Speare Memorial Hospital
Speare Memorial Hospital in Plymouth, NH publishes cash prices for 284 common procedures listed here, from its own machine-readable price file updated Jul 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 203 of 282 procedures and above it for 64. By typical cash price it ranks #5 of 15 New Hampshire hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
16 Hospital Road, Plymouth, NH 03264 Collected Sep 27, 2026 Source price file (603) 536-1120
Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 3 of 5 CCN 301311 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete 3+ Views Bi | $427.80 | $690.00 | — | — | 38% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Rt | $137.02 | $221.00 | — | 43% below | 38% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views LT | $137.02 | $221.00 | — | 43% below | 38% |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete 3+ Views Bi | $427.80 | $690.00 | — | — | 38% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views LT | $137.02 | $221.00 | — | — | 38% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Rt | $137.02 | $221.00 | — | — | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 US SegPres (ABI) LE 1-2 Lvl Bi | $282.10 | $455.00 | — | — | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Toe Brachial Index (TBI) | $282.10 | $455.00 | — | 39% below | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Seg Pressures (ABI) w/ TBI | $282.10 | $455.00 | — | 39% below | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US SegPres (ABI) LE 1-2 Lvl Un | $282.10 | $455.00 | — | 39% below | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WCC UPR/L XTREMITY ART 2 LEVEL | $282.10 | $455.00 | — | 39% below | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 US SegPres (ABI) LE 1-2 Lvl Bi | $282.10 | $455.00 | — | — | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Seg Pressures (ABI) w/ TBI | $282.10 | $455.00 | — | — | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US SegPres (ABI) LE 1-2 Lvl Un | $282.10 | $455.00 | — | — | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 WCC UPR/L XTREMITY ART 2 LEVEL | $282.10 | $455.00 | — | — | 38% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Toe Brachial Index (TBI) | $282.10 | $455.00 | — | — | 38% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus | $585.90 | $945.00 | — | 6% below | 38% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus | $585.90 | $945.00 | — | — | 38% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Img WB Inj | $1,891.00 | $3,050.00 | — | 19% below | 38% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Img WB Inj | $1,891.00 | $3,050.00 | — | — | 38% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Complete Bilateral | $837.00 | $1,350.00 | — | — | 38% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left | $558.00 | $900.00 | — | 51% above | 38% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right | $558.00 | $900.00 | — | 51% above | 38% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Complete Bilateral | $837.00 | $1,350.00 | — | — | 38% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right | $558.00 | $900.00 | — | — | 38% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left | $558.00 | $900.00 | — | — | 38% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilateral | $651.00 | $1,050.00 | — | — | 38% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ED US Brst Uniw/I Ltd FF 76642 | $434.00 | $700.00 | — | 33% above | 38% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right | $434.00 | $700.00 | — | 33% above | 38% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $434.00 | $700.00 | — | 33% above | 38% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilateral | $651.00 | $1,050.00 | — | — | 38% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ED US Brst Uniw/I Ltd FF 76642 | $434.00 | $700.00 | — | — | 38% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right | $434.00 | $700.00 | — | — | 38% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left | $434.00 | $700.00 | — | — | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary | $1,760.80 | $2,840.00 | — | 11% below | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest | $1,760.80 | $2,840.00 | — | 11% below | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 XRAY CT ANGIOGRPHY CHEST 71275 | $1,760.80 | $2,840.00 | — | 11% below | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST W/O + W. 71275 | $1,760.80 | $2,840.00 | — | 11% below | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Pulmonary | $1,760.80 | $2,840.00 | — | — | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest | $1,760.80 | $2,840.00 | — | — | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 XRAY CT ANGIOGRPHY CHEST 71275 | $1,760.80 | $2,840.00 | — | — | 38% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST W/O + W. 71275 | $1,760.80 | $2,840.00 | — | — | 38% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen & Pelvis w/o Cntrst | $2,244.40 | $3,620.00 | — | 3% below | 38% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELV W/O CONTRAST 74176 | $2,244.40 | $3,620.00 | — | 3% below | 38% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen & Pelvis w/o Cntrst | $2,244.40 | $3,620.00 | — | — | 38% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PELV W/O CONTRAST 74176 | $2,244.40 | $3,620.00 | — | — | 38% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELV W/CONTRAST 74177 | $2,449.00 | $3,950.00 | — | 4% below | 38% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Cont | $2,449.00 | $3,950.00 | — | 4% below | 38% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Cont | $2,449.00 | $3,950.00 | — | — | 38% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELV W/CONTRAST 74177 | $2,449.00 | $3,950.00 | — | — | 38% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd and Pelv w/+ w/o Cntrst | $2,604.00 | $4,200.00 | — | 14% below | 38% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd and Pelv w/+ w/o Cntrst | $2,604.00 | $4,200.00 | — | — | 38% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $1,488.00 | $2,400.00 | — | 11% below | 38% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $1,488.00 | $2,400.00 | — | — | 38% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $1,054.00 | $1,700.00 | — | 23% below | 38% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $1,054.00 | $1,700.00 | — | — | 38% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,240.00 | $2,000.00 | — | 28% below | 38% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast | $1,240.00 | $2,000.00 | — | 28% below | 38% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $1,240.00 | $2,000.00 | — | — | 38% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast | $1,240.00 | $2,000.00 | — | — | 38% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $1,007.50 | $1,625.00 | — | 24% below | 38% |
| CT scan of the head or brain, no contrast dye CPT 70450 Ext Proc CT Scan Head 70450 | $1,007.50 | $1,625.00 | — | 24% below | 38% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast | $1,007.50 | $1,625.00 | — | — | 38% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ext Proc CT Scan Head 70450 | $1,007.50 | $1,625.00 | — | — | 38% |
| CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast | $1,100.50 | $1,775.00 | — | 31% below | 38% |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast | $1,100.50 | $1,775.00 | — | — | 38% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/+ w/o Contrast | $1,193.50 | $1,925.00 | — | 42% below | 38% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/+ w/o Contrast | $1,193.50 | $1,925.00 | — | — | 38% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $1,116.00 | $1,800.00 | — | 47% below | 38% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $1,116.00 | $1,800.00 | — | — | 38% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $1,426.00 | $2,300.00 | — | 29% below | 38% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $1,426.00 | $2,300.00 | — | — | 38% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $1,581.00 | $2,550.00 | — | 5% below | 38% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $1,581.00 | $2,550.00 | — | — | 38% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $1,240.00 | $2,000.00 | — | — | 38% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $1,240.00 | $2,000.00 | — | — | 38% |
| Chest X-ray, 2 views both sides CPT 71046 XR Chest Decubitus Bilateral | $325.50 | $525.00 | — | — | 38% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views w/ Fluoroscpy | $104.16 | $168.00 | — | 69% below | 38% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $217.00 | $350.00 | — | 34% below | 38% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 XR Chest Decubitus Bilateral | $325.50 | $525.00 | — | — | 38% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views w/ Fluoroscpy | $104.16 | $168.00 | — | — | 38% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $217.00 | $350.00 | — | — | 38% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal | $204.60 | $330.00 | — | 17% below | 38% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Portable | $204.60 | $330.00 | — | 17% below | 38% |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Left | $204.60 | $330.00 | — | 17% below | 38% |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Right | $204.60 | $330.00 | — | 17% below | 38% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal | $204.60 | $330.00 | — | — | 38% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Portable | $204.60 | $330.00 | — | — | 38% |
| Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Right | $204.60 | $330.00 | — | — | 38% |
| Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Left | $204.60 | $330.00 | — | — | 38% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $620.00 | $1,000.00 | — | 7% below | 38% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $620.00 | $1,000.00 | — | — | 38% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 Bone Density DEXA Axial Skeltn | $393.70 | $635.00 | — | 11% below | 38% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 Bone Density DEXA Axial Skeltn | $393.70 | $635.00 | — | — | 38% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 BD Bone Density Forearm Right | $167.40 | $270.00 | — | 57% below | 38% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 BD Bone Density Forearm Left | $167.40 | $270.00 | — | 57% below | 38% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 BD Bone Density Forearm Right | $167.40 | $270.00 | — | — | 38% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient one side CPT 77081 BD Bone Density Forearm Left | $167.40 | $270.00 | — | — | 38% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Ob Us Detailed One Fetus 76811 | $461.28 | $744.00 | — | 55% below | 38% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Fetal Exam | $961.00 | $1,550.00 | — | 7% below | 38% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 Ob Us Detailed One Fetus 76811 | $461.28 | $744.00 | — | — | 38% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Detailed Fetal Exam | $961.00 | $1,550.00 | — | — | 38% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX SCAN W/O CONTR 71250 | $1,240.00 | $2,000.00 | — | 22% below | 38% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast | $1,240.00 | $2,000.00 | — | 22% below | 38% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung CA Diag. w/o Contrast | $1,240.00 | $2,000.00 | — | 22% below | 38% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Lung CA Diag. w/o Contrast | $1,240.00 | $2,000.00 | — | — | 38% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast | $1,240.00 | $2,000.00 | — | — | 38% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX SCAN W/O CONTR 71250 | $1,240.00 | $2,000.00 | — | — | 38% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX SCAN W/ CONT 71260 | $1,333.00 | $2,150.00 | — | 20% below | 38% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Lung CA Diag. w/ Contrast | $1,333.00 | $2,150.00 | — | 20% below | 38% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast | $1,333.00 | $2,150.00 | — | 20% below | 38% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast | $1,333.00 | $2,150.00 | — | — | 38% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX SCAN W/ CONT 71260 | $1,333.00 | $2,150.00 | — | — | 38% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Lung CA Diag. w/ Contrast | $1,333.00 | $2,150.00 | — | — | 38% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnos Bilat | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Post Bx Bilateral | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Dig Dx Addtl Views Bi | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIGI ADD VIEWS BI 77066 | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bi | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts CPT 77066 MAMMO DIGITAL DIAGNOSTIC W/3D | $868.00 | $1,400.00 | — | 73% above | 38% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Dig Dx Addtl Views Bi | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Post Bx Bilateral | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIGI ADD VIEWS BI 77066 | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bi | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnos Bilat | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, both breasts inpatient CPT 77066 MAMMO DIGITAL DIAGNOSTIC W/3D | $868.00 | $1,400.00 | — | — | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Post Bx Unilateral RT | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGI ADD VIEWS LT 77065 | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Post Bx Unilateral LT | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGI ADD VIEWS RT 77065 | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL UNILAT LT 77065 | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL UNILAT RT 77065 | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic LT | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Dig Dx Addtl Views RT | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Dig Dx Addtl Views LT | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic RT | $682.00 | $1,100.00 | — | 123% above | 38% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Scrn RT 77067 | $744.00 | $1,200.00 | — | 144% above | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGITAL UNILAT LT 77065 | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGITAL UNILAT RT 77065 | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGI ADD VIEWS RT 77065 | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DIGI ADD VIEWS LT 77065 | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Dig Dx Addtl Views LT | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Dig Dx Addtl Views RT | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Post Bx Unilateral LT | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Post Bx Unilateral RT | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic RT | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic LT | $682.00 | $1,100.00 | — | — | 38% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Scrn RT 77067 | $744.00 | $1,200.00 | — | — | 38% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upp Ext Venous Duplex Bi | $1,224.50 | $1,975.00 | — | — | 38% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US Lower Ext Venous Duplx Bil | $1,224.50 | $1,975.00 | — | 71% below | 38% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upp Ext Venous Duplex Bi | $1,224.50 | $1,975.00 | — | — | 38% |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Lower Ext Venous Duplx Bil | $1,224.50 | $1,975.00 | — | — | 38% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2D w/ Contrast | $1,817.84 | $2,932.00 | — | 14% above | 38% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2D | $1,817.84 | $2,932.00 | — | 14% above | 38% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo 2D | $1,817.84 | $2,932.00 | — | — | 38% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Echo 2D w/ Contrast | $1,817.84 | $2,932.00 | — | — | 38% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepato Inj + Scan | $2,108.00 | $3,400.00 | — | 15% above | 38% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepato Inj + Scan | $2,108.00 | $3,400.00 | — | — | 38% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Unattended Sleep Study in home | $557.38 | $899.00 | — | 35% below | 38% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP HOME STUDY 95806 | $557.38 | $899.00 | — | 35% below | 38% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP Home Study 95806 | $557.38 | $899.00 | — | 35% below | 38% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Unattended Sleep Study in home | $557.38 | $899.00 | — | — | 38% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP HOME STUDY 95806 | $557.38 | $899.00 | — | — | 38% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP Home Study 95806 | $557.38 | $899.00 | — | — | 38% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY w/ ASV 95811 | $2,201.00 | $3,550.00 | — | 67% below | 38% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP APNEA SPLIT NIGHT 95811 | $2,708.78 | $4,369.00 | — | 60% below | 38% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY NIGHT 2 CPAP 95811 | $2,708.78 | $4,369.00 | — | 60% below | 38% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY w/ ASV 95811 | $2,201.00 | $3,550.00 | — | — | 38% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY NIGHT 2 CPAP 95811 | $2,708.78 | $4,369.00 | — | — | 38% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP APNEA SPLIT NIGHT 95811 | $2,708.78 | $4,369.00 | — | — | 38% |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral | $196.54 | $317.00 | — | — | 38% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views LT | $131.44 | $212.00 | — | 47% below | 38% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views RT | $131.44 | $212.00 | — | 47% below | 38% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral | $196.54 | $317.00 | — | — | 38% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views LT | $131.44 | $212.00 | — | — | 38% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views RT | $131.44 | $212.00 | — | — | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $496.00 | $800.00 | — | 4% below | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US FAST Abdomen LTD | $496.00 | $800.00 | — | 4% below | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Gall Bladder Ltd 76705 | $496.00 | $800.00 | — | 4% below | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $496.00 | $800.00 | — | 4% below | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abdomen 76705 | $496.00 | $800.00 | — | 4% below | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US Abdomen 76705 | $496.00 | $800.00 | — | — | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder | $496.00 | $800.00 | — | — | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US Gall Bladder Ltd 76705 | $496.00 | $800.00 | — | — | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ED US FAST Abdomen LTD | $496.00 | $800.00 | — | — | 38% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited | $496.00 | $800.00 | — | — | 38% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Ca Scrn Lw Dose Annual | $1,178.00 | $1,900.00 | — | 28% above | 38% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Ca Scrn Lw Dose Annual | $1,178.00 | $1,900.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $744.00 | $1,200.00 | — | 55% below | 38% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $744.00 | $1,200.00 | — | 55% below | 38% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $744.00 | $1,200.00 | — | 55% below | 38% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $1,550.00 | $2,500.00 | — | 6% below | 38% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $1,550.00 | $2,500.00 | — | 6% below | 38% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $1,550.00 | $2,500.00 | — | 6% below | 38% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $744.00 | $1,200.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $744.00 | $1,200.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $744.00 | $1,200.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $1,550.00 | $2,500.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $1,550.00 | $2,500.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $1,550.00 | $2,500.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast LT | $2,728.00 | $4,400.00 | — | 5% above | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast RT | $2,728.00 | $4,400.00 | — | 5% above | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $2,728.00 | $4,400.00 | — | 5% above | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast LT | $2,728.00 | $4,400.00 | — | 5% above | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast RT | $2,728.00 | $4,400.00 | — | 5% above | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast RT | $2,728.00 | $4,400.00 | — | 5% above | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $2,728.00 | $4,400.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast RT | $2,728.00 | $4,400.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast LT | $2,728.00 | $4,400.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast RT | $2,728.00 | $4,400.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast LT | $2,728.00 | $4,400.00 | — | — | 38% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast RT | $2,728.00 | $4,400.00 | — | — | 38% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $892.80 | $1,440.00 | — | 56% below | 38% |
