% below	75%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia DNA Probe	$26.31	$105.25	$35.09–$117.56	71% below	75%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CTRNA Chlamydia trachomatis Amp RNA	$26.25	$105.00	$35.09–$117.56	—	75%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia DNA Probe	$26.31	$105.25	$35.09–$117.56	—	75%
Complete blood count (CBC) with differential CPT 85025 CBC W/Auto Diff Complete	$26.31	$105.25	$7.77–$84.20	51% below	75%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/Auto Diff Complete	$26.31	$105.25	$7.77–$84.20	—	75%
Complete blood count (CBC), no differential CPT 85027 CBC w/Manual Diff Standard	$20.19	$80.75	$6.47–$64.60	59% below	75%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/Manual Diff Standard	$20.19	$80.75	$6.47–$64.60	—	75%
Comprehensive metabolic panel (blood test) CPT 80053 Chem 12	$51.75	$207.00	$10.56–$165.60	59% below	75%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Chem 12	$51.75	$207.00	$10.56–$165.60	—	75%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quant	$22.50	$90.00	$10.18–$72.00	82% below	75%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, Plasma MAYO_DIRM	$72.00	$288.00	$10.18–$230.40	43% below	75%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer, P	$78.69	$314.75	$10.18–$251.80	37% below	75%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer Quant	$22.50	$90.00	$10.18–$72.00	—	75%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, Plasma MAYO_DIRM	$72.00	$288.00	$10.18–$230.40	—	75%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer, P	$78.69	$314.75	$10.18–$251.80	—	75%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-S	$42.19	$168.75	$22.23–$135.00	69% below	75%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Dhea-S	$42.19	$168.75	$22.23–$135.00	—	75%
Estradiol blood test CPT 82670 500649 Estradiol: Total 82670_LC	$28.13	$112.50	$27.94–$116.77	80% below	75%
Estradiol blood test CPT 82670 Estradiol	$55.69	$222.75	$27.94–$178.20	61% below	75%
Estradiol blood test inpatient CPT 82670 500649 Estradiol: Total 82670_LC	$28.13	$112.50	$27.94–$116.77	—	75%
Estradiol blood test inpatient CPT 82670 Estradiol	$55.69	$222.75	$27.94–$178.20	—	75%
FSH (follicle-stimulating hormone) test CPT 83001 Fsh	$67.06	$268.25	$18.58–$214.60	34% below	75%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Fsh	$67.06	$268.25	$18.58–$214.60	—	75%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal LC	$67.50	$270.00	$19.63–$216.00	64% below	75%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, F MAYO	$196.44	$785.75	$19.63–$628.60	6% above	75%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal LC	$67.50	$270.00	$19.63–$216.00	—	75%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, F MAYO	$196.44	$785.75	$19.63–$628.60	—	75%
Ferritin blood test (iron stores) CPT 82728 Assay of Ferritin	$30.13	$120.50	$13.63–$96.40	64% below	75%
Ferritin blood test (iron stores) inpatient CPT 82728 Assay of Ferritin	$30.13	$120.50	$13.63–$96.40	—	75%
Folate (folic acid) blood test CPT 82746 Folic Acid	$44.63	$178.50	$14.70–$142.80	41% below	75%
Folate (folic acid) blood test CPT 82746 Folate Level	$44.63	$178.50	$14.70–$142.80	41% below	75%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$44.63	$178.50	$14.70–$142.80	—	75%
Folate (folic acid) blood test inpatient CPT 82746 Folic Acid	$44.63	$178.50	$14.70–$142.80	—	75%
Free T3 thyroid hormone test CPT 84481 T3 Free	$37.06	$148.25	$16.94–$118.60	63% below	75%
Free T3 thyroid hormone test inpatient CPT 84481 T3 Free	$37.06	$148.25	$16.94–$118.60	—	75%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free	$28.69	$114.75	$9.02–$91.80	61% below	75%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4	$28.69	$114.75	$9.02–$91.80	61% below	75%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 Free	$28.69	$114.75	$9.02–$91.80	—	75%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4	$28.69	$114.75	$9.02–$91.80	—	75%
Free testosterone test CPT 84402 Testosterone Free	$50.88	$203.50	$25.47–$162.80	59% below	75%
Free testosterone test CPT 84402 Testosterone, Free, S MAYO	$50.88	$203.50	$25.47–$162.80	59% below	75%
Free testosterone test CPT 84402 Testosterone Bio	$50.88	$203.50	$25.47–$162.80	59% below	75%
Free testosterone test CPT 84402 Testosterone, Bioavailable, S MAYO	$50.88	$203.50	$25.47–$162.80	59% below	75%
Free testosterone test inpatient CPT 84402 Testosterone Free	$50.88	$203.50	$25.47–$162.80	—	75%
Free testosterone test inpatient CPT 84402 Testosterone Bio	$50.88	$203.50	$25.47–$162.80	—	75%
Free testosterone test inpatient CPT 84402 Testosterone, Bioavailable, S MAYO	$50.88	$203.50	$25.47–$162.80	—	75%
Free testosterone test inpatient CPT 84402 Testosterone, Free, S MAYO	$50.88	$203.50	$25.47–$162.80	—	75%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 80050 Lab Panel	$104.56	$418.25	$0.01–$334.60	62% below	75%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 80050 Lab Panel	$104.56	$418.25	$0.01–$334.60	—	75%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .GTT-1 Hr	$21.44	$85.75	$4.75–$68.60	50% below	75%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .GTT-1 Hr	$21.44	$85.75	$4.75–$68.60	—	75%
Glucose tolerance test, 3 samples CPT 82951 .GTT-2 Hr	$21.44	$85.75	$12.87–$68.60	76% below	75%
Glucose tolerance test, 3 samples CPT 82951 .GTT-30 Min	$21.44	$85.75	$12.87–$68.60	76% below	75%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT-2 Hr	$21.44	$85.75	$12.87–$68.60	—	75%
Glucose tolerance test, 3 samples inpatient CPT 82951 .GTT-30 Min	$21.44	$85.75	$12.87–$68.60	—	75%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA Probe	$26.31	$105.25	$35.09–$117.56	68% below	75%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC Culture	$26.31	$105.25	$35.09–$117.56	68% below	75%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA Probe	$26.31	$105.25	$35.09–$117.56	—	75%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC Culture	$26.31	$105.25	$35.09–$117.56	—	75%
H. pylori antibody blood test CPT 86677 Helicobac Pylori Ab,IgG,IgM,IgA,S	$33.25	$133.00	$16.85–$106.40	56% below	75%
H. pylori antibody blood test CPT 86677 Bill Only Helicobacter pylori Antibodies, IgA, IgG, IgM LabC	$227.63	$910.50	$16.85–$728.40	203% above	75%
H. pylori antibody blood test inpatient CPT 86677 Helicobac Pylori Ab,IgG,IgM,IgA,S	$33.25	$133.00	$16.85–$106.40	—	75%
H. pylori antibody blood test inpatient CPT 86677 Bill Only Helicobacter pylori Antibodies, IgA, IgG, IgM LabC	$227.63	$910.50	$16.85–$728.40	—	75%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag, F MAYO	$87.69	$350.75	$14.38–$280.60	27% below	75%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag, F MAYO	$87.69	$350.75	$14.38–$280.60	—	75%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 550655 RNA, PCR(NonGraph)rfx/GenoPRI_LC	$57.75	$231.00	$85.10–$313.76	83% below	75%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, PCR(NonGraph)rfx/GenoPRI LC	$57.75	$231.00	$85.10–$313.76	83% below	75%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA, Real Time PCR (Non-Graph) LC	$63.75	$255.00	$85.10–$313.76	82% below	75%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Quant Reflex to Resist, P MAYO	$155.50	$622.00	$85.10–$497.60	55% below	75%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA rfx to Genotyp Resist, P MAYO	$155.50	$622.00	$85.10–$497.60	55% below	75%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA Detect / Quant, P MAYO	$155.50	$622.00	$85.10–$497.60	55% below	75%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 550655 RNA, PCR(NonGraph)rfx/GenoPRI_LC	$57.75	$231.00	$85.10–$313.76	—	75%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, PCR(NonGraph)rfx/GenoPRI LC	$57.75	$231.00	$85.10–$313.76	—	75%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA, Real Time PCR (Non-Graph) LC	$63.75	$255.00	$85.10–$313.76	—	75%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Quant Reflex to Resist, P MAYO	$155.50	$622.00	$85.10–$497.60	—	75%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA rfx to Genotyp Resist, P MAYO	$155.50	$622.00	$85.10–$497.60	—	75%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA Detect / Quant, P MAYO	$155.50	$622.00	$85.10–$497.60	—	75%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Antigen/Antibody Combo	$35.94	$143.75	$24.08–$115.00	56% below	75%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV ANTIGEN/ANTIBODY COMBO	$35.94	$143.75	$24.08–$115.00	56% below	75%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/-2 AG and AB Diagnostic, P HIVDX	$36.69	$146.75	$24.08–$117.40	55% below	75%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV ANTIGEN/ANTIBODY COMBO	$35.94	$143.75	$24.08–$115.00	—	75%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Antigen/Antibody Combo	$35.94	$143.75	$24.08–$115.00	—	75%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/-2 AG and AB Diagnostic, P HIVDX	$36.69	$146.75	$24.08–$117.40	—	75%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C	$24.50	$98.00	$9.71–$78.40	60% below	75%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C	$24.50	$98.00	$9.71–$78.40	—	75%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$38.13	$152.50	$10.74–$122.00	45% below	75%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$38.13	$152.50	$10.74–$122.00	—	75%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$48.25	$193.00	$10.33–$154.40	25% below	75%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$48.25	$193.00	$10.33–$154.40	—	75%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C	$63.00	$252.00	$14.27–$201.60	26% below	75%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C	$63.00	$252.00	$14.27–$201.60	—	75%
