Hospital Lebanon-Claremont, NH-VT

Speare Memorial Hospital

Speare Memorial Hospital in Plymouth, NH publishes cash prices for 374 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 282 of 368 procedures and above it for 67. By typical cash price it ranks #4 of 20 New Hampshire hospitals and #4 of 6 hospitals in the Lebanon, NH area, cheapest first. Select a procedure to compare it with other hospitals nearby.

16 Hospital Road, Plymouth, NH 03264 Collected Sep 27, 2026 Source price file Check a bill from this hospital (603) 536-1120

Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 3 of 5 CCN 301311 · CMS hospital register NPI 1760496376

Financial assistance

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

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

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

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast	$1,922.00	$3,100.00	—	11% below	38%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast	$1,922.00	$3,100.00	—	—	38%
Abdominal X-ray, 2 views CPT 74019 XR Abd Comp w Decub +/or Erect	$260.40	$420.00	—	1% below	38%
Abdominal X-ray, 2 views inpatient CPT 74019 XR Abd Comp w Decub +/or Erect	$260.40	$420.00	—	—	38%
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 LT	$137.02	$221.00	—	50% below	38%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Rt	$137.02	$221.00	—	50% 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 Rt	$137.02	$221.00	—	—	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-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	—	37% below	38%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Seg Pressures (ABI) w/ TBI	$282.10	$455.00	—	37% 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	—	37% 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	—	37% 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 US Toe Brachial Index (TBI)	$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%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder (Tournier) LT	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder (Tournier) RT	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left	$1,041.60	$1,680.00	—	25% below	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Right	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Left	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder (Tournier) RT	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Left	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder (Tournier) LT	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left	$1,041.60	$1,680.00	—	—	38%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Right	$1,041.60	$1,680.00	—	—	38%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$585.90	$945.00	—	3% 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	—	at median	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	—	at median	38%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$558.00	$900.00	—	at median	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 Left	$558.00	$900.00	—	—	38%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$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	—	19% above	38%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$434.00	$700.00	—	19% above	38%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$434.00	$700.00	—	19% 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 (CTA) of the abdomen and pelvis CPT 74174 Ext Proc CTA Abd/Plv w/c 74174	$2,356.00	$3,800.00	—	11% below	38%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD/PELVIS W/WO CNT 74174	$2,356.00	$3,800.00	—	11% below	38%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis	$2,356.00	$3,800.00	—	11% below	38%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABD/PELVIS W/WO CNT 74174	$2,356.00	$3,800.00	—	—	38%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 Ext Proc CTA Abd/Plv w/c 74174	$2,356.00	$3,800.00	—	—	38%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis	$2,356.00	$3,800.00	—	—	38%
CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head	$1,553.72	$2,506.00	—	25% below	38%
CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head	$1,553.72	$2,506.00	—	—	38%
CT angiography (CTA) of the neck CPT 70498 CT Angio Neck	$1,553.72	$2,506.00	—	25% below	38%
CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck	$1,553.72	$2,506.00	—	—	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	—	16% 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	—	16% below	38%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary	$1,760.80	$2,840.00	—	16% 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	—	16% 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 W/O + W. 71275	$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	$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	—	9% 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	—	9% 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 Abdomen and Pelvis w/ Cont	$2,449.00	$3,950.00	—	13% below	38%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELV W/CONTRAST 74177	$2,449.00	$3,950.00	—	13% 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	—	16% 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	—	21% 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	—	21% below	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 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 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 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 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	—	28% 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	—	39% 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	—	21% 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	—	2% 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	—	3% 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 CT scan without and with contrast CPT 71270 CT Thorax w/ + w/o Contrast	$1,426.00	$2,300.00	—	43% below	38%
Chest CT scan without and with contrast CPT 71270 CT Lung CA Diag. w/& w/o Cont	$1,426.00	$2,300.00	—	43% below	38%
Chest CT scan without and with contrast inpatient CPT 71270 CT Lung CA Diag. w/& w/o Cont	$1,426.00	$2,300.00	—	—	38%
Chest CT scan without and with contrast inpatient CPT 71270 CT Thorax w/ + w/o Contrast	$1,426.00	$2,300.00	—	—	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	—	59% below	38%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$217.00	$350.00	—	16% 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 Portable	$204.60	$330.00	—	9% below	38%
Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal	$204.60	$330.00	—	9% below	38%
Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Right	$204.60	$330.00	—	9% below	38%
Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Left	$204.60	$330.00	—	9% 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%
Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR Clavicle Bilateral	$344.10	$555.00	—	—	38%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right	$110.36	$178.00	—	57% below	38%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left	$110.36	$178.00	—	57% below	38%
Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR Clavicle Bilateral	$344.10	$555.00	—	—	38%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right	$110.36	$178.00	—	—	38%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left	$110.36	$178.00	—	—	38%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete	$620.00	$1,000.00	—	at median	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	—	9% 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 Left	$167.40	$270.00	—	68% below	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	—	68% 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	—	57% below	38%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Fetal Exam	$961.00	$1,550.00	—	10% 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 Lung CA Diag. w/o Contrast	$1,240.00	$2,000.00	—	11% below	38%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast	$1,240.00	$2,000.00	—	11% below	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	—	11% below	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 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 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 Lung CA Diag. 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 Thorax w/ Contrast	$1,333.00	$2,150.00	—	—	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 Digital Diagnos Bilat	$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 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 CPT 77066 MAMMO DIGITAL DIAGNOSTIC W/3D	$868.00	$1,400.00	—	61% above	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 both sides CPT 77066 MG Mammo Dig Dx Addtl Views Bi	$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 Dig Dx Addtl Views LT	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL UNILAT LT 77065	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGI ADD VIEWS RT 77065	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGITAL UNILAT RT 77065	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DIGI ADD VIEWS LT 77065	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic LT	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Post Bx Unilateral RT	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic RT	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Dig Dx Addtl Views RT	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Post Bx Unilateral LT	$682.00	$1,100.00	—	12% above	38%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Scrn RT 77067	$744.00	$1,200.00	—	22% above	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 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 MAMMO DIGI ADD VIEWS RT 77065	$682.00	$1,100.00	—	—	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 MG Mammo Digital Diagnostic LT	$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 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 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	$1,817.84	$2,932.00	—	16% above	38%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Echo 2D w/ Contrast	$1,817.84	$2,932.00	—	16% 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%
Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 Views Bilateral	$151.90	$245.00	—	—	38%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left	$101.68	$164.00	—	62% below	38%
Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right	$210.80	$340.00	—	22% below	38%
Elbow X-ray, 2 views inpatient both sides CPT 73070 XR Elbow 2 Views Bilateral	$151.90	$245.00	—	—	38%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left	$101.68	$164.00	—	—	38%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right	$210.80	$340.00	—	—	38%
Elbow X-ray, complete, 3 or more views CPT 73080 XR Elbow Complete 3+ Views Bil	$427.80	$690.00	—	48% above	38%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views LT	$137.02	$221.00	—	53% below	38%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views RT	$285.20	$460.00	—	1% below	38%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 XR Elbow Complete 3+ Views Bil	$427.80	$690.00	—	—	38%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views LT	$137.02	$221.00	—	—	38%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views RT	$285.20	$460.00	—	—	38%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Temporal Bones w/o Contrast	$1,240.00	$2,000.00	—	16% below	38%
Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella w/o Contrast	$1,240.00	$2,000.00	—	16% below	38%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast	$1,333.00	$2,150.00	—	9% below	38%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Temporal Bones w/o Contrast	$1,240.00	$2,000.00	—	—	38%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella w/o Contrast	$1,240.00	$2,000.00	—	—	38%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast	$1,333.00	$2,150.00	—	—	38%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches	$309.38	$499.00	—	16% below	38%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views	$309.38	$499.00	—	16% below	38%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views	$309.38	$499.00	—	—	38%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches	$309.38	$499.00	—	—	38%
Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 Views Bilateral	$330.46	$533.00	—	—	38%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right	$106.02	$171.00	—	58% below	38%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left	$106.02	$171.00	—	58% below	38%
Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR Forearm 2 Views Bilateral	$330.46	$533.00	—	—	38%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left	$106.02	$171.00	—	—	38%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right	$106.02	$171.00	—	—	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%
Hand X-ray, 2 views both sides CPT 73120 XR Hand 2 Views Bilateral	$337.90	$545.00	—	—	38%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right	$108.50	$175.00	—	60% below	38%
Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left	$225.06	$363.00	—	17% below	38%
Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 2 Views Bilateral	$337.90	$545.00	—	—	38%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right	$108.50	$175.00	—	—	38%
Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left	$225.06	$363.00	—	—	38%
Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneous Bilateral	$358.36	$578.00	—	—	38%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Left	$114.70	$185.00	—	53% below	38%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneous Right	$114.70	$185.00	—	53% below	38%
Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR Calcaneous Bilateral	$358.36	$578.00	—	—	38%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Right	$114.70	$185.00	—	—	38%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneous Left	$114.70	$185.00	—	—	38%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP Home Study 95806	$557.38	$899.00	—	20% below	38%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Unattended Sleep Study in home	$557.38	$899.00	—	20% below	38%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP HOME STUDY 95806	$557.38	$899.00	—	20% below	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%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 Unattended Sleep Study in home	$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	—	56% 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	—	46% 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	—	46% 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 RT	$131.44	$212.00	—	62% below	38%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views LT	$131.44	$212.00	—	62% 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 RT	$131.44	$212.00	—	—	38%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views LT	$131.44	$212.00	—	—	38%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR Knee Complete 4+ View Bilat	$228.16	$368.00	—	—	38%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views RT	$151.90	$245.00	—	54% below	38%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views LT	$151.90	$245.00	—	54% below	38%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR Knee Complete 4+ View Bilat	$228.16	$368.00	—	—	38%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views RT	$151.90	$245.00	—	—	38%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views LT	$151.90	$245.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Stryker Protocol RT	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrst RT	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrst LT	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee Stryker Protocol LT	$1,283.40	$2,070.00	—	8% below	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Stryker Protocol LT	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Left	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Right	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrst LT	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrst RT	$1,283.40	$2,070.00	—	—	38%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee Stryker Protocol RT	$1,283.40	$2,070.00	—	—	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	—	2% 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	—	2% below	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$496.00	$800.00	—	2% below	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ED US Abdomen 76705	$496.00	$800.00	—	2% below	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$496.00	$800.00	—	2% below	38%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$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 FAST Abdomen LTD	$496.00	$800.00	—	—	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 ED US Gall Bladder Ltd 76705	$496.00	$800.00	—	—	38%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 US Extr Nonvasc Limited Bilat	$494.76	$798.00	—	—	38%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 ED US LTD JT/NnVsc XTRStx76882	$329.84	$532.00	—	1% below	38%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Extremity Non-Vasc Lm 76882	$329.84	$532.00	—	1% below	38%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem Nonvasc Limited RT	$329.84	$532.00	—	1% below	38%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Extrem Nonvasc Limited LT	$329.84	$532.00	—	1% below	38%
Limited ultrasound of an arm or leg (non-vascular) inpatient both sides CPT 76882 US Extr Nonvasc Limited Bilat	$494.76	$798.00	—	—	38%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Extremity Non-Vasc Lm 76882	$329.84	$532.00	—	—	38%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 ED US LTD JT/NnVsc XTRStx76882	$329.84	$532.00	—	—	38%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extrem Nonvasc Limited RT	$329.84	$532.00	—	—	38%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Extrem Nonvasc Limited LT	$329.84	$532.00	—	—	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	—	58% 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%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right	$129.58	$209.00	—	52% below	38%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left	$269.70	$435.00	—	at median	38%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right	$129.58	$209.00	—	—	38%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left	$269.70	$435.00	—	—	38%
MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast	$744.00	$1,200.00	—	62% below	38%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast	$744.00	$1,200.00	—	—	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	—	66% below	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	—	66% 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	—	66% 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	—	29% 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	—	29% 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	—	29% below	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 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 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 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, 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, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left	$2,728.00	$4,400.00	—	30% below	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	—	30% below	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	—	30% below	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	—	30% below	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	—	30% below	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	—	30% below	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 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 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 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 Knee 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	—	64% below	38%