| MRI of the abdomen without contrast CPT 74181 MRI Abd Liver Protocol w/o Con | $1,860.00 | $3,000.00 | — | 8% below | 38% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $892.80 | $1,440.00 | — | — | 38% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abd Liver Protocol w/o Con | $1,860.00 | $3,000.00 | — | — | 38% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $2,604.00 | $4,200.00 | — | 33% below | 38% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abd Liver Prtcl w/+w/o Cnt | $2,604.00 | $4,200.00 | — | 33% below | 38% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $2,604.00 | $4,200.00 | — | — | 38% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abd Liver Prtcl w/+w/o Cnt | $2,604.00 | $4,200.00 | — | — | 38% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain/Pituitary w/o Contr | $744.00 | $1,200.00 | — | 68% below | 38% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $1,550.00 | $2,500.00 | — | 33% below | 38% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain/Pituitary w/o Contr | $744.00 | $1,200.00 | — | — | 38% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $1,550.00 | $2,500.00 | — | — | 38% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast | $2,480.00 | $4,000.00 | — | 49% below | 38% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain/Pituit w/ + w/o Cont | $2,480.00 | $4,000.00 | — | 49% below | 38% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $2,480.00 | $4,000.00 | — | 49% below | 38% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC w/ + w/o Contrast | $2,480.00 | $4,000.00 | — | — | 38% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $2,480.00 | $4,000.00 | — | — | 38% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain/Pituit w/ + w/o Cont | $2,480.00 | $4,000.00 | — | — | 38% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $1,860.00 | $3,000.00 | — | 24% below | 38% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $1,860.00 | $3,000.00 | — | — | 38% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/+w/o Contst | $2,666.00 | $4,300.00 | — | 44% below | 38% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/+w/o Contst | $2,666.00 | $4,300.00 | — | — | 38% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrst | $1,860.00 | $3,000.00 | — | 8% below | 38% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrst | $1,860.00 | $3,000.00 | — | — | 38% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/+w/o Cont | $2,480.00 | $4,000.00 | — | 42% below | 38% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/+w/o Cont | $2,480.00 | $4,000.00 | — | — | 38% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrst | $892.80 | $1,440.00 | — | 64% below | 38% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrst | $892.80 | $1,440.00 | — | — | 38% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $2,170.00 | $3,500.00 | — | 50% below | 38% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $2,170.00 | $3,500.00 | — | — | 38% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $1,550.00 | $2,500.00 | — | 21% below | 38% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $1,550.00 | $2,500.00 | — | — | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $902.10 | $1,455.00 | — | 48% below | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $1,878.60 | $3,030.00 | — | 8% above | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $1,878.60 | $3,030.00 | — | 8% above | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $1,878.60 | $3,030.00 | — | 8% above | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $1,878.60 | $3,030.00 | — | 8% above | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast RT | $1,878.60 | $3,030.00 | — | 8% above | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $902.10 | $1,455.00 | — | — | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast RT | $1,878.60 | $3,030.00 | — | — | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $1,878.60 | $3,030.00 | — | — | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $1,878.60 | $3,030.00 | — | — | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $1,878.60 | $3,030.00 | — | — | 38% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $1,878.60 | $3,030.00 | — | — | 38% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Rest Inj | $2,914.00 | $4,700.00 | — | 5% above | 38% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardl SPCT Rst Std Tl201 | $2,914.00 | $4,700.00 | — | 5% above | 38% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardl SPCT Rst Std Tl201 | $2,914.00 | $4,700.00 | — | — | 38% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial SPECT Rest Inj | $2,914.00 | $4,700.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh Gozellix Init | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh NetSpot Init | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh Gozellix Subs | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh DetectNet Subs | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh DetectNet Init | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh NetSpot Subs | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Skull to Mid-Thigh Init | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Skull to Mid-Thigh Subs | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh Pylarify Init | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh Pylarify Subs | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh Illuccix Init | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PETCT Vtx-Thigh Illuccix Subs | $3,871.28 | $6,244.00 | — | at median | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh NetSpot Subs | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh Gozellix Subs | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh Gozellix Init | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh DetectNet Subs | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh Illuccix Init | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh DetectNet Init | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh Pylarify Init | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh NetSpot Init | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh Pylarify Subs | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Skull to Mid-Thigh Init | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Vtx-Thigh Illuccix Subs | $3,871.28 | $6,244.00 | — | — | 38% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PETCT Skull to Mid-Thigh Subs | $3,871.28 | $6,244.00 | — | — | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Limited | $312.48 | $504.00 | — | 17% below | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder Volume | $312.48 | $504.00 | — | 17% below | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Ltd w/Tansvg if indc | $312.48 | $504.00 | — | 17% below | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ED US Transabdominal Ltd 76857 | $312.48 | $504.00 | — | 17% below | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up one side CPT 76857 PlvUS (N Ob) RT w/ ImD Lm76857 | $150.04 | $242.00 | — | 60% below | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder Volume | $312.48 | $504.00 | — | — | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Limited | $312.48 | $504.00 | — | — | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ED US Transabdominal Ltd 76857 | $312.48 | $504.00 | — | — | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvis Ltd w/Tansvg if indc | $312.48 | $504.00 | — | — | 38% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient one side CPT 76857 PlvUS (N Ob) RT w/ ImD Lm76857 | $150.04 | $242.00 | — | — | 38% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Comp w/Trnsvg if ind | $620.00 | $1,000.00 | — | 3% below | 38% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Comp w/Trnsvg if ind | $620.00 | $1,000.00 | — | — | 38% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ob Us +/= 14 WksOneFetus76805 | $330.46 | $533.00 | — | 46% below | 38% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Comp >14 Weeks w/UA Dopp | $688.20 | $1,110.00 | — | 13% above | 38% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks | $688.20 | $1,110.00 | — | 13% above | 38% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 wks w/TVS if ind | $688.20 | $1,110.00 | — | 13% above | 38% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ob Us +/= 14 WksOneFetus76805 | $330.46 | $533.00 | — | — | 38% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks | $688.20 | $1,110.00 | — | — | 38% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Comp >14 Weeks w/UA Dopp | $688.20 | $1,110.00 | — | — | 38% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB > 14 wks w/TVS if ind | $688.20 | $1,110.00 | — | — | 38% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Ob Us < 14 Wks One Fetus 76801 | $589.00 | $950.00 | — | 8% below | 38% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 wks w/TVS if indic | $589.00 | $950.00 | — | 8% below | 38% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 wks w/TVS if indic | $589.00 | $950.00 | — | — | 38% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Ob Us < 14 Wks One Fetus 76801 | $589.00 | $950.00 | — | — | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Ob Us, Limited Fetus(S) 76815 | $327.36 | $528.00 | — | 21% below | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited | $682.00 | $1,100.00 | — | 64% above | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Ext. Ceph | $682.00 | $1,100.00 | — | 64% above | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PREG ECHO LIMITED 76815 | $682.00 | $1,100.00 | — | 64% above | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited > 14 Weeks | $682.00 | $1,100.00 | — | 64% above | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ED US OB LTD Fetus(s) 76815 | $682.00 | $1,100.00 | — | 64% above | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Ob Us, Limited Fetus(S) 76815 | $327.36 | $528.00 | — | — | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 ED US OB LTD Fetus(s) 76815 | $682.00 | $1,100.00 | — | — | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Ext. Ceph | $682.00 | $1,100.00 | — | — | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 PREG ECHO LIMITED 76815 | $682.00 | $1,100.00 | — | — | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited > 14 Weeks | $682.00 | $1,100.00 | — | — | 38% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited | $682.00 | $1,100.00 | — | — | 38% |
| Screening mammogram, both breasts both sides CPT 77067 MG SCR MAMMO BI INCL CAD | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts both sides CPT 77067 MAMMO DG SCR BI INCL CAD 77067 | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts CPT 77067 MG Mammo Digital Screening Bil | $744.00 | $1,200.00 | — | 89% above | 38% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening RT | $744.00 | $1,200.00 | — | 89% above | 38% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening LT | $744.00 | $1,200.00 | — | 89% above | 38% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Scrn LT 77067 | $744.00 | $1,200.00 | — | 89% above | 38% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO DG SCR BI INCL CAD 77067 | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG SCR MAMMO BI INCL CAD | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts inpatient CPT 77067 MG Mammo Digital Screening Bil | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening RT | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Scrn LT 77067 | $744.00 | $1,200.00 | — | — | 38% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening LT | $744.00 | $1,200.00 | — | — | 38% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Compl 2+ Views BI | $174.22 | $281.00 | — | — | 38% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Compl 2+ Views RT | $116.56 | $188.00 | — | 50% below | 38% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Compl 2+ Views LT | $116.56 | $188.00 | — | 50% below | 38% |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Compl 2+ Views BI | $174.22 | $281.00 | — | — | 38% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Compl 2+ Views RT | $116.56 | $188.00 | — | — | 38% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Compl 2+ Views LT | $116.56 | $188.00 | — | — | 38% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY 95810 | $2,201.00 | $3,550.00 | — | 63% below | 38% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY 95810 | $2,201.00 | $3,550.00 | — | — | 38% |
| Transvaginal pelvic ultrasound CPT 76830 AMB US Transvaginl NonOB 76830 | $342.24 | $552.00 | — | 50% below | 38% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB | $713.00 | $1,150.00 | — | 3% above | 38% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $713.00 | $1,150.00 | — | 3% above | 38% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 AMB US Transvaginl NonOB 76830 | $342.24 | $552.00 | — | — | 38% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON-OB | $713.00 | $1,150.00 | — | — | 38% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $713.00 | $1,150.00 | — | — | 38% |
| Transvaginal ultrasound during pregnancy CPT 76817 Transvag Us Obst w/oth 76817 | $238.08 | $384.00 | — | 55% below | 38% |
| Transvaginal ultrasound during pregnancy CPT 76817 Transvaginal Us Obst 76817 | $238.08 | $384.00 | — | 55% below | 38% |
| Transvaginal ultrasound during pregnancy CPT 76817 PREG ECHO TRANSVAGINAL 76817 | $496.00 | $800.00 | — | 6% below | 38% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $496.00 | $800.00 | — | 6% below | 38% |
| Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB | $496.00 | $800.00 | — | 6% below | 38% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 Transvaginal Us Obst 76817 | $238.08 | $384.00 | — | — | 38% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 Transvag Us Obst w/oth 76817 | $238.08 | $384.00 | — | — | 38% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $496.00 | $800.00 | — | — | 38% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OB | $496.00 | $800.00 | — | — | 38% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 PREG ECHO TRANSVAGINAL 76817 | $496.00 | $800.00 | — | — | 38% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $657.20 | $1,060.00 | — | 29% below | 38% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $657.20 | $1,060.00 | — | — | 38% |
| Ultrasound of the scrotum and testicles CPT 76870 ED US scrotum + contents 76870 | $589.00 | $950.00 | — | at median | 38% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotm (Cnt) w/Dpler if ind | $589.00 | $950.00 | — | at median | 38% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotm (Cnt) w/Dpler if ind | $589.00 | $950.00 | — | — | 38% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 ED US scrotum + contents 76870 | $589.00 | $950.00 | — | — | 38% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Exam Of Head And Neck 76536 | $327.36 | $528.00 | — | 35% below | 38% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $682.00 | $1,100.00 | — | 35% above | 38% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Us Exam Of Head And Neck 76536 | $327.36 | $528.00 | — | — | 38% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $682.00 | $1,100.00 | — | — | 38% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI Sing Cont w/Sm Bwl | $682.00 | $1,100.00 | — | at median | 38% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI Single Contrast | $682.00 | $1,100.00 | — | at median | 38% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI + KUB | $682.00 | $1,100.00 | — | at median | 38% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI + KUB | $682.00 | $1,100.00 | — | — | 38% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI Single Contrast | $682.00 | $1,100.00 | — | — | 38% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI Sing Cont w/Sm Bwl | $682.00 | $1,100.00 | — | — | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 ED US Dp Scn Extr (DVT) 93971 | $775.00 | $1,250.00 | — | 13% below | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex LT | $775.00 | $1,250.00 | — | 13% below | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex RT | $775.00 | $1,250.00 | — | 13% below | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex RT | $775.00 | $1,250.00 | — | 13% below | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex LT | $775.00 | $1,250.00 | — | 13% below | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 ED US Dp Scn Extr (DVT) 93971 | $775.00 | $1,250.00 | — | — | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex LT | $775.00 | $1,250.00 | — | — | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex LT | $775.00 | $1,250.00 | — | — | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex RT | $775.00 | $1,250.00 | — | — | 38% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex RT | $775.00 | $1,250.00 | — | — | 38% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete 3+ Views Bi | $205.84 | $332.00 | — | — | 38% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views RT | $137.64 | $222.00 | — | 46% below | 38% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views LT | $137.64 | $222.00 | — | 46% below | 38% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete 3+ Views Bi | $205.84 | $332.00 | — | — | 38% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views RT | $137.64 | $222.00 | — | — | 38% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views LT | $137.64 | $222.00 | — | — | 38% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip w/ w/o Pelvis 2-3 Vw LT | $137.02 | $221.00 | — | 53% below | 38% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip w/ w/o Pelvis 2-3 Vw RT | $137.02 | $221.00 | — | 53% below | 38% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip w/ w/o Pelvis 2-3 Vw LT | $137.02 | $221.00 | — | — | 38% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip w/ w/o Pelvis 2-3 Vw RT | $137.02 | $221.00 | — | — | 38% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View | $248.00 | $400.00 | — | 8% below | 38% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View Portable | $248.00 | $400.00 | — | 8% below | 38% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View | $248.00 | $400.00 | — | — | 38% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View Portable | $248.00 | $400.00 | — | — | 38% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral | $196.54 | $317.00 | — | — | 38% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $131.44 | $212.00 | — | 31% below | 38% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $131.44 | $212.00 | — | 31% below | 38% |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral | $196.54 | $317.00 | — | — | 38% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $131.44 | $212.00 | — | — | 38% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $131.44 | $212.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Right | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Left | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Left | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Right | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 4th Digit Left | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Right | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 5th Digit Right | $130.20 | $210.00 | — | 28% below | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left | $270.94 | $437.00 | — | 50% above | 38% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Right | $270.94 | $437.00 | — | 50% above | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Right | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Left | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Right | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 4th Digit Left | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Right | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 2nd Digit Left | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Left | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 5th Digit Right | $130.20 | $210.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger 3rd Digit Left | $270.94 | $437.00 | — | — | 38% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger Thumb Right | $270.94 | $437.00 | — | — | 38% |
| X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral | $165.54 | $267.00 | — | — | 38% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $110.36 | $178.00 | — | 33% below | 38% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $229.40 | $370.00 | — | 39% above | 38% |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral | $165.54 | $267.00 | — | — | 38% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $110.36 | $178.00 | — | — | 38% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $229.40 | $370.00 | — | — | 38% |