Hepatitis C viral load (HCV RNA) test CPT 87522 Bill HCV RNA Detect/Quant, S MAYO	$64.00	$256.00	$42.84–$204.80	78% below	75%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C Quan Pcr	$110.94	$443.75	$42.84–$355.00	63% below	75%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC	$41.25	$165.00	$42.84–$179.00	86% below	75%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Bill HCV RNA Detect/Quant, S MAYO	$64.00	$256.00	$42.84–$204.80	—	75%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep C Quan Pcr	$110.94	$443.75	$42.84–$355.00	—	75%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Non-Graph) LC	$41.25	$165.00	$42.84–$179.00	—	75%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Virus Type I Igg	$25.13	$100.50	$13.19–$80.40	62% below	75%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Virus Type I Igg	$25.13	$100.50	$13.19–$80.40	—	75%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus Type Ii Igg	$36.75	$147.00	$19.35–$117.60	39% below	75%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus Type Ii Igg	$36.75	$147.00	$19.35–$117.60	—	75%
High-sensitivity CRP (hs-CRP) test CPT 86141 C Reactive Protein Ultra Sens	$29.13	$116.50	$12.95–$93.20	59% below	75%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein Ultra Sensitive	$29.13	$116.50	$12.95–$93.20	59% below	75%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein Ultra Sensitive	$29.13	$116.50	$12.95–$93.20	—	75%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C Reactive Protein Ultra Sens	$29.13	$116.50	$12.95–$93.20	—	75%
Homocysteine blood test CPT 83090 Homocysteine Serum	$45.06	$180.25	$17.92–$144.20	59% below	75%
Homocysteine blood test inpatient CPT 83090 Homocysteine Serum	$45.06	$180.25	$17.92–$144.20	—	75%
Insulin blood test CPT 83525 Insulin, S	$21.75	$87.00	$11.43–$69.60	63% below	75%
Insulin blood test CPT 83525 Insulin	$21.75	$87.00	$11.43–$69.60	63% below	75%
Insulin blood test CPT 83525 Insulin Total, S Mayo	$23.25	$93.00	$11.43–$74.40	61% below	75%
Insulin blood test inpatient CPT 83525 Insulin, S	$21.75	$87.00	$11.43–$69.60	—	75%
Insulin blood test inpatient CPT 83525 Insulin	$21.75	$87.00	$11.43–$69.60	—	75%
Insulin blood test inpatient CPT 83525 Insulin Total, S Mayo	$23.25	$93.00	$11.43–$74.40	—	75%
Iron blood test (serum iron) CPT 83540 Iron (Fe) Panel	$21.44	$85.75	$6.47–$68.60	54% below	75%
Iron blood test (serum iron) CPT 83540 Iron Serum	$21.44	$85.75	$6.47–$68.60	54% below	75%
Iron blood test (serum iron) inpatient CPT 83540 Iron (Fe) Panel	$21.44	$85.75	$6.47–$68.60	—	75%
Iron blood test (serum iron) inpatient CPT 83540 Iron Serum	$21.44	$85.75	$6.47–$68.60	—	75%
Iron-binding capacity (TIBC) test CPT 83550 Tibc	$36.25	$145.00	$8.74–$116.00	46% below	75%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Tibc	$36.25	$145.00	$8.74–$116.00	—	75%
Kidney function blood test panel CPT 80069 Renal Panel Standard	$88.88	$355.50	$8.68–$284.40	16% below	75%
Kidney function blood test panel inpatient CPT 80069 Renal Panel Standard	$88.88	$355.50	$8.68–$284.40	—	75%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone	$75.25	$301.00	$18.52–$240.80	26% below	75%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone	$75.25	$301.00	$18.52–$240.80	—	75%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Body Fluid	$20.31	$81.25	$6.89–$65.00	68% below	75%
Lipase blood test (pancreas enzyme) CPT 83690 Assay of Lipase	$20.31	$81.25	$6.89–$65.00	68% below	75%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Assay of Lipase	$20.31	$81.25	$6.89–$65.00	—	75%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Body Fluid	$20.31	$81.25	$6.89–$65.00	—	75%
Liver function blood test panel CPT 80076 Hepatic Function Panel	$62.00	$248.00	$8.17–$198.40	54% below	75%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$62.00	$248.00	$8.17–$198.40	—	75%
Lyme disease antibody test CPT 86618 Lyme Disease Serology w/Reflex LC	$16.50	$66.00	$17.03–$71.17	82% below	75%
Lyme disease antibody test CPT 86618 Lyme CNS Infection IgG with Ab Index Reflex MAYO	$38.31	$153.25	$17.03–$122.60	58% below	75%
Lyme disease antibody test CPT 86618 Lyme Titer	$38.31	$153.25	$17.03–$122.60	58% below	75%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Serology w/Reflex LC	$16.50	$66.00	$17.03–$71.17	—	75%
Lyme disease antibody test inpatient CPT 86618 Lyme Titer	$38.31	$153.25	$17.03–$122.60	—	75%
Lyme disease antibody test inpatient CPT 86618 Lyme CNS Infection IgG with Ab Index Reflex MAYO	$38.31	$153.25	$17.03–$122.60	—	75%
Magnesium blood test CPT 83735 SSAT Magnesium, U	$14.31	$57.25	$6.70–$45.80	70% below	75%
Magnesium blood test CPT 83735 Magnesium Serum	$20.31	$81.25	$6.70–$65.00	57% below	75%
Magnesium blood test CPT 83735 Magnesium Level 24 Hour Urine	$27.31	$109.25	$6.70–$87.40	42% below	75%
Magnesium blood test CPT 83735 Magnesium Urine	$27.31	$109.25	$6.70–$87.40	42% below	75%
Magnesium blood test inpatient CPT 83735 SSAT Magnesium, U	$14.31	$57.25	$6.70–$45.80	—	75%
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$20.31	$81.25	$6.70–$65.00	—	75%
Magnesium blood test inpatient CPT 83735 Magnesium Level 24 Hour Urine	$27.31	$109.25	$6.70–$87.40	—	75%
Magnesium blood test inpatient CPT 83735 Magnesium Urine	$27.31	$109.25	$6.70–$87.40	—	75%
Measles (rubeola) antibody test CPT 86765 RPOG_Measles (Rubeola) Ab, IgG, S MAYO	$18.25	$73.00	$12.88–$58.40	69% below	75%
Measles (rubeola) antibody test CPT 86765 Measles Igg Ab	$18.25	$73.00	$12.88–$58.40	69% below	75%
Measles (rubeola) antibody test CPT 86765 ROM Measles (Rubeola) Ab, IgM, S MAYO	$27.31	$109.25	$12.88–$87.40	54% below	75%
Measles (rubeola) antibody test inpatient CPT 86765 Measles Igg Ab	$18.25	$73.00	$12.88–$58.40	—	75%
Measles (rubeola) antibody test inpatient CPT 86765 RPOG_Measles (Rubeola) Ab, IgG, S MAYO	$18.25	$73.00	$12.88–$58.40	—	75%
Measles (rubeola) antibody test inpatient CPT 86765 ROM Measles (Rubeola) Ab, IgM, S MAYO	$27.31	$109.25	$12.88–$87.40	—	75%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen	$19.38	$77.50	$5.18–$62.00	53% below	75%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mono Screen	$19.38	$77.50	$5.18–$62.00	—	75%
PSA (prostate-specific antigen) blood test, free CPT 84154 Free PSA	$18.00	$72.00	$18.39–$76.88	76% below	75%
PSA (prostate-specific antigen) blood test, free CPT 84154 Psa Free	$34.94	$139.75	$18.39–$111.80	54% below	75%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Free PSA	$18.00	$72.00	$18.39–$76.88	—	75%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa Free	$34.94	$139.75	$18.39–$111.80	—	75%
PSA (prostate-specific antigen) blood test, total CPT 84153 Total PSA	$18.00	$72.00	$18.39–$76.88	77% below	75%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Total	$34.94	$139.75	$18.39–$111.80	55% below	75%
PSA (prostate-specific antigen) blood test, total CPT 84153 Psa Diagnostic	$63.06	$252.25	$18.39–$201.80	18% below	75%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Total PSA	$18.00	$72.00	$18.39–$76.88	—	75%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Total	$34.94	$139.75	$18.39–$111.80	—	75%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Psa Diagnostic	$63.06	$252.25	$18.39–$201.80	—	75%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact	$82.38	$329.50	$41.28–$263.60	52% below	75%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact	$82.38	$329.50	$41.28–$263.60	—	75%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin	$11.50	$46.00	$6.01–$36.80	78% below	75%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Thrombopl Time, P MAYO	$18.44	$73.75	$6.01–$59.00	65% below	75%