MRI of the abdomen without contrast CPT 74181 MRI Abd Liver Protocol w/o Con	$1,860.00	$3,000.00	—	25% 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	—	30% 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	—	30% below	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 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 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	—	32% 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 Brain/Pituit w/ + w/o Cont	$2,480.00	$4,000.00	—	32% below	38%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast	$2,480.00	$4,000.00	—	32% 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	—	32% 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	—	31% 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	—	25% 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	—	36% 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	—	38% 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	—	42% 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	—	57% below	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	—	10% below	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	—	10% 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	—	10% below	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	—	10% below	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	—	10% below	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 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%
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 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%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views	$354.02	$571.00	—	13% below	38%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views	$354.02	$571.00	—	—	38%
Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrst	$1,333.00	$2,150.00	—	16% below	38%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrst	$1,333.00	$2,150.00	—	—	38%
Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Cntrst	$1,240.00	$2,000.00	—	11% below	38%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Cntrst	$1,240.00	$2,000.00	—	—	38%
Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue	$200.26	$323.00	—	9% below	38%
Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue	$200.26	$323.00	—	—	38%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardl SPCT Rst Std Tl201	$2,914.00	$4,700.00	—	2% above	38%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Rest Inj	$2,914.00	$4,700.00	—	2% 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 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 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 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 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 Illuccix 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 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 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 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 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 Gozellix Init	$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 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 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 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 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 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 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 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 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 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 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 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 Skull to Mid-Thigh Subs	$3,871.28	$6,244.00	—	—	38%
Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast	$1,178.00	$1,900.00	—	20% below	38%
Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast	$1,178.00	$1,900.00	—	—	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvis Ltd w/Tansvg if indc	$312.48	$504.00	—	15% below	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ED US Transabdominal Ltd 76857	$312.48	$504.00	—	15% below	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Limited	$312.48	$504.00	—	15% below	38%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder Volume	$312.48	$504.00	—	15% 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	—	59% below	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 US Bladder Volume	$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 CPT 76857 ED US Transabdominal Ltd 76857	$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	—	8% above	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	—	47% below	38%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB > 14 wks w/TVS if ind	$688.20	$1,110.00	—	11% above	38%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Comp >14 Weeks w/UA Dopp	$688.20	$1,110.00	—	11% above	38%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks	$688.20	$1,110.00	—	11% 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 Comp >14 Weeks w/UA Dopp	$688.20	$1,110.00	—	—	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 > 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	—	1% 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	—	1% below	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 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, limited (heartbeat, position, fluid) CPT 76815 Ob Us, Limited Fetus(S) 76815	$327.36	$528.00	—	22% below	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Ext. Ceph	$682.00	$1,100.00	—	62% above	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited > 14 Weeks	$682.00	$1,100.00	—	62% above	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$682.00	$1,100.00	—	62% above	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 ED US OB LTD Fetus(s) 76815	$682.00	$1,100.00	—	62% above	38%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 PREG ECHO LIMITED 76815	$682.00	$1,100.00	—	62% 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 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 Ext. Ceph	$682.00	$1,100.00	—	—	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 Limited	$682.00	$1,100.00	—	—	38%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right	$110.36	$178.00	—	54% below	38%
Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left	$110.36	$178.00	—	54% below	38%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Left	$110.36	$178.00	—	—	38%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Right	$110.36	$178.00	—	—	38%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Left	$147.56	$238.00	—	59% below	38%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Right	$147.56	$238.00	—	59% below	38%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Right	$147.56	$238.00	—	—	38%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Left	$147.56	$238.00	—	—	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	—	56% above	38%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Scrn LT 77067	$744.00	$1,200.00	—	56% above	38%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening LT	$744.00	$1,200.00	—	56% above	38%
Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening RT	$744.00	$1,200.00	—	56% above	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 both sides CPT 77067 MAMMO DG SCR BI INCL CAD 77067	$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 Scrn LT 77067	$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 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	—	58% below	38%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Compl 2+ Views LT	$116.56	$188.00	—	58% 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 LT	$116.56	$188.00	—	—	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%
Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete	$241.80	$390.00	—	32% below	38%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete	$241.80	$390.00	—	—	38%
Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views	$238.70	$385.00	—	13% below	38%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views	$238.70	$385.00	—	—	38%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY 95810	$2,201.00	$3,550.00	—	30% below	38%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY 95810	$2,201.00	$3,550.00	—	—	38%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 XR Lower Extr Tdlr(13m-3y) Bil	$344.10	$555.00	—	17% above	38%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Lower Extr Tdlr(13m-3y) RT	$110.36	$178.00	—	63% below	38%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 views Right	$110.36	$178.00	—	63% below	38%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 views Left	$110.36	$178.00	—	63% below	38%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Lower Extr Tdlr(13m-3y) LT	$229.40	$370.00	—	22% below	38%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR Lower Extr Tdlr(13m-3y) Bil	$344.10	$555.00	—	—	38%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Lower Extr Tdlr(13m-3y) RT	$110.36	$178.00	—	—	38%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 views Right	$110.36	$178.00	—	—	38%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 views Left	$110.36	$178.00	—	—	38%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Lower Extr Tdlr(13m-3y) LT	$229.40	$370.00	—	—	38%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast	$1,240.00	$2,000.00	—	4% below	38%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast	$1,240.00	$2,000.00	—	—	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Right	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 3rd Digit Left	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Right	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Left	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 4th Digit Right	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Left	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 2nd Digit Left	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes 5th Digit Right	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Right	$89.28	$144.00	—	60% below	38%
Toe X-ray, 2 or more views one side CPT 73660 XR Toes Great Left	$186.00	$300.00	—	16% below	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Right	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 5th Digit Left	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Right	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Left	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 4th Digit Right	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Right	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 3rd Digit Left	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Left	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes 2nd Digit Right	$89.28	$144.00	—	—	38%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toes Great Left	$186.00	$300.00	—	—	38%
Transvaginal pelvic ultrasound CPT 76830 AMB US Transvaginl NonOB 76830	$342.24	$552.00	—	39% below	38%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB	$713.00	$1,150.00	—	28% above	38%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB	$713.00	$1,150.00	—	28% 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	—	46% below	38%
Transvaginal ultrasound during pregnancy CPT 76817 Transvaginal Us Obst 76817	$238.08	$384.00	—	46% below	38%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$496.00	$800.00	—	12% above	38%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OB	$496.00	$800.00	—	12% above	38%
Transvaginal ultrasound during pregnancy CPT 76817 PREG ECHO TRANSVAGINAL 76817	$496.00	$800.00	—	12% above	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 Transvaginal Us Obst 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	—	3% 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	—	10% above	38%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotm (Cnt) w/Dpler if ind	$589.00	$950.00	—	10% above	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	—	6% below	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	—	6% below	38%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI + KUB	$682.00	$1,100.00	—	6% below	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%
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 arm X-ray (humerus), 2 views CPT 73060 XR Upper Extr Tdlr(13m-3y) Bil	$165.54	$267.00	—	39% below	38%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right	$110.36	$178.00	—	59% below	38%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Upper Extr Tdlr(13m-3y) LT	$110.36	$178.00	—	59% below	38%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Upper Extr Tdlr(13m-3y) RT	$110.36	$178.00	—	59% below	38%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left	$229.40	$370.00	—	16% below	38%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 XR Upper Extr Tdlr(13m-3y) Bil	$165.54	$267.00	—	—	38%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Upper Extr Tdlr(13m-3y) RT	$110.36	$178.00	—	—	38%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Upper Extr Tdlr(13m-3y) LT	$110.36	$178.00	—	—	38%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right	$110.36	$178.00	—	—	38%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left	$229.40	$370.00	—	—	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	—	6% 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	—	6% 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	—	6% 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	—	6% 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	—	6% 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 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 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 Lower 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 LT	$775.00	$1,250.00	—	—	38%
Wrist X-ray, 2 views both sides CPT 73100 XR Wrist 2 Views Bilateral	$176.70	$285.00	—	—	38%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right	$117.80	$190.00	—	54% below	38%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left	$117.80	$190.00	—	54% below	38%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist Comp w/ Navicular LT	$244.90	$395.00	—	4% below	38%
Wrist X-ray, 2 views one side CPT 73100 XR Wrist Comp w/ Navicular RT	$244.90	$395.00	—	4% below	38%
Wrist X-ray, 2 views inpatient both sides CPT 73100 XR Wrist 2 Views Bilateral	$176.70	$285.00	—	—	38%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right	$117.80	$190.00	—	—	38%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left	$117.80	$190.00	—	—	38%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist Comp w/ Navicular RT	$244.90	$395.00	—	—	38%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist Comp w/ Navicular LT	$244.90	$395.00	—	—	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 LT	$137.64	$222.00	—	51% below	38%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views RT	$137.64	$222.00	—	51% 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	—	58% 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	—	58% 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	—	5% above	38%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View Portable	$248.00	$400.00	—	5% above	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	—	46% below	38%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right	$131.44	$212.00	—	46% 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 5th Digit Right	$130.20	$210.00	—	37% 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	—	37% below	38%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 2nd Digit Left	$130.20	$210.00	—	37% below	38%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Left	$130.20	$210.00	—	37% 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	—	37% 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	—	37% 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	—	37% 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	—	37% below	38%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger Thumb Right	$270.94	$437.00	—	30% above	38%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger 3rd Digit Left	$270.94	$437.00	—	30% above	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 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 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 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 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 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 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	—	52% below	38%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left	$229.40	$370.00	—	1% below	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	—	24% 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	—	60% 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	—	17% below	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	—	48% 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	—	7% 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	—	56% 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	—	56% 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 RT	$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 LT	$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	—	15% 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	—	58% 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	—	11% 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	—	7% 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
ACTH blood test CPT 82024 ACTH Plasma 3 specimen L38927	$186.00	$300.00	—	28% below	38%
ACTH blood test CPT 82024 Assay of ACTH Plasma L225276	$215.76	$348.00	—	16% below	38%
ACTH blood test CPT 82024 ACTH, Plasma L004440	$215.76	$348.00	—	16% below	38%
ACTH blood test inpatient CPT 82024 ACTH Plasma 3 specimen L38927	$186.00	$300.00	—	—	38%
ACTH blood test inpatient CPT 82024 Assay of ACTH Plasma L225276	$215.76	$348.00	—	—	38%
ACTH blood test inpatient CPT 82024 ACTH, Plasma L004440	$215.76	$348.00	—	—	38%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 AlninAmn ALT SGP L550960	$29.76	$48.00	—	51% below	38%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 (ALT) (SGPT) L403604	$29.76	$48.00	—	51% below	38%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 (ALT) (SGPT) L402175	$29.76	$48.00	—	51% below	38%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$29.76	$48.00	—	51% 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 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%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$29.76	$48.00	—	—	38%
AST (aspartate aminotransferase) enzyme test CPT 84450 (AST) (SGOT) L402175	$29.14	$47.00	—	45% below	38%
AST (aspartate aminotransferase) enzyme test CPT 84450 (AST) (SGOT) L403604	$29.14	$47.00	—	45% below	38%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST TRANSFERASE ASPARTATE	$29.14	$47.00	—	45% below	38%
AST (aspartate aminotransferase) enzyme test CPT 84450 84450 Trnsfrs AST/SGOT L550960	$29.14	$47.00	—	45% 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 84450 Trnsfrs AST/SGOT L550960	$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%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 L144000 Acut Viral Hep (A,B,C)	$265.98	$429.00	—	25% below	38%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) L144000	$265.98	$429.00	—	25% 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%
Albumin blood test CPT 82040 Albumin Level	$27.90	$45.00	—	41% below	38%
Albumin blood test CPT 82040 82040 Albumin serm plsma WhlBd	$27.90	$45.00	—	41% below	38%
Albumin blood test inpatient CPT 82040 82040 Albumin serm plsma WhlBd	$27.90	$45.00	—	—	38%
Albumin blood test inpatient CPT 82040 Albumin Level	$27.90	$45.00	—	—	38%
Aldosterone blood test CPT 82088 Aldosterone LCMS, Srm L004374	$227.54	$367.00	—	8% below	38%
Aldosterone blood test CPT 82088 Aldosterone, Urine L004291	$227.54	$367.00	—	8% below	38%
Aldosterone blood test CPT 82088 82088 ASSAY OF ALDOSTERONE	$227.54	$367.00	—	8% below	38%
Aldosterone blood test inpatient CPT 82088 82088 ASSAY OF ALDOSTERONE	$227.54	$367.00	—	—	38%
Aldosterone blood test inpatient CPT 82088 Aldosterone, Urine L004291	$227.54	$367.00	—	—	38%
Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS, Srm L004374	$227.54	$367.00	—	—	38%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 Phosphatase, alkaline	$29.14	$47.00	—	57% below	38%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase	$29.14	$47.00	—	57% below	38%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase	$29.14	$47.00	—	—	38%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 Phosphatase, alkaline	$29.14	$47.00	—	—	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allg Spec IGE Crude Xt L607950	$13.02	$21.00	—	61% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf Vegtbl II L601823	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602745 Allergen IgE Avocado	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf Shellfish L062695	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profl Dog IgE L606659	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Mold L062448	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602818 Allrgn IgE BlckPpprcrn	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prof, Fd-Milk L601856	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf, Fd-Fruit L601872	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602519 Allergen IgE Garlic	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prf Food-Basc L648014	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Food L602989	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Prfl BascFood L660423	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602810 Allergen IgE Ginger	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Pedtrc 3-6 yo L671934	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602841 Allergen IgE Hop(Food)	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602794 Allergen IgE Lentil	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602734 Allergen IgE KiwiFruit	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602732 Allrgn IgE CheesChdTp	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602492 Allergn IgE Choc/Cacao	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602782 Allergen IgE Coffee	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLG SPEC IGE CRDXTRC EA	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profl Nut IgE L604764	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Resp-Area1 w/rf L606995	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Fd IgE II w/Rfl L604783	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602825 Blueberry	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602497 Gluten, IgE	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L826336 Rhodotorula, IgE	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 T070-IgE White Mlberry L602569	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 RF IgE qnt/sn exPeanut L603916	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 T041-IgE Hickory, Whte L602941	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 _Allergen, generic bill 86003	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 T015-IgE Ash, White L602927	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE qnt/sqnt ex Peanut L603916	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 T008-IgE Elm, American L602476	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 IgE Sesame Seed L602485	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 T007-IgE Oak, White L602480	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602568 Macadamia Nut	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 T001-IgE Mpl/Box Elder L602489	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Allergen spc IgE; qnt/sq	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Pediatric Allrgy Pnl 4 L604975	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602550 Pine nut, Pignoles	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 M006-IgE Alter alterta L602455	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 M003-IgE Asprgil fumig L602471	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602526 Goats Milk	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 K084-IgE Sunflowr Seed L602766	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 K082-IgE Latex L602669	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Mini Profile L649749	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 I006-IgE Cockroach Ger L602488	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Alg spec ige crud xtrc L607660	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 H002-IgE Hse Dst Hlstr L602546	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Lambs Quarters L602537	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 G008-IgE Bluegrass, KY L602496	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy Grass L602506	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Ragweed, Short L602463	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 G005-IgE Rye Grs, Perl L602543	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602529- Clam	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 G004-IgE Fescue, Meadw L602549	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Common Silver Birch L602936	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 G003-IgE Orchard Grass L602867	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L603927 Allergen Prfl Mlk IgE	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F341-IgE Cranberry L602764	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE L600937	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F293-IgE Papaya Food L602828	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F259-IgE Grape L602802	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F225-IgE Pumpkin L602786	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Grasses Panel L644682	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F210-IgE Pineapple L602770	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602486 Pistachio nut	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L607021 Allergen Cat Dog IgE	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE L605651	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Spc CrudeAllrgn Ext ea L650003	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Corn L602460	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F091-IgE Mango L602741	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 AllrgnPrfl Cat IgE w/R L606650	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgG4 Egg (Yolk) L605342	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Hymenoptera Profile 2 L606895	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F075-IgE Egg (Yolk) L602487	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Alg EggWhite IgE w/Rfx L603940	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F036-IgE Coconut L602512	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profil Fish 7 L601013	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F024-IgE Shrimp L602473	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Setomelanomma rostrata L602561	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F020-IgE Almond L602479	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prof Fd-Citrus L600981	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgG4 Soybean L605307	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson Grass allergen L602503	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F014-IgE Soybean L602457	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prof Food-Meat L602284	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut L602451	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 DermatophagdsPtrnyssns L602467	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F009-IgE Rice L602511	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (5) Fish L601663	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F007-IgE Oat L602553	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allrgn Prf Dog CmpRflx L606659	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F006-IgE Barley L602504	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prf Food Veg I L601831	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgE Wheat L602459	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F002-IgE Milk L602453	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergn Prf Food VegII L601823	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F001-IgE Egg White L602452	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 E071-IgE Mouse Epithlm L602994	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602726 Allergen IgE Melon	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander L602456	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Hair/Dander L602454	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602726 Allergen IgE SwtPotat	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 E001-IgE Cat Dander L602454	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen P Std Env(37) L605651	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Rhodotorula, IgE L826336	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 D002-IgE D farinae L602475	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 ALLERGEN sp IgE Qn/SQ ea	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Zone 2 L676528	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602783 Allergen IgE Tea	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Zone 1 L676510	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens, Perennial L062497	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602510 Allergen IgE Tuna	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens(7) L671926	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (15) Inhlnts L604412	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 L602823 Allergen IgE Turkey	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergens (13) Envrn L604419	$29.14	$47.00	—	12% below	38%
Allergy blood test, specific IgE, per allergen CPT 86003 F004-IgG4 Wheat L605296	$37.20	$60.00	—	13% 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 Allergens, Zone 2 L676528	$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 L602825 Blueberry	$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 G008-IgE Bluegrass, KY L602496	$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 G005-IgE Rye Grs, Perl L602543	$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 G003-IgE Orchard Grass L602867	$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 F293-IgE Papaya Food L602828	$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 F225-IgE Pumpkin L602786	$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 F091-IgE Mango L602741	$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 F075-IgE Egg (Yolk) L602487	$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 F024-IgE Shrimp L602473	$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 F014-IgG4 Soybean L605307	$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 F013-IgE Peanut L602451	$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 F007-IgE Oat L602553	$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 F004-IgE Wheat L602459	$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 F001-IgE Egg White L602452	$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 E005-IgE Dog Dander L602456	$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 E001-IgE Cat Dander L602454	$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 Allergens, Zone 1 L676510	$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(7) L671926	$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 (13) Envrn L604419	$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 Allergen Prf Shellfish L062695	$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 Prof, Fd-Milk L601856	$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 Prf Food-Basc L648014	$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 Pedtrc 3-6 yo L671934	$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 Rhodotorula, IgE L826336	$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 F009-IgE Corn L602460	$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 Allergen Specific IgE L605651	$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 Allergen Profile, Food L602989	$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 Allrgn Prf Dog CmpRflx L606659	$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 Johnson Grass allergen L602503	$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 Alg EggWhite IgE w/Rfx L603940	$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 Grasses Panel L644682	$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 L602529- Clam	$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 Alg spec ige crud xtrc L607660	$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 IgE Sesame Seed L602485	$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 F004-IgG4 Wheat L605296	$37.20	$60.00	—	—	38%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Serum, Tumor Mrkr L002253	$93.62	$151.00	—	20% below	38%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP Tumor Marker (SrM) L480012	$93.62	$151.00	—	20% below	38%
Alpha-fetoprotein (AFP) blood test CPT 82105 AlphaFetoprotein serum L017319	$93.62	$151.00	—	20% below	38%
Alpha-fetoprotein (AFP) blood test CPT 82105 L010801 AFPMtrnl Srm Spina Bif	$93.62	$151.00	—	20% below	38%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Tumor Mrkr L002253	$93.62	$151.00	—	—	38%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP Tumor Marker (SrM) L480012	$93.62	$151.00	—	—	38%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AlphaFetoprotein serum L017319	$93.62	$151.00	—	—	38%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 L010801 AFPMtrnl Srm Spina Bif	$93.62	$151.00	—	—	38%
Ammonia blood test CPT 82140 Ammonia Level	$81.84	$132.00	—	15% below	38%
Ammonia blood test CPT 82140 82140 Ammonia	$81.84	$132.00	—	15% below	38%
Ammonia blood test inpatient CPT 82140 Ammonia Level	$81.84	$132.00	—	—	38%
Ammonia blood test inpatient CPT 82140 82140 Ammonia	$81.84	$132.00	—	—	38%
Amylase blood test CPT 82150 Amylase, Body Fluid L088062	$36.58	$59.00	—	51% below	38%
Amylase blood test CPT 82150 Amylase Level	$36.58	$59.00	—	51% below	38%
Amylase blood test CPT 82150 82150 Amylase	$36.58	$59.00	—	51% below	38%
Amylase blood test CPT 82150 Amylase Isoenzymes L123110	$36.58	$59.00	—	51% below	38%
Amylase blood test inpatient CPT 82150 82150 Amylase	$36.58	$59.00	—	—	38%
Amylase blood test inpatient CPT 82150 Amylase, Body Fluid L088062	$36.58	$59.00	—	—	38%
Amylase blood test inpatient CPT 82150 Amylase Isoenzymes L123110	$36.58	$59.00	—	—	38%
Amylase blood test inpatient CPT 82150 Amylase Level	$36.58	$59.00	—	—	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 86200 Cyclic ctrllntd pept CCP	$72.54	$117.00	—	28% below	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CyclCtrllntdPeptide Ab L520205	$72.54	$117.00	—	28% below	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CBG with Free Cortisol L500440	$72.54	$117.00	—	28% below	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody L164065	$72.54	$117.00	—	28% below	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Circ Peptide Ab L520298	$72.54	$117.00	—	28% below	38%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Anti-CCP Ab IgG + IgA L520008	$72.54	$117.00	—	28% below	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%
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 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%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IFA ReflexL340897	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Lupus Antinuclear Ab L520342	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclr antibd (ANA) L520293	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Multiplex Rflx 9 L164863	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Ab (ANA) L520205	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies L382965	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA w/Reflex L164962	$67.58	$109.00	—	30% below	38%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antib, IFA L164947	$67.58	$109.00	—	30% below	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 Lupus Antinuclear Ab L520342	$67.58	$109.00	—	—	38%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA w/Reflex L164962	$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 ANA Multiplex Rflx 9 L164863	$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 Antibodies L382965	$67.58	$109.00	—	—	38%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclr antibd (ANA) L520293	$67.58	$109.00	—	—	38%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-proBNP	$73.16	$118.00	—	63% below	38%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 L143000 NT-proBNP	$179.80	$290.00	—	9% below	38%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-Term Pro B-Type Natr Peptide	$179.80	$290.00	—	9% below	38%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BType Natriuretic Peptide(BNP)	$179.80	$290.00	—	9% 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 BType Natriuretic Peptide(BNP)	$179.80	$290.00	—	—	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 L143000 NT-proBNP	$179.80	$290.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasopharyngeal Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Comprehensive Throat Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Cult, Ster L180802	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BordetellaP NasophCult L180224	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture L182354	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture oth specim aer L183111	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Routine (aerobic only) Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture LC 008334	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070-& CULTURE AEROBIC	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cltr othr spcmn aerobc L188227	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Catheter Tip Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Cerebrospinal Fluid Culture	$48.36	$78.00	—	54% below	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Routine (aerobic only) Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 87070-& CULTURE AEROBIC	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cltr othr spcmn aerobc L188227	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Culture oth specim aer L183111	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture L182354	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BordetellaP NasophCult L180224	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Cult, Ster L180802	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Comprehensive Throat Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasopharyngeal Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Cerebrospinal Fluid Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Catheter Tip Culture	$48.36	$78.00	—	—	38%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture LC 008334	$48.36	$78.00	—	—	38%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL TOTAL CA	$47.74	$77.00	—	31% below	38%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL TOTAL CA	$47.74	$77.00	—	—	38%
Bilirubin blood test, total CPT 82247 82247 Bilirubin total L550960	$28.52	$46.00	—	27% below	38%
Bilirubin blood test, total CPT 82247 Bilirubin Cord Blood	$28.52	$46.00	—	27% below	38%
Bilirubin blood test, total CPT 82247 Bilirubin Total	$28.52	$46.00	—	27% below	38%
Bilirubin blood test, total inpatient CPT 82247 82247 Bilirubin total L550960	$28.52	$46.00	—	—	38%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total	$28.52	$46.00	—	—	38%
Bilirubin blood test, total inpatient CPT 82247 Bilirubin Cord Blood	$28.52	$46.00	—	—	38%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH 88305 Bill Surg Level IV	$169.26	$273.00	—	36% 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	—	59% 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 ROUTINE VENIPUNCTURE	$14.26	$23.00	—	14% below	38%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ONC INF Blood Draw Peripheral	$14.26	$23.00	—	14% below	38%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture by MA/Nurse 36415	$14.26	$23.00	—	14% below	38%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 _Venipuncture bill L998085	$14.26	$23.00	—	14% below	38%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$14.26	$23.00	—	—	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 glucose (sugar) test CPT 82947 Glucose Fasting Challenge	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 Glucose, 2 Hr Post Prandial	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 Glucose Level	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 Whole Blood Glucose POC	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 Fasting Plasma Glucose	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 Glucose Fasting Glucola Prentl	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT POC	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 Glucose, 1 Hr Post Prandial	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 GTT 2hr Challenge Notify	$22.32	$36.00	—	36% below	38%
Blood glucose (sugar) test CPT 82947 82947 Glucose qnt bld L550960	$22.32	$36.00	—	36% below	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 Challenge	$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 GTT 2hr Challenge Notify	$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 82947 Glucose qnt bld L550960	$22.32	$36.00	—	—	38%