| X-ray of the foot, complete, 3 or more views CPT 73630 XR Foot Complete 3+ Views Bilt | $390.60 | $630.00 | — | 88% above | 38% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views LT | $125.24 | $202.00 | — | 40% below | 38% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views RT | $260.40 | $420.00 | — | 25% above | 38% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 XR Foot Complete 3+ Views Bilt | $390.60 | $630.00 | — | — | 38% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views LT | $125.24 | $202.00 | — | — | 38% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views RT | $260.40 | $420.00 | — | — | 38% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete 3+ View Bilat | $446.40 | $720.00 | — | — | 38% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views RT | $143.22 | $231.00 | — | 44% below | 38% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views LT | $297.60 | $480.00 | — | 17% above | 38% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete 3+ View Bilat | $446.40 | $720.00 | — | — | 38% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views RT | $143.22 | $231.00 | — | — | 38% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views LT | $297.60 | $480.00 | — | — | 38% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $169.88 | $274.00 | — | — | 38% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views RT | $113.46 | $183.00 | — | 45% below | 38% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views LT | $113.46 | $183.00 | — | 45% below | 38% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $169.88 | $274.00 | — | — | 38% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views LT | $113.46 | $183.00 | — | — | 38% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views RT | $113.46 | $183.00 | — | — | 38% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2-3 Views | $256.68 | $414.00 | — | 25% below | 38% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2-3 Views | $256.68 | $414.00 | — | — | 38% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4+ Views | $164.30 | $265.00 | — | 57% below | 38% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4+ Views | $164.30 | $265.00 | — | — | 38% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $203.36 | $328.00 | — | 30% below | 38% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views | $203.36 | $328.00 | — | — | 38% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $262.26 | $423.00 | — | 3% below | 38% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views | $262.26 | $423.00 | — | — | 38% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $252.34 | $407.00 | — | 9% below | 38% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $252.34 | $407.00 | — | — | 38% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $260.40 | $420.00 | — | at median | 38% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $260.40 | $420.00 | — | — | 38% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views | $229.40 | $370.00 | — | 22% below | 38% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views | $229.40 | $370.00 | — | — | 38% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 (ALT) (SGPT) L403604 | $29.76 | $48.00 | — | 57% below | 38% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 AlninAmn ALT SGP L550960 | $29.76 | $48.00 | — | 57% below | 38% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 (ALT) (SGPT) L402175 | $29.76 | $48.00 | — | 57% below | 38% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $29.76 | $48.00 | — | 57% below | 38% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 (ALT) (SGPT) L403604 | $29.76 | $48.00 | — | — | 38% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT) | $29.76 | $48.00 | — | — | 38% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 AlninAmn ALT SGP L550960 | $29.76 | $48.00 | — | — | 38% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 (ALT) (SGPT) L402175 | $29.76 | $48.00 | — | — | 38% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST TRANSFERASE ASPARTATE | $29.14 | $47.00 | — | 57% below | 38% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 84450 Trnsfrs AST/SGOT L550960 | $29.14 | $47.00 | — | 57% below | 38% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 (AST) (SGOT) L403604 | $29.14 | $47.00 | — | 57% below | 38% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 (AST) (SGOT) L402175 | $29.14 | $47.00 | — | 57% below | 38% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST TRANSFERASE ASPARTATE | $29.14 | $47.00 | — | — | 38% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 (AST) (SGOT) L402175 | $29.14 | $47.00 | — | — | 38% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 (AST) (SGOT) L403604 | $29.14 | $47.00 | — | — | 38% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 Trnsfrs AST/SGOT L550960 | $29.14 | $47.00 | — | — | 38% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) L144000 | $265.98 | $429.00 | — | 46% below | 38% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 L144000 Acut Viral Hep (A,B,C) | $265.98 | $429.00 | — | 46% below | 38% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 L144000 Acut Viral Hep (A,B,C) | $265.98 | $429.00 | — | — | 38% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) L144000 | $265.98 | $429.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allg Spec IGE Crude Xt L607950 | $13.02 | $21.00 | — | 59% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F091-IgE Mango L602741 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Fd IgE II w/Rfl L604783 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgG4 Egg (Yolk) L605342 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) L602487 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F036-IgE Coconut L602512 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F024-IgE Shrimp L602473 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F020-IgE Almond L602479 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgG4 Soybean L605307 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean L602457 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut L602451 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Rice L602511 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Resp-Area1 w/rf L606995 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profl Nut IgE L604764 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLG SPEC IGE CRDXTRC EA | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602782 Allergen IgE Coffee | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602492 Allergn IgE Choc/Cacao | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602732 Allrgn IgE CheesChdTp | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602734 Allergen IgE KiwiFruit | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602794 Allergen IgE Lentil | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602841 Allergen IgE Hop(Food) | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602810 Allergen IgE Ginger | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602519 Allergen IgE Garlic | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602818 Allrgn IgE BlckPpprcrn | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602745 Allergen IgE Avocado | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602823 Allergen IgE Turkey | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602510 Allergen IgE Tuna | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602783 Allergen IgE Tea | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602726 Allergen IgE SwtPotat | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602726 Allergen IgE Melon | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prf Food VegII L601823 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prf Food Veg I L601831 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (5) Fish L601663 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prof Food-Meat L602284 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prof Fd-Citrus L600981 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profil Fish 7 L601013 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Hymenoptera Profile 2 L606895 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602486 Pistachio nut | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE L600937 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Common Silver Birch L602936 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Ragweed, Short L602463 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lambs Quarters L602537 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mini Profile L649749 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602526 Goats Milk | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602550 Pine nut, Pignoles | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602568 Macadamia Nut | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE qnt/sqnt ex Peanut L603916 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RF IgE qnt/sn exPeanut L603916 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Corn L602460 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Spc CrudeAllrgn Ext ea L650003 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE L605651 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food L602989 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profl Dog IgE L606659 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Prf Dog CmpRflx L606659 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DermatophagdsPtrnyssns L602467 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Johnson Grass allergen L602503 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Setomelanomma rostrata L602561 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Alg EggWhite IgE w/Rfx L603940 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AllrgnPrfl Cat IgE w/R L606650 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Grasses Panel L644682 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L603927 Allergen Prfl Mlk IgE | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602529- Clam | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L607021 Allergen Cat Dog IgE | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F007-IgE Oat L602553 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F006-IgE Barley L602504 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat L602459 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk L602453 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White L602452 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen P Std Env(37) L605651 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G008-IgE Bluegrass, KY L602496 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Rhodotorula, IgE L826336 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 H002-IgE Hse Dst Hlstr L602546 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLERGEN sp IgE Qn/SQ ea | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 I006-IgE Cockroach Ger L602488 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pedtrc 3-6 yo L671934 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 K082-IgE Latex L602669 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E071-IgE Mouse Epithlm L602994 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander L602456 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cat Hair/Dander L602454 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Dander L602454 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 D002-IgE D farinae L602475 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Zone 2 L676528 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Zone 1 L676510 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Perennial L062497 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Alg spec ige crud xtrc L607660 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pediatric Allrgy Pnl 4 L604975 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T001-IgE Mpl/Box Elder L602489 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 Allergen spc IgE; qnt/sq | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Sesame Seed L602485 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 _Allergen, generic bill 86003 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(7) L671926 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (15) Inhlnts L604412 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf Shellfish L062695 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T007-IgE Oak, White L602480 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf Vegtbl II L601823 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T008-IgE Elm, American L602476 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (13) Envrn L604419 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T015-IgE Ash, White L602927 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T041-IgE Hickory, Whte L602941 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T070-IgE White Mlberry L602569 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L826336 Rhodotorula, IgE | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602497 Gluten, IgE | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 L602825 Blueberry | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy Grass L602506 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G005-IgE Rye Grs, Perl L602543 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G004-IgE Fescue, Meadw L602549 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 G003-IgE Orchard Grass L602867 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F341-IgE Cranberry L602764 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F293-IgE Papaya Food L602828 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F259-IgE Grape L602802 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F225-IgE Pumpkin L602786 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F210-IgE Pineapple L602770 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prof, Fd-Milk L601856 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Mold L062448 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prfl BascFood L660423 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 K084-IgE Sunflowr Seed L602766 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf Food-Basc L648014 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Asprgil fumig L602471 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf, Fd-Fruit L601872 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 M006-IgE Alter alterta L602455 | $29.14 | $47.00 | — | 9% below | 38% |
| Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgG4 Wheat L605296 | $37.20 | $60.00 | — | 16% above | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allg Spec IGE Crude Xt L607950 | $13.02 | $21.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G008-IgE Bluegrass, KY L602496 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen P Std Env(37) L605651 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rhodotorula, IgE L826336 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 ALLERGEN sp IgE Qn/SQ ea | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Pedtrc 3-6 yo L671934 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Prfl BascFood L660423 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Prf Food-Basc L648014 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Prf, Fd-Fruit L601872 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Prof, Fd-Milk L601856 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Mold L062448 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Prf Shellfish L062695 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Prf Vegtbl II L601823 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (13) Envrn L604419 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (15) Inhlnts L604412 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens(7) L671926 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 _Allergen, generic bill 86003 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Sesame Seed L602485 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Allergen spc IgE; qnt/sq | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alg spec ige crud xtrc L607660 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L607021 Allergen Cat Dog IgE | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Perennial L062497 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Zone 1 L676510 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens, Zone 2 L676528 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D002-IgE D farinae L602475 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E001-IgE Cat Dander L602454 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Hair/Dander L602454 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Dander L602456 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E071-IgE Mouse Epithlm L602994 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F001-IgE Egg White L602452 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F002-IgE Milk L602453 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgE Wheat L602459 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F006-IgE Barley L602504 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F007-IgE Oat L602553 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602529- Clam | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L603927 Allergen Prfl Mlk IgE | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Grasses Panel L644682 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AllrgnPrfl Cat IgE w/R L606650 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alg EggWhite IgE w/Rfx L603940 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Setomelanomma rostrata L602561 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson Grass allergen L602503 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DermatophagdsPtrnyssns L602467 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allrgn Prf Dog CmpRflx L606659 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profl Dog IgE L606659 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Food L602989 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE L605651 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Spc CrudeAllrgn Ext ea L650003 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F009-IgE Corn L602460 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RF IgE qnt/sn exPeanut L603916 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE qnt/sqnt ex Peanut L603916 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602568 Macadamia Nut | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602550 Pine nut, Pignoles | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602526 Goats Milk | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Mini Profile L649749 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lambs Quarters L602537 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ragweed, Short L602463 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Silver Birch L602936 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE L600937 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602486 Pistachio nut | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hymenoptera Profile 2 L606895 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profil Fish 7 L601013 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergn Prof Fd-Citrus L600981 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergn Prof Food-Meat L602284 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergens (5) Fish L601663 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergn Prf Food Veg I L601831 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergn Prf Food VegII L601823 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602726 Allergen IgE Melon | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602726 Allergen IgE SwtPotat | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602783 Allergen IgE Tea | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602510 Allergen IgE Tuna | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602823 Allergen IgE Turkey | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602745 Allergen IgE Avocado | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602818 Allrgn IgE BlckPpprcrn | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602519 Allergen IgE Garlic | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602810 Allergen IgE Ginger | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602841 Allergen IgE Hop(Food) | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602794 Allergen IgE Lentil | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602734 Allergen IgE KiwiFruit | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602732 Allrgn IgE CheesChdTp | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602492 Allergn IgE Choc/Cacao | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602782 Allergen IgE Coffee | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 ALLG SPEC IGE CRDXTRC EA | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profl Nut IgE L604764 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allrgn Resp-Area1 w/rf L606995 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allrgn Fd IgE II w/Rfl L604783 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F009-IgE Rice L602511 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut L602451 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgE Soybean L602457 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F014-IgG4 Soybean L605307 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F020-IgE Almond L602479 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F024-IgE Shrimp L602473 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F036-IgE Coconut L602512 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F075-IgE Egg (Yolk) L602487 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F075-IgG4 Egg (Yolk) L605342 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602825 Blueberry | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F091-IgE Mango L602741 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F210-IgE Pineapple L602770 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F225-IgE Pumpkin L602786 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F259-IgE Grape L602802 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F293-IgE Papaya Food L602828 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F341-IgE Cranberry L602764 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G003-IgE Orchard Grass L602867 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G004-IgE Fescue, Meadw L602549 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G005-IgE Rye Grs, Perl L602543 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G006-IgE Timothy Grass L602506 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L602497 Gluten, IgE | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L826336 Rhodotorula, IgE | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T070-IgE White Mlberry L602569 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T041-IgE Hickory, Whte L602941 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T015-IgE Ash, White L602927 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T008-IgE Elm, American L602476 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T007-IgE Oak, White L602480 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T001-IgE Mpl/Box Elder L602489 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pediatric Allrgy Pnl 4 L604975 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M006-IgE Alter alterta L602455 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M003-IgE Asprgil fumig L602471 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K084-IgE Sunflowr Seed L602766 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 K082-IgE Latex L602669 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I006-IgE Cockroach Ger L602488 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 H002-IgE Hse Dst Hlstr L602546 | $29.14 | $47.00 | — | — | 38% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F004-IgG4 Wheat L605296 | $37.20 | $60.00 | — | — | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody L164065 | $72.54 | $117.00 | — | 45% below | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Anti-CCP Ab IgG + IgA L520008 | $72.54 | $117.00 | — | 45% below | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Circ Peptide Ab L520298 | $72.54 | $117.00 | — | 45% below | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CyclCtrllntdPeptide Ab L520205 | $72.54 | $117.00 | — | 45% below | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CBG with Free Cortisol L500440 | $72.54 | $117.00 | — | 45% below | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 86200 Cyclic ctrllntd pept CCP | $72.54 | $117.00 | — | 45% below | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Circ Peptide Ab L520298 | $72.54 | $117.00 | — | — | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 86200 Cyclic ctrllntd pept CCP | $72.54 | $117.00 | — | — | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody L164065 | $72.54 | $117.00 | — | — | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CyclCtrllntdPeptide Ab L520205 | $72.54 | $117.00 | — | — | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Anti-CCP Ab IgG + IgA L520008 | $72.54 | $117.00 | — | — | 38% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CBG with Free Cortisol L500440 | $72.54 | $117.