Partial thromboplastin time (PTT) clotting test CPT 85730 Aptt	$23.81	$95.25	$6.01–$76.20	55% below	75%
Partial thromboplastin time (PTT) clotting test CPT 85730 FLUPV Lupus Anticoag	$29.44	$117.75	$6.01–$94.20	44% below	75%
Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Thrombopl Time, P	$46.44	$185.75	$6.01–$148.60	12% below	75%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin	$11.50	$46.00	$6.01–$36.80	—	75%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Thrombopl Time, P MAYO	$18.44	$73.75	$6.01–$59.00	—	75%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Aptt	$23.81	$95.25	$6.01–$76.20	—	75%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 FLUPV Lupus Anticoag	$29.44	$117.75	$6.01–$94.20	—	75%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Activated Partial Thrombopl Time, P	$46.44	$185.75	$6.01–$148.60	—	75%
Progesterone blood test CPT 84144 Assay of Progesterone	$39.75	$159.00	$20.86–$127.20	64% below	75%
Progesterone blood test inpatient CPT 84144 Assay of Progesterone	$39.75	$159.00	$20.86–$127.20	—	75%
Prolactin blood test CPT 84146 Prolactin Serum	$55.69	$222.75	$19.38–$178.20	55% below	75%
Prolactin blood test inpatient CPT 84146 Prolactin Serum	$55.69	$222.75	$19.38–$178.20	—	75%
Prothrombin time (PT/INR) clotting test CPT 85610 PT	$8.00	$32.00	$4.29–$25.60	71% below	75%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (PT), P MAYO	$12.13	$48.50	$4.29–$38.80	57% below	75%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$20.31	$81.25	$4.29–$65.00	27% below	75%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time (PT), P	$30.56	$122.25	$4.29–$97.80	9% above	75%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT	$8.00	$32.00	$4.29–$25.60	—	75%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (PT), P MAYO	$12.13	$48.50	$4.29–$38.80	—	75%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$20.31	$81.25	$4.29–$65.00	—	75%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time (PT), P	$30.56	$122.25	$4.29–$97.80	—	75%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 ER Streptococcus Group A Rapid Id	$23.06	$92.25	$16.53–$73.80	42% below	75%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 ER Streptococcus Group A Rapid Id	$23.06	$92.25	$16.53–$73.80	—	75%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, Serum MAYO	$13.44	$53.75	$5.67–$43.00	70% below	75%
Rheumatoid factor (RF) test CPT 86431 504509 86431 RheumatoidFactor Quant_LC	$20.75	$83.00	$5.67–$66.40	53% below	75%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor, Serum MAYO	$13.44	$53.75	$5.67–$43.00	—	75%
Rheumatoid factor (RF) test inpatient CPT 86431 504509 86431 RheumatoidFactor Quant_LC	$20.75	$83.00	$5.67–$66.40	—	75%
Rubella antibody test (immunity check) CPT 86762 RBPG Rubella Antibody	$22.25	$89.00	$14.39–$71.20	58% below	75%
Rubella antibody test (immunity check) CPT 86762 Rubella Ab, IgG, S MAYO	$22.25	$89.00	$14.39–$71.20	58% below	75%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG 1	$22.25	$89.00	$14.39–$71.20	58% below	75%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Ab, IgG, S MAYO	$22.25	$89.00	$14.39–$71.20	—	75%
Rubella antibody test (immunity check) inpatient CPT 86762 RBPG Rubella Antibody	$22.25	$89.00	$14.39–$71.20	—	75%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG 1	$22.25	$89.00	$14.39–$71.20	—	75%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Semen Analysis Complete	$27.31	$109.25	$12.31–$87.40	77% below	75%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Semen Analysis Complete	$27.31	$109.25	$12.31–$87.40	—	75%
Stool ova and parasites exam CPT 87177 Ova Parasite Concentration	$16.94	$67.75	$8.90–$54.20	71% below	75%
Stool ova and parasites exam inpatient CPT 87177 Ova Parasite Concentration	$16.94	$67.75	$8.90–$54.20	—	75%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood - Emesis	$13.50	$54.00	$4.38–$43.20	37% below	75%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screen 4	$14.06	$56.25	$4.38–$45.00	34% below	75%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood - Stool	$14.13	$56.50	$4.38–$45.20	34% below	75%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood - Emesis	$13.50	$54.00	$4.38–$43.20	—	75%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Screen 4	$14.06	$56.25	$4.38–$45.00	—	75%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood - Stool	$14.13	$56.50	$4.38–$45.20	—	75%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult Blood, GL, Immunochemical, F_Mayo	$36.00	$144.00	$15.92–$115.20	29% below	75%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Occult Blood, GL, Immunochemical, F_Mayo	$36.00	$144.00	$15.92–$115.20	—	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF LC	$4.13	$16.50	$4.27–$17.84	86% below	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl - Csf	$22.38	$89.50	$4.27–$71.60	24% below	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr Test	$22.50	$90.00	$4.27–$72.00	24% below	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Ag Reagin with Rfx MAYO_RRPR	$40.00	$160.00	$4.27–$128.00	35% above	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF LC	$4.13	$16.50	$4.27–$17.84	—	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl - Csf	$22.38	$89.50	$4.27–$71.60	—	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rpr Test	$22.50	$90.00	$4.27–$72.00	—	75%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Ag Reagin with Rfx MAYO_RRPR	$40.00	$160.00	$4.27–$128.00	—	75%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus LC	$27.75	$111.00	$53.28–$259.01	85% below	75%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus (client Incubated) LC	$27.75	$111.00	$53.28–$259.01	85% below	75%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus I-0032 CL	$48.38	$193.50	$61.98–$259.01	75% below	75%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 86480 QuantiFERON-TB Gold Plus I-0032 CL_Corelab	$48.38	$193.50	$61.98–$259.01	75% below	75%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold In-Tube, B MAYO	$57.06	$228.25	$61.98–$259.01	70% below	75%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus (client Incubated) LC	$27.75	$111.00	$53.28–$259.01	—	75%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus LC	$27.75	$111.00	$53.28–$259.01	—	75%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 86480 QuantiFERON-TB Gold Plus I-0032 CL_Corelab	$48.38	$193.50	$61.98–$259.01	—	75%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus I-0032 CL	$48.38	$193.50	$61.98–$259.01	—	75%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold In-Tube, B MAYO	$57.06	$228.25	$61.98–$259.01	—	75%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total, S MAYO	$51.56	$206.25	$25.81–$165.00	57% below	75%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total, S MAYO	$51.56	$206.25	$25.81–$165.00	—	75%
Thyroid peroxidase (TPO) antibody test CPT 86376 LKM Liver/Kidney Microsom, Ab	$18.38	$73.50	$14.55–$60.77	76% below	75%
Thyroid peroxidase (TPO) antibody test CPT 86376 FCUIP Microsomal Antibody each	$27.06	$108.25	$14.55–$86.60	65% below	75%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab	$27.75	$111.00	$14.55–$88.80	64% below	75%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid P Ab	$45.00	$180.00	$14.55–$144.00	41% below	75%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LKM Liver/Kidney Microsom, Ab	$18.38	$73.50	$14.55–$60.77	—	75%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 FCUIP Microsomal Antibody each	$27.06	$108.25	$14.55–$86.60	—	75%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Ab	$27.75	$111.00	$14.55–$88.80	—	75%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid P Ab	$45.00	$180.00	$14.55–$144.00	—	75%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thryoid Stimulating Hormone	$26.56	$106.25	$16.80–$85.00	42% below	75%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay Tsh	$26.56	$106.25	$16.80–$85.00	42% below	75%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 FCUIP Assay Thyroid Stim Hormone	$31.25	$125.00	$16.80–$100.00	32% below	75%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thryoid Stimulating Hormone	$26.56	$106.25	$16.80–$85.00	—	75%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay Tsh	$26.56	$106.25	$16.80–$85.00	—	75%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 FCUIP Assay Thyroid Stim Hormone	$31.25	$125.00	$16.80–$100.00	—	75%