Blood glucose (sugar) test inpatient CPT 82947 Whole Blood Glucose POC	$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 Glucose Fasting Glucola Prentl	$22.32	$36.00	—	—	38%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$22.32	$36.00	—	—	38%
Blood lead test CPT 83655 Whole Blood Lead Level POC	$27.90	$45.00	—	62% below	38%
Blood lead test CPT 83655 83655 Lead	$57.04	$92.00	—	22% below	38%
Blood lead test CPT 83655 Lead, Blood (Adult) L007625	$57.04	$92.00	—	22% below	38%
Blood lead test CPT 83655 Lead HMP1 Urine L007046	$57.04	$92.00	—	22% below	38%
Blood lead test CPT 83655 Assay of Lead L706200	$57.04	$92.00	—	22% below	38%
Blood lead test CPT 83655 Assay of Lead L250281	$57.04	$92.00	—	22% below	38%
Blood lead test CPT 83655 Lead, Blood (Pediatrc) L717009	$57.04	$92.00	—	22% below	38%
Blood lead test CPT 83655 Lead L042580	$57.04	$92.00	—	22% below	38%
Blood lead test inpatient CPT 83655 Whole Blood Lead Level POC	$27.90	$45.00	—	—	38%
Blood lead test inpatient CPT 83655 Lead L042580	$57.04	$92.00	—	—	38%
Blood lead test inpatient CPT 83655 83655 Lead	$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 Assay of Lead L250281	$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 Assay of Lead L706200	$57.04	$92.00	—	—	38%
Blood lead test inpatient CPT 83655 Lead, Blood (Adult) L007625	$57.04	$92.00	—	—	38%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, Beta Qual, Serum	$101.06	$163.00	—	6% 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 Blood Typ, Ser, ABO L006049	$85.56	$138.00	—	73% above	38%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$85.56	$138.00	—	73% above	38%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB Ref Lab ABO Type	$85.56	$138.00	—	73% above	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%
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 Blood Typ, Ser, ABO L006049	$85.56	$138.00	—	—	38%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen	$22.32	$36.00	—	25% below	38%
Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen	$22.32	$36.00	—	—	38%
C-peptide blood test CPT 84681 Assay of c-peptide L213660	$116.56	$188.00	—	16% below	38%
C-peptide blood test CPT 84681 C-Peptide, Serum L010108	$116.56	$188.00	—	16% below	38%
C-peptide blood test inpatient CPT 84681 Assay of c-peptide L213660	$116.56	$188.00	—	—	38%
C-peptide blood test inpatient CPT 84681 C-Peptide, Serum L010108	$116.56	$188.00	—	—	38%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$101.06	$163.00	—	48% above	38%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 86140 C-reactive protein	$101.06	$163.00	—	48% 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 diffcle Toxn Gne NAA L183988	$208.32	$336.00	—	at median	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) 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	—	18% 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 CA 125 Tumor Antigen L081610	$116.56	$188.00	—	22% below	38%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antign (CA) 125 L002303	$116.56	$188.00	—	22% 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	—	93% 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	—	93% above	38%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Rapid COVID 19 PCR	$241.80	$390.00	—	93% 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%
Calcium blood test, total CPT 82310 Calcium; total L054601	$29.14	$47.00	—	13% below	38%
Calcium blood test, total CPT 82310 82310 Calcium; total	$29.14	$47.00	—	13% below	38%
Calcium blood test, total CPT 82310 Calcium Level, Random Urine	$29.14	$47.00	—	13% below	38%
Calcium blood test, total CPT 82310 Calcium Level Total	$29.14	$47.00	—	13% below	38%
Calcium blood test, total inpatient CPT 82310 82310 Calcium; total	$29.14	$47.00	—	—	38%
Calcium blood test, total inpatient CPT 82310 Calcium Level Total	$29.14	$47.00	—	—	38%
Calcium blood test, total inpatient CPT 82310 Calcium Level, Random Urine	$29.14	$47.00	—	—	38%
Calcium blood test, total inpatient CPT 82310 Calcium; total L054601	$29.14	$47.00	—	—	38%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antgn L002139	$106.02	$171.00	—	23% below	38%
Carcinoembryonic antigen (CEA) test CPT 82378 CD4/CD8 Ratio Profile L505271	$221.34	$357.00	—	60% above	38%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Carcinoembryonic Antgn L002139	$106.02	$171.00	—	—	38%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CD4/CD8 Ratio Profile L505271	$221.34	$357.00	—	—	38%
Chickenpox (varicella) immunity blood test CPT 86787 EMP H VARICELLA TITRE	$71.92	$116.00	—	31% below	38%
Chickenpox (varicella) immunity blood test CPT 86787 Varicll-Zstr V Ab, IgG L096206	$71.92	$116.00	—	31% below	38%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zstr Ab, IgM L096776	$71.92	$116.00	—	31% below	38%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 EMP H VARICELLA TITRE	$71.92	$116.00	—	—	38%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicll-Zstr V Ab, IgG L096206	$71.92	$116.00	—	—	38%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zstr Ab, IgM L096776	$71.92	$116.00	—	—	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Gonrrhoea/Chlamyda PCR (Urine)	$84.94	$137.00	—	51% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlmyd dna amp prb L180107	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by PCR	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Chlamydia trachmt ampprb	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis L186200	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis L180051	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Rectal Swab L188672	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/GC Amplific L183194	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydi trachmts, NAA L188078	$166.78	$269.00	—	3% below	38%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Phrg Swb NAA L188698	$166.78	$269.00	—	3% 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 Chlamydia Rectal Swab L188672	$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/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%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Chlamydia trachmt ampprb	$166.78	$269.00	—	—	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel L303756	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel L385077	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Cascade L361946	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 EMP H LIPID PANEL	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel L123544	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL L030155	$75.02	$121.00	—	38% below	38%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel L884247	$75.02	$121.00	—	38% below	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 L303756	$75.02	$121.00	—	—	38%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$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 L884247	$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 L030155	$75.02	$121.00	—	—	38%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Cascade L361946	$75.02	$121.00	—	—	38%
Complete blood count (CBC) with differential CPT 85025 CBC Auto W/ Auto Diff L005009	$67.58	$109.00	—	53% above	38%
Complete blood count (CBC) with differential CPT 85025 Cmplt cbc w a. dif wbc L042077	$67.58	$109.00	—	53% above	38%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$67.58	$109.00	—	53% above	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) 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 COMPLETE CBC W/AUTO DIFF WBC	$67.58	$109.00	—	—	38%
Complete blood count (CBC), no differential CPT 85027 CBC COMPLETE AUTO NO DIFF	$36.58	$59.00	—	30% below	38%
Complete blood count (CBC), no differential CPT 85027 Auto CBC L121363	$36.58	$59.00	—	30% below	38%
Complete blood count (CBC), no differential inpatient CPT 85027 Auto CBC L121363	$36.58	$59.00	—	—	38%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC COMPLETE AUTO NO DIFF	$36.58	$59.00	—	—	38%
Comprehensive metabolic panel (blood test) CPT 80053 Comp. Metablc Pnl (14) L322000	$92.38	$149.00	—	2% below	38%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$92.38	$149.00	—	2% below	38%
Comprehensive metabolic panel (blood test) CPT 80053 80053 COMPREHEN METABOLC PANEL	$92.38	$149.00	—	2% below	38%
Comprehensive metabolic panel (blood test) CPT 80053 Add CMP to BMP	$92.38	$149.00	—	2% below	38%
Comprehensive metabolic panel (blood test) CPT 80053 Add CMP to iSTAT Chm 8+ (POCT)	$92.38	$149.00	—	2% below	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 Add CMP to BMP	$92.38	$149.00	—	—	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 80053 COMPREHEN METABOLC PANEL	$92.38	$149.00	—	—	38%
Cortisol blood test, total CPT 82533 L104026 Cortisol, PM	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 Cortisol L104000	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 Cortisol Dexame Reflex L503990	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 82533 Cortisol; total	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 Cortisol L004051	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 L104018 Cortisol, AM	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 Cortisol, ACTH StimulL140761	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 CBG with Free Cortisol L500440	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 82533 Salivary Cortisol	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 L500179 Salivary Cortisol MS	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 Cortisl, Salvry (2 sp) L502120	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total CPT 82533 Cortisol (3 Specimens) L028498	$91.14	$147.00	—	24% below	38%
Cortisol blood test, total inpatient CPT 82533 Cortisol (3 Specimens) L028498	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 CBG with Free Cortisol L500440	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 Cortisol, ACTH StimulL140761	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 L500179 Salivary Cortisol MS	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 Cortisol L104000	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 82533 Salivary Cortisol	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 Cortisl, Salvry (2 sp) L502120	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 L104018 Cortisol, AM	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 Cortisol Dexame Reflex L503990	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 L104026 Cortisol, PM	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 82533 Cortisol; total	$91.14	$147.00	—	—	38%
Cortisol blood test, total inpatient CPT 82533 Cortisol L004051	$91.14	$147.00	—	—	38%
Creatine kinase (CK) blood test, total CPT 82550 Assay of ck (cpk) L002311	$36.58	$59.00	—	46% below	38%
Creatine kinase (CK) blood test, total CPT 82550 CK, Total+Isoenzms Srm L002154	$36.58	$59.00	—	46% below	38%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Total L002154	$36.58	$59.00	—	46% below	38%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase	$36.58	$59.00	—	46% below	38%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK, Total+Isoenzms Srm L002154	$36.58	$59.00	—	—	38%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase	$36.58	$59.00	—	—	38%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase Total L002154	$36.58	$59.00	—	—	38%
Creatine kinase (CK) blood test, total inpatient CPT 82550 Assay of ck (cpk) L002311	$36.58	$59.00	—	—	38%
Creatinine blood test CPT 82565 Creatinine Lvl	$29.14	$47.00	—	35% below	38%
Creatinine blood test CPT 82565 Creatnne and Est. GFR (Serum)	$29.14	$47.00	—	35% below	38%
Creatinine blood test inpatient CPT 82565 Creatinine Lvl	$29.14	$47.00	—	—	38%
Creatinine blood test inpatient CPT 82565 Creatnne and Est. GFR (Serum)	$29.14	$47.00	—	—	38%
Cytomegalovirus (CMV) antibody test CPT 86644 Pre-eclampsia Panel	$80.60	$130.00	—	34% below	38%
Cytomegalovirus (CMV) antibody test CPT 86644 Cytmglvs (CMV) Ab, IgG L006494	$80.60	$130.00	—	34% below	38%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV Abs IgG/IgM L221085	$80.60	$130.00	—	34% below	38%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV Abs IgG/IgM L221085	$80.60	$130.00	—	—	38%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Cytmglvs (CMV) Ab, IgG L006494	$80.60	$130.00	—	—	38%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Pre-eclampsia Panel	$80.60	$130.00	—	—	38%
D-dimer blood test (blood clot marker) CPT 85379 Fibrin DP D-dimer qnt L385730	$57.04	$92.00	—	48% below	38%
D-dimer blood test (blood clot marker) CPT 85379 DDimer, Quantitative	$57.04	$92.00	—	48% below	38%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DDimer, Quantitative	$57.04	$92.00	—	—	38%
D-dimer blood test (blood clot marker) inpatient CPT 85379 Fibrin DP D-dimer qnt L385730	$57.04	$92.00	—	—	38%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate L004020	$124.62	$201.00	—	14% below	38%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate L004020	$124.62	$201.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV ANLYZR L912470	$57.82	$93.25	—	75% below	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Test Prsmv Chem A207479	$115.32	$186.00	—	50% below	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 L912081 Drug Scrn 17 w rflx	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 L735316 Ethyl Alc, Scrn Urine	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 L738792 ?-Hydrxy GHB Scrn Ur	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BUP MAT Mon 2, Urine L701985	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine/Cotinine SC U L737919	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 PnMn Profile Urine 13D L763824	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug of Abuse Screen SM	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 80307-drug test(s) presumptive	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ethyl Glucurnde Urine L737600	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Scrn13 w/Cnf,Mcnm L809509	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug tests presumptv L791194	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drugs of Abuse Scrn, Urine tox	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 GHB Scrn Cnfrm (MS) WB L738802	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 UDS Only 18, MAT L705540	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturates Scrw/rfx L700877	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Buprenorphine, Urine L763400	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepines Sc/rfx L700878	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FTY, Scr w/Refl Conf,U L721574	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 THC Screen Only, Urine L701869	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 SedativeHypntc Pnl UR L701085	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DrugScrn 13 w/RfCn Srm L700845	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 THC screen w/Reflex L700881	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Tramadol Sc&cnfm Urine L761018	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 L764422 Montir 14ClsPrf (LCMW)	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabo, Urine L716555	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drg Scrn Umb Crd w/Rfl L824268	$292.64	$472.00	—	27% above	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST PRSMV ANLYZR L912470	$57.82	$93.25	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Test Prsmv Chem A207479	$115.32	$186.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FTY, Scr w/Refl Conf,U L721574	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug tests presumptv L791194	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Scrn13 w/Cnf,Mcnm L809509	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine/Cotinine SC U L737919	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 PnMn Profile Urine 13D L763824	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 GHB Scrn Cnfrm (MS) WB L738802	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Barbiturates Scrw/rfx L700877	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Benzodiazepines Sc/rfx L700878	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC Screen Only, Urine L701869	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 SedativeHypntc Pnl UR L701085	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DrugScrn 13 w/RfCn Srm L700845	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 THC screen w/Reflex L700881	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Tramadol Sc&cnfm Urine L761018	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 L764422 Montir 14ClsPrf (LCMW)	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Nicotine Metabo, Urine L716555	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Ethyl Glucurnde Urine L737600	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Buprenorphine, Urine L763400	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drugs of Abuse Scrn, Urine tox	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drg Scrn Umb Crd w/Rfl L824268	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 UDS Only 18, MAT L705540	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BUP MAT Mon 2, Urine L701985	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 L912081 Drug Scrn 17 w rflx	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 L735316 Ethyl Alc, Scrn Urine	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 L738792 ?-Hydrxy GHB Scrn Ur	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Urine Drug of Abuse Screen SM	$292.64	$472.00	—	—	38%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307-drug test(s) presumptive	$292.64	$472.00	—	—	38%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel	$39.68	$64.00	—	25% below	38%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 Electrolyte Panel	$39.68	$64.00	—	—	38%
Epstein-Barr virus (EBV) antibody test CPT 86665 EpstnBrr Viral Capsid L096255	$101.68	$164.00	—	3% below	38%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 Antibd Epstein-Barr VCA	$101.68	$164.00	—	3% below	38%
Epstein-Barr virus (EBV) antibody test CPT 86665 EpsBrrVr Ab to VCA IgG L096230	$101.68	$164.00	—	3% below	38%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Antibody Profile L240610	$101.68	$164.00	—	3% below	38%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 EBV-VCA, IgM	$101.68	$164.00	—	3% below	38%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EpstnBrr Viral Capsid L096255	$101.68	$164.00	—	—	38%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV Antibody Profile L240610	$101.68	$164.00	—	—	38%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 Antibd Epstein-Barr VCA	$101.68	$164.00	—	—	38%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 EBV-VCA, IgM	$101.68	$164.00	—	—	38%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EpsBrrVr Ab to VCA IgG L096230	$101.68	$164.00	—	—	38%
Estradiol blood test CPT 82670 Estradiol L004515	$156.24	$252.00	—	2% below	38%
Estradiol blood test CPT 82670 82670 Estradiol	$156.24	$252.00	—	2% below	38%
Estradiol blood test CPT 82670 L140244 Estradiol Sen, LC/MS	$156.24	$252.00	—	2% below	38%
Estradiol blood test CPT 82670 Estradiol Total L504295	$156.24	$252.00	—	2% below	38%
Estradiol blood test inpatient CPT 82670 L140244 Estradiol Sen, LC/MS	$156.24	$252.00	—	—	38%
Estradiol blood test inpatient CPT 82670 Estradiol L004515	$156.24	$252.00	—	—	38%
Estradiol blood test inpatient CPT 82670 82670 Estradiol	$156.24	$252.00	—	—	38%
Estradiol blood test inpatient CPT 82670 Estradiol Total L504295	$156.24	$252.00	—	—	38%
FSH (follicle-stimulating hormone) test CPT 83001 Gonadotropin FSH L504295	$104.16	$168.00	—	17% below	38%
FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum L004309	$104.16	$168.00	—	17% 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	—	49% 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 L121363	$76.26	$123.00	—	29% below	38%
Ferritin blood test (iron stores) CPT 82728 Assay of Ferritin L004598	$76.26	$123.00	—	29% below	38%
Ferritin blood test (iron stores) CPT 82728 Assay of ferritin L042077	$76.26	$123.00	—	29% below	38%
Ferritin blood test (iron stores) CPT 82728 Ferritin	$76.26	$123.00	—	29% below	38%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin L121363	$76.26	$123.00	—	—	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 Ferritin	$76.26	$123.00	—	—	38%
Ferritin blood test (iron stores) inpatient CPT 82728 Assay of Ferritin L004598	$76.26	$123.00	—	—	38%
Fibrinogen blood test CPT 85384 Fibrinogen Level	$54.56	$88.00	—	33% below	38%