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclr antibd (ANA) L520293 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex L164962 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (ANA) L520205 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Multiplex Rflx 9 L164863 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies L382965 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Antinuclear Ab L520342 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA ReflexL340897 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antib, IFA L164947 | $67.58 | $109.00 | — | 44% below | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Multiplex Rflx 9 L164863 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Lupus Antinuclear Ab L520342 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antib, IFA L164947 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Ab (ANA) L520205 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies L382965 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IFA ReflexL340897 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclr antibd (ANA) L520293 | $67.58 | $109.00 | — | — | 38% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex L164962 | $67.58 | $109.00 | — | — | 38% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP | $73.16 | $118.00 | — | 66% below | 38% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BType Natriuretic Peptide(BNP) | $179.80 | $290.00 | — | 16% below | 38% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-Term Pro B-Type Natr Peptide | $179.80 | $290.00 | — | 16% below | 38% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 L143000 NT-proBNP | $179.80 | $290.00 | — | 16% below | 38% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-proBNP | $73.16 | $118.00 | — | — | 38% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 N-Term Pro B-Type Natr Peptide | $179.80 | $290.00 | — | — | 38% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BType Natriuretic Peptide(BNP) | $179.80 | $290.00 | — | — | 38% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 L143000 NT-proBNP | $179.80 | $290.00 | — | — | 38% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL TOTAL CA | $47.74 | $77.00 | — | 32% below | 38% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL TOTAL CA | $47.74 | $77.00 | — | — | 38% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH 88305 Bill Surg Level IV | $169.26 | $273.00 | — | 24% below | 38% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 PATH 88305 Bill Surg Level IV | $169.26 | $273.00 | — | — | 38% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $57.66 | $93.00 | — | 63% below | 38% |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE | $57.66 | $93.00 | — | — | 38% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture by MA/Nurse 36415 | $14.26 | $23.00 | — | 28% below | 38% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ONC INF Blood Draw Peripheral | $14.26 | $23.00 | — | 28% below | 38% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE | $14.26 | $23.00 | — | 28% below | 38% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 _Venipuncture bill L998085 | $14.26 | $23.00 | — | 28% below | 38% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ONC INF Blood Draw Peripheral | $14.26 | $23.00 | — | — | 38% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture by MA/Nurse 36415 | $14.26 | $23.00 | — | — | 38% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 _Venipuncture bill L998085 | $14.26 | $23.00 | — | — | 38% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE | $14.26 | $23.00 | — | — | 38% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting Challenge | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 Whole Blood Glucose POC | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT POC | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 Fasting Plasma Glucose | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 Glucose, 2 Hr Post Prandial | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting Glucola Prentl | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 Glucose, 1 Hr Post Prandial | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 GTT 2hr Challenge Notify | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test CPT 82947 82947 Glucose qnt bld L550960 | $22.32 | $36.00 | — | 44% below | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 GTT 2hr Challenge Notify | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 82947 Glucose qnt bld L550960 | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting Challenge | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT POC | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose, 1 Hr Post Prandial | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting Glucola Prentl | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose, 2 Hr Post Prandial | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Fasting Plasma Glucose | $22.32 | $36.00 | — | — | 38% |
| Blood glucose (sugar) test inpatient CPT 82947 Whole Blood Glucose POC | $22.32 | $36.00 | — | — | 38% |
| Blood lead test CPT 83655 Whole Blood Lead Level POC | $27.90 | $45.00 | — | 79% below | 38% |
| Blood lead test CPT 83655 Lead HMP1 Urine L007046 | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test CPT 83655 Assay of Lead L250281 | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test CPT 83655 Lead L042580 | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test CPT 83655 83655 Lead | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test CPT 83655 Lead, Blood (Adult) L007625 | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test CPT 83655 Lead, Blood (Pediatrc) L717009 | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test CPT 83655 Assay of Lead L706200 | $57.04 | $92.00 | — | 58% below | 38% |
| Blood lead test inpatient CPT 83655 Whole Blood Lead Level POC | $27.90 | $45.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 Assay of Lead L250281 | $57.04 | $92.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Adult) L007625 | $57.04 | $92.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 Assay of Lead L706200 | $57.04 | $92.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 Lead L042580 | $57.04 | $92.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Pediatrc) L717009 | $57.04 | $92.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 Lead HMP1 Urine L007046 | $57.04 | $92.00 | — | — | 38% |
| Blood lead test inpatient CPT 83655 83655 Lead | $57.04 | $92.00 | — | — | 38% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, Beta Qual, Serum | $101.06 | $163.00 | — | 3% above | 38% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, Beta Qual, Serum | $101.06 | $163.00 | — | — | 38% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Ref Lab ABO Type | $85.56 | $138.00 | — | 41% above | 38% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO | $85.56 | $138.00 | — | 41% above | 38% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Typ, Ser, ABO L006049 | $85.56 | $138.00 | — | 41% above | 38% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Typ, Ser, ABO L006049 | $85.56 | $138.00 | — | — | 38% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO | $85.56 | $138.00 | — | — | 38% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB Ref Lab ABO Type | $85.56 | $138.00 | — | — | 38% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $101.06 | $163.00 | — | 20% above | 38% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 86140 C-reactive protein | $101.06 | $163.00 | — | 20% above | 38% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $101.06 | $163.00 | — | — | 38% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 86140 C-reactive protein | $101.06 | $163.00 | — | — | 38% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C Diff/Epi PCR | $208.32 | $336.00 | — | at median | 38% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C diffcle Toxn Gne NAA L183988 | $208.32 | $336.00 | — | at median | 38% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C diffcle Toxn Gne NAA L183988 | $208.32 | $336.00 | — | — | 38% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C Diff/Epi PCR | $208.32 | $336.00 | — | — | 38% |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 L002261 | $116.56 | $188.00 | — | 44% below | 38% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 L002261 | $116.56 | $188.00 | — | — | 38% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antign (CA) 125 L002303 | $116.56 | $188.00 | — | 49% below | 38% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 Tumor Antigen L081610 | $116.56 | $188.00 | — | 49% below | 38% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antign (CA) 125 L002303 | $116.56 | $188.00 | — | — | 38% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 Tumor Antigen L081610 | $116.56 | $188.00 | — | — | 38% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 NAA | $241.80 | $390.00 | — | 56% above | 38% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid COVID 19 PCR | $241.80 | $390.00 | — | 56% above | 38% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB BL | $241.80 | $390.00 | — | 56% above | 38% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 NAA | $241.80 | $390.00 | — | — | 38% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Rapid COVID 19 PCR | $241.80 | $390.00 | — | — | 38% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB BL | $241.80 | $390.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Gonrrhoea/Chlamyda PCR (Urine) | $84.94 | $137.00 | — | 52% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/GC Amplific L183194 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydi trachmts, NAA L188078 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Phrg Swb NAA L188698 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis L180051 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by PCR | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis L186200 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Chlamydia trachmt ampprb | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Rectal Swab L188672 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlmyd dna amp prb L180107 | $166.78 | $269.00 | — | 5% below | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Gonrrhoea/Chlamyda PCR (Urine) | $84.94 | $137.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Chlamydia trachmt ampprb | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis L180051 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlmyd dna amp prb L180107 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis L186200 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Phrg Swb NAA L188698 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Rectal Swab L188672 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia/GC Amplific L183194 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydi trachmts, NAA L188078 | $166.78 | $269.00 | — | — | 38% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia by PCR | $166.78 | $269.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL L030155 | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 EMP H LIPID PANEL | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Cascade L361946 | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel L385077 | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel L303756 | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel L123544 | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel L884247 | $75.02 | $121.00 | — | 28% below | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Cascade L361946 | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 EMP H LIPID PANEL | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid panel L884247 | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel L123544 | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel L303756 | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel L385077 | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL L030155 | $75.02 | $121.00 | — | — | 38% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $75.02 | $121.00 | — | — | 38% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $67.58 | $109.00 | — | 42% above | 38% |
| Complete blood count (CBC) with differential CPT 85025 CBC Auto W/ Auto Diff L005009 | $67.58 | $109.00 | — | 42% above | 38% |
| Complete blood count (CBC) with differential CPT 85025 Cmplt cbc w a. dif wbc L042077 | $67.58 | $109.00 | — | 42% above | 38% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $67.58 | $109.00 | — | — | 38% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC Auto W/ Auto Diff L005009 | $67.58 | $109.00 | — | — | 38% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Cmplt cbc w a. dif wbc L042077 | $67.58 | $109.00 | — | — | 38% |
| Complete blood count (CBC), no differential CPT 85027 CBC COMPLETE AUTO NO DIFF | $36.58 | $59.00 | — | 37% below | 38% |
| Complete blood count (CBC), no differential CPT 85027 Auto CBC L121363 | $36.58 | $59.00 | — | 37% below | 38% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC COMPLETE AUTO NO DIFF | $36.58 | $59.00 | — | — | 38% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Auto CBC L121363 | $36.58 | $59.00 | — | — | 38% |
| Comprehensive metabolic panel (blood test) CPT 80053 80053 COMPREHEN METABOLC PANEL | $92.38 | $149.00 | — | 7% below | 38% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $92.38 | $149.00 | — | 7% below | 38% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comp. Metablc Pnl (14) L322000 | $92.38 | $149.00 | — | 7% below | 38% |
| Comprehensive metabolic panel (blood test) CPT 80053 Add CMP to BMP | $92.38 | $149.00 | — | 7% below | 38% |
| Comprehensive metabolic panel (blood test) CPT 80053 Add CMP to iSTAT Chm 8+ (POCT) | $92.38 | $149.00 | — | 7% below | 38% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $92.38 | $149.00 | — | — | 38% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Add CMP to BMP | $92.38 | $149.00 | — | — | 38% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comp. Metablc Pnl (14) L322000 | $92.38 | $149.00 | — | — | 38% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Add CMP to iSTAT Chm 8+ (POCT) | $92.38 | $149.00 | — | — | 38% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 80053 COMPREHEN METABOLC PANEL | $92.38 | $149.00 | — | — | 38% |
| D-dimer blood test (blood clot marker) CPT 85379 Fibrin DP D-dimer qnt L385730 | $57.04 | $92.00 | — | 56% below | 38% |
| D-dimer blood test (blood clot marker) CPT 85379 DDimer, Quantitative | $57.04 | $92.00 | — | 56% below | 38% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 Fibrin DP D-dimer qnt L385730 | $57.04 | $92.00 | — | — | 38% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 DDimer, Quantitative | $57.04 | $92.00 | — | — | 38% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate L004020 | $124.62 | $201.00 | — | 18% below | 38% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate L004020 | $124.62 | $201.00 | — | — | 38% |
| Estradiol blood test CPT 82670 Estradiol L004515 | $156.24 | $252.00 | — | 3% below | 38% |
| Estradiol blood test CPT 82670 82670 Estradiol | $156.24 | $252.00 | — | 3% below | 38% |
| Estradiol blood test CPT 82670 L140244 Estradiol Sen, LC/MS | $156.24 | $252.00 | — | 3% below | 38% |
| Estradiol blood test CPT 82670 Estradiol Total L504295 | $156.24 | $252.00 | — | 3% below | 38% |
| Estradiol blood test inpatient CPT 82670 Estradiol L004515 | $156.24 | $252.00 | — | — | 38% |
| Estradiol blood test inpatient CPT 82670 Estradiol Total L504295 | $156.24 | $252.00 | — | — | 38% |
| Estradiol blood test inpatient CPT 82670 L140244 Estradiol Sen, LC/MS | $156.24 | $252.00 | — | — | 38% |
| Estradiol blood test inpatient CPT 82670 82670 Estradiol | $156.24 | $252.00 | — | — | 38% |
| FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin FSH L504295 | $104.16 | $168.00 | — | 21% below | 38% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum L004309 | $104.16 | $168.00 | — | 21% below | 38% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Gonadotropin FSH L504295 | $104.16 | $168.00 | — | — | 38% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Serum L004309 | $104.16 | $168.00 | — | — | 38% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal L123255 | $109.74 | $177.00 | — | 56% below | 38% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal L123255 | $109.74 | $177.00 | — | — | 38% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $76.26 | $123.00 | — | 18% below | 38% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin L121363 | $76.26 | $123.00 | — | 18% below | 38% |
| Ferritin blood test (iron stores) CPT 82728 Assay of Ferritin L004598 | $76.26 | $123.00 | — | 18% below | 38% |
| Ferritin blood test (iron stores) CPT 82728 Assay of ferritin L042077 | $76.26 | $123.00 | — | 18% below | 38% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Assay of ferritin L042077 | $76.26 | $123.00 | — | — | 38% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Assay of Ferritin L004598 | $76.26 | $123.00 | — | — | 38% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin L121363 | $76.26 | $123.00 | — | — | 38% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $76.26 | $123.00 | — | — | 38% |
| Folate (folic acid) blood test CPT 82746 Assay of folc acd srm L042077 | $82.46 | $133.00 | — | 10% below | 38% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $82.46 | $133.00 | — | 10% below | 38% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $82.46 | $133.00 | — | — | 38% |
| Folate (folic acid) blood test inpatient CPT 82746 Assay of folc acd srm L042077 | $82.46 | $133.00 | — | — | 38% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine (T3), Free | $31.62 | $51.00 | — | 85% below | 38% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyrnne T3 Free L010389 | $94.86 | $153.00 | — | 55% below | 38% |
| Free T3 thyroid hormone test CPT 84481 _T3Free L010390 | $94.86 | $153.00 | — | 55% below | 38% |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine (T3), Free | $31.62 | $51.00 | — | — | 38% |
| Free T3 thyroid hormone test inpatient CPT 84481 _T3Free L010390 | $94.86 | $153.00 | — | — | 38% |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyrnne T3 Free L010389 | $94.86 | $153.00 | — | — | 38% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $50.84 | $82.00 | — | 56% below | 38% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 _Thyrx (T4) Fre, Dr, S L001976 | $50.84 | $82.00 | — | 56% below | 38% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 _Thyx (T4) Fre, Drt, S L001977 | $50.84 | $82.00 | — | 56% below | 38% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 _Thyrx (T4) Fre, Dr, S L001976 | $50.84 | $82.00 | — | — | 38% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level | $50.84 | $82.00 | — | — | 38% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 _Thyx (T4) Fre, Drt, S L001977 | $50.84 | $82.00 | — | — | 38% |
| Free testosterone test CPT 84402 Testostrne, Free, Drct L144980 | $130.82 | $211.00 | — | 35% below | 38% |
| Free testosterone test CPT 84402 Testosterone, free L081786 | $130.82 | $211.00 | — | 35% below | 38% |
| Free testosterone test CPT 84402 84402 ASSAY FREE TESTOSTERONE | $130.82 | $211.00 | — | 35% below | 38% |
| Free testosterone test inpatient CPT 84402 Testostrne, Free, Drct L144980 | $130.82 | $211.00 | — | — | 38% |
| Free testosterone test inpatient CPT 84402 Testosterone, free L081786 | $130.82 | $211.00 | — | — | 38% |
| Free testosterone test inpatient CPT 84402 84402 ASSAY FREE TESTOSTERONE | $130.82 | $211.00 | — | — | 38% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel (Champva) | $232.50 | $375.00 | — | at median | 38% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 General Health Panel (Champva) | $232.50 | $375.00 | — | — | 38% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .Glucose 1 Hour Glucola Prentl | $26.66 | $43.00 | — | 49% below | 38% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 1 Hr Gluc Prenatal Chllnge | $26.66 | $43.00 | — | 49% below | 38% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hr Challenge | $71.92 | $116.00 | — | 38% above | 38% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .Glucose 1 Hour Glucola Prentl | $26.66 | $43.00 | — | — | 38% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT 1 Hr Gluc Prenatal Chllnge | $26.66 | $43.00 | — | — | 38% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hr Challenge | $71.92 | $116.00 | — | — | 38% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose3Hour GlucolaPrenat | $71.92 | $116.00 | — | 55% below | 38% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose3Hour GlucolaPrenat | $71.92 | $116.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae L180051 | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.gonorrh dna amp prb L180107 | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neissria gonrrhoe, NAA L188086 | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae l186200 | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus Rectal Swab L188672 | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N GNORRHOEAE DNA AMP PRB | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus PhrgSwb NAA L188698 | $195.92 | $316.00 | — | at median | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonococcus Rectal Swab L188672 | $195.92 | $316.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neissria gonrrhoe, NAA L188086 | $195.92 | $316.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonococcus PhrgSwb NAA L188698 | $195.92 | $316.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae l186200 | $195.92 | $316.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.gonorrh dna amp prb L180107 | $195.92 | $316.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Neisseria gonorrhoeae L180051 | $195.92 | $316.00 | — | — | 38% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 N GNORRHOEAE DNA AMP PRB | $195.92 | $316.00 | — | — | 38% |