Trichomonas test (NAAT) CPT 87661 TVRNA Trichomonas Vaginalis Amp RNA	$222.81	$891.25	$35.09–$713.00	62% above	75%
Trichomonas test (NAAT) inpatient CPT 87661 TVRNA Trichomonas Vaginalis Amp RNA	$222.81	$891.25	$35.09–$713.00	—	75%
Uric acid blood test CPT 84550 Uric Acid Serum	$20.31	$81.25	$4.52–$65.00	52% below	75%
Uric acid blood test inpatient CPT 84550 Uric Acid Serum	$20.31	$81.25	$4.52–$65.00	—	75%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis Automated w/Micro	$22.69	$90.75	$3.17–$72.60	39% below	75%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis Automated w/Micro	$22.69	$90.75	$3.17–$72.60	—	75%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis w/ Microscopic Standard	$2.81	$11.25	$2.25–$9.39	86% below	75%
Urinalysis without microscope exam, automated CPT 81003 306266 81003 Urinalysis Auto W/O Scope_Labcorp	$3.94	$15.75	$2.25–$12.60	80% below	75%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis Automated W/O Micro	$11.50	$46.00	$2.25–$36.80	43% below	75%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis w/ Microscopic Standard	$2.81	$11.25	$2.25–$9.39	—	75%
Urinalysis without microscope exam, automated inpatient CPT 81003 306266 81003 Urinalysis Auto W/O Scope_Labcorp	$3.94	$15.75	$2.25–$12.60	—	75%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis Automated W/O Micro	$11.50	$46.00	$2.25–$36.80	—	75%
Urinalysis without microscope exam, manual CPT 81002 Urinalysis Dipstick	$9.19	$36.75	$3.48–$29.40	29% below	75%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis Dipstick	$9.19	$36.75	$3.48–$29.40	—	75%
Urine pregnancy test, read by color change CPT 81025 ER Urine HCG	$15.25	$61.00	$8.61–$48.80	69% below	75%
Urine pregnancy test, read by color change inpatient CPT 81025 ER Urine HCG	$15.25	$61.00	$8.61–$48.80	—	75%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$47.56	$190.25	$15.08–$152.20	38% below	75%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$47.56	$190.25	$15.08–$152.20	—	75%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D Total	$63.63	$254.50	$29.60–$203.60	53% below	75%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy	$63.63	$254.50	$29.60–$203.60	53% below	75%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy	$63.63	$254.50	$29.60–$203.60	—	75%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D Total	$63.63	$254.50	$29.60–$203.60	—	75%
Zinc blood test CPT 84630 Zinc, S MAYO	$22.75	$91.00	$11.39–$72.80	63% below	75%
Zinc blood test inpatient CPT 84630 Zinc, S MAYO	$22.75	$91.00	$11.39–$72.80	—	75%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg Quantitative	$33.56	$134.25	$15.05–$107.40	60% below	75%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Pregnancy Test Serum 1	$33.56	$134.25	$15.05–$107.40	60% below	75%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Pregnancy Test Serum 1	$33.56	$134.25	$15.05–$107.40	—	75%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Hcg Quantitative	$33.56	$134.25	$15.05–$107.40	—	75%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 Removal of adenoids	$2,294.00	$9,176.01	$2,578.45–$7,340.81	29% below	75%
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 Neck spine fuse&remov bel c2	$15,374.53	$61,498.13	$4,139.00–$49,198.50	9% above	75%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 GRAFT SINGLE STRAND SEMITENDINOSUS TENDON	$1,645.19	$6,580.75	$899.00–$13,087.35	91% below	75%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Knee arthroscopy/surgery	$6,824.91	$27,299.65	$4,139.00–$21,839.72	65% below	75%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 GRAFT SINGLE STRAND SEMITENDINOSUS TENDON	$1,645.19	$6,580.75	$899.00–$13,087.35	—	75%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Sho arthrs srg rt8tr cuf rpr	$9,765.41	$39,061.65	$4,139.00–$31,249.32	20% below	75%
Balloon dilation of the maxillary sinus opening, one side CPT 31295 Nsl/sins ndsc surg max sins	$5,995.45	$23,981.79	$5,266.00–$19,185.43	40% below	75%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Treat metatarsal fracture	$3,506.47	$14,025.86	$194.26–$11,220.69	794% above	75%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 Correction hallux valgus	$2,563.75	$10,254.99	$2,669.17–$8,203.99	41% above	75%
Bunion correction with removal of part of the big toe joint CPT 28292 Correction hallux valgus	$3,915.36	$15,661.45	$2,669.17–$12,529.16	233% above	75%
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL TechFee	$593.06	$2,372.25	$498.45–$1,897.80	28% below	75%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion.	$662.81	$2,651.25	$498.45–$2,121.00	19% below	75%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$689.25	$2,757.00	$498.45–$2,205.60	16% below	75%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion electric ext	$1,470.68	$5,882.73	$529.47–$4,706.18	79% above	75%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL TechFee	$593.06	$2,372.25	$498.45–$1,897.80	—	75%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion.	$662.81	$2,651.25	$498.45–$2,121.00	—	75%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$689.25	$2,757.00	$498.45–$2,205.60	—	75%
Carpal tunnel release, open surgery CPT 64721 Carpal tunnel surgery	$1,993.94	$7,975.76	$1,654.97–$6,380.61	34% below	75%
Cataract surgery with lens implant CPT 66984 Xcapsl ctrc rmvl w/o ecp	$2,370.38	$9,481.53	$1,957.26–$7,585.22	54% below	75%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 Circum 28 days or older	$2,770.52	$11,082.06	$1,149.00–$8,865.65	13% below	75%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ER Closed Dist Radial Fx Wo Manip Tc	$299.81	$1,199.25	$182.88–$959.40	49% below	75%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ER Closed Dist Radial Fx Wo Manip Tc	$299.81	$1,199.25	$182.88–$959.40	—	75%
Colonoscopy with polyp removal CPT 45385 Colonoscopy w/lesion removal	$2,498.24	$9,992.96	$977.36–$7,994.37	47% above	75%
Colonoscopy with tissue sample CPT 45380 Colonoscopy and biopsy	$1,508.87	$6,035.48	$977.36–$4,828.38	15% below	75%
Colonoscopy, diagnostic CPT 45378 Diagnostic colonoscopy	$735.58	$2,942.30	$747.96–$2,353.84	42% below	75%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 Bx of cervix w/scope leep	$2,597.14	$10,388.57	$1,149.00–$8,310.86	27% above	75%
Complex cataract surgery with lens implant CPT 66982 Xcapsl ctrc rmvl cplx wo ecp	$2,489.49	$9,957.94	$1,957.26–$7,966.35	43% below	75%
Cystoscopy with ureteral stent placement CPT 52332 Cystoscopy and treatment	$5,079.15	$20,316.59	$2,897.81–$16,253.27	15% below	75%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy	$1,925.70	$7,702.79	$542.23–$6,162.23	80% above	75%
D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation and curettage	$2,371.64	$9,486.54	$2,472.85–$7,589.23	23% below	75%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 Create eardrum opening	$1,651.94	$6,607.76	$1,274.96–$5,286.21	50% below	75%
Earwax removal by irrigation (rinsing), one ear CPT 69209 Remove Impacted Ear Wax-Irrigation	$77.94	$311.75	$49.39–$249.40	5% above	75%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Remove Impacted Ear Wax-Irrigation	$77.94	$311.75	$49.39–$249.40	—	75%
Earwax removal with instruments, one ear both sides CPT 69210 69210 WC Impacted Cerumen Removal Bilateral	$74.88	$299.50	$44.89–$239.60	—	75%
Earwax removal with instruments, one ear CPT 69210 ER Remove Impacted Ear Wax-Instrumentation	$73.81	$295.25	$49.39–$236.20	19% below	75%
Earwax removal with instruments, one ear CPT 69210 Remove impacted ear wax uni	$1,503.64	$6,014.55	$52.46–$4,811.64	1541% above	75%
Earwax removal with instruments, one ear one side CPT 69210 69210 WC Impacted Cerumen Removal Unilateral	$56.31	$225.25	$44.89–$180.20	39% below	75%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 69210 WC Impacted Cerumen Removal Bilateral	$74.88	$299.50	$44.89–$239.60	—	75%
Earwax removal with instruments, one ear inpatient CPT 69210 ER Remove Impacted Ear Wax-Instrumentation	$73.81	$295.25	$49.39–$236.20	—	75%
Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 WC Impacted Cerumen Removal Unilateral	$56.31	$225.25	$44.89–$180.20	—	75%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 Nsl/sins ndsc w/tot ethmdct	$4,823.89	$19,295.57	$4,139.00–$15,436.46	44% below	75%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 Nsl/sins ndsc frnt tiss rmvl	$6,456.88	$25,827.53	$4,139.00–$20,662.02	22% below	75%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 Endoscopy maxillary sinus	$4,329.18	$17,316.70	$4,139.00–$13,853.36	47% below	75%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Diagnostic sigmoidoscopy	$1,128.56	$4,514.22	$747.96–$3,611.38	at median	75%