Fibrinogen blood test CPT 85384 Fibrinogen Activity L001610	$54.56	$88.00	—	33% below	38%
Fibrinogen blood test CPT 85384 Fibrinogen; activity L164535	$54.56	$88.00	—	33% below	38%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Level	$54.56	$88.00	—	—	38%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen; activity L164535	$54.56	$88.00	—	—	38%
Fibrinogen blood test inpatient CPT 85384 Fibrinogen Activity L001610	$54.56	$88.00	—	—	38%
Folate (folic acid) blood test CPT 82746 Folate Level	$82.46	$133.00	—	7% below	38%
Folate (folic acid) blood test CPT 82746 Assay of folc acd srm L042077	$82.46	$133.00	—	7% 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	—	81% below	38%
Free T3 thyroid hormone test CPT 84481 Triiodothyrnne T3 Free L010389	$94.86	$153.00	—	42% below	38%
Free T3 thyroid hormone test CPT 84481 _T3Free L010390	$94.86	$153.00	—	42% 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 _Thyrx (T4) Fre, Dr, S L001976	$50.84	$82.00	—	48% below	38%
Free T4 (free thyroxine) thyroid blood test CPT 84439 _Thyx (T4) Fre, Drt, S L001977	$50.84	$82.00	—	48% below	38%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level	$50.84	$82.00	—	48% below	38%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 _Thyx (T4) Fre, Drt, S L001977	$50.84	$82.00	—	—	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 testosterone test CPT 84402 Testostrne, Free, Drct L144980	$130.82	$211.00	—	7% below	38%
Free testosterone test CPT 84402 Testosterone, free L081786	$130.82	$211.00	—	7% below	38%
Free testosterone test CPT 84402 84402 ASSAY FREE TESTOSTERONE	$130.82	$211.00	—	7% below	38%
Free testosterone test inpatient CPT 84402 84402 ASSAY FREE TESTOSTERONE	$130.82	$211.00	—	—	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%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 82977 Assay of GGT L550960	$40.30	$65.00	—	38% below	38%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT(Gamma Glutamyl Transfrase)	$40.30	$65.00	—	38% below	38%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 82977 Assay of GGT L550960	$40.30	$65.00	—	—	38%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT(Gamma Glutamyl Transfrase)	$40.30	$65.00	—	—	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 GTT 1 Hr Gluc Prenatal Chllnge	$26.66	$43.00	—	48% below	38%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .Glucose 1 Hour Glucola Prentl	$26.66	$43.00	—	48% below	38%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hr Challenge	$71.92	$116.00	—	39% 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	—	42% 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 Gonococcus PhrgSwb NAA L188698	$195.92	$316.00	—	7% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neissria gonrrhoe, NAA L188086	$195.92	$316.00	—	7% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 N GNORRHOEAE DNA AMP PRB	$195.92	$316.00	—	7% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus Rectal Swab L188672	$195.92	$316.00	—	7% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae L180051	$195.92	$316.00	—	7% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.gonorrh dna amp prb L180107	$195.92	$316.00	—	7% below	38%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria gonorrhoeae l186200	$195.92	$316.00	—	7% below	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 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 Neisseria gonorrhoeae l186200	$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 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 86677 Antbd Helicobacter pylor	$94.24	$152.00	—	48% below	38%
H. pylori antibody blood test CPT 86677 Helicbtr pylori IgM Ab L163204	$94.24	$152.00	—	48% below	38%
H. pylori antibody blood test CPT 86677 H. pylori, IgG Abs L162289	$94.24	$152.00	—	48% below	38%
H. pylori antibody blood test CPT 86677 H pyl IgM, IgG, IgA Ab L163683	$94.24	$152.00	—	48% below	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 86677 Antbd Helicobacter pylor	$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	—	29% 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	—	6% below	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant w/R Trans L550880	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 A3000867 HIV1 Qnt NAAT, Plasma	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 L550390 HIV-1 QntPCR w/rf Trof	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA Rl Tm PCR (N-Grph) L550430	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 L550430 HIV-1 Qnt R-t PCR (NG)	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 L550625 HIV-1 Qn RltmPCR NGw/R	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 Quant PCR L550920	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 87536 Infect agent DNA/RNA HIV	$474.92	$766.00	—	10% above	38%
HIV viral load test (HIV-1 RNA, quantitative) one side CPT 87536 HIV-1, Qnt, RT PCR (G) L550420	$474.92	$766.00	—	10% above	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 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 HIV-1 Quant PCR L550920	$474.92	$766.00	—	—	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 L550625 HIV-1 Qn RltmPCR NGw/R	$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 RNA Rl Tm PCR (N-Grph) L550430	$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	—	6% 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	—	63% below	38%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (Glycosylated)	$54.56	$88.00	—	23% below	38%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 L102525 Hemoglobin A1c w/ eAG	$54.56	$88.00	—	23% 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%
Hemoglobin blood test CPT 85018 Hemoglobin POC	$6.82	$11.00	—	69% below	38%
Hemoglobin blood test CPT 85018 Blood count (Hgb) L121003	$13.64	$22.00	—	38% below	38%
Hemoglobin blood test CPT 85018 Hemoglobin	$13.64	$22.00	—	38% below	38%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin POC	$6.82	$11.00	—	—	38%
Hemoglobin blood test inpatient CPT 85018 Hemoglobin	$13.64	$22.00	—	—	38%
Hemoglobin blood test inpatient CPT 85018 Blood count (Hgb) L121003	$13.64	$22.00	—	—	38%
Hepatitis B core antibody test (total) CPT 86704 Hep b core antbd total L144025	$67.58	$109.00	—	5% below	38%
Hepatitis B core antibody test (total) CPT 86704 Ab ID hepatitis B core L144025	$67.58	$109.00	—	5% below	38%
Hepatitis B core antibody test (total) CPT 86704 HBV/HCV (Profile VIII) L255505	$67.58	$109.00	—	5% below	38%
Hepatitis B core antibody test (total) CPT 86704 HepB core ab (HBcAb)totL098418	$67.58	$109.00	—	5% below	38%
Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab, Tot L006718	$67.58	$109.00	—	5% below	38%
Hepatitis B core antibody test (total) inpatient CPT 86704 HBV/HCV (Profile VIII) L255505	$67.58	$109.00	—	—	38%
Hepatitis B core antibody test (total) inpatient CPT 86704 HepB core ab (HBcAb)totL098418	$67.58	$109.00	—	—	38%
Hepatitis B core antibody test (total) inpatient CPT 86704 Ab ID hepatitis B core L144025	$67.58	$109.00	—	—	38%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot L006718	$67.58	$109.00	—	—	38%
Hepatitis B core antibody test (total) inpatient CPT 86704 Hep b core antbd total L144025	$67.58	$109.00	—	—	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Ab ID hepatitis B srfc L144025	$60.14	$97.00	—	17% below	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EMP H HBSAB	$60.14	$97.00	—	17% below	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B (S) Ab L006395	$60.14	$97.00	—	17% below	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep b surface antibody L144025	$60.14	$97.00	—	17% below	38%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 86706 Hepatitis B srf an HBsAb	$60.14	$97.00	—	17% below	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 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 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 (S) Ab L006395	$60.14	$97.00	—	—	38%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen L006510	$57.66	$93.00	—	28% below	38%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Qual/s-qnt HepB SrfcAg L144025	$57.66	$93.00	—	28% below	38%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis b srfc ag ia L144025	$57.66	$93.00	—	28% below	38%
Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 Inf agnt antign imunoass	$57.66	$93.00	—	28% below	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 HBsAg Screen L006510	$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 Qual/s-qnt HepB SrfcAg L144025	$57.66	$93.00	—	—	38%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Ab w/Rflx to Q PCR L144050	$79.98	$129.00	—	49% below	38%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody rflx NAA L144045	$79.98	$129.00	—	49% below	38%
Hepatitis C antibody blood test (screening) CPT 86803 L140659 HepatitisC Virus (HCV)	$79.98	$129.00	—	49% below	38%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C antibody L144025	$79.98	$129.00	—	49% below	38%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis c ab test L144025	$79.98	$129.00	—	49% below	38%
Hepatitis C antibody blood test (screening) CPT 86803 86803 Hepatitis C antibody	$79.98	$129.00	—	49% below	38%
Hepatitis C antibody blood test (screening) CPT 86803 HCV Antbd RFX QuantPCR L144050	$79.98	$129.00	—	49% below	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 HCV Antbd RFX QuantPCR L144050	$79.98	$129.00	—	—	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 HCV Antibody rflx NAA L144045	$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 L140659 HepatitisC Virus (HCV)	$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 viral load (HCV RNA) test CPT 87522 HCV RealTime PCR Quant L550312	$239.32	$386.00	—	50% below	38%
Hepatitis C viral load (HCV RNA) test CPT 87522 HepCVirus(HCV) RNADiag L550870	$239.32	$386.00	—	50% below	38%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA PCR Qnt RfxGnt L550090	$239.32	$386.00	—	50% below	38%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hep C HVC, Quant PCR L550080	$239.32	$386.00	—	50% below	38%
Hepatitis C viral load (HCV RNA) test CPT 87522 HepCVirus (HCV) QntRNA L551300	$239.32	$386.00	—	50% below	38%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Qnt (NGrh) L550080	$239.32	$386.00	—	50% below	38%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 _HCV RT-PCR Quant (NG) L550362	$239.32	$386.00	—	50% below	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 HepCVirus (HCV) QntRNA L551300	$239.32	$386.00	—	—	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 HCV RNA PCR Qnt RfxGnt L550090	$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%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Qnt (NGrh) L550080	$239.32	$386.00	—	—	38%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IgG/M w/Rflx L163589	$73.78	$119.00	—	30% below	38%
Herpes blood test, HSV-1 antibody CPT 86695 Antibody ID HSV Type 1 L164099	$73.78	$119.00	—	30% below	38%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1&2 Ab, IgG w/Rf L164922	$73.78	$119.00	—	30% below	38%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Antibd herpes simplex t1	$73.78	$119.00	—	30% below	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-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-2 antibody CPT 86696 _HSV 2 IgG L163006	$108.50	$175.00	—	11% below	38%
Herpes blood test, HSV-2 antibody CPT 86696 Antibody ID HSV Type 2 L164099	$108.50	$175.00	—	11% below	38%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Antibd herpes simplex t2	$108.50	$175.00	—	11% below	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 Antibody ID HSV Type 2 L164099	$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	—	26% 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 Homocysteine L501790	$100.44	$162.00	—	23% below	38%
Homocysteine blood test CPT 83090 Homocyst(e)ine, Plasma L706994	$100.44	$162.00	—	23% 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 Insulin L004333	$63.86	$103.00	—	31% below	38%
Insulin blood test CPT 83525 Assay of insulin L213660	$63.86	$103.00	—	31% below	38%
Insulin blood test CPT 83525 Insulin Total L501561	$63.86	$103.00	—	31% below	38%
Insulin blood test CPT 83525 83525 Insulin; total	$63.86	$103.00	—	31% below	38%
Insulin blood test CPT 83525 Insulin (2 Specimens) L146902	$63.86	$103.00	—	31% below	38%
Insulin blood test inpatient CPT 83525 Insulin (2 Specimens) L146902	$63.86	$103.00	—	—	38%
Insulin blood test inpatient CPT 83525 83525 Insulin; total	$63.86	$103.00	—	—	38%
Insulin blood test inpatient CPT 83525 Insulin L004333	$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 Assay of insulin L213660	$63.86	$103.00	—	—	38%
Iron blood test (serum iron) CPT 83540 Assay of iron L042077	$36.58	$59.00	—	42% below	38%
Iron blood test (serum iron) CPT 83540 Iron Level	$36.58	$59.00	—	42% 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	—	31% 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	—	22% below	38%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizng Horm(LH), S L004283	$103.54	$167.00	—	—	38%
Lactate (lactic acid) blood test CPT 83605 D-Lactate L823388	$65.10	$105.00	—	39% below	38%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid, Plasma (Venous)	$65.10	$105.00	—	39% below	38%
Lactate (lactic acid) blood test CPT 83605 .Rpt Lactic Acid,Plasma (Ven)	$65.10	$105.00	—	39% below	38%
Lactate (lactic acid) blood test inpatient CPT 83605 D-Lactate L823388	$65.10	$105.00	—	—	38%
Lactate (lactic acid) blood test inpatient CPT 83605 .Rpt Lactic Acid,Plasma (Ven)	$65.10	$105.00	—	—	38%
Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid, Plasma (Venous)	$65.10	$105.00	—	—	38%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH, Body Fluid	$34.10	$55.00	—	31% below	38%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase	$34.10	$55.00	—	31% below	38%
Lactate dehydrogenase (LDH) blood test CPT 83615 83615 Lactate dehydrgns LD,LDH	$34.10	$55.00	—	31% below	38%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH, Body Fluid	$34.10	$55.00	—	—	38%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 83615 Lactate dehydrgns LD,LDH	$34.10	$55.00	—	—	38%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase	$34.10	$55.00	—	—	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	—	32% below	38%
Liver function blood test panel CPT 80076 Hepatic Function Panel L385077	$45.88	$74.00	—	32% 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 Lyme, Totl Ab Test/Rfx L160325	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 86618 Antibody; Borrelia burgd	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 L164089 Lyme IgG/IgM	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 Lyme disease antibody 3006053	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 Lyme Ab Mod2TierPrfS/P L164226	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 Borrelia Burgdorfri Ab L164705	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 BorreliaBurgdorfri ARUP3003255	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 L164226 LymeDisease Tot Ab w/r	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 C6 B. burgdrfri (Lyme) L015400	$95.48	$154.00	—	9% below	38%
Lyme disease antibody test CPT 86618 Lyme Disease Antibody IgG+IgM	$95.48	$154.00	—	9% below	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 L164226 LymeDisease Tot Ab w/r	$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 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, 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%
Lyme disease antibody test inpatient CPT 86618 Lyme disease antibody 3006053	$95.48	$154.00	—	—	38%
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Antibody IgG+IgM	$95.48	$154.00	—	—	38%
Magnesium blood test CPT 83735 Magnesium, Urine L003400	$31.00	$50.00	—	41% below	38%
Magnesium blood test CPT 83735 Assay of magnesium A2008771	$31.00	$50.00	—	41% below	38%
Magnesium blood test CPT 83735 83735 Magnesium	$31.00	$50.00	—	41% below	38%
Magnesium blood test CPT 83735 Magnesium, Urine L013730	$31.00	$50.00	—	41% below	38%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$31.00	$50.00	—	41% below	38%
Magnesium blood test CPT 83735 Magnesium, RBC L080283	$31.00	$50.00	—	41% below	38%
Magnesium blood test inpatient CPT 83735 83735 Magnesium	$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 Magnesium, Urine L013730	$31.00	$50.00	—	—	38%
Magnesium blood test inpatient CPT 83735 Magnesium, Urine L003400	$31.00	$50.00	—	—	38%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC L080283	$31.00	$50.00	—	—	38%
Magnesium blood test inpatient CPT 83735 Assay of magnesium A2008771	$31.00	$50.00	—	—	38%
Measles (rubeola) antibody test CPT 86765 86765 Antibody; rubeola	$71.92	$116.00	—	22% below	38%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies,IgM L160218	$71.92	$116.00	—	22% below	38%
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies,IgG L096560	$71.92	$116.00	—	22% below	38%
Measles (rubeola) antibody test CPT 86765 Measles(Rubeola)Ab,IgM L160178	$71.92	$116.00	—	22% below	38%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies,IgG L096560	$71.92	$116.00	—	—	38%
Measles (rubeola) antibody test inpatient CPT 86765 86765 Antibody; rubeola	$71.92	$116.00	—	—	38%
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies,IgM L160218	$71.92	$116.00	—	—	38%
Measles (rubeola) antibody test inpatient CPT 86765 Measles(Rubeola)Ab,IgM L160178	$71.92	$116.00	—	—	38%
Mono test (heterophile antibody, Monospot) CPT 86308 Infectious Mononucleosis Scrn	$29.14	$47.00	—	53% below	38%
Mono test (heterophile antibody, Monospot) CPT 86308 Monospot: Whole Blood POC	$29.14	$47.00	—	53% below	38%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monospot: Whole Blood POC	$29.14	$47.00	—	—	38%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Infectious Mononucleosis Scrn	$29.14	$47.00	—	—	38%
Mumps immunity blood test CPT 86735 Mumps Antibodies, IgM L160499	$73.16	$118.00	—	24% below	38%
Mumps immunity blood test CPT 86735 MMR Immunity L058495	$73.16	$118.00	—	24% below	38%
Mumps immunity blood test CPT 86735 Mumps(IgG/M) L262295	$73.16	$118.00	—	24% below	38%
Mumps immunity blood test CPT 86735 86735 Antibody; mumps	$73.16	$118.00	—	24% below	38%
Mumps immunity blood test CPT 86735 Mumps Antibodies, IgG L096552	$73.16	$118.00	—	24% below	38%
Mumps immunity blood test CPT 86735 EMP H MUMPS TITRE	$73.16	$118.00	—	24% below	38%
Mumps immunity blood test inpatient CPT 86735 MMR Immunity L058495	$73.16	$118.00	—	—	38%
Mumps immunity blood test inpatient CPT 86735 EMP H MUMPS TITRE	$73.16	$118.00	—	—	38%
Mumps immunity blood test inpatient CPT 86735 86735 Antibody; mumps	$73.16	$118.00	—	—	38%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgG L096552	$73.16	$118.00	—	—	38%
Mumps immunity blood test inpatient CPT 86735 Mumps(IgG/M) L262295	$73.16	$118.00	—	—	38%
Mumps immunity blood test inpatient CPT 86735 Mumps Antibodies, IgM L160499	$73.16	$118.00	—	—	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	—	19% 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	—	2% below	38%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, Diagnostic	$102.92	$166.00	—	2% below	38%
PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Health DT ARUP3000134	$102.92	$166.00	—	2% below	38%
PSA (prostate-specific antigen) blood test, total CPT 84153 84153 Prostat spcf anti tl PSA	$102.92	$166.00	—	2% below	38%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Ultrasensitive L140731	$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 84153 Prostat spcf anti tl PSA	$102.92	$166.00	—	—	38%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, Diagnostic	$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	—	24% 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 Cytopath,C/V,Thin Layer 88142	$113.46	$183.00	—	6% 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	—	6% above	38%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 88142 AP Cyto Gyn ATL Manl SCR	$113.46	$183.00	—	6% above	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%
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%