| H. pylori antibody blood test CPT 86677 H pyl IgM, IgG, IgA Ab L163683 | $94.24 | $152.00 | — | 49% below | 38% |
| H. pylori antibody blood test CPT 86677 H. pylori, IgG Abs L162289 | $94.24 | $152.00 | — | 49% below | 38% |
| H. pylori antibody blood test CPT 86677 86677 Antbd Helicobacter pylor | $94.24 | $152.00 | — | 49% below | 38% |
| H. pylori antibody blood test CPT 86677 Helicbtr pylori IgM Ab L163204 | $94.24 | $152.00 | — | 49% below | 38% |
| H. pylori antibody blood test inpatient CPT 86677 86677 Antbd Helicobacter pylor | $94.24 | $152.00 | — | — | 38% |
| H. pylori antibody blood test inpatient CPT 86677 H pyl IgM, IgG, IgA Ab L163683 | $94.24 | $152.00 | — | — | 38% |
| H. pylori antibody blood test inpatient CPT 86677 H. pylori, IgG Abs L162289 | $94.24 | $152.00 | — | — | 38% |
| H. pylori antibody blood test inpatient CPT 86677 Helicbtr pylori IgM Ab L163204 | $94.24 | $152.00 | — | — | 38% |
| H. pylori stool antigen test CPT 87338 H. pylori Stool Ag EIA L180764 | $80.60 | $130.00 | — | 37% below | 38% |
| H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag EIA L180764 | $80.60 | $130.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 rflx GA for L550920 | $403.00 | $650.00 | — | 25% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant PCR L550920 | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 L550625 HIV-1 Qn RltmPCR NGw/R | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant w/R Trans L550880 | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Rl Tm PCR (N-Grph) L550430 | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 L550430 HIV-1 Qnt R-t PCR (NG) | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 L550390 HIV-1 QntPCR w/rf Trof | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 87536 Infect agent DNA/RNA HIV | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 A3000867 HIV1 Qnt NAAT, Plasma | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1, Qnt, RT PCR (G) L550420 | $474.92 | $766.00 | — | 12% below | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 rflx GA for L550920 | $403.00 | $650.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 A3000867 HIV1 Qnt NAAT, Plasma | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA Rl Tm PCR (N-Grph) L550430 | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 L550430 HIV-1 Qnt R-t PCR (NG) | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 87536 Infect agent DNA/RNA HIV | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant w/R Trans L550880 | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 L550390 HIV-1 QntPCR w/rf Trof | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 L550625 HIV-1 Qn RltmPCR NGw/R | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 Quant PCR L550920 | $474.92 | $766.00 | — | — | 38% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient one side CPT 87536 HIV-1, Qnt, RT PCR (G) L550420 | $474.92 | $766.00 | — | — | 38% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab with Reflex L083935 | $134.54 | $217.00 | — | 13% above | 38% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab with Reflex L083935 | $134.54 | $217.00 | — | — | 38% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 HPV genotyping high risk | $195.92 | $316.00 | — | at median | 38% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 HPV genotyping high risk | $195.92 | $316.00 | — | — | 38% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c POC | $26.04 | $42.00 | — | 67% below | 38% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 L102525 Hemoglobin A1c w/ eAG | $54.56 | $88.00 | — | 31% below | 38% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (Glycosylated) | $54.56 | $88.00 | — | 31% below | 38% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c POC | $26.04 | $42.00 | — | — | 38% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (Glycosylated) | $54.56 | $88.00 | — | — | 38% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 L102525 Hemoglobin A1c w/ eAG | $54.56 | $88.00 | — | — | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B (S) Ab L006395 | $60.14 | $97.00 | — | 51% below | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Ab ID hepatitis B srfc L144025 | $60.14 | $97.00 | — | 51% below | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EMP H HBSAB | $60.14 | $97.00 | — | 51% below | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep b surface antibody L144025 | $60.14 | $97.00 | — | 51% below | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 86706 Hepatitis B srf an HBsAb | $60.14 | $97.00 | — | 51% below | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B (S) Ab L006395 | $60.14 | $97.00 | — | — | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Ab ID hepatitis B srfc L144025 | $60.14 | $97.00 | — | — | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep b surface antibody L144025 | $60.14 | $97.00 | — | — | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 86706 Hepatitis B srf an HBsAb | $60.14 | $97.00 | — | — | 38% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 EMP H HBSAB | $60.14 | $97.00 | — | — | 38% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Qual/s-qnt HepB SrfcAg L144025 | $57.66 | $93.00 | — | 44% below | 38% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis b srfc ag ia L144025 | $57.66 | $93.00 | — | 44% below | 38% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen L006510 | $57.66 | $93.00 | — | 44% below | 38% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 Inf agnt antign imunoass | $57.66 | $93.00 | — | 44% below | 38% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Qual/s-qnt HepB SrfcAg L144025 | $57.66 | $93.00 | — | — | 38% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 87340 Inf agnt antign imunoass | $57.66 | $93.00 | — | — | 38% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis b srfc ag ia L144025 | $57.66 | $93.00 | — | — | 38% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen L006510 | $57.66 | $93.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis c ab test L144025 | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antbd RFX QuantPCR L144050 | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 L140659 HepatitisC Virus (HCV) | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody rflx NAA L144045 | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab w/Rflx to Q PCR L144050 | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody L144025 | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) CPT 86803 86803 Hepatitis C antibody | $79.98 | $129.00 | — | 51% below | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Ab w/Rflx to Q PCR L144050 | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 L140659 HepatitisC Virus (HCV) | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antbd RFX QuantPCR L144050 | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 86803 Hepatitis C antibody | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis c ab test L144025 | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C antibody L144025 | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody rflx NAA L144045 | $79.98 | $129.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C HVC, Quant PCR L550080 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HepCVirus(HCV) RNADiag L550870 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HepCVirus (HCV) QntRNA L551300 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RealTime PCR Quant L550312 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA PCR Qnt RfxGnt L550090 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Qnt (NGrh) L550080 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 _HCV RT-PCR Quant (NG) L550362 | $239.32 | $386.00 | — | 55% below | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hep C HVC, Quant PCR L550080 | $239.32 | $386.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RealTime PCR Quant L550312 | $239.32 | $386.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HepCVirus(HCV) RNADiag L550870 | $239.32 | $386.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA PCR Qnt RfxGnt L550090 | $239.32 | $386.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HepCVirus (HCV) QntRNA L551300 | $239.32 | $386.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Qnt (NGrh) L550080 | $239.32 | $386.00 | — | — | 38% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 _HCV RT-PCR Quant (NG) L550362 | $239.32 | $386.00 | — | — | 38% |
| Herpes blood test, HSV-1 antibody CPT 86695 86695 Antibd herpes simplex t1 | $73.78 | $119.00 | — | 50% below | 38% |
| Herpes blood test, HSV-1 antibody CPT 86695 Antibody ID HSV Type 1 L164099 | $73.78 | $119.00 | — | 50% below | 38% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1&2 Ab, IgG w/Rf L164922 | $73.78 | $119.00 | — | 50% below | 38% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IgG/M w/Rflx L163589 | $73.78 | $119.00 | — | 50% below | 38% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 IgG/M w/Rflx L163589 | $73.78 | $119.00 | — | — | 38% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 Antibody ID HSV Type 1 L164099 | $73.78 | $119.00 | — | — | 38% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Antibd herpes simplex t1 | $73.78 | $119.00 | — | — | 38% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1&2 Ab, IgG w/Rf L164922 | $73.78 | $119.00 | — | — | 38% |
| Herpes blood test, HSV-2 antibody CPT 86696 Antibody ID HSV Type 2 L164099 | $108.50 | $175.00 | — | 37% below | 38% |
| Herpes blood test, HSV-2 antibody CPT 86696 _HSV 2 IgG L163006 | $108.50 | $175.00 | — | 37% below | 38% |
| Herpes blood test, HSV-2 antibody CPT 86696 86696 Antibd herpes simplex t2 | $108.50 | $175.00 | — | 37% below | 38% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 Antibody ID HSV Type 2 L164099 | $108.50 | $175.00 | — | — | 38% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Antibd herpes simplex t2 | $108.50 | $175.00 | — | — | 38% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 _HSV 2 IgG L163006 | $108.50 | $175.00 | — | — | 38% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reac Prtn Hgh Sens (CV Risk) | $72.54 | $117.00 | — | 30% below | 38% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reac Prtn Hgh Sens (CV Risk) | $72.54 | $117.00 | — | — | 38% |
| Homocysteine blood test CPT 83090 Homocyst(e)ine, Plasma L706994 | $100.44 | $162.00 | — | 41% below | 38% |
| Homocysteine blood test CPT 83090 Homocysteine L501790 | $100.44 | $162.00 | — | 41% below | 38% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine L501790 | $100.44 | $162.00 | — | — | 38% |
| Homocysteine blood test inpatient CPT 83090 Homocyst(e)ine, Plasma L706994 | $100.44 | $162.00 | — | — | 38% |
| Insulin blood test CPT 83525 Assay of insulin L213660 | $63.86 | $103.00 | — | 56% below | 38% |
| Insulin blood test CPT 83525 Insulin L004333 | $63.86 | $103.00 | — | 56% below | 38% |
| Insulin blood test CPT 83525 Insulin Total L501561 | $63.86 | $103.00 | — | 56% below | 38% |
| Insulin blood test CPT 83525 Insulin (2 Specimens) L146902 | $63.86 | $103.00 | — | 56% below | 38% |
| Insulin blood test CPT 83525 83525 Insulin; total | $63.86 | $103.00 | — | 56% below | 38% |
| Insulin blood test inpatient CPT 83525 83525 Insulin; total | $63.86 | $103.00 | — | — | 38% |
| Insulin blood test inpatient CPT 83525 Assay of insulin L213660 | $63.86 | $103.00 | — | — | 38% |
| Insulin blood test inpatient CPT 83525 Insulin (2 Specimens) L146902 | $63.86 | $103.00 | — | — | 38% |
| Insulin blood test inpatient CPT 83525 Insulin Total L501561 | $63.86 | $103.00 | — | — | 38% |
| Insulin blood test inpatient CPT 83525 Insulin L004333 | $63.86 | $103.00 | — | — | 38% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $36.58 | $59.00 | — | 55% below | 38% |
| Iron blood test (serum iron) CPT 83540 Assay of iron L042077 | $36.58 | $59.00 | — | 55% below | 38% |
| Iron blood test (serum iron) inpatient CPT 83540 Assay of iron L042077 | $36.58 | $59.00 | — | — | 38% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $36.58 | $59.00 | — | — | 38% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY | $48.98 | $79.00 | — | 5% below | 38% |
| Iron-binding capacity (TIBC) test CPT 83550 Iron binding test L042077 | $48.98 | $79.00 | — | 5% below | 38% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron binding test L042077 | $48.98 | $79.00 | — | — | 38% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY | $48.98 | $79.00 | — | — | 38% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $48.98 | $79.00 | — | 55% below | 38% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $48.98 | $79.00 | — | — | 38% |
| LH (luteinizing hormone) test CPT 83002 Luteinizng Horm(LH), S L004283 | $103.54 | $167.00 | — | 36% below | 38% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizng Horm(LH), S L004283 | $103.54 | $167.00 | — | — | 38% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $75.02 | $121.00 | — | at median | 38% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE | $75.02 | $121.00 | — | — | 38% |
| Liver function blood test panel CPT 80076 Hepatic Function Pnl - LFTs | $45.88 | $74.00 | — | 53% below | 38% |
| Liver function blood test panel CPT 80076 Hepatic Function Panel L385077 | $45.88 | $74.00 | — | 53% below | 38% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel L385077 | $45.88 | $74.00 | — | — | 38% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Pnl - LFTs | $45.88 | $74.00 | — | — | 38% |
| Lyme disease antibody test CPT 86618 86618 Antibody; Borrelia burgd | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 Lyme, Totl Ab Test/Rfx L160325 | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 L164089 Lyme IgG/IgM | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 L164226 LymeDisease Tot Ab w/r | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 BorreliaBurgdorfri ARUP3003255 | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 Borrelia Burgdorfri Ab L164705 | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 Lyme Disease Antibody IgG+IgM | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 C6 B. burgdrfri (Lyme) L015400 | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 Lyme Ab Mod2TierPrfS/P L164226 | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test CPT 86618 Lyme disease antibody 3006053 | $95.48 | $154.00 | — | 17% below | 38% |
| Lyme disease antibody test inpatient CPT 86618 BorreliaBurgdorfri ARUP3003255 | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 Borrelia Burgdorfri Ab L164705 | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Ab Mod2TierPrfS/P L164226 | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 Lyme disease antibody 3006053 | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 L164089 Lyme IgG/IgM | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody IgG+IgM | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 L164226 LymeDisease Tot Ab w/r | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 Lyme, Totl Ab Test/Rfx L160325 | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 86618 Antibody; Borrelia burgd | $95.48 | $154.00 | — | — | 38% |
| Lyme disease antibody test inpatient CPT 86618 C6 B. burgdrfri (Lyme) L015400 | $95.48 | $154.00 | — | — | 38% |
| Magnesium blood test CPT 83735 Assay of magnesium A2008771 | $31.00 | $50.00 | — | 40% below | 38% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $31.00 | $50.00 | — | 40% below | 38% |
| Magnesium blood test CPT 83735 Magnesium, RBC L080283 | $31.00 | $50.00 | — | 40% below | 38% |
| Magnesium blood test CPT 83735 Magnesium, Urine L003400 | $31.00 | $50.00 | — | 40% below | 38% |
| Magnesium blood test CPT 83735 Magnesium, Urine L013730 | $31.00 | $50.00 | — | 40% below | 38% |
| Magnesium blood test CPT 83735 83735 Magnesium | $31.00 | $50.00 | — | 40% below | 38% |
| Magnesium blood test inpatient CPT 83735 Magnesium, RBC L080283 | $31.00 | $50.00 | — | — | 38% |
| Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM | $31.00 | $50.00 | — | — | 38% |
| Magnesium blood test inpatient CPT 83735 83735 Magnesium | $31.00 | $50.00 | — | — | 38% |
| Magnesium blood test inpatient CPT 83735 Assay of magnesium A2008771 | $31.00 | $50.00 | — | — | 38% |
| Magnesium blood test inpatient CPT 83735 Magnesium, Urine L013730 | $31.00 | $50.00 | — | — | 38% |
| Magnesium blood test inpatient CPT 83735 Magnesium, Urine L003400 | $31.00 | $50.00 | — | — | 38% |
| Measles (rubeola) antibody test CPT 86765 86765 Antibody; rubeola | $71.92 | $116.00 | — | 46% below | 38% |
| Measles (rubeola) antibody test CPT 86765 Measles(Rubeola)Ab,IgM L160178 | $71.92 | $116.00 | — | 46% below | 38% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies,IgM L160218 | $71.92 | $116.00 | — | 46% below | 38% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies,IgG L096560 | $71.92 | $116.00 | — | 46% below | 38% |
| Measles (rubeola) antibody test inpatient CPT 86765 86765 Antibody; rubeola | $71.92 | $116.00 | — | — | 38% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles(Rubeola)Ab,IgM L160178 | $71.92 | $116.00 | — | — | 38% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies,IgG L096560 | $71.92 | $116.00 | — | — | 38% |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies,IgM L160218 | $71.92 | $116.00 | — | — | 38% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Infectious Mononucleosis Scrn | $29.14 | $47.00 | — | 54% below | 38% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Monospot: Whole Blood POC | $29.14 | $47.00 | — | 54% below | 38% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Infectious Mononucleosis Scrn | $29.14 | $47.00 | — | — | 38% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monospot: Whole Blood POC | $29.14 | $47.00 | — | — | 38% |
| Obstetric blood test panel CPT 80055 OB Panel Bill Only | $267.22 | $431.00 | — | at median | 38% |
| Obstetric blood test panel inpatient CPT 80055 OB Panel Bill Only | $267.22 | $431.00 | — | — | 38% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Total+% Free L480947 | $89.90 | $145.00 | — | 50% below | 38% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Total+% Free L480947 | $89.90 | $145.00 | — | — | 38% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Ultrasensitive L140731 | $102.92 | $166.00 | — | 3% below | 38% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Diagnostic | $102.92 | $166.00 | — | 3% below | 38% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Health DT ARUP3000134 | $102.92 | $166.00 | — | 3% below | 38% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 Prostat spcf anti tl PSA | $102.92 | $166.00 | — | 3% below | 38% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Diagnostic | $102.92 | $166.00 | — | — | 38% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 Prostat spcf anti tl PSA | $102.92 | $166.00 | — | — | 38% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Health DT ARUP3000134 | $102.92 | $166.00 | — | — | 38% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Ultrasensitive L140731 | $102.92 | $166.00 | — | — | 38% |
| Pap test (liquid-based, automated screening with review) CPT 88175 88175 AP Cytopath C/V Auto Fld | $148.80 | $240.00 | — | 44% above | 38% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 AP Cytopath C/V Auto Fld | $148.80 | $240.00 | — | — | 38% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Cyto Gyn ATL Manl SCR | $113.46 | $183.00 | — | 12% above | 38% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Cyto Gyn Thin Prep Dx | $113.46 | $183.00 | — | 12% above | 38% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopath,C/V,Thin Layer 88142 | $113.46 | $183.00 | — | 12% above | 38% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Cyto Gyn Thin Prep Dx | $113.46 | $183.00 | — | — | 38% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 88142 AP Cyto Gyn ATL Manl SCR | $113.46 | $183.00 | — | — | 38% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytopath,C/V,Thin Layer 88142 | $113.46 | $183.00 | — | — | 38% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact L015610 | $230.64 | $372.00 | — | at median | 38% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (PTH) L054601 | $230.64 | $372.00 | — | at median | 38% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact L015610 | $230.64 | $372.00 | — | — | 38% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (PTH) L054601 | $230.64 | $372.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma or Whl bld L501790 | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 (PTT) Plasma/whl blood L500711 | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma/whole blood L385730 | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma/whole bloodL504400 | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma/whole blood L117079 | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin tme par L500390 | $34.10 | $55.00 | — | 51% below | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $34.10 | $55.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 (PTT) Plasma/whl blood L500711 | $34.10 | $55.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin tme par L500390 | $34.10 | $55.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT plasma/whole blood L117079 | $34.10 | $55.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT plasma/whole bloodL504400 | $34.10 | $55.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT plasma/whole blood L385730 | $34.10 | $55.00 | — | — | 38% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT plasma or Whl bld L501790 | $34.10 | $55.00 | — | — | 38% |
| Progesterone blood test CPT 84144 Progesterone L004317 | $116.56 | $188.00 | — | 42% below | 38% |
| Progesterone blood test inpatient CPT 84144 Progesterone L004317 | $116.56 | $188.00 | — | — | 38% |
| Prolactin blood test CPT 84146 Macroprolactin L500324 | $108.50 | $175.00 | — | 55% below | 38% |