Gallbladder removal, laparoscopic CPT 47562 Laparoscopic cholecystectomy	$4,146.51	$16,586.04	$4,139.00–$13,268.83	31% below	75%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 Laparo cholecystectomy/graph	$6,242.15	$24,968.60	$4,139.00–$19,974.88	at median	75%
Hammertoe correction surgery CPT 28285 Repair of hammertoe	$3,059.80	$12,239.18	$1,149.00–$9,791.34	28% above	75%
Hemorrhoid banding (rubber band ligation) CPT 46221 Ligation of hemorrhoid(s)	$2,382.41	$9,529.65	$747.96–$7,623.72	75% above	75%
Hemorrhoidectomy (internal and external), one area CPT 46255 Remove int/ext hem 1 group	$4,037.42	$16,149.67	$1,149.00–$12,919.74	3% below	75%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Contrast Hysterosalpingography	$74.94	$299.75	$0.01–$239.80	74% below	75%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 Contrast Hysterosalpingography	$74.94	$299.75	$0.01–$239.80	—	75%
Hysteroscopy with endometrial ablation CPT 58563 Hysteroscopy ablation	$3,379.42	$13,517.67	$4,139.00–$10,814.14	55% below	75%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 Hysteroscopy biopsy	$3,842.22	$15,368.89	$1,149.00–$12,295.11	8% below	75%
IUD insertion (the device itself billed separately) CPT 58300 Insert intrauterine device	$1,487.66	$5,950.63	$159.50–$4,760.50	141% above	75%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 WC Incision and drainage simple/single	$140.88	$563.50	$127.03–$450.80	37% below	75%
Incision and drainage of a simple or single skin abscess CPT 10060 G0460 ACP PRP Wound Care	$173.81	$695.25	$127.03–$556.20	23% below	75%
Incision and drainage of a simple or single skin abscess CPT 10060 ER ID Of Abscess: Simple/Single Tc	$254.94	$1,019.75	$159.34–$815.80	13% above	75%
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage of skin abscess	$3,782.64	$15,130.54	$169.25–$12,104.43	1581% above	75%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 WC Incision and drainage simple/single	$140.88	$563.50	$127.03–$450.80	—	75%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 G0460 ACP PRP Wound Care	$173.81	$695.25	$127.03–$556.20	—	75%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ER ID Of Abscess: Simple/Single Tc	$254.94	$1,019.75	$159.34–$815.80	—	75%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp i/hern init reduc >5 yr	$3,673.26	$14,693.05	$2,998.69–$11,754.44	41% below	75%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJ TENDON SHEATH/LIGAMENT TECH	$177.94	$711.75	$57.09–$569.40	10% below	75%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS TechFee	$371.19	$1,484.75	$231.82–$1,187.80	87% above	75%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJ TENDON SHEATH/LIGAMENT TECH	$177.94	$711.75	$57.09–$569.40	—	75%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS TechFee	$371.19	$1,484.75	$231.82–$1,187.80	—	75%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Aspiration/Inj Major Jt/Bursa w/o US	$64.75	$259.00	$124.32–$899.00	70% below	75%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER Arthrocent/Aspir/Injur--Major Tc	$297.63	$1,190.50	$231.82–$952.40	39% above	75%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Aspiration/Inj Major Jt/Bursa w/o US	$64.75	$259.00	$124.32–$899.00	—	75%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ER Arthrocent/Aspir/Injur--Major Tc	$297.63	$1,190.50	$231.82–$952.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER Arthrocent, Aspir/Inj - Inter Tc	$297.63	$1,190.50	$231.82–$952.40	49% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 WC Aspiration/Inject. intermediate Joint/Bursa	$364.31	$1,457.25	$50.51–$1,165.80	82% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Fluoro Guidance Local Needle For Joint	$578.25	$2,313.00	$231.82–$1,850.40	189% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR Fluoro Ankle Joint Inj Asp Lt	$370.44	$1,481.75	$231.82–$1,185.40	85% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR Fluoro Elbow Joint Inj Asp Rt	$370.44	$1,481.75	$231.82–$1,185.40	85% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR Fluoro Elbow Joint Inj Asp Lt	$370.44	$1,481.75	$231.82–$1,185.40	85% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR Fluoro Ankle Joint Inj Asp Rt	$370.44	$1,481.75	$231.82–$1,185.40	85% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR Fluoro Wrist Joint Inj Asp Rt	$370.44	$1,481.75	$231.82–$1,185.40	85% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 XR Fluoro Wrist Joint Inj Asp Lt	$370.44	$1,481.75	$231.82–$1,185.40	85% above	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ER Arthrocent, Aspir/Inj - Inter Tc	$297.63	$1,190.50	$231.82–$952.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 WC Aspiration/Inject. intermediate Joint/Bursa	$364.31	$1,457.25	$50.51–$1,165.80	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Fluoro Guidance Local Needle For Joint	$578.25	$2,313.00	$231.82–$1,850.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR Fluoro Ankle Joint Inj Asp Lt	$370.44	$1,481.75	$231.82–$1,185.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR Fluoro Ankle Joint Inj Asp Rt	$370.44	$1,481.75	$231.82–$1,185.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR Fluoro Elbow Joint Inj Asp Lt	$370.44	$1,481.75	$231.82–$1,185.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR Fluoro Elbow Joint Inj Asp Rt	$370.44	$1,481.75	$231.82–$1,185.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR Fluoro Wrist Joint Inj Asp Lt	$370.44	$1,481.75	$231.82–$1,185.40	—	75%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 XR Fluoro Wrist Joint Inj Asp Rt	$370.44	$1,481.75	$231.82–$1,185.40	—	75%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 WC Aspiration/Injection of Small Joint/Bursa	$211.69	$846.75	$48.66–$677.40	5% above	75%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 WC Aspiration/Injection of Small Joint/Bursa	$211.69	$846.75	$48.66–$677.40	—	75%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Knee arthroscopy/surgery	$4,734.89	$18,939.56	$2,669.17–$15,151.65	57% below	75%
Knee arthroscopy with meniscus trim CPT 29881 Knee arthroscopy/surgery	$3,229.69	$12,918.76	$2,669.17–$10,335.01	53% below	75%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Knee arthroscopy/surgery	$3,487.09	$13,948.35	$2,669.17–$11,158.68	50% below	75%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Knee arthroscopy/surgery	$2,978.77	$11,915.08	$2,669.17–$9,532.06	52% below	75%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 Laparoscopy appendectomy	$6,736.51	$26,946.05	$4,139.00–$21,556.84	16% below	75%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 Tlh uterus 250 g or less	$6,685.73	$26,742.92	$4,139.00–$21,394.34	58% below	75%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 Tlh w/t/o 250 g or less	$6,908.75	$27,635.00	$4,139.00–$22,108.00	57% below	75%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 Lap ing hernia repair init	$4,579.20	$18,316.78	$4,139.00–$14,653.42	38% below	75%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 Laparoscopy remove adnexa	$3,869.32	$15,477.29	$4,139.00–$12,381.83	64% below	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 WC Wound Repair Interm: =<2.5Cm	$236.06	$944.25	$202.56–$764.50	38% below	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee	$491.06	$1,964.25	$306.69–$1,571.40	29% above	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Intmd rpr s/a/t/ext 2.5 cm/<	$3,221.06	$12,884.23	$325.77–$10,307.38	748% above	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 WC Wound Repair Interm: =<2.5Cm	$236.06	$944.25	$202.56–$764.50	—	75%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee	$491.06	$1,964.25	$306.69–$1,571.40	—	75%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 Low back disk surgery	$6,776.46	$27,105.83	$4,139.00–$21,684.66	44% below	75%
Lumpectomy (partial mastectomy) CPT 19301 Partial mastectomy	$7,157.82	$28,631.27	$2,976.21–$22,905.02	460% above	75%
Mastectomy (total removal of the breast) CPT 19303 Mast simple complete	$6,616.35	$26,465.41	$1,149.00–$21,172.33	348% above	75%
Miscarriage treatment with D&C, first trimester CPT 59820 Care of miscarriage	$2,369.85	$9,479.38	$2,472.85–$7,583.50	51% below	75%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc tr-ext b9+marg 0.5 cm<	$4,050.95	$16,203.81	$586.52–$12,963.05	1540% above	75%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Exc face-mm b9+marg 0.5 cm/<	$2,463.80	$9,855.20	$586.52–$7,884.16	753% above	75%