Parathyroid hormone (PTH) blood test CPT 83970 Parathormone (PTH) L054601	$230.64	$372.00	—	6% below	38%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact L015610	$230.64	$372.00	—	6% below	38%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathormone (PTH) L054601	$230.64	$372.00	—	—	38%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact L015610	$230.64	$372.00	—	—	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma/whole blood L117079	$34.10	$55.00	—	45% below	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma/whole bloodL504400	$34.10	$55.00	—	45% below	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin tme par L500390	$34.10	$55.00	—	45% below	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma/whole blood L385730	$34.10	$55.00	—	45% below	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT plasma or Whl bld L501790	$34.10	$55.00	—	45% below	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 (PTT) Plasma/whl blood L500711	$34.10	$55.00	—	45% below	38%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$34.10	$55.00	—	45% below	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 bloodL504400	$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/whl blood L500711	$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%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$34.10	$55.00	—	—	38%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level	$26.66	$43.00	—	58% below	38%
Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level	$26.66	$43.00	—	—	38%
Potassium blood test CPT 84132 Potassium Level	$26.66	$43.00	—	50% below	38%
Potassium blood test CPT 84132 Potassium, RBC L202314	$32.86	$53.00	—	39% below	38%
Potassium blood test inpatient CPT 84132 Potassium Level	$26.66	$43.00	—	—	38%
Potassium blood test inpatient CPT 84132 Potassium, RBC L202314	$32.86	$53.00	—	—	38%
Progesterone blood test CPT 84144 Progesterone L004317	$116.56	$188.00	—	24% below	38%
Progesterone blood test inpatient CPT 84144 Progesterone L004317	$116.56	$188.00	—	—	38%
Prolactin blood test CPT 84146 Glyco Antibod IgG IgM L163002	$108.50	$175.00	—	24% below	38%
Prolactin blood test CPT 84146 Prolactin L004465	$108.50	$175.00	—	24% below	38%
Prolactin blood test CPT 84146 Macroprolactin L500324	$108.50	$175.00	—	24% below	38%
Prolactin blood test inpatient CPT 84146 Prolactin L004465	$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 Macroprolactin L500324	$108.50	$175.00	—	—	38%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME and INR	$24.18	$39.00	—	46% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time L385730	$24.18	$39.00	—	46% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time (PT) L117079	$24.18	$39.00	—	46% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time (PT) L500711	$24.18	$39.00	—	46% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time 85610	$24.18	$39.00	—	46% below	38%
Prothrombin time (PT/INR) clotting test CPT 85610 INR POC	$24.18	$39.00	—	46% below	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 INR POC	$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%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time (PT) L117079	$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 Rapid Infl (flu) A or B Vr Agn	$78.12	$126.00	—	—	38%
Rapid flu test (influenza antigen) inpatient CPT 87804 87804-QW Infect agnt antgn det	$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	—	at median	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%
Renin blood test CPT 84244 Renin Activity, Plasma L002006	$122.76	$198.00	—	20% below	38%
Renin blood test CPT 84244 Aldosterone/Renin Rat L004354	$122.76	$198.00	—	20% below	38%
Renin blood test inpatient CPT 84244 Aldosterone/Renin Rat L004354	$122.76	$198.00	—	—	38%
Renin blood test inpatient CPT 84244 Renin Activity, Plasma L002006	$122.76	$198.00	—	—	38%
Rh blood typing CPT 86901 RH 86901	$77.50	$125.00	—	39% above	38%
Rh blood typing CPT 86901 Blood Typ, Ser, Rh (d) L006049	$77.50	$125.00	—	39% above	38%
Rh blood typing CPT 86901 BB Ref Lab Rh Type	$77.50	$125.00	—	39% above	38%
Rh blood typing inpatient CPT 86901 BB Ref Lab Rh Type	$77.50	$125.00	—	—	38%
Rh blood typing inpatient CPT 86901 RH 86901	$77.50	$125.00	—	—	38%
Rh blood typing inpatient CPT 86901 Blood Typ, Ser, Rh (d) L006049	$77.50	$125.00	—	—	38%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid fact quant L520293	$32.24	$52.00	—	38% below	38%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Qnt L520205	$32.24	$52.00	—	38% below	38%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factr Quant L520298	$32.24	$52.00	—	38% below	38%
Rheumatoid factor (RF) test CPT 86431 86431 Rheumatoid factor; quant	$32.24	$52.00	—	38% below	38%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factr Quant L164065	$32.24	$52.00	—	38% below	38%
Rheumatoid factor (RF) test CPT 86431 Rheum Arthritis Factor L006502	$32.24	$52.00	—	38% 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 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 86431 Rheumatoid factor; quant	$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 Rheumatoid Factr Quant L520298	$32.24	$52.00	—	—	38%
Rubella antibody test (immunity check) CPT 86762 86762 Antibody; rubella	$76.26	$123.00	—	1% below	38%
Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies,Ig GL006197	$76.26	$123.00	—	1% below	38%
Rubella antibody test (immunity check) CPT 86762 Rubella Screen, IgG	$76.26	$123.00	—	1% below	38%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies,Ig GL006197	$76.26	$123.00	—	—	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%
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) CPT 85652 SEDIMENTATION RATE RBC AUTO	$15.50	$25.00	—	57% below	38%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SedmntnRate ModWstrgrn L005215	$15.50	$25.00	—	—	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%
Sodium blood test CPT 84295 84295 NA, srm plsma or Whl Bld	$27.28	$44.00	—	20% below	38%
Sodium blood test CPT 84295 Sodium Level	$27.28	$44.00	—	20% below	38%
Sodium blood test inpatient CPT 84295 Sodium Level	$27.28	$44.00	—	—	38%
Sodium blood test inpatient CPT 84295 84295 NA, srm plsma or Whl Bld	$27.28	$44.00	—	—	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 CPT 87177 O+P Exam, Formaln Only L180851	$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 1	$24.80	$40.00	—	33% below	38%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood 3	$24.80	$40.00	—	33% below	38%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood 2	$24.80	$40.00	—	33% 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 2	$24.80	$40.00	—	—	38%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood 1	$24.80	$40.00	—	—	38%
Syphilis antibody test (Treponema pallidum) CPT 86780 T pallidum Ab (FTA-Ab) L006379	$74.40	$120.00	—	35% below	38%
Syphilis antibody test (Treponema pallidum) CPT 86780 L082348 Treponemal Antibd TPPA	$74.40	$120.00	—	35% below	38%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema pallidum L012021	$74.40	$120.00	—	35% below	38%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis TrpnmPlldm Ab L082345	$74.40	$120.00	—	35% below	38%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema palldum Anbd L082370	$74.40	$120.00	—	35% below	38%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 L082348 Treponemal Antibd TPPA	$74.40	$120.00	—	—	38%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T pallidum Ab (FTA-Ab) L006379	$74.40	$120.00	—	—	38%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema pallidum L012021	$74.40	$120.00	—	—	38%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Treponema palldum Anbd L082370	$74.40	$120.00	—	—	38%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Syphilis TrpnmPlldm Ab L082345	$74.40	$120.00	—	—	38%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, CSF L006445	$24.18	$39.00	—	35% below	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	—	35% below	38%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 L006099 RPR	$24.18	$39.00	—	35% below	38%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Syphilis RPR L006072	$24.18	$39.00	—	35% below	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%
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%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 EMP H T-SPOT TB GOLD	$323.64	$522.00	—	47% above	38%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QFT TB Gold+ (Clnt in) L182893	$323.64	$522.00	—	47% above	38%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantifern-TB Gold Pls L182879	$323.64	$522.00	—	47% above	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 QFT TB Gold+ (Clnt in) L182893	$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, total L081786	$144.46	$233.00	—	9% below	38%
Testosterone blood test, total (not free testosterone) CPT 84403 Testost,Free and Total L140103	$144.46	$233.00	—	9% below	38%
Testosterone blood test, total (not free testosterone) CPT 84403 TestostrnTot W,C,hypoM L070001	$144.46	$233.00	—	9% below	38%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum L004226	$144.46	$233.00	—	9% below	38%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, total L081786	$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 TestostrnTot W,C,hypoM L070001	$144.46	$233.00	—	—	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Antibodies L006684	$81.22	$131.00	—	36% below	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 _Thyrod Perox (TPO) Ab L330018	$81.22	$131.00	—	36% below	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidny Micrsml Ab L163980	$81.22	$131.00	—	36% below	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyrd Perxdse (TPO) Ab L006676	$81.22	$131.00	—	36% below	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 L520018 Anti-TPO Ab (RDL)	$81.22	$131.00	—	36% below	38%
Thyroid peroxidase (TPO) antibody test CPT 86376 L520087 Anti-Liver/Kidney RDL	$81.22	$131.00	—	36% below	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 Thyroid Antibodies L006684	$81.22	$131.00	—	—	38%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyrd Perxdse (TPO) Ab L006676	$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 L520018 Anti-TPO Ab (RDL)	$81.22	$131.00	—	—	38%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 _Thyrod Perox (TPO) Ab L330018	$81.22	$131.00	—	—	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE TSH	$94.24	$152.00	—	21% below	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stim Hormone L000620	$94.24	$152.00	—	21% below	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID CASCADE PROF L330015	$94.24	$152.00	—	21% below	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYR STIM HRM TSH RFX FREE T4	$94.24	$152.00	—	21% below	38%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulatng Hrm L027011	$94.24	$152.00	—	21% below	38%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE TSH	$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 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%
Total IgE blood test CPT 82785 Immunoglb A/E/G/M, Srm L002295	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 Gammaglobulin IgE L600937	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 Gammaglobulin IgE L607660	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 Allergns w/Ttl IgE Ar1 L602627	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 82785 Gammaglobulin immuno IgE	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 Immunoglobulin E, Totl L002170	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 Gammaglobulin IgE L650003	$92.38	$149.00	—	4% below	38%
Total IgE blood test CPT 82785 Allrgn Resp w/rf 82785 L606995	$92.38	$149.00	—	4% below	38%
Total IgE blood test inpatient CPT 82785 Gammaglobulin IgE L607660	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 Allergns w/Ttl IgE Ar1 L602627	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Totl L002170	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 Immunoglb A/E/G/M, Srm L002295	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 Gammaglobulin IgE L650003	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 Gammaglobulin IgE L600937	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 Allrgn Resp w/rf 82785 L606995	$92.38	$149.00	—	—	38%
Total IgE blood test inpatient CPT 82785 82785 Gammaglobulin immuno IgE	$92.38	$149.00	—	—	38%
Total cholesterol blood test CPT 82465 Cholesterol Total	$24.80	$40.00	—	40% below	38%
Total cholesterol blood test CPT 82465 82465 CHOLESTEROL L550960	$24.80	$40.00	—	40% below	38%
Total cholesterol blood test inpatient CPT 82465 82465 CHOLESTEROL L550960	$24.80	$40.00	—	—	38%
Total cholesterol blood test inpatient CPT 82465 Cholesterol Total	$24.80	$40.00	—	—	38%
Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4) L001149	$38.44	$62.00	—	44% below	38%
Total thyroxine (T4) blood test CPT 84436 Thyroxine Total L027011	$38.44	$62.00	—	44% below	38%
Total thyroxine (T4) blood test CPT 84436 Thyroxine (Total) L000620	$38.44	$62.00	—	44% below	38%
Total thyroxine (T4) blood test CPT 84436 Thyroxine Total L000455	$38.44	$62.00	—	44% below	38%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine Total L000455	$38.44	$62.00	—	—	38%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine Total L027011	$38.44	$62.00	—	—	38%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (Total) L000620	$38.44	$62.00	—	—	38%
Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4) L001149	$38.44	$62.00	—	—	38%
Total triiodothyronine (T3) blood test CPT 84480 T3 Total	$79.36	$128.00	—	25% below	38%
Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine t3 tl L027011	$79.36	$128.00	—	25% below	38%
Total triiodothyronine (T3) blood test CPT 84480 L002188 Triiodothyronine (t3)	$79.36	$128.00	—	25% below	38%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine t3 tl L027011	$79.36	$128.00	—	—	38%
Total triiodothyronine (T3) blood test inpatient CPT 84480 L002188 Triiodothyronine (t3)	$79.36	$128.00	—	—	38%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 Total	$79.36	$128.00	—	—	38%
Transferrin blood test CPT 84466 Transferrin L004937	$71.30	$115.00	—	55% below	38%
Transferrin blood test inpatient CPT 84466 Transferrin L004937	$71.30	$115.00	—	—	38%
Trichomonas test (NAAT) CPT 87661 Trich vaginalis amplif L180107	$165.54	$267.00	—	5% below	38%
Trichomonas test (NAAT) CPT 87661 TrichomonasVaginls NAA L188052	$165.54	$267.00	—	5% below	38%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis, NAA MVP	$165.54	$267.00	—	5% below	38%
Trichomonas test (NAAT) CPT 87661 87661 trichomonas vaginl amppr	$165.54	$267.00	—	5% below	38%
Trichomonas test (NAAT) inpatient CPT 87661 TrichomonasVaginls NAA L188052	$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 87661 trichomonas vaginl amppr	$165.54	$267.00	—	—	38%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis, NAA MVP	$165.54	$267.00	—	—	38%
Triglycerides blood test CPT 84478 84478 Triglicerides L550960	$32.24	$52.00	—	47% below	38%
Triglycerides blood test CPT 84478 Triglycerides	$32.24	$52.00	—	47% below	38%
Triglycerides blood test inpatient CPT 84478 Triglycerides	$32.24	$52.00	—	—	38%
Triglycerides blood test inpatient CPT 84478 84478 Triglicerides L550960	$32.24	$52.00	—	—	38%
Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANTITATIVE	$70.06	$113.00	—	44% below	38%
Troponin test, quantitative CPT 84484 iSTAT Troponin I	$70.06	$113.00	—	44% below	38%
Troponin test, quantitative CPT 84484 Troponin T (Hi Senstv) L140150	$70.06	$113.00	—	44% below	38%
Troponin test, quantitative inpatient CPT 84484 iSTAT Troponin I	$70.06	$113.00	—	—	38%
Troponin test, quantitative inpatient CPT 84484 ASSAY OF TROPONIN QUANTITATIVE	$70.06	$113.00	—	—	38%
Troponin test, quantitative inpatient CPT 84484 Troponin T (Hi Senstv) L140150	$70.06	$113.00	—	—	38%
Uric acid blood test CPT 84550 Uric Acid	$25.42	$41.00	—	56% below	38%
Uric acid blood test CPT 84550 Uric Acid, Blood L520205	$25.42	$41.00	—	56% below	38%
Uric acid blood test inpatient CPT 84550 Uric Acid	$25.42	$41.00	—	—	38%
Uric acid blood test inpatient CPT 84550 Uric Acid, Blood L520205	$25.42	$41.00	—	—	38%
Urinalysis with microscope exam, automated CPT 81001 Transfusion Reactn Inv Urine	$17.98	$29.00	—	64% below	38%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic	$17.98	$29.00	—	64% below	38%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic	$17.98	$29.00	—	—	38%
Urinalysis with microscope exam, automated inpatient CPT 81001 Transfusion Reactn Inv Urine	$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 SCOPE	$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 L131888 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 inpatient CPT 81003 UrinalysisDipstickAutomatedPOC	$6.20	$10.00	—	—	38%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$13.02	$21.00	—	—	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 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 L131888 Specific Gravity Urine	$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 URINE CULTURE BACTERIAL QUANT	$45.26	$73.00	—	45% below	38%
Urine culture for bacteria, with colony count CPT 87086 QUANT COLONY COUNT URINE	$45.26	$73.00	—	45% below	38%
Urine culture for bacteria, with colony count CPT 87086 87086 CULTURE URINE COLONY Cnt	$45.26	$73.00	—	45% below	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 QUANT COLONY COUNT URINE	$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 microalbumin (albumin) test CPT 82043 L140050 Albumin 24-Hour Urine	$10.54	$17.00	—	88% below	38%
Urine microalbumin (albumin) test CPT 82043 Microalbumin, Urine Random	$32.86	$53.00	—	61% below	38%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Level 24 Hr Urine	$32.86	$53.00	—	61% below	38%
Urine microalbumin (albumin) test CPT 82043 Ur albumin quantitativ L140285	$32.86	$53.00	—	61% below	38%
Urine microalbumin (albumin) test CPT 82043 Ur Albumin Quantitative	$32.86	$53.00	—	61% below	38%
Urine microalbumin (albumin) test inpatient CPT 82043 L140050 Albumin 24-Hour Urine	$10.54	$17.00	—	—	38%
Urine microalbumin (albumin) test inpatient CPT 82043 Ur albumin quantitativ L140285	$32.86	$53.00	—	—	38%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin Level 24 Hr Urine	$32.86	$53.00	—	—	38%
Urine microalbumin (albumin) test inpatient CPT 82043 Microalbumin, Urine Random	$32.86	$53.00	—	—	38%
Urine microalbumin (albumin) test inpatient CPT 82043 Ur Albumin Quantitative	$32.86	$53.00	—	—	38%
Urine pregnancy test, read by color change CPT 81025 HCG, Urine POC	$52.08	$84.00	—	41% above	38%
Urine pregnancy test, read by color change CPT 81025 HCG Qualitative Urine	$107.88	$174.00	—	193% 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 B12 Defic Cscd L141503	$84.32	$136.00	—	15% below	38%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$84.32	$136.00	—	15% below	38%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12+Folate	$84.32	$136.00	—	15% below	38%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12	$84.32	$136.00	—	15% below	38%
Vitamin B12 (cobalamin) blood test CPT 82607 Vit B12 w/ref MA ARUP-0055662	$84.32	$136.00	—	15% below	38%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin b-12 L042077	$84.32	$136.00	—	15% below	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 b-12 L042077	$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 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 CYANOCOBALAMIN VITAMIN B-12	$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	—	16% 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	—	16% below	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%
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, 1,25-dihydroxy blood test CPT 82652 Calc(1,25 di-OH Vit D) L081091	$215.14	$347.00	—	33% below	38%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calc(1,25 di-OH Vit D) L081091	$215.14	$347.00	—	—	38%
Zinc blood test CPT 84630 Assay of Zinc L819845	$63.86	$103.00	—	32% below	38%
Zinc blood test CPT 84630 Zinc, Whole Blood L070032	$63.86	$103.00	—	32% below	38%
Zinc blood test CPT 84630 Zinc, RBC L070029	$63.86	$103.00	—	32% below	38%
Zinc blood test CPT 84630 Zinc, Plasma or Serum L001800	$63.86	$103.00	—	32% below	38%
Zinc blood test inpatient CPT 84630 Zinc, Plasma or Serum L001800	$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, RBC L070029	$63.86	$103.00	—	—	38%
Zinc blood test inpatient CPT 84630 Assay of Zinc L819845	$63.86	$103.00	—	—	38%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GonadotropinChrncQuant L017319	$84.32	$136.00	—	36% below	38%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG,Beta Sbnt, Qnt, SE L004416	$84.32	$136.00	—	36% below	38%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG, Beta Quant, Serum	$84.32	$136.00	—	36% below	38%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Tumor Marker L140450	$84.32	$136.00	—	36% below	38%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Gonadotropin chrnc qnt L385077	$84.32	$136.00	—	36% below	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%
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%