| Prolactin blood test CPT 84146 Prolactin L004465 | $108.50 | $175.00 | — | 55% below | 38% |
| Prolactin blood test CPT 84146 Glyco Antibod IgG IgM L163002 | $108.50 | $175.00 | — | 55% below | 38% |
| Prolactin blood test inpatient CPT 84146 Macroprolactin L500324 | $108.50 | $175.00 | — | — | 38% |
| Prolactin blood test inpatient CPT 84146 Glyco Antibod IgG IgM L163002 | $108.50 | $175.00 | — | — | 38% |
| Prolactin blood test inpatient CPT 84146 Prolactin L004465 | $108.50 | $175.00 | — | — | 38% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time (PT) L500711 | $24.18 | $39.00 | — | 52% below | 38% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time (PT) L117079 | $24.18 | $39.00 | — | 52% below | 38% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time L385730 | $24.18 | $39.00 | — | 52% below | 38% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME and INR | $24.18 | $39.00 | — | 52% below | 38% |
| Prothrombin time (PT/INR) clotting test CPT 85610 INR POC | $24.18 | $39.00 | — | 52% below | 38% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time 85610 | $24.18 | $39.00 | — | 52% below | 38% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time (PT) L117079 | $24.18 | $39.00 | — | — | 38% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 INR POC | $24.18 | $39.00 | — | — | 38% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME and INR | $24.18 | $39.00 | — | — | 38% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time (PT) L500711 | $24.18 | $39.00 | — | — | 38% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time L385730 | $24.18 | $39.00 | — | — | 38% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time 85610 | $24.18 | $39.00 | — | — | 38% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen POC | $28.52 | $46.00 | — | 2% above | 38% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Methemoglobin, Blood L007047 | $59.52 | $96.00 | — | 112% above | 38% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Urine Drug Screen POC | $28.52 | $46.00 | — | — | 38% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Methemoglobin, Blood L007047 | $59.52 | $96.00 | — | — | 38% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza POC | $37.82 | $61.00 | — | 71% below | 38% |
| Rapid flu test (influenza antigen) CPT 87804 87804-QW Infect agnt antgn det | $78.12 | $126.00 | — | 40% below | 38% |
| Rapid flu test (influenza antigen) CPT 87804 Rapid Infl (flu) A or B Vr Agn | $78.12 | $126.00 | — | 40% below | 38% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza POC | $37.82 | $61.00 | — | — | 38% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 87804-QW Infect agnt antgn det | $78.12 | $126.00 | — | — | 38% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Rapid Infl (flu) A or B Vr Agn | $78.12 | $126.00 | — | — | 38% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A POC | $37.82 | $61.00 | — | 51% below | 38% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rpd Gp A Strp Scrn, w/ b-up cl | $78.12 | $126.00 | — | 1% above | 38% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep A POC | $37.82 | $61.00 | — | — | 38% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rpd Gp A Strp Scrn, w/ b-up cl | $78.12 | $126.00 | — | — | 38% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factr Quant L520298 | $32.24 | $52.00 | — | 55% below | 38% |
| Rheumatoid factor (RF) test CPT 86431 Rheum Arthritis Factor L006502 | $32.24 | $52.00 | — | 55% below | 38% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factr Quant L164065 | $32.24 | $52.00 | — | 55% below | 38% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Qnt L520205 | $32.24 | $52.00 | — | 55% below | 38% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid fact quant L520293 | $32.24 | $52.00 | — | 55% below | 38% |
| Rheumatoid factor (RF) test CPT 86431 86431 Rheumatoid factor; quant | $32.24 | $52.00 | — | 55% below | 38% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheum Arthritis Factor L006502 | $32.24 | $52.00 | — | — | 38% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factr Quant L520298 | $32.24 | $52.00 | — | — | 38% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Qnt L520205 | $32.24 | $52.00 | — | — | 38% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid fact quant L520293 | $32.24 | $52.00 | — | — | 38% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factr Quant L164065 | $32.24 | $52.00 | — | — | 38% |
| Rheumatoid factor (RF) test inpatient CPT 86431 86431 Rheumatoid factor; quant | $32.24 | $52.00 | — | — | 38% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Screen, IgG | $76.26 | $123.00 | — | 13% below | 38% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies,Ig GL006197 | $76.26 | $123.00 | — | 13% below | 38% |
| Rubella antibody test (immunity check) CPT 86762 86762 Antibody; rubella | $76.26 | $123.00 | — | 13% below | 38% |
| Rubella antibody test (immunity check) inpatient CPT 86762 86762 Antibody; rubella | $76.26 | $123.00 | — | — | 38% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Screen, IgG | $76.26 | $123.00 | — | — | 38% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies,Ig GL006197 | $76.26 | $123.00 | — | — | 38% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE RBC AUTO | $15.50 | $25.00 | — | 57% below | 38% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SedmntnRate ModWstrgrn L005215 | $15.50 | $25.00 | — | 57% below | 38% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RA Expanded Profile L164065 | $15.50 | $25.00 | — | 57% below | 38% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RA Expanded Profile L164065 | $15.50 | $25.00 | — | — | 38% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE RBC AUTO | $15.50 | $25.00 | — | — | 38% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SedmntnRate ModWstrgrn L005215 | $15.50 | $25.00 | — | — | 38% |
| Stool ova and parasites exam CPT 87177 O+P Exam, Formaln Only L180851 | $50.22 | $81.00 | — | 55% below | 38% |
| Stool ova and parasites exam CPT 87177 87177 Ova+parasite drct smr ID | $50.22 | $81.00 | — | 55% below | 38% |
| Stool ova and parasites exam inpatient CPT 87177 87177 Ova+parasite drct smr ID | $50.22 | $81.00 | — | — | 38% |
| Stool ova and parasites exam inpatient CPT 87177 O+P Exam, Formaln Only L180851 | $50.22 | $81.00 | — | — | 38% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood 2 | $24.80 | $40.00 | — | 49% below | 38% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood 3 | $24.80 | $40.00 | — | 49% below | 38% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood 1 | $24.80 | $40.00 | — | 49% below | 38% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood 3 | $24.80 | $40.00 | — | — | 38% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood 1 | $24.80 | $40.00 | — | — | 38% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood 2 | $24.80 | $40.00 | — | — | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR Rfx QNRPR/Confm TP L012005 | $24.18 | $39.00 | — | 45% below | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF L006445 | $24.18 | $39.00 | — | 45% below | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis RPR L006072 | $24.18 | $39.00 | — | 45% below | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 L006099 RPR | $24.18 | $39.00 | — | 45% below | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR Rfx QNRPR/Confm TP L012005 | $24.18 | $39.00 | — | — | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 L006099 RPR | $24.18 | $39.00 | — | — | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, CSF L006445 | $24.18 | $39.00 | — | — | 38% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Syphilis RPR L006072 | $24.18 | $39.00 | — | — | 38% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QFT TB Gold+ (Clnt in) L182893 | $323.64 | $522.00 | — | 49% above | 38% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantifern-TB Gold Pls L182879 | $323.64 | $522.00 | — | 49% above | 38% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 EMP H T-SPOT TB GOLD | $323.64 | $522.00 | — | 49% above | 38% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QFT TB Gold+ (Clnt in) L182893 | $323.64 | $522.00 | — | — | 38% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantifern-TB Gold Pls L182879 | $323.64 | $522.00 | — | — | 38% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 EMP H T-SPOT TB GOLD | $323.64 | $522.00 | — | — | 38% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum L004226 | $144.46 | $233.00 | — | 38% below | 38% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testost,Free and Total L140103 | $144.46 | $233.00 | — | 38% below | 38% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TestostrnTot W,C,hypoM L070001 | $144.46 | $233.00 | — | 38% below | 38% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, total L081786 | $144.46 | $233.00 | — | 38% below | 38% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TestostrnTot W,C,hypoM L070001 | $144.46 | $233.00 | — | — | 38% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testost,Free and Total L140103 | $144.46 | $233.00 | — | — | 38% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Serum L004226 | $144.46 | $233.00 | — | — | 38% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, total L081786 | $144.46 | $233.00 | — | — | 38% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyrd Perxdse (TPO) Ab L006676 | $81.22 | $131.00 | — | 44% below | 38% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidny Micrsml Ab L163980 | $81.22 | $131.00 | — | 44% below | 38% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 L520018 Anti-TPO Ab (RDL) | $81.22 | $131.00 | — | 44% below | 38% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 L520087 Anti-Liver/Kidney RDL | $81.22 | $131.00 | — | 44% below | 38% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies L006684 | $81.22 | $131.00 | — | 44% below | 38% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 _Thyrod Perox (TPO) Ab L330018 | $81.22 | $131.00 | — | 44% below | 38% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Antibodies L006684 | $81.22 | $131.00 | — | — | 38% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 _Thyrod Perox (TPO) Ab L330018 | $81.22 | $131.00 | — | — | 38% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 L520087 Anti-Liver/Kidney RDL | $81.22 | $131.00 | — | — | 38% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidny Micrsml Ab L163980 | $81.22 | $131.00 | — | — | 38% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 L520018 Anti-TPO Ab (RDL) | $81.22 | $131.00 | — | — | 38% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyrd Perxdse (TPO) Ab L006676 | $81.22 | $131.00 | — | — | 38% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE PROF L330015 | $94.24 | $152.00 | — | 23% below | 38% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulatng Hrm L027011 | $94.24 | $152.00 | — | 23% below | 38% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYR STIM HRM TSH RFX FREE T4 | $94.24 | $152.00 | — | 23% below | 38% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone L000620 | $94.24 | $152.00 | — | 23% below | 38% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE TSH | $94.24 | $152.00 | — | 23% below | 38% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYR STIM HRM TSH RFX FREE T4 | $94.24 | $152.00 | — | — | 38% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID CASCADE PROF L330015 | $94.24 | $152.00 | — | — | 38% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulatng Hrm L027011 | $94.24 | $152.00 | — | — | 38% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stim Hormone L000620 | $94.24 | $152.00 | — | — | 38% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE TSH | $94.24 | $152.00 | — | — | 38% |
| Trichomonas test (NAAT) CPT 87661 Trich vaginalis amplif L180107 | $165.54 | $267.00 | — | 28% below | 38% |
| Trichomonas test (NAAT) CPT 87661 TrichomonasVaginls NAA L188052 | $165.54 | $267.00 | — | 28% below | 38% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA MVP | $165.54 | $267.00 | — | 28% below | 38% |
| Trichomonas test (NAAT) CPT 87661 87661 trichomonas vaginl amppr | $165.54 | $267.00 | — | 28% below | 38% |
| Trichomonas test (NAAT) inpatient CPT 87661 87661 trichomonas vaginl amppr | $165.54 | $267.00 | — | — | 38% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA MVP | $165.54 | $267.00 | — | — | 38% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trich vaginalis amplif L180107 | $165.54 | $267.00 | — | — | 38% |
| Trichomonas test (NAAT) inpatient CPT 87661 TrichomonasVaginls NAA L188052 | $165.54 | $267.00 | — | — | 38% |
| Uric acid blood test CPT 84550 Uric Acid, Blood L520205 | $25.42 | $41.00 | — | 59% below | 38% |
| Uric acid blood test CPT 84550 Uric Acid | $25.42 | $41.00 | — | 59% below | 38% |
| Uric acid blood test inpatient CPT 84550 Uric Acid, Blood L520205 | $25.42 | $41.00 | — | — | 38% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $25.42 | $41.00 | — | — | 38% |
| Urinalysis with microscope exam, automated CPT 81001 Transfusion Reactn Inv Urine | $17.98 | $29.00 | — | 72% below | 38% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic | $17.98 | $29.00 | — | 72% below | 38% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Transfusion Reactn Inv Urine | $17.98 | $29.00 | — | — | 38% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic | $17.98 | $29.00 | — | — | 38% |
| Urinalysis without microscope exam, automated CPT 81003 UrinalysisDipstickAutomatedPOC | $6.20 | $10.00 | — | 76% below | 38% |
| Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY, URINE | $13.02 | $21.00 | — | 49% below | 38% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCP W/RFLX | $13.02 | $21.00 | — | 49% below | 38% |
| Urinalysis without microscope exam, automated CPT 81003 L131888 Specific Gravity Urine | $13.02 | $21.00 | — | 49% below | 38% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP W/O SCP N RFLX | $13.02 | $21.00 | — | 49% below | 38% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $13.02 | $21.00 | — | 49% below | 38% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 UrinalysisDipstickAutomatedPOC | $6.20 | $10.00 | — | — | 38% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP W/O SCP N RFLX | $13.02 | $21.00 | — | — | 38% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 L131888 Specific Gravity Urine | $13.02 | $21.00 | — | — | 38% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCP W/RFLX | $13.02 | $21.00 | — | — | 38% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY, URINE | $13.02 | $21.00 | — | — | 38% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE | $13.02 | $21.00 | — | — | 38% |
| Urinalysis without microscope exam, manual CPT 81002 UrinalDipstckNONAutomated POC | $8.68 | $14.00 | — | 54% below | 38% |
| Urinalysis without microscope exam, manual CPT 81002 Reducing Substances, Urine | $17.98 | $29.00 | — | 5% below | 38% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UrinalDipstckNONAutomated POC | $8.68 | $14.00 | — | — | 38% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Reducing Substances, Urine | $17.98 | $29.00 | — | — | 38% |
| Urine culture for bacteria, with colony count CPT 87086 QUANT COLONY COUNT URINE | $45.26 | $73.00 | — | 48% below | 38% |
| Urine culture for bacteria, with colony count CPT 87086 87086 CULTURE URINE COLONY Cnt | $45.26 | $73.00 | — | 48% below | 38% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE BACTERIAL QUANT | $45.26 | $73.00 | — | 48% below | 38% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 QUANT COLONY COUNT URINE | $45.26 | $73.00 | — | — | 38% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 87086 CULTURE URINE COLONY Cnt | $45.26 | $73.00 | — | — | 38% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE BACTERIAL QUANT | $45.26 | $73.00 | — | — | 38% |
| Urine pregnancy test, read by color change CPT 81025 HCG, Urine POC | $52.08 | $84.00 | — | 16% above | 38% |
| Urine pregnancy test, read by color change CPT 81025 HCG Qualitative Urine | $107.88 | $174.00 | — | 141% above | 38% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG, Urine POC | $52.08 | $84.00 | — | — | 38% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG Qualitative Urine | $107.88 | $174.00 | — | — | 38% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin b-12 L042077 | $84.32 | $136.00 | — | 16% below | 38% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12+Folate | $84.32 | $136.00 | — | 16% below | 38% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Defic Cscd L141503 | $84.32 | $136.00 | — | 16% below | 38% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12 | $84.32 | $136.00 | — | 16% below | 38% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vit B12 w/ref MA ARUP-0055662 | $84.32 | $136.00 | — | 16% below | 38% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $84.32 | $136.00 | — | 16% below | 38% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN VITAMIN B-12 | $84.32 | $136.00 | — | — | 38% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vit B12 w/ref MA ARUP-0055662 | $84.32 | $136.00 | — | — | 38% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12+Folate | $84.32 | $136.00 | — | — | 38% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Defic Cscd L141503 | $84.32 | $136.00 | — | — | 38% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $84.32 | $136.00 | — | — | 38% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin b-12 L042077 | $84.32 | $136.00 | — | — | 38% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D,25-Hydroxy | $165.54 | $267.00 | — | 4% below | 38% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydxvt D LCMS D2+D3 L504115 | $165.54 | $267.00 | — | 4% below | 38% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydxvt D LCMS D2+D3 L504115 | $165.54 | $267.00 | — | — | 38% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D,25-Hydroxy | $165.54 | $267.00 | — | — | 38% |
| Zinc blood test CPT 84630 Zinc, RBC L070029 | $63.86 | $103.00 | — | 45% below | 38% |
| Zinc blood test CPT 84630 Assay of Zinc L819845 | $63.86 | $103.00 | — | 45% below | 38% |
| Zinc blood test CPT 84630 Zinc, Whole Blood L070032 | $63.86 | $103.00 | — | 45% below | 38% |
| Zinc blood test CPT 84630 Zinc, Plasma or Serum L001800 | $63.86 | $103.00 | — | 45% below | 38% |
| Zinc blood test inpatient CPT 84630 Zinc, RBC L070029 | $63.86 | $103.00 | — | — | 38% |
| Zinc blood test inpatient CPT 84630 Assay of Zinc L819845 | $63.86 | $103.00 | — | — | 38% |
| Zinc blood test inpatient CPT 84630 Zinc, Whole Blood L070032 | $63.86 | $103.00 | — | — | 38% |
| Zinc blood test inpatient CPT 84630 Zinc, Plasma or Serum L001800 | $63.86 | $103.00 | — | — | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker L140450 | $84.32 | $136.00 | — | 55% below | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GonadotropinChrncQuant L017319 | $84.32 | $136.00 | — | 55% below | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin chrnc qnt L385077 | $84.32 | $136.00 | — | 55% below | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Sbnt, Qnt, SE L004416 | $84.32 | $136.00 | — | 55% below | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, Beta Quant, Serum | $84.32 | $136.00 | — | 55% below | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Tumor Marker L140450 | $84.32 | $136.00 | — | — | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG, Beta Quant, Serum | $84.32 | $136.00 | — | — | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GonadotropinChrncQuant L017319 | $84.32 | $136.00 | — | — | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Gonadotropin chrnc qnt L385077 | $84.32 | $136.00 | — | — | 38% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG,Beta Sbnt, Qnt, SE L004416 | $84.32 | $136.00 | — | — | 38% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Bx w/Stereo Guide RT | $4,052.32 | $6,536.00 | — | 39% above | 38% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Bx w/Stereo Guide LT | $4,052.32 | $6,536.00 | — | 39% above | 38% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Bx w/Stereo Guide LT | $4,052.32 | $6,536.00 | — | — | 38% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Bx w/Stereo Guide RT | $4,052.32 | $6,536.00 | — | — | 38% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ED Cltx Ankle Fx w/o Man 27786 | $318.06 | $513.00 | — | 41% above | 38% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ED Cltx Ankle Fx w/o Man 27786 | $318.06 | $513.00 | — | — | 38% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ED Cardioversion 92960 | $527.00 | $850.00 | — | 47% below | 38% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED Cardioversion 92960 | $527.00 | $850.00 | — | — | 38% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/ Gomco clamp | $1,019.28 | $1,644.00 | — | 134% above | 38% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision w/Plastibll clmp | $1,019.28 | $1,644.00 | — | 134% above | 38% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/Plastibll clmp | $1,019.28 | $1,644.00 | — | — | 38% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision w/ Gomco clamp | $1,019.28 | $1,644.00 | — | — | 38% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED Cltx FX rads/uln w/om 25600 | $365.18 | $589.00 | — | 39% above | 38% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ED Cltx FX rads/uln w/om 25600 | $365.18 | $589.00 | — | — | 38% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 ED Dstr Premalgn Lsn 1st 17000 | $65.10 | $105.00 | — | 19% below | 38% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 ED Dstr Premalgn Lsn 1st 17000 | $65.10 | $105.00 | — | — | 38% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 ED Cerumen lavage unltrl 69209 | $89.90 | $145.00 | — | at median | 38% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED Cerumen lavage unltrl 69209 | $89.90 | $145.00 | — | — | 38% |
| Earwax removal with instruments, one ear CPT 69210 WCC REMOVE IMPACTED EAR WAX UN | $130.20 | $210.00 | — | 65% above | 38% |
| Earwax removal with instruments, one ear CPT 69210 ED Cerumen Rem inst 1 sd 69210 | $130.20 | $210.00 | — | 65% above | 38% |
| Earwax removal with instruments, one ear inpatient CPT 69210 ED Cerumen Rem inst 1 sd 69210 | $130.20 | $210.00 | — | — | 38% |