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion nail plate;simple/single (Surg)	$250.44	$1,001.75	$69.84–$801.40	52% above	75%
Nail removal (partial or complete), one nail CPT 11730 11730 REMOVAL OF NAIL PLATE	$250.44	$1,001.75	$69.84–$801.40	52% above	75%
Nail removal (partial or complete), one nail CPT 11730 ER Avulsion Nail Plate: Single Tc	$254.94	$1,019.75	$159.34–$815.80	55% above	75%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion nail plate;simple/single (Surg)	$250.44	$1,001.75	$69.84–$801.40	—	75%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730 REMOVAL OF NAIL PLATE	$250.44	$1,001.75	$69.84–$801.40	—	75%
Nail removal (partial or complete), one nail inpatient CPT 11730 ER Avulsion Nail Plate: Single Tc	$254.94	$1,019.75	$159.34–$815.80	—	75%
Paracentesis with imaging guidance CPT 49083 Paracentesis Radiologist Performed	$592.88	$2,371.50	$717.96–$1,897.20	31% below	75%
Paracentesis with imaging guidance inpatient CPT 49083 Paracentesis Radiologist Performed	$592.88	$2,371.50	$717.96–$1,897.20	—	75%
Partial knee replacement (one compartment) CPT 27446 Revision of knee joint	$15,253.01	$61,012.05	$4,139.00–$48,809.64	67% above	75%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 WC Permanent Nail Removal	$291.06	$1,164.25	$230.07–$1,022.60	27% below	75%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ER Excision Of Nail/Matrix Tc	$491.06	$1,964.25	$306.69–$1,571.40	24% above	75%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal of nail bed	$2,047.92	$8,191.66	$325.77–$6,553.33	416% above	75%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 WC Permanent Nail Removal	$291.06	$1,164.25	$230.07–$1,022.60	—	75%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ER Excision Of Nail/Matrix Tc	$491.06	$1,964.25	$306.69–$1,571.40	—	75%
Prostate biopsy CPT 55700 55700 - Biopsy, prostate; needle or punch, single or multipl	$927.25	$3,709.00	$191.27–$3,726.07	69% below	75%
Prostate biopsy CPT 55700 Biopsy of prostate	$3,092.95	$12,371.81	$1,149.00–$9,897.45	4% above	75%
Prostate biopsy inpatient CPT 55700 55700 - Biopsy, prostate; needle or punch, single or multipl	$927.25	$3,709.00	$191.27–$3,726.07	—	75%
Removal of a breast lump, open surgery CPT 19120 Removal of breast lesion	$2,470.76	$9,883.03	$1,149.00–$7,906.42	148% above	75%
Removal of a foreign object under the skin, simple CPT 10120 ER IR FB Subcutaneous: Simple	$491.06	$1,964.25	$306.69–$1,571.40	61% above	75%
Removal of a foreign object under the skin, simple CPT 10120 WC Incision Removal of Foreign Body	$1,653.06	$6,612.25	$135.66–$5,289.80	443% above	75%
Removal of a foreign object under the skin, simple CPT 10120 Remove foreign body	$1,865.50	$7,462.00	$325.77–$5,969.60	513% above	75%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ER IR FB Subcutaneous: Simple	$491.06	$1,964.25	$306.69–$1,571.40	—	75%
Removal of a foreign object under the skin, simple inpatient CPT 10120 WC Incision Removal of Foreign Body	$1,653.06	$6,612.25	$135.66–$5,289.80	—	75%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 Partial removal of thyroid	$4,840.55	$19,362.18	$4,139.00–$15,489.74	60% below	75%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colon ca scrn not hi rsk ind	$806.72	$3,226.88	$747.96–$2,581.50	6% above	75%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SET DILATOR URETERAL 6-18FR	$303.44	$1,213.75	$0.01–$1,671.96	60% below	75%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colorectal scrn; hi risk ind	$857.63	$3,430.53	$747.96–$2,744.42	14% above	75%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SET DILATOR URETERAL 6-18FR	$303.44	$1,213.75	$0.01–$1,671.96	—	75%
Septoplasty to straighten the nasal septum CPT 30520 Repair of nasal septum	$2,688.56	$10,754.25	$2,578.45–$8,603.40	60% below	75%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Fragmenting of kidney stone	$4,306.92	$17,227.67	$2,726.94–$13,782.14	55% below	75%
Short arm cast (elbow to hand) CPT 29075 CT IAC w/ Cont	$89.63	$358.50	$82.95–$574.99	63% below	75%
Short arm cast (elbow to hand) CPT 29075 ER Application Short Arm Cast Tc	$314.56	$1,258.25	$214.05–$1,006.60	31% above	75%
Short arm cast (elbow to hand) inpatient CPT 29075 CT IAC w/ Cont	$89.63	$358.50	$82.95–$574.99	—	75%
Short arm cast (elbow to hand) inpatient CPT 29075 ER Application Short Arm Cast Tc	$314.56	$1,258.25	$214.05–$1,006.60	—	75%
Short arm splint (forearm and hand) CPT 29125 ER Apply Short Arm Splint Stat Tc	$185.69	$742.75	$100.05–$594.20	26% above	75%
Short arm splint (forearm and hand) inpatient CPT 29125 ER Apply Short Arm Splint Stat Tc	$185.69	$742.75	$100.05–$594.20	—	75%
Short leg cast (below the knee) CPT 29405 ER Application Short Leg Cast Knee-Toes Tc	$314.56	$1,258.25	$214.05–$1,006.60	12% above	75%
Short leg cast (below the knee) inpatient CPT 29405 ER Application Short Leg Cast Knee-Toes Tc	$314.56	$1,258.25	$214.05–$1,006.60	—	75%
Short leg splint (calf to foot) CPT 29515 29515 Application of short leg splint	$113.69	$454.75	$66.27–$363.80	31% below	75%
Short leg splint (calf to foot) CPT 29515 ER Application Short Leg Splint Tc	$187.38	$749.50	$125.36–$599.60	13% above	75%
Short leg splint (calf to foot) inpatient CPT 29515 29515 Application of short leg splint	$113.69	$454.75	$66.27–$363.80	—	75%
Short leg splint (calf to foot) inpatient CPT 29515 ER Application Short Leg Splint Tc	$187.38	$749.50	$125.36–$599.60	—	75%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 WC Wound Repair Simple: =<2.5Cm Tc	$109.00	$436.00	$60.84–$366.24	51% below	75%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER Wound Repair Simple: =<2.5Cm Tc	$254.94	$1,019.75	$159.34–$815.80	15% above	75%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 WC Wound Repair Simple: =<2.5Cm Tc	$109.00	$436.00	$60.84–$366.24	—	75%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ER Wound Repair Simple: =<2.5Cm Tc	$254.94	$1,019.75	$159.34–$815.80	—	75%
Skin biopsy, punch, one lesion CPT 11104 Punch bx skin single lesion	$3,286.71	$13,146.82	$325.77–$10,517.46	1154% above	75%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ER Spinal Puncture, Lumbar, Diag Tc	$525.06	$2,100.25	$563.43–$1,680.20	4% above	75%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE PROCEDURE TRAY CHARGE	$525.06	$2,100.25	$107.81–$1,680.20	4% above	75%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture, Lumbar, Diag	$525.06	$2,100.25	$107.81–$1,680.20	4% above	75%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Dx lmbr spi pnxr	$3,584.18	$14,336.70	$553.77–$11,469.36	612% above	75%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE PROCEDURE TRAY CHARGE	$525.06	$2,100.25	$107.81–$1,680.20	—	75%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Puncture, Lumbar, Diag	$525.06	$2,100.25	$107.81–$1,680.20	—	75%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ER Spinal Puncture, Lumbar, Diag Tc	$525.06	$2,100.25	$563.43–$1,680.20	—	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 WC Wound Repair Simple: 2.6-7.5Cm	$138.81	$555.25	$80.77–$444.20	52% below	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER Wound Repair Smple: 2.6-7.5Cm Tc	$254.94	$1,019.75	$159.34–$815.80	12% below	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 WC Wound Repair Simple: 2.6-7.5Cm	$138.81	$555.25	$80.77–$444.20	—	75%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ER Wound Repair Smple: 2.6-7.5Cm Tc	$254.94	$1,019.75	$159.34–$815.80	—	75%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER Face Wound Simple: =<2.5Cm Tc	$254.94	$1,019.75	$159.34–$815.80	4% below	75%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ER Face Wound Simple: =<2.5Cm Tc	$254.94	$1,019.75	$159.34–$815.80	—	75%
TURP (transurethral resection of the prostate) CPT 52601 Prostatectomy (turp)	$5,079.24	$20,316.94	$4,139.00–$16,253.55	49% below	75%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 WC Tangential biopsy of single skin lesion	$143.06	$572.25	$53.85–$457.80	25% below	75%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 WC Tangential biopsy of single skin lesion	$143.06	$572.25	$53.85–$457.80	—	75%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$126.44	$505.75	$242.76–$1,149.22	86% below	75%
Thoracentesis with imaging guidance CPT 32555 CT Thoracentesis	$745.56	$2,982.25	$479.61–$2,385.80	17% below	75%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis	$745.56	$2,982.25	$479.61–$2,385.80	17% below	75%