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 LT	$4,052.32	$6,536.00	—	47% above	38%
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	—	47% 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 RT	$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 LT	$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	—	26% 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	—	52% 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	—	126% 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	—	126% above	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%
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%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED Cltx FX rads/uln w/om 25600	$365.18	$589.00	—	37% 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	—	11% 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	—	25% above	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 ED Cerumen Rem inst 1 sd 69210	$130.20	$210.00	—	99% above	38%
Earwax removal with instruments, one ear CPT 69210 WCC REMOVE IMPACTED EAR WAX UN	$130.20	$210.00	—	99% above	38%
Earwax removal with instruments, one ear inpatient CPT 69210 WCC REMOVE IMPACTED EAR WAX UN	$130.20	$210.00	—	—	38%
Earwax removal with instruments, one ear inpatient CPT 69210 ED Cerumen Rem inst 1 sd 69210	$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 ED Dr Skin Absc Smp/sing 10060	$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 WCC I&D ABSC; SMPL OR SGL	$269.70	$435.00	—	27% above	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%
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%
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	—	185% 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	—	185% 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 ED Asp/inj Joint Medium 20605	$275.90	$445.00	—	at median	38%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 XR Joint Injection MD	$275.90	$445.00	—	at median	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	—	4% above	38%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ED Asp/Inj Joint Small 20600	$269.70	$435.00	—	4% above	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 XR Joint Injection SM	$269.70	$435.00	—	—	38%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ED Asp/Inj Joint Small 20600	$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	—	35% 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	—	28% 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 ED Avulse Nail Plate Sng 11730	$189.10	$305.00	—	8% above	38%
Nail removal (partial or complete), one nail CPT 11730 WCC SPL AVULSE NP SGL 11730	$189.10	$305.00	—	8% above	38%
Nail removal (partial or complete), one nail inpatient CPT 11730 WCC SPL AVULSE NP SGL 11730	$189.10	$305.00	—	—	38%
Nail removal (partial or complete), one nail inpatient CPT 11730 ED Avulse Nail Plate Sng 11730	$189.10	$305.00	—	—	38%
Paracentesis with imaging guidance CPT 49083 US Paracentesis	$2,003.22	$3,231.00	—	98% above	38%
Paracentesis with imaging guidance CPT 49083 ED Abd Paracentsis W/Img 49083	$2,003.22	$3,231.00	—	98% 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	—	31% above	38%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 WCC REMOVAL OF NAIL BED 11750	$542.50	$875.00	—	31% above	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%
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%
Removal of a foreign object under the skin, simple CPT 10120 ED Remove FB SC Simple 10120	$288.30	$465.00	—	6% below	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 ED Apply Forearm Cast 29075	$226.30	$365.00	—	73% above	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) 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 29125-OCC THER STATIC SA SPLIN	$210.80	$340.00	—	78% above	38%
Short arm splint (forearm and hand) CPT 29125 ED App Shrt Arm Splnt St 29125	$210.80	$340.00	—	78% above	38%
Short arm splint (forearm and hand) CPT 29125 OT Appl static shortarm splint	$210.80	$340.00	—	78% above	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 arm splint (forearm and hand) inpatient CPT 29125 OT Appl static shortarm splint	$210.80	$340.00	—	—	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) CPT 29405 WCC SHORT LEG CAST	$248.00	$400.00	—	3% above	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 OCC THER APPLY SH 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	—	84% above	38%
Short leg splint (calf to foot) CPT 29515 ED Apply Short Leg Cast 29515	$210.80	$340.00	—	84% 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	—	17% below	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	—	17% below	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%
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%
Skin biopsy, punch, one lesion CPT 11104 WCC BX-SKIN SQ/MM; SGL 11104	$179.80	$290.00	—	16% 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	—	2% 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	—	25% below	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	—	22% below	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	—	at median	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 RT	$4,052.32	$6,536.00	—	159% above	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	—	159% 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 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 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 inpatient CPT 11042 ED Dbr SC Tiss <=20 sqcm 11042	$328.60	$530.00	—	—	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%