| Earwax removal with instruments, one ear inpatient CPT 69210 WCC REMOVE IMPACTED EAR WAX UN | $130.20 | $210.00 | — | — | 38% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 XR Cath/Intro of Contrast | $248.00 | $400.00 | — | 23% below | 38% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 XR Cath/Intro of Contrast | $248.00 | $400.00 | — | — | 38% |
| Incision and drainage of a simple or single skin abscess CPT 10060 WCC I&D ABSC; SMPL OR SGL | $269.70 | $435.00 | — | 27% above | 38% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ED I&D Simple/single 10060 | $269.70 | $435.00 | — | 27% above | 38% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ED Dr Skin Absc Smp/sing 10060 | $269.70 | $435.00 | — | 27% above | 38% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WCC I&D ABSC; SMPL OR SGL | $269.70 | $435.00 | — | — | 38% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED I&D Simple/single 10060 | $269.70 | $435.00 | — | — | 38% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED Dr Skin Absc Smp/sing 10060 | $269.70 | $435.00 | — | — | 38% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED Asp/Inj Joint Large 20610 | $959.76 | $1,548.00 | — | 191% above | 38% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR Joint Injection LG | $959.76 | $1,548.00 | — | 191% above | 38% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED Asp/Inj Joint Large 20610 | $959.76 | $1,548.00 | — | — | 38% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XR Joint Injection LG | $959.76 | $1,548.00 | — | — | 38% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR Joint Injection MD | $275.90 | $445.00 | — | 23% above | 38% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ED Asp/inj Joint Medium 20605 | $275.90 | $445.00 | — | 23% above | 38% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ED Asp/inj Joint Medium 20605 | $275.90 | $445.00 | — | — | 38% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 XR Joint Injection MD | $275.90 | $445.00 | — | — | 38% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 XR Joint Injection SM | $269.70 | $435.00 | — | 16% above | 38% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ED Asp/Inj Joint Small 20600 | $269.70 | $435.00 | — | 16% above | 38% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ED Asp/Inj Joint Small 20600 | $269.70 | $435.00 | — | — | 38% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 XR Joint Injection SM | $269.70 | $435.00 | — | — | 38% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED Inr S/ax/tnk/ex <=2.5 12031 | $235.60 | $380.00 | — | 14% below | 38% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED Inr S/ax/tnk/ex <=2.5 12031 | $235.60 | $380.00 | — | — | 38% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 ED Exc BgnLsnT/A/L< 0.5cm11400 | $217.00 | $350.00 | — | 30% below | 38% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 ED Exc BgnLsnT/A/L< 0.5cm11400 | $217.00 | $350.00 | — | — | 38% |
| Nail removal (partial or complete), one nail CPT 11730 WCC SPL AVULSE NP SGL 11730 | $189.10 | $305.00 | — | 23% above | 38% |
| Nail removal (partial or complete), one nail CPT 11730 ED Avulse Nail Plate Sng 11730 | $189.10 | $305.00 | — | 23% above | 38% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 ED Avulse Nail Plate Sng 11730 | $189.10 | $305.00 | — | — | 38% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 WCC SPL AVULSE NP SGL 11730 | $189.10 | $305.00 | — | — | 38% |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis | $2,003.22 | $3,231.00 | — | 77% above | 38% |
| Paracentesis with imaging guidance CPT 49083 ED Abd Paracentsis W/Img 49083 | $2,003.22 | $3,231.00 | — | 77% above | 38% |
| Paracentesis with imaging guidance inpatient CPT 49083 ED Abd Paracentsis W/Img 49083 | $2,003.22 | $3,231.00 | — | — | 38% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis | $2,003.22 | $3,231.00 | — | — | 38% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED Exc Nail Matrix Prmnt 11750 | $542.50 | $875.00 | — | at median | 38% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 WCC REMOVAL OF NAIL BED 11750 | $542.50 | $875.00 | — | at median | 38% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED Exc Nail Matrix Prmnt 11750 | $542.50 | $875.00 | — | — | 38% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 WCC REMOVAL OF NAIL BED 11750 | $542.50 | $875.00 | — | — | 38% |
| Removal of a foreign object under the skin, simple CPT 10120 ED Remove FB SC Simple 10120 | $288.30 | $465.00 | — | 5% above | 38% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 ED Remove FB SC Simple 10120 | $288.30 | $465.00 | — | — | 38% |
| Short arm cast (elbow to hand) CPT 29075 OCC THER APPLY SHORT ARM CAST | $226.30 | $365.00 | — | 73% above | 38% |
| Short arm cast (elbow to hand) CPT 29075 ED Apply Forearm Cast 29075 | $226.30 | $365.00 | — | 73% above | 38% |
| Short arm cast (elbow to hand) inpatient CPT 29075 OCC THER APPLY SHORT ARM CAST | $226.30 | $365.00 | — | — | 38% |
| Short arm cast (elbow to hand) inpatient CPT 29075 ED Apply Forearm Cast 29075 | $226.30 | $365.00 | — | — | 38% |
| Short arm splint (forearm and hand) CPT 29125 OT Appl static shortarm splint | $210.80 | $340.00 | — | 42% above | 38% |
| Short arm splint (forearm and hand) CPT 29125 29125-OCC THER STATIC SA SPLIN | $210.80 | $340.00 | — | 42% above | 38% |
| Short arm splint (forearm and hand) CPT 29125 ED App Shrt Arm Splnt St 29125 | $210.80 | $340.00 | — | 42% above | 38% |
| Short arm splint (forearm and hand) inpatient CPT 29125 OT Appl static shortarm splint | $210.80 | $340.00 | — | — | 38% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125-OCC THER STATIC SA SPLIN | $210.80 | $340.00 | — | — | 38% |
| Short arm splint (forearm and hand) inpatient CPT 29125 ED App Shrt Arm Splnt St 29125 | $210.80 | $340.00 | — | — | 38% |
| Short leg cast (below the knee) CPT 29405 WCC SHORT LEG CAST | $248.00 | $400.00 | — | 3% above | 38% |
| Short leg cast (below the knee) CPT 29405 ED Apply Short Leg Cast 29405 | $248.00 | $400.00 | — | 3% above | 38% |
| Short leg cast (below the knee) CPT 29405 OCC THER APPLY SH LEG CAST | $248.00 | $400.00 | — | 3% above | 38% |
| Short leg cast (below the knee) inpatient CPT 29405 OCC THER APPLY SH LEG CAST | $248.00 | $400.00 | — | — | 38% |
| Short leg cast (below the knee) inpatient CPT 29405 WCC SHORT LEG CAST | $248.00 | $400.00 | — | — | 38% |
| Short leg cast (below the knee) inpatient CPT 29405 ED Apply Short Leg Cast 29405 | $248.00 | $400.00 | — | — | 38% |
| Short leg splint (calf to foot) CPT 29515 OCC THER APPLY SHRT LEG SPLINT | $210.80 | $340.00 | — | 73% above | 38% |
| Short leg splint (calf to foot) CPT 29515 ED Apply Short Leg Cast 29515 | $210.80 | $340.00 | — | 73% above | 38% |
| Short leg splint (calf to foot) inpatient CPT 29515 OCC THER APPLY SHRT LEG SPLINT | $210.80 | $340.00 | — | — | 38% |
| Short leg splint (calf to foot) inpatient CPT 29515 ED Apply Short Leg Cast 29515 | $210.80 | $340.00 | — | — | 38% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED SR Sc/n/a/t/e <=2.5cm 12001 | $189.10 | $305.00 | — | 13% above | 38% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 WCC WOUND CLOSURE - SIMPLE | $189.10 | $305.00 | — | 13% above | 38% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED SR Sc/n/a/t/e <=2.5cm 12001 | $189.10 | $305.00 | — | — | 38% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 WCC WOUND CLOSURE - SIMPLE | $189.10 | $305.00 | — | — | 38% |
| Skin biopsy, punch, one lesion CPT 11104 WCC BX-SKIN SQ/MM; SGL 11104 | $179.80 | $290.00 | — | 6% above | 38% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 WCC BX-SKIN SQ/MM; SGL 11104 | $179.80 | $290.00 | — | — | 38% |
| Skin tag removal, up to 15 tags CPT 11200 ED Rem Skin Tags < = 15 11200 | $161.20 | $260.00 | — | 10% above | 38% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 ED Rem Skin Tags < = 15 11200 | $161.20 | $260.00 | — | — | 38% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 ED Lumbar Puncture 62270 | $539.40 | $870.00 | — | 9% below | 38% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED Lumbar Puncture 62270 | $539.40 | $870.00 | — | — | 38% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED R S/n/a/t/e 2.6-7.5cm 12002 | $201.50 | $325.00 | — | 7% above | 38% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED R S/n/a/t/e 2.6-7.5cm 12002 | $201.50 | $325.00 | — | — | 38% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED Rep F/E/E/N/L/M<=2.5cm12011 | $189.10 | $305.00 | — | 10% above | 38% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED Rep F/E/E/N/L/M<=2.5cm12011 | $189.10 | $305.00 | — | — | 38% |
| Thoracentesis with imaging guidance CPT 32555 US Thoracentesis | $1,063.30 | $1,715.00 | — | 2% below | 38% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis | $1,063.30 | $1,715.00 | — | — | 38% |
| Trigger point injections, 1 or 2 muscles CPT 20552 ED Inj Trg Pt S/ml 1-2 Ms20552 | $217.00 | $350.00 | — | 21% below | 38% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED Inj Trg Pt S/ml 1-2 Ms20552 | $217.00 | $350.00 | — | — | 38% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion both sides CPT 19083 US Guided Breast Biopsy BI | $6,078.48 | $9,804.00 | — | — | 38% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Guided Breast Biopsy LT | $4,052.32 | $6,536.00 | — | 73% above | 38% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Guided Breast Biopsy RT | $4,052.32 | $6,536.00 | — | 73% above | 38% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient both sides CPT 19083 US Guided Breast Biopsy BI | $6,078.48 | $9,804.00 | — | — | 38% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Guided Breast Biopsy LT | $4,052.32 | $6,536.00 | — | — | 38% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Guided Breast Biopsy RT | $4,052.32 | $6,536.00 | — | — | 38% |
| Wart removal, up to 14 warts CPT 17110 ED Dest Benign Lesn<= 14 17110 | $164.30 | $265.00 | — | 125% above | 38% |
| Wart removal, up to 14 warts inpatient CPT 17110 ED Dest Benign Lesn<= 14 17110 | $164.30 | $265.00 | — | — | 38% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED Dbr SC Tiss <=20 sqcm 11042 | $328.60 | $530.00 | — | at median | 38% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WCC DEB SUBQ TISSUE 20 SQ CM/< | $328.60 | $530.00 | — | at median | 38% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WCC DEB SUBQ TISSUE 20 SQ CM/< | $328.60 | $530.00 | — | — | 38% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ED Dbr SC Tiss <=20 sqcm 11042 | $328.60 | $530.00 | — | — | 38% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin Fee | $1,025.48 | $1,654.00 | — | at median | 38% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admin Fee | $1,025.48 | $1,654.00 | — | — | 38% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Tx 94640 | $129.58 | $209.00 | — | 47% below | 38% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AIRWAY InhlTrtmnt INT 94640 | $269.08 | $434.00 | — | 11% above | 38% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AIRWAY InhalTrtmnt SB 94640 | $269.08 | $434.00 | — | 11% above | 38% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Tx 94640 | $129.58 | $209.00 | — | — | 38% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AIRWAY InhlTrtmnt INT 94640 | $269.08 | $434.00 | — | — | 38% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AIRWAY InhalTrtmnt SB 94640 | $269.08 | $434.00 | — | — | 38% |
| Chemotherapy IV infusion, first hour CPT 96413 INF/C IV Infusion init/single | $403.00 | $650.00 | — | 24% below | 38% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 INF/C IV Infusion init/single | $403.00 | $650.00 | — | — | 38% |
| Critical care, first 30 to 74 minutes CPT 99291 ED Visit Critical Care 99291 | $2,747.22 | $4,431.00 | — | 31% above | 38% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 ED Visit Critical Care 99291 | $2,747.22 | $4,431.00 | — | — | 38% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 Electrocardiogram POC | $117.80 | $190.00 | — | 61% above | 38% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 Electrocardiogram POC | $117.80 | $190.00 | — | — | 38% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING FAC | $97.96 | $158.00 | — | 44% below | 38% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED ELECTROCARDIOGRAM TRAC FAC | $203.98 | $329.00 | — | 16% above | 38% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING FAC | $97.96 | $158.00 | — | — | 38% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED ELECTROCARDIOGRAM TRAC FAC | $203.98 | $329.00 | — | — | 38% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VST MAYX RQ PHY/QHP 99281 | $242.42 | $391.00 | — | 24% above | 38% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VST MAYX RQ PHY/QHP 99281 | $242.42 | $391.00 | — | — | 38% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EM DEPT VISIT SF MDM 99282 | $480.50 | $775.00 | — | 68% above | 38% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EM DEPT VISIT SF MDM 99282 | $480.50 | $775.00 | — | — | 38% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EM DEPT VISIT LOW MDM 99283 | $821.50 | $1,325.00 | — | 54% above | 38% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EM DEPT VISIT LOW MDM 99283 | $821.50 | $1,325.00 | — | — | 38% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EM DEPT VISIT MOD MDM 99284 | $961.00 | $1,550.00 | — | 1% above | 38% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EM DEPT VISIT MOD MDM 99284 | $961.00 | $1,550.00 | — | — | 38% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EM DEPT VISIT HIGH MDM 99285 | $1,085.00 | $1,750.00 | — | 16% below | 38% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EM DEPT VISIT HIGH MDM 99285 | $1,085.00 | $1,750.00 | — | — | 38% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRSST MAX/SBMX TRDML 93017 | $669.60 | $1,080.00 | — | 28% below | 38% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 ECG Treadmill Stress Test | $669.60 | $1,080.00 | — | 28% below | 38% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ECG Treadmill Stress Test | $669.60 | $1,080.00 | — | — | 38% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRSST MAX/SBMX TRDML 93017 | $669.60 | $1,080.00 | — | — | 38% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF/H IV Inf Initial 31-60 min | $393.70 | $635.00 | — | 4% above | 38% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED IV INF HDRTN INIT 31 M-1 HR | $393.70 | $635.00 | — | 4% above | 38% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED IV INF HDRTN INIT 31 M-1 HR | $393.70 | $635.00 | — | — | 38% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF/H IV Inf Initial 31-60 min | $393.70 | $635.00 | — | — | 38% |
| IV infusion of a medicine, first hour CPT 96365 AMB Infusion 1st hour | $192.82 | $311.00 | — | 42% below | 38% |
| IV infusion of a medicine, first hour CPT 96365 INF/NC IV Infusion Ther Init | $192.82 | $311.00 | — | 42% below | 38% |
| IV infusion of a medicine, first hour CPT 96365 ED Th/Ph/Diag IV INF INIT <1HR | $400.52 | $646.00 | — | 21% above | 38% |
| IV infusion of a medicine, first hour inpatient CPT 96365 AMB Infusion 1st hour | $192.82 | $311.00 | — | — | 38% |
| IV infusion of a medicine, first hour inpatient CPT 96365 INF/NC IV Infusion Ther Init | $192.82 | $311.00 | — | — | 38% |
| IV infusion of a medicine, first hour inpatient CPT 96365 ED Th/Ph/Diag IV INF INIT <1HR | $400.52 | $646.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Nirsevimab Inj,Sq IM SS admin | $13.64 | $22.00 | — | 81% below | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Nirsevimab Inj, subcutns or IM | $37.20 | $60.00 | — | 48% below | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SC Ther/Prph/Diag INJ 96372 | $84.32 | $136.00 | — | 17% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 AMB Ther/Proph/Diag Inj SC/IM | $84.32 | $136.00 | — | 17% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 WCC THER/PROPH/DIAG INJ SC/IM | $175.46 | $283.00 | — | 144% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ONC INF SC/IM Admin | $175.46 | $283.00 | — | 144% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THER,PROPH,DX INJ sq/im | $175.46 | $283.00 | — | 144% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED THER/PROPH/DIAG INJ SC/IM | $175.46 | $283.00 | — | 144% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF Sub IM INJ | $175.46 | $283.00 | — | 144% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $175.46 | $283.00 | — | 144% above | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Nirsevimab Inj,Sq IM SS admin | $13.64 | $22.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Nirsevimab Inj, subcutns or IM | $37.20 | $60.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 AMB Ther/Proph/Diag Inj SC/IM | $84.32 | $136.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SC Ther/Prph/Diag INJ 96372 | $84.32 | $136.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED THER/PROPH/DIAG INJ SC/IM | $175.46 | $283.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THER,PROPH,DX INJ sq/im | $175.46 | $283.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF Sub IM INJ | $175.46 | $283.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM | $175.46 | $283.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ONC INF SC/IM Admin | $175.46 | $283.00 | — | — | 38% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 WCC THER/PROPH/DIAG INJ SC/IM | $175.46 | $283.00 | — | — | 38% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Dx Eval 90791 | $177.94 | $287.00 | — | 18% below | 38% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric Dx Eval 90791 | $177.94 | $287.00 | — | — | 38% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeduc Unit | $158.10 | $255.00 | — | 85% above | 38% |
| Neuromuscular re-education, 15 minutes CPT 97112 97112-PHYS THER NRMSC RE-E 15m | $158.10 | $255.00 | — | 85% above | 38% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation U | $158.10 | $255.00 | — | 85% above | 38% |
| Neuromuscular re-education, 15 minutes CPT 97112 97112-OCC THER NEUROMUSC RE-ED | $158.10 | $255.00 | — | 85% above | 38% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112-PHYS THER NRMSC RE-E 15m | $158.10 | $255.00 | — | — | 38% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation U | $158.10 | $255.00 | — | — | 38% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeduc Unit | $158.10 | $255.00 | — | — | 38% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112-OCC THER NEUROMUSC RE-ED | $158.10 | $255.00 | — | — | 38% |
| New patient office visit, about 30 minutes CPT 99203 WCC LEVEL 3 NEW PATIENT FACILT | $155.00 | $250.00 | — | 3% below | 38% |
| New patient office visit, about 30 minutes inpatient CPT 99203 WCC LEVEL 3 NEW PATIENT FACILT | $155.00 | $250.00 | — | — | 38% |
| New patient office visit, about 45 minutes CPT 99204 WCC LEVEL 4 NEW PATIENT FACILT | $182.90 | $295.00 | — | 14% below | 38% |
| New patient office visit, about 45 minutes inpatient CPT 99204 WCC LEVEL 4 NEW PATIENT FACILT | $182.90 | $295.00 | — | — | 38% |
| New patient office visit, about 60 minutes CPT 99205 WCC LEVEL 5 NEW PATIENT FACILT | $238.70 | $385.00 | — | 12% below | 38% |
| New patient office visit, about 60 minutes inpatient CPT 99205 WCC LEVEL 5 NEW PATIENT FACILT | $238.70 | $385.00 | — | — | 38% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 WCC LEVEL 2 NEW PATIENT FACILT | $133.30 | $215.00 | — | 12% above | 38% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WCC LEVEL 2 NEW PATIENT FACILT | $133.30 | $215.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As/15m 97802 | $49.60 | $80.00 | — | 30% below | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv INIT As/15m 97802 | $49.60 | $80.00 | — | 30% below | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/30m 97802 | $89.28 | $144.00 | — | 25% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 30m 97802 | $89.28 | $144.00 | — | 25% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv INIT As/45m 97802 | $119.04 | $192.00 | — | 67% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 45m 97802 | $119.04 | $192.00 | — | 67% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 60m 97802 | $138.88 | $224.00 | — | 95% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/60m 97802 | $138.88 | $224.00 | — | 95% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 75m 97802 | $148.80 | $240.00 | — | 109% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/75m 97802 | $148.80 | $240.00 | — | 109% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/90m 97802 | $163.68 | $264.00 | — | 130% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 90m 97802 | $163.68 | $264.00 | — | 130% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init A 105m 97802 | $173.60 | $280.00 | — | 144% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 105 97802 | $173.60 | $280.00 | — | 144% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init A 120m 97802 | $178.56 | $288.00 | — | 151% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 120 97802 | $178.56 | $288.00 | — | 151% above | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv INIT As/15m 97802 | $49.60 | $80.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As/15m 97802 | $49.60 | $80.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv Init As/30m 97802 | $89.28 | $144.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 30m 97802 | $89.28 | $144.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 45m 97802 | $119.04 | $192.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv INIT As/45m 97802 | $119.04 | $192.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 60m 97802 | $138.88 | $224.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv Init As/60m 97802 | $138.88 | $224.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 75m 97802 | $148.80 | $240.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv Init As/75m 97802 | $148.80 | $240.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv Init As/90m 97802 | $163.68 | $264.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 90m 97802 | $163.68 | $264.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 105 97802 | $173.60 | $280.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv Init A 105m 97802 | $173.60 | $280.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Med NuT Indv Init A 120m 97802 | $178.56 | $288.00 | — | — | 38% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 TLH MNT INDV INIT As 120 97802 | $178.56 | $288.00 | — | — | 38% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units Low Complx | $238.70 | $385.00 | — | 18% below | 38% |