Thoracentesis with imaging guidance CPT 32555 Aspirate pleura w/ imaging	$1,198.60	$4,794.40	$509.45–$3,835.52	34% above	75%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$126.44	$505.75	$242.76–$1,149.22	—	75%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis	$745.56	$2,982.25	$479.61–$2,385.80	—	75%
Thoracentesis with imaging guidance inpatient CPT 32555 CT Thoracentesis	$745.56	$2,982.25	$479.61–$2,385.80	—	75%
Tonsil and adenoid removal, age 12 or older CPT 42821 Remove tonsils and adenoids	$2,089.14	$8,356.57	$2,578.45–$6,685.26	49% below	75%
Tonsil and adenoid removal, child under 12 CPT 42820 Remove tonsils and adenoids	$2,459.77	$9,839.06	$4,139.00–$7,871.25	35% below	75%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 Removal of tonsils	$2,495.44	$9,981.76	$2,578.45–$7,985.41	23% below	75%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 Removal of tonsils	$992.51	$3,970.05	$1,905.62–$5,460.40	78% below	75%
Total hip replacement CPT 27130 Total hip arthroplasty	$16,783.87	$67,135.47	$4,139.00–$53,708.38	467% above	75%
Total knee replacement CPT 27447 Total knee arthroplasty	$16,610.01	$66,440.02	$4,139.00–$53,152.02	438% above	75%
Total shoulder replacement CPT 23472 Reconstruct shoulder joint	$9,394.93	$37,579.71	$4,139.00–$30,063.77	30% below	75%
Trigger finger release surgery CPT 26055 Incise finger tendon sheath	$1,959.73	$7,838.90	$1,149.00–$6,271.12	24% above	75%
Trigger point injections, 1 or 2 muscles CPT 20552 Trigger Point Injection	$296.63	$1,186.50	$231.82–$949.20	45% above	75%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 Trigger Point Injection	$296.63	$1,186.50	$231.82–$949.20	—	75%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 Laparoscopy tubal cautery	$3,034.41	$12,137.64	$4,139.00–$9,710.11	32% above	75%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx breast 1st lesion us imag	$2,670.70	$10,682.81	$1,149.00–$8,546.25	50% above	75%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US Breast Biopsy Bil	$3,084.00	$12,336.00	$1,248.45–$9,868.80	73% above	75%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US Breast Biopsy Bil	$3,084.00	$12,336.00	$1,248.45–$9,868.80	—	75%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Esoph egd dilation <30 mm	$2,902.88	$11,611.53	$1,530.84–$9,289.22	18% above	75%
Upper endoscopy (EGD) with biopsy CPT 43239 Egd biopsy single/multiple	$1,699.23	$6,796.90	$762.64–$5,437.52	at median	75%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd remove lesion snare	$1,913.46	$7,653.82	$1,530.84–$6,123.06	3% below	75%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd guide wire insertion	$596.06	$2,384.25	$762.64–$1,907.40	48% below	75%
Upper endoscopy (EGD), diagnostic CPT 43235 Egd diagnostic brush wash	$1,031.55	$4,126.21	$762.64–$3,300.97	5% below	75%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/uretero w/lithotripsy	$5,694.36	$22,777.44	$4,139.00–$18,221.95	54% below	75%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of sperm duct(s)	$3,000.00	$12,000.00	$1,149.00–$9,600.00	257% above	75%
Wart removal, up to 14 warts CPT 17110 17110 WC Destruction Flat WaRight/Mole	$105.75	$423.00	$89.29–$366.24	33% below	75%
Wart removal, up to 14 warts CPT 17110 Destruct b9 lesion 1-14	$1,412.43	$5,649.71	$169.25–$4,519.77	792% above	75%
Wart removal, up to 14 warts inpatient CPT 17110 17110 WC Destruction Flat WaRight/Mole	$105.75	$423.00	$89.29–$366.24	—	75%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 WC Debridement, subcutaneous tissue; first 20 sq cm or	$316.06	$1,264.25	$83.41–$1,011.40	18% below	75%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Deb subq tissue 20 sq cm/<	$3,472.16	$13,888.62	$305.59–$11,110.90	803% above	75%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 WC Debridement, subcutaneous tissue; first 20 sq cm or	$316.06	$1,264.25	$83.41–$1,011.40	—	75%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 Treat fx rad extra-articul	$3,209.50	$12,838.00	$4,139.00–$10,270.40	36% below	75%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 InfCtr Administration of Blood Products	$418.75	$1,675.00	$41.70–$1,340.00	36% below	75%
Blood transfusion (giving blood or blood components) CPT 36430 Administration of Blood Products	$435.50	$1,742.00	$41.70–$1,393.60	34% below	75%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 InfCtr Administration of Blood Products	$418.75	$1,675.00	$41.70–$1,340.00	—	75%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Administration of Blood Products	$435.50	$1,742.00	$41.70–$1,393.60	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Sputum Induction	$22.69	$90.75	$22.12–$899.00	86% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB Subsequent Treatment (IPPB)	$132.50	$530.00	$22.12–$424.00	16% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI Treatment Subsequent Treatment (MDI Treatment)	$132.50	$530.00	$22.12–$424.00	16% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Drug Neb Initial Treatment	$132.50	$530.00	$22.12–$424.00	16% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler (MDI) Subsequent	$132.50	$530.00	$22.12–$424.00	16% below	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Sputum Induction	$22.69	$90.75	$22.12–$899.00	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Drug Neb Initial Treatment	$132.50	$530.00	$22.12–$424.00	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Meter Dose Inhaler (MDI) Subsequent	$132.50	$530.00	$22.12–$424.00	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB Subsequent Treatment (IPPB)	$132.50	$530.00	$22.12–$424.00	—	75%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI Treatment Subsequent Treatment (MDI Treatment)	$132.50	$530.00	$22.12–$424.00	—	75%
Chemotherapy IV infusion, first hour CPT 96413 InfCtr Chemo Infusion Initial Hr	$401.63	$1,606.50	$282.91–$1,285.20	7% below	75%
Chemotherapy IV infusion, first hour inpatient CPT 96413 InfCtr Chemo Infusion Initial Hr	$401.63	$1,606.50	$282.91–$1,285.20	—	75%
Critical care, first 30 to 74 minutes CPT 99291 ER Critical Care 30-74min TC	$881.25	$3,525.00	$660.92–$2,820.00	35% below	75%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER Critical Care 30-74min TC	$881.25	$3,525.00	$660.92–$2,820.00	—	75%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG, Awake Drowsy	$248.88	$995.50	$234.83–$796.40	67% below	75%
EEG (brain wave test), awake and drowsy, routine CPT 95816 Electroencephalogram Awake/Drowsy	$248.88	$995.50	$234.83–$796.40	67% below	75%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 Electroencephalogram Awake/Drowsy	$248.88	$995.50	$234.83–$796.40	—	75%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG, Awake Drowsy	$248.88	$995.50	$234.83–$796.40	—	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG (Cardiology)	$106.31	$425.25	$10.24–$340.20	44% below	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG	$115.06	$460.25	$10.24–$368.20	40% below	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram	$115.06	$460.25	$10.24–$368.20	40% below	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG (Cardiology)	$106.31	$425.25	$10.24–$340.20	—	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram	$115.06	$460.25	$10.24–$368.20	—	75%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG	$115.06	$460.25	$10.24–$368.20	—	75%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Room II Minor	$85.25	$341.00	$64.36–$272.80	39% below	75%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Room II Minor	$85.25	$341.00	$64.36–$272.80	—	75%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Room III Low/moderate	$158.88	$635.50	$116.55–$508.40	33% below	75%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Room III Low/moderate	$158.88	$635.50	$116.55–$508.40	—	75%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Room IV Moderate	$279.50	$1,118.00	$205.34–$894.40	36% below	75%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Room IV Moderate	$279.50	$1,118.00	$205.34–$894.40	—	75%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Room V High	$470.19	$1,880.75	$322.78–$1,504.60	30% below	75%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Room V High	$470.19	$1,880.75	$322.78–$1,504.60	—	75%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Room VI Comprehensive	$694.06	$2,776.25	$463.30–$2,221.00	34% below	75%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Room VI Comprehensive	$694.06	$2,776.25	$463.30–$2,221.00	—	75%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill Cardiolite	$335.31	$1,341.25	$234.83–$1,073.00	59% below	75%
Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test / Treadmill	$335.31	$1,341.25	$234.83–$1,073.00	59% below	75%
Exercise stress test, tracing only, the hospital charge CPT 93017 Lexiscan Cardiolite	$335.31	$1,341.25	$234.83–$1,073.00	59% below	75%
Exercise stress test, tracing only, the hospital charge CPT 93017 Dobutamine Cardiolite	$335.31	$1,341.25	$234.83–$1,073.00	59% below	75%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill, ETT	$348.75	$1,395.00	$234.83–$1,116.00	57% below	75%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill Cardiolite	$335.31	$1,341.25	$234.83–$1,073.00	—	75%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Dobutamine Cardiolite	$335.31	$1,341.25	$234.83–$1,073.00	—	75%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Lexiscan Cardiolite	$335.31	$1,341.25	$234.83–$1,073.00	—	75%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test / Treadmill	$335.31	$1,341.25	$234.83–$1,073.00	—	75%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill, ETT	$348.75	$1,395.00	$234.83–$1,116.00	—	75%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER IV Infuse Hydration Initial Hr	$152.50	$610.00	$70.21–$488.00	38% below	75%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 InfCtr IV Infuse Hydration Initial Hour	$152.50	$610.00	$70.21–$488.00	38% below	75%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 InfCtr IV Infuse Hydration Initial Hour	$152.50	$610.00	$70.21–$488.00	—	75%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ER IV Infuse Hydration Initial Hr	$152.50	$610.00	$70.21–$488.00	—	75%
IV infusion of a medicine, first hour CPT 96365 InfCtr IV Infusion Therapy Initial	$244.56	$978.25	$84.99–$782.60	19% below	75%
IV infusion of a medicine, first hour CPT 96365 ER IV Infusion Therapy Initial	$254.38	$1,017.50	$84.99–$814.00	16% below	75%
IV infusion of a medicine, first hour inpatient CPT 96365 InfCtr IV Infusion Therapy Initial	$244.56	$978.25	$84.99–$782.60	—	75%
IV infusion of a medicine, first hour inpatient CPT 96365 ER IV Infusion Therapy Initial	$254.38	$1,017.50	$84.99–$814.00	—	75%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection-therapeutic/antibiotic Sub/im	$75.44	$301.75	$31.48–$241.40	22% below	75%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER Injection-Therapeutic/Antibiotic Sub/IM	$75.44	$301.75	$31.48–$241.40	22% below	75%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 InfCtr Injection - Therapeutic Sub/IM	$75.44	$301.75	$31.48–$241.40	22% below	75%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection-therapeutic/antibiotic Sub/im	$75.44	$301.75	$31.48–$241.40	—	75%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 InfCtr Injection - Therapeutic Sub/IM	$75.44	$301.75	$31.48–$241.40	—	75%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER Injection-Therapeutic/Antibiotic Sub/IM	$75.44	$301.75	$31.48–$241.40	—	75%
Neuromuscular re-education, 15 minutes CPT 97112 SP Neuromuscular Re-education	$28.81	$115.25	$0.01–$173.00	68% below	75%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 SP Neuromuscular Re-education	$28.81	$115.25	$0.01–$173.00	—	75%
New patient office visit, about 30 minutes CPT 99203 99203 WC Visit New Intermediate	$88.06	$352.25	$0.01–$294.76	35% below	75%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 WC Visit New Intermediate	$88.06	$352.25	$0.01–$294.76	—	75%
New patient office visit, about 45 minutes CPT 99204 99204 WC Visit New Extended	$119.44	$477.75	$0.01–$390.58	34% below	75%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 WC Visit New Extended	$119.44	$477.75	$0.01–$390.58	—	75%
New patient office visit, about 60 minutes CPT 99205 99205 WC Visit New Complex	$159.00	$636.00	$0.01–$534.40	39% below	75%
New patient office visit, about 60 minutes inpatient CPT 99205 99205 WC Visit New Complex	$159.00	$636.00	$0.01–$534.40	—	75%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 WC Visit New Limited	$68.19	$272.75	$0.01–$241.82	32% below	75%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 WC Visit New Limited	$68.19	$272.75	$0.01–$241.82	—	75%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Nutrition Instruction Individual Initial ea 15min	$46.38	$185.50	$0.01–$148.40	6% above	75%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Nutrition Instruction Individual Initial ea 15min	$46.38	$185.50	$0.01–$148.40	—	75%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 97163 PT Eval High Complex 45 min	$59.94	$239.75	$0.01–$191.80	65% below	75%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 97163 PT Eval High Complex 45 min	$59.94	$239.75	$0.01–$191.80	—	75%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 WC Visit Complex Established	$119.44	$477.75	$0.01–$390.58	41% below	75%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 WC Visit Complex Established	$119.44	$477.75	$0.01–$390.58	—	75%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 WC Visit, Intermediate Established	$65.00	$260.00	$0.01–$241.82	44% below	75%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 WC Visit, Intermediate Established	$65.00	$260.00	$0.01–$241.82	—	75%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 WC Visit, Extended Established	$88.06	$352.25	$0.01–$294.76	45% below	75%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 WC Visit, Extended Established	$88.06	$352.25	$0.01–$294.76	—	75%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 WC Visit, Limited Established	$68.19	$272.75	$0.01–$241.82	1% below	75%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 WC Visit, Limited Established	$68.19	$272.75	$0.01–$241.82	—	75%
Spirometry (breathing test) CPT 94010 Simple Spirometry	$129.81	$519.25	$44.69–$415.40	40% below	75%
Spirometry (breathing test) inpatient CPT 94010 Simple Spirometry	$129.81	$519.25	$44.69–$415.40	—	75%
Spirometry before and after a bronchodilator CPT 94060 PFT Bedside Pre Post	$190.63	$762.50	$75.16–$610.00	58% below	75%
Spirometry before and after a bronchodilator CPT 94060 RT Pre Post Spiro Charge	$240.81	$963.25	$75.16–$770.60	47% below	75%
Spirometry before and after a bronchodilator CPT 94060 PFT Spirometry Pre Post	$240.81	$963.25	$75.16–$770.60	47% below	75%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Bedside Pre Post	$190.63	$762.50	$75.16–$610.00	—	75%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT Pre Post Spiro Charge	$240.81	$963.25	$75.16–$770.60	—	75%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT Spirometry Pre Post	$240.81	$963.25	$75.16–$770.60	—	75%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy 2	$75.25	$301.00	$100.05–$240.80	60% below	75%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 Therapeutic Phlebotomy	$75.81	$303.25	$100.05–$242.60	60% below	75%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 InfCtr Therapeutic Phlebotomy	$75.81	$303.25	$100.05–$242.60	60% below	75%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phelbotomy Charge	$75.81	$303.25	$100.05–$242.60	60% below	75%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy 2	$75.25	$301.00	$100.05–$240.80	—	75%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 Therapeutic Phlebotomy	$75.81	$303.25	$100.05–$242.60	—	75%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phelbotomy Charge	$75.81	$303.25	$100.05–$242.60	—	75%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 InfCtr Therapeutic Phlebotomy	$75.81	$303.25	$100.05–$242.60	—	75%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 D.T. (Adult)	$66.50	$266.00	$0.01–$212.80	7% below	75%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 D.T. (Adult)	$66.50	$266.00	$0.01–$212.80	—	75%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 InfCtr Influenza Vaccine Admin	$17.63	$70.50	$22.49–$128.87	70% below	75%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER Vaccine Administration	$17.63	$70.50	$33.84–$128.87	70% below	75%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 InfCtr Influenza Vaccine Admin	$17.63	$70.50	$22.49–$128.87	—	75%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER Vaccine Administration	$17.63	$70.50	$33.84–$128.87	—	75%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ER Vaccine Administration Each Addl	$19.19	$76.75	$0.01–$61.40	60% below	75%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ER Vaccine Administration Each Addl	$19.19	$76.75	$0.01–$61.40	—	75%

Source file: https://app.vestacare.com/download/csv/43-0633449_missourideltamedicalcenter_standardcharges.csv