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	—	26% above	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	—	at median	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AIRWAY InhlTrtmnt INT 94640	$269.08	$434.00	—	108% above	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AIRWAY InhalTrtmnt SB 94640	$269.08	$434.00	—	108% 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 InhalTrtmnt SB 94640	$269.08	$434.00	—	—	38%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AIRWAY InhlTrtmnt INT 94640	$269.08	$434.00	—	—	38%
Chemotherapy IV infusion, first hour CPT 96413 INF/C IV Infusion init/single	$403.00	$650.00	—	29% 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	—	135% 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	—	36% below	38%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED ELECTROCARDIOGRAM TRAC FAC	$203.98	$329.00	—	32% 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	—	26% 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	—	67% 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	—	3% 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	—	17% 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 ECG Treadmill Stress Test	$669.60	$1,080.00	—	21% below	38%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRSST MAX/SBMX TRDML 93017	$669.60	$1,080.00	—	21% below	38%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRSST MAX/SBMX TRDML 93017	$669.60	$1,080.00	—	—	38%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 ECG Treadmill Stress Test	$669.60	$1,080.00	—	—	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	—	18% above	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	—	18% 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 INF/NC IV Infusion Ther Init	$192.82	$311.00	—	43% below	38%
IV infusion of a medicine, first hour CPT 96365 AMB Infusion 1st hour	$192.82	$311.00	—	43% below	38%
IV infusion of a medicine, first hour CPT 96365 ED Th/Ph/Diag IV INF INIT <1HR	$400.52	$646.00	—	19% 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%
IV push of a medicine, first drug CPT 96374 INF/NC IV Push Singl/Init Drug	$211.42	$341.00	—	9% above	38%
IV push of a medicine, first drug CPT 96374 ED IV PSH INIT T/P/D INJ 96374	$211.42	$341.00	—	9% above	38%
IV push of a medicine, first drug inpatient CPT 96374 INF/NC IV Push Singl/Init Drug	$211.42	$341.00	—	—	38%
IV push of a medicine, first drug inpatient CPT 96374 ED IV PSH INIT T/P/D INJ 96374	$211.42	$341.00	—	—	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	—	84% 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	—	56% 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	—	1% below	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	—	1% below	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	—	105% above	38%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF Sub IM INJ	$175.46	$283.00	—	105% 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	—	105% 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	—	105% 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	—	105% 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	—	105% 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 WCC 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 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 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 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%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Dx Eval 90791	$177.94	$287.00	—	65% 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 97112-PHYS THER NRMSC RE-E 15m	$158.10	$255.00	—	60% above	38%
Neuromuscular re-education, 15 minutes CPT 97112 97112-OCC THER NEUROMUSC RE-ED	$158.10	$255.00	—	60% above	38%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation U	$158.10	$255.00	—	60% above	38%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeduc Unit	$158.10	$255.00	—	60% above	38%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112-OCC THER NEUROMUSC RE-ED	$158.10	$255.00	—	—	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%
New patient office visit, about 30 minutes CPT 99203 WCC LEVEL 3 NEW PATIENT FACILT	$155.00	$250.00	—	at median	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 Med NuT Indv INIT As/15m 97802	$49.60	$80.00	—	17% below	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As/15m 97802	$49.60	$80.00	—	17% below	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 30m 97802	$89.28	$144.00	—	50% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/30m 97802	$89.28	$144.00	—	50% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 45m 97802	$119.04	$192.00	—	100% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv INIT As/45m 97802	$119.04	$192.00	—	100% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/60m 97802	$138.88	$224.00	—	133% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 60m 97802	$138.88	$224.00	—	133% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/75m 97802	$148.80	$240.00	—	150% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 75m 97802	$148.80	$240.00	—	150% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 90m 97802	$163.68	$264.00	—	175% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init As/90m 97802	$163.68	$264.00	—	175% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init A 105m 97802	$173.60	$280.00	—	191% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 105 97802	$173.60	$280.00	—	191% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 TLH MNT INDV INIT As 120 97802	$178.56	$288.00	—	200% above	38%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Med NuT Indv Init A 120m 97802	$178.56	$288.00	—	200% above	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/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 TLH MNT INDV INIT As 90m 97802	$163.68	$264.00	—	—	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 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 OCC THER EVAL LOW COMPLX 30M	$238.70	$385.00	—	at median	38%
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units Low Complx	$238.70	$385.00	—	at median	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	—	6% below	38%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Eval Charge High Complex	$257.30	$415.00	—	6% below	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, high complexity (typically about 45 minutes) inpatient CPT 97163 97163 PHYS THER EVL HI CMP 45M	$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	—	at median	38%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 PHYS THER EVL LO CMP 20M	$226.30	$365.00	—	at median	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, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Eval Charge Low Complx	$226.30	$365.00	—	—	38%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Charge Moderate	$241.80	$390.00	—	at median	38%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 PHYS THER EVL MD CMP 30M	$241.80	$390.00	—	at median	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 OT Manual Therapy Units	$193.44	$312.00	—	121% above	38%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$193.44	$312.00	—	121% above	38%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140-PHYS THERMANTHERAPY 15m	$193.44	$312.00	—	121% above	38%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140-OCC THER MANUAL THERAPY	$193.44	$312.00	—	121% above	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, 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, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$155.62	$251.00	—	57% above	38%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110-PHYS THER THEREX 15 MIN	$155.62	$251.00	—	57% above	38%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$155.62	$251.00	—	57% above	38%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110-OCC THER THEREX 15M	$155.62	$251.00	—	57% 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 PT Therapeutic Exercise Units	$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%
Psychiatric evaluation with medical services CPT 90792 Psych Dx Eval w/Med Serv 90792	$200.26	$323.00	—	22% 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	—	—	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	—	68% 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	—	84% below	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	—	75% 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	—	47% below	38%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RT Smoke/TobaccCnsl 3-10 99406	$24.80	$40.00	—	31% 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	—	9% 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	—	9% below	38%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WCC LEVEL 5 EST PATIENT FACILT	$195.30	$315.00	—	9% 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 EMP H LEVEL III	$111.60	$180.00	—	21% above	38%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WCC LEVEL 3 EST PATIENT FACILT	$111.60	$180.00	—	21% 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	—	21% above	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	—	21% above	38%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Self Pay Termination	$650.38	$1,049.00	—	603% 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 WCC LEVEL 3 EST PATIENT FACILT	$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 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	—	at median	38%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WCC LEVEL 4 EST PATIENT FACILT	$139.50	$225.00	—	at median	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	—	at median	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	—	1% below	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	—	1% below	38%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EMP H LEVEL II	$89.90	$145.00	—	1% below	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	—	1% below	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%
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%
Speech and language evaluation CPT 92523 Eval Lang Compr Express Unit	$351.54	$567.00	—	at median	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	—	40% below	38%
Spirometry (breathing test) CPT 94010 Spirometry	$248.00	$400.00	—	26% 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	—	16% 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	—	at median	38%
Therapeutic activities (functional training), 15 minutes CPT 97530 97530-PHYS THER THER ACTV 15M	$92.38	$149.00	—	at median	38%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Unit	$92.38	$149.00	—	at median	38%
Therapeutic activities (functional training), 15 minutes CPT 97530 97530-OCC THER THER ACTIVITY 1	$184.14	$297.00	—	99% 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 OT Therapeutic Activities Unit	$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 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	—	34% 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	—	7% above	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	—	93% below	38%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 EMP H VARICELLA VACCINE	$121.21	$195.50	—	75% 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	—	16% above	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	—	20% above	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	—	20% above	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 Afluria TIV Syr 0.5 mL Clnc/ E	$31.93	$51.50	—	—	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%
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	—	6% 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	—	25% 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	—	76% below	38%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 EMP H HEPATITIS C VIRUS AB	$48.36	$78.00	—	72% below	38%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HpB/EngB/Rcmbvx ADLT	$111.91	$180.50	—	36% below	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%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 AMB Hep B Recomb (Hcplisav B)	$354.33	$571.50	—	4% above	38%
Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 AMB Hep B Recomb (Hcplisav B)	$354.33	$571.50	—	—	38%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B VAC 10MCG/0.5ML PF	$81.53	$131.50	—	47% below	38%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B VAC 10MCG/0.5ML PF	$81.53	$131.50	—	—	38%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib/ActHIB	$24.80	$40.00	—	9% above	38%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 ActHIB/Hiberix	$25.42	$41.00	—	12% above	38%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 Hib/ActHIB	$24.80	$40.00	—	—	38%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 ActHIB/Hiberix	$25.42	$41.00	—	—	38%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 Jap Enc Vax	$71.61	$115.50	—	—	38%
Japanese encephalitis vaccine (Ixiaro), 2-dose schedule inpatient CPT 90738 Jap Enc Vax	$71.61	$115.50	—	—	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 ACWY vaccine (MenQuadfi) CPT 90619 AMB meningococcal Menquadfi	$257.30	$415.00	—	—	38%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 AMB Meningitis ACWY Conjug	$402.69	$649.50	—	—	38%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 AMB meningococcal Menquadfi	$257.30	$415.00	—	—	38%
Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 AMB Meningitis ACWY Conjug	$402.69	$649.50	—	—	38%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MenB 2dose/Bexsero	$113.77	$183.50	—	38% below	38%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MenB 2dose/Bexsero	$113.77	$183.50	—	—	38%
Meningococcal B vaccine (Trumenba) CPT 90621 MenB 3dose/Trumenba	$96.41	$155.50	—	94% below	38%
Meningococcal B vaccine (Trumenba) inpatient CPT 90621 MenB 3dose/Trumenba	$96.41	$155.50	—	—	38%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PCV13/Prevnar	$230.02	$371.00	—	64% below	38%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PCV13/Prevnar	$230.02	$371.00	—	—	38%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 AMB Pneumococcal Vax PCV15 IM	$360.84	$582.00	—	72% below	38%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 AMB Pneumococcal Vax PCV15 IM	$360.84	$582.00	—	—	38%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 AMB PCV20/Prevnar 20	$461.59	$744.50	—	7% below	38%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 AMB PCV20/Prevnar 20	$461.59	$744.50	—	—	38%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 AMB Pneumonia-21 (Capvaxive)	$478.95	$772.50	—	70% above	38%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684 AMB Pneumonia-21 (Capvaxive)	$478.95	$772.50	—	—	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%
Polio vaccine, inactivated (IPV) CPT 90713 IPV/Ipol	$83.70	$135.00	—	at median	38%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 IPV/Ipol	$83.70	$135.00	—	—	38%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 AMB Nirsevimab/Beyfortus 100	$654.72	$1,056.00	—	—	38%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 AMB Nirsevimab/Beyfortus 200	$1,436.85	$2,317.50	—	—	38%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 AMB Nirsevimab/Beyfortus 100	$654.72	$1,056.00	—	—	38%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 AMB Nirsevimab/Beyfortus 200	$1,436.85	$2,317.50	—	—	38%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 AMB Nirsevimab/Beyfortus 50	$654.72	$1,056.00	—	50% 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	—	66% 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	—	26% 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	—	58% below	38%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 EMP H TETANUS/DIPTHERIA VAX	$36.27	$58.50	—	51% 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	—	29% below	38%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap/Boostrix/Adacel	$59.52	$96.00	—	5% 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	—	57% 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	—	57% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Pneumo Vax Admin 90471 / G0009	$21.70	$35.00	—	31% 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	—	31% 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	—	31% 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	—	31% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 AMB INFLUENZA Vaccine Admin	$21.70	$35.00	—	31% 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	—	31% 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	—	31% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VaxAdmin 90471/G0008	$21.70	$35.00	—	31% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Adult Pneumonia Vax Adm	$21.70	$35.00	—	31% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED Admin Vaccine First 90471	$21.70	$35.00	—	31% 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	—	31% below	38%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 AMB Imm. Adm. Single Inj	$21.70	$35.00	—	31% 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	—	31% 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	—	31% below	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 Imm Admin State Supplied Vax	$13.64	$22.00	—	—	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 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 Imm. Adm. Single Inj	$21.70	$35.00	—	—	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 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 1 V	$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 ED Admin Vaccine First 90471	$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 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 INFLUENZA VaxAdmin 90471/G0008	$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 (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 IM ADM PRQ ID SBQ/IM Flu 90471	$21.70	$35.00	—	—	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin Inj StSup Vax Ea Add	$13.64	$22.00	—	58% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin State Sup Vax Ea add	$13.64	$22.00	—	58% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$15.50	$25.00	—	52% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 AMB Imm. Adm -Each Additional	$15.50	$25.00	—	52% 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	—	52% below	38%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Imm Admin Inject Ea Addl 90472	$15.50	$25.00	—	52% 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 IMMUNIZATION ADMIN EACH ADD	$15.50	$25.00	—	—	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 ED Immun Adm Ea Addl Vax 90472	$15.50	$25.00	—	—	38%
Yellow fever vaccine, live CPT 90717 Yellow Fever Vax	$33.17	$53.50	—	66% below	38%
Yellow fever vaccine, live inpatient CPT 90717 Yellow Fever Vax	$33.17	$53.50	—	—	38%

Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More

Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More

List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More

Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More

Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.

Off list How much lower the cash price is than the list price.

No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More

At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More

Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.

Source file: https://hospitalpricedisclosure.com/download.aspx?pi=4EZY3sRA8HLb8Qjm705tAg*-*