| Occupational therapy evaluation, low complexity CPT 97165 OCC THER EVAL LOW COMPLX 30M | $238.70 | $385.00 | — | 18% below | 38% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OCC THER EVAL LOW COMPLX 30M | $238.70 | $385.00 | — | — | 38% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Units Low Complx | $238.70 | $385.00 | — | — | 38% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 97163 PHYS THER EVL HI CMP 45M | $257.30 | $415.00 | — | 11% below | 38% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval Charge High Complex | $257.30 | $415.00 | — | 11% below | 38% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 97163 PHYS THER EVL HI CMP 45M | $257.30 | $415.00 | — | — | 38% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Eval Charge High Complex | $257.30 | $415.00 | — | — | 38% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Eval Charge Low Complx | $226.30 | $365.00 | — | 17% below | 38% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 PHYS THER EVL LO CMP 20M | $226.30 | $365.00 | — | 17% below | 38% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Charge Low Complx | $226.30 | $365.00 | — | — | 38% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 97161 PHYS THER EVL LO CMP 20M | $226.30 | $365.00 | — | — | 38% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 PHYS THER EVL MD CMP 30M | $241.80 | $390.00 | — | 14% below | 38% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Charge Moderate | $241.80 | $390.00 | — | 14% below | 38% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 97162 PHYS THER EVL MD CMP 30M | $241.80 | $390.00 | — | — | 38% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Charge Moderate | $241.80 | $390.00 | — | — | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units | $193.44 | $312.00 | — | 125% above | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140-OCC THER MANUAL THERAPY | $193.44 | $312.00 | — | 125% above | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units | $193.44 | $312.00 | — | 125% above | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140-PHYS THERMANTHERAPY 15m | $193.44 | $312.00 | — | 125% above | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140-OCC THER MANUAL THERAPY | $193.44 | $312.00 | — | — | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140-PHYS THERMANTHERAPY 15m | $193.44 | $312.00 | — | — | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units | $193.44 | $312.00 | — | — | 38% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units | $193.44 | $312.00 | — | — | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110-PHYS THER THEREX 15 MIN | $155.62 | $251.00 | — | 88% above | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $155.62 | $251.00 | — | 88% above | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units | $155.62 | $251.00 | — | 88% above | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110-OCC THER THEREX 15M | $155.62 | $251.00 | — | 88% above | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110-PHYS THER THEREX 15 MIN | $155.62 | $251.00 | — | — | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110-OCC THER THEREX 15M | $155.62 | $251.00 | — | — | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units | $155.62 | $251.00 | — | — | 38% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $155.62 | $251.00 | — | — | 38% |
| Psychiatric evaluation with medical services CPT 90792 Psych Dx Eval w/Med Serv 90792 | $200.26 | $323.00 | — | 18% above | 38% |
| Psychiatric evaluation with medical services inpatient CPT 90792 Psych Dx Eval w/Med Serv 90792 | $200.26 | $323.00 | — | — | 38% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 Psych Crisis Init 60m 90839 | $225.06 | $363.00 | — | 34% above | 38% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 Psych Crisis Init 60m 90839 | $225.06 | $363.00 | — | — | 38% |
| Psychotherapy session, 30 minutes CPT 90832 Psych w/Patient 30 min 90832 | $107.26 | $173.00 | — | 18% below | 38% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 Psych w/Patient 30 min 90832 | $107.26 | $173.00 | — | — | 38% |
| Psychotherapy session, 45 minutes CPT 90834 Psych w/ Patient 45 min 90834 | $143.22 | $231.00 | — | 4% above | 38% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 Psych w/ Patient 45 min 90834 | $143.22 | $231.00 | — | — | 38% |
| Psychotherapy session, 60 minutes CPT 90837 Psych w/ Patient 60 min 90837 | $170.50 | $275.00 | — | 72% below | 38% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 Psych w/ Patient 60 min 90837 | $170.50 | $275.00 | — | — | 38% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $19.22 | $31.00 | — | 45% below | 38% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT Smoke/TobaccCnsl 3-10 99406 | $24.80 | $40.00 | — | 29% below | 38% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $19.22 | $31.00 | — | — | 38% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RT Smoke/TobaccCnsl 3-10 99406 | $24.80 | $40.00 | — | — | 38% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ONC FAC FEE O/P EST HI 40-54 M | $195.30 | $315.00 | — | 5% below | 38% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 WCC LEVEL 5 EST PATIENT FACILT | $195.30 | $315.00 | — | 5% below | 38% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ONC Fac Fee O/P EST HI 40-54 M | $195.30 | $315.00 | — | 5% below | 38% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WCC LEVEL 5 EST PATIENT FACILT | $195.30 | $315.00 | — | — | 38% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ONC Fac Fee O/P EST HI 40-54 M | $195.30 | $315.00 | — | — | 38% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ONC FAC FEE O/P EST HI 40-54 M | $195.30 | $315.00 | — | — | 38% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONC FAC FEE O/P EST LW 20-29 M | $111.60 | $180.00 | — | 10% above | 38% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WCC LEVEL 3 EST PATIENT FACILT | $111.60 | $180.00 | — | 10% above | 38% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONC FacFee O/P EST Low 20-29 M | $111.60 | $180.00 | — | 10% above | 38% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EMP H LEVEL III | $111.60 | $180.00 | — | 10% above | 38% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Self Pay Termination | $650.38 | $1,049.00 | — | 542% above | 38% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONC FAC FEE O/P EST LW 20-29 M | $111.60 | $180.00 | — | — | 38% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONC FacFee O/P EST Low 20-29 M | $111.60 | $180.00 | — | — | 38% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EMP H LEVEL III | $111.60 | $180.00 | — | — | 38% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WCC LEVEL 3 EST PATIENT FACILT | $111.60 | $180.00 | — | — | 38% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Self Pay Termination | $650.38 | $1,049.00 | — | — | 38% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONC FacFee O/P EST Mod 30-39 M | $139.50 | $225.00 | — | 6% below | 38% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONC FAC FEE O/P EST MD 30-39 M | $139.50 | $225.00 | — | 6% below | 38% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WCC LEVEL 4 EST PATIENT FACILT | $139.50 | $225.00 | — | 6% below | 38% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONC FAC FEE O/P EST MD 30-39 M | $139.50 | $225.00 | — | — | 38% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONC FacFee O/P EST Mod 30-39 M | $139.50 | $225.00 | — | — | 38% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WCC LEVEL 4 EST PATIENT FACILT | $139.50 | $225.00 | — | — | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WCC LEVEL 2 EST PATIENT FACILT | $89.90 | $145.00 | — | 10% above | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONC Fac Fee O/P EST SF 10-19 M | $89.90 | $145.00 | — | 10% above | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONC FAC FEE O/P EST SF 10-19 M | $89.90 | $145.00 | — | 10% above | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EMP H LEVEL II | $89.90 | $145.00 | — | 10% above | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONC Fac Fee O/P EST SF 10-19 M | $89.90 | $145.00 | — | — | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONC FAC FEE O/P EST SF 10-19 M | $89.90 | $145.00 | — | — | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EMP H LEVEL II | $89.90 | $145.00 | — | — | 38% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WCC LEVEL 2 EST PATIENT FACILT | $89.90 | $145.00 | — | — | 38% |
| Speech and language evaluation CPT 92523 Eval Lang Compr Express Unit | $351.54 | $567.00 | — | 32% below | 38% |
| Speech and language evaluation inpatient CPT 92523 Eval Lang Compr Express Unit | $351.54 | $567.00 | — | — | 38% |
| Spirometry (breathing test) CPT 94010 Spirometry POC | $119.04 | $192.00 | — | 41% below | 38% |
| Spirometry (breathing test) CPT 94010 Spirometry | $248.00 | $400.00 | — | 22% above | 38% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry POC | $119.04 | $192.00 | — | — | 38% |
| Spirometry (breathing test) inpatient CPT 94010 Spirometry | $248.00 | $400.00 | — | — | 38% |
| Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre+Post Bronchdltr | $285.82 | $461.00 | — | 14% below | 38% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 Spirometry Pre+Post Bronchdltr | $285.82 | $461.00 | — | — | 38% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units | $92.38 | $149.00 | — | 18% above | 38% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Unit | $92.38 | $149.00 | — | 18% above | 38% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530-PHYS THER THER ACTV 15M | $92.38 | $149.00 | — | 18% above | 38% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530-OCC THER THER ACTIVITY 1 | $184.14 | $297.00 | — | 134% above | 38% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units | $92.38 | $149.00 | — | — | 38% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530-PHYS THER THER ACTV 15M | $92.38 | $149.00 | — | — | 38% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Unit | $92.38 | $149.00 | — | — | 38% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530-OCC THER THER ACTIVITY 1 | $184.14 | $297.00 | — | — | 38% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF Therapeutic Phlebotomy | $161.20 | $260.00 | — | 62% below | 38% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF Therapeutic Phlebotomy | $161.20 | $260.00 | — | — | 38% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New Hampshire | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad High Dose TIV 0.5 ml | $77.50 | $125.00 | — | 15% above | 38% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Fluad HD TIV 0.5 ml Clinic /E | $79.98 | $129.00 | — | 18% above | 38% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 AMB Fluad HD TIV Syr 0.5 ml | $79.98 | $129.00 | — | 18% above | 38% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Fluad High Dose TIV 0.5 ml | $77.50 | $125.00 | — | — | 38% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 AMB Fluad HD TIV Syr 0.5 ml | $79.98 | $129.00 | — | — | 38% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Fluad HD TIV 0.5 ml Clinic /E | $79.98 | $129.00 | — | — | 38% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CVDVac 50MCG/0.5ML IM Spikevax | $127.72 | $206.00 | — | 17% below | 38% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CVDVac 50MCG/0.5ML IM Spikevax | $127.72 | $206.00 | — | — | 38% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 CVDVac30MCG TrsSucIM Comirnaty | $118.11 | $190.50 | — | at median | 38% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 CVDVac30MCG TrsSucIM Comirnaty | $118.11 | $190.50 | — | — | 38% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella/Varivax | $33.17 | $53.50 | — | 82% below | 38% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 EMP H VARICELLA VACCINE | $121.21 | $195.50 | — | 35% below | 38% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella/Varivax | $33.17 | $53.50 | — | — | 38% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 EMP H VARICELLA VACCINE | $121.21 | $195.50 | — | — | 38% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria TIV Syringe 0.5 mL | $31.00 | $50.00 | — | 72% below | 38% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Afluria TIV Syr 0.5 mL Clnc/ E | $31.93 | $51.50 | — | 71% below | 38% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AMB Afluria TIV Syr 0.5 ml | $31.93 | $51.50 | — | 71% below | 38% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria TIV Syringe 0.5 mL | $31.00 | $50.00 | — | — | 38% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AMB Afluria TIV Syr 0.5 ml | $31.93 | $51.50 | — | — | 38% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Afluria TIV Syr 0.5 mL Clnc/ E | $31.93 | $51.50 | — | — | 38% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV9/Gardasil 9 | $171.12 | $276.00 | — | 38% below | 38% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV9/Gardasil 9 | $171.12 | $276.00 | — | — | 38% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HpA-HpB/Twinrix | $102.92 | $166.00 | — | 5% below | 38% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HpA-HpB/Twinrix | $102.92 | $166.00 | — | — | 38% |
| Hepatitis A vaccine, adult dose CPT 90632 EMP H HEPATITIS A VACCINE | $55.49 | $89.50 | — | 24% below | 38% |
| Hepatitis A vaccine, adult dose CPT 90632 HpA/Hvrx/Vaqta ADLT | $107.26 | $173.00 | — | 46% above | 38% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 EMP H HEPATITIS A VACCINE | $55.49 | $89.50 | — | — | 38% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 HpA/Hvrx/Vaqta ADLT | $107.26 | $173.00 | — | — | 38% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 EMP H HEPATITIS B VACCINE | $42.16 | $68.00 | — | 47% below | 38% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 EMP H HEPATITIS C VIRUS AB | $48.36 | $78.00 | — | 39% below | 38% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HpB/EngB/Rcmbvx ADLT | $111.91 | $180.50 | — | 40% above | 38% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 EMP H HEPATITIS B VACCINE | $42.16 | $68.00 | — | — | 38% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 EMP H HEPATITIS C VIRUS AB | $48.36 | $78.00 | — | — | 38% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HpB/EngB/Rcmbvx ADLT | $111.91 | $180.50 | — | — | 38% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 EMP H MMR VACCINE | $67.58 | $109.00 | — | 38% below | 38% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR Vax | $86.18 | $139.00 | — | 21% below | 38% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 EMP H MMR VACCINE | $67.58 | $109.00 | — | — | 38% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR Vax | $86.18 | $139.00 | — | — | 38% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 EMP H MENINGOCOCCAL VACCINE | $118.11 | $190.50 | — | 3% below | 38% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MenCnj/Menact/Menveo | $172.98 | $279.00 | — | 42% above | 38% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 EMP H MENINGOCOCCAL VACCINE | $118.11 | $190.50 | — | — | 38% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MenCnj/Menact/Menveo | $172.98 | $279.00 | — | — | 38% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MenB 2dose/Bexsero | $113.77 | $183.50 | — | 27% below | 38% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MenB 2dose/Bexsero | $113.77 | $183.50 | — | — | 38% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 AMB PCV20/Prevnar 20 | $461.59 | $744.50 | — | 30% below | 38% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 AMB PCV20/Prevnar 20 | $461.59 | $744.50 | — | — | 38% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23/Pneumovax | $222.27 | $358.50 | — | at median | 38% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23/Pneumovax | $222.27 | $358.50 | — | — | 38% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 AMB Nirsevimab/Beyfortus 50 | $654.72 | $1,056.00 | — | 18% below | 38% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 AMB Nirsevimab/Beyfortus 50 | $654.72 | $1,056.00 | — | — | 38% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 AMB Abrysvo 0.5 ml | $481.43 | $776.50 | — | 121% above | 38% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 AMB Abrysvo 0.5 ml | $481.43 | $776.50 | — | — | 38% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 AMB Arexvy 0.5 ml | $473.06 | $763.00 | — | — | 38% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults inpatient CPT 90679 AMB Arexvy 0.5 ml | $473.06 | $763.00 | — | — | 38% |
| Rabies vaccine, one dose CPT 90675 EMP H RABIES VACCINE | $212.04 | $342.00 | — | 62% below | 38% |
| Rabies vaccine, one dose inpatient CPT 90675 EMP H RABIES VACCINE | $212.04 | $342.00 | — | — | 38% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingles/Shingrix | $141.05 | $227.50 | — | 22% below | 38% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Shingles/Shingrix | $141.05 | $227.50 | — | — | 38% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Preser Free | $31.31 | $50.50 | — | 49% below | 38% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 EMP H TETANUS/DIPTHERIA VAX | $36.27 | $58.50 | — | 41% below | 38% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Preser Free | $31.31 | $50.50 | — | — | 38% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 EMP H TETANUS/DIPTHERIA VAX | $36.27 | $58.50 | — | — | 38% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 EMP H TDAP VACCINE | $40.30 | $65.00 | — | 24% below | 38% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap/Boostrix/Adacel | $59.52 | $96.00 | — | 13% above | 38% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 EMP H TDAP VACCINE | $40.30 | $65.00 | — | — | 38% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap/Boostrix/Adacel | $59.52 | $96.00 | — | — | 38% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid Inj/TyphimVi | $63.86 | $103.00 | — | 19% below | 38% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhoid Inj/TyphimVi | $63.86 | $103.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm Admin State Supplied Vax | $13.64 | $22.00 | — | 77% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm Admin Inj State Supp Vax 1 | $13.64 | $22.00 | — | 77% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SBQ/IM Flu 90471 | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMADM PRQ ID SUBQ/IM NJXS 1 V | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 AMB INFLUENZA Vaccine Admin | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 V | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 AMB Imm. Adm. Single Inj | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Adult Pneumonia Vax Adm | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 AMB Adult Hep B Vax Admin | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMADM PRQ ID SBQ/IM NJXS 90471 | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU VAX Admin Pub Clinic / Emp | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED Admin Vaccine First 90471 | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SBQ/IM Flu 1 V | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Imm Admin Injctn Fst/sng 90471 | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VaxAdmin 90471/G0008 | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pneumo Vax Admin 90471 / G0009 | $21.70 | $35.00 | — | 64% below | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Imm Admin State Supplied Vax | $13.64 | $22.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Imm Admin Inj State Supp Vax 1 | $13.64 | $22.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Adult Pneumonia Vax Adm | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 AMB INFLUENZA Vaccine Admin | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 AMB Imm. Adm. Single Inj | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMADM PRQ ID SUBQ/IM NJXS 1 V | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 V | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SBQ/IM Flu 90471 | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Pneumo Vax Admin 90471 / G0009 | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA VaxAdmin 90471/G0008 | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Imm Admin Injctn Fst/sng 90471 | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SBQ/IM Flu 1 V | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED Admin Vaccine First 90471 | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FLU VAX Admin Pub Clinic / Emp | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMADM PRQ ID SBQ/IM NJXS 90471 | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 AMB Adult Hep B Vax Admin | $21.70 | $35.00 | — | — | 38% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin State Sup Vax Ea add | $13.64 | $22.00 | — | 70% below | 38% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin Inj StSup Vax Ea Add | $13.64 | $22.00 | — | 70% below | 38% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin Inject Ea Addl 90472 | $15.50 | $25.00 | — | 66% below | 38% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 AMB Imm. Adm -Each Additional | $15.50 | $25.00 | — | 66% below | 38% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $15.50 | $25.00 | — | 66% below | 38% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ED Immun Adm Ea Addl Vax 90472 | $15.50 | $25.00 | — | 66% below | 38% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Imm Admin State Sup Vax Ea add | $13.64 | $22.00 | — | — | 38% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Imm Admin Inj StSup Vax Ea Add | $13.64 | $22.00 | — | — | 38% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Imm Admin Inject Ea Addl 90472 | $15.50 | $25.00 | — | — | 38% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 AMB Imm. Adm -Each Additional | $15.50 | $25.00 | — | — | 38% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD | $15.50 | $25.00 | — | — | 38% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ED Immun Adm Ea Addl Vax 90472 | $15.50 | $25.00 | — | — | 38% |
Source file: https://hospitalpricedisclosure.com/download.aspx?pi=4EZY3sRA8HLb8Qjm705tAg*-*