Hospital

Jefferson Hospital

Listed in its price file as “Hospital Authority of Jefferson County and the City of Louisville dba”.

Jefferson Hospital in Louisville, GA publishes cash prices for 284 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Georgia median for 251 of 279 procedures and above it for 27. By typical cash price it ranks #2 of 92 Georgia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1067 Peachtree Street, Louisville, Georgia 30434 Collected Sep 27, 2026 Source price file (478) 625-7000

Acute care hospital Emergency department CCN 110100 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Abdominal X-ray, 2 views CPT 74019 XR ABD COMPLETE INCL DECUB & OR ERECT	$54.50	$109.00	$11.89–$84.48	80% below	50%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABD COMPLETE INCL DECUB & OR ERECT	$54.50	$109.00	$11.89–$84.48	—	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE, 3 VIEWS, LEFT	$334.00	$668.00	$9.00–$598.26	23% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE, 3 VIEWS, RIGHT	$334.00	$668.00	$9.00–$598.26	23% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS LEFT	$385.98	$771.95	$9.00–$598.26	42% above	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 VIEWS RIGHT	$385.98	$771.95	$9.00–$598.26	42% above	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE, 3 VIEWS, RIGHT	$334.00	$668.00	$9.00–$598.26	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE, 3 VIEWS, LEFT	$334.00	$668.00	$9.00–$598.26	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS RIGHT	$385.98	$771.95	$9.00–$598.26	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS LEFT	$385.98	$771.95	$9.00–$598.26	—	50%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREASTS UNILATERAL\ BILATERAL	$467.00	$934.00	$341.84–$723.85	—	50%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREASTS UNILATERAL\ BILATERAL	$467.00	$934.00	$341.84–$723.85	—	50%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD	$403.50	$807.00	$89.54–$625.43	74% below	50%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD	$403.50	$807.00	$89.54–$625.43	—	50%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W/CONTRAST & NONCONT	$405.00	$810.00	$296.46–$627.75	76% below	50%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK W/CONTRAST & NONCONT	$405.00	$810.00	$296.46–$627.75	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST PE with CONTRAST	$583.92	$1,167.84	$92.80–$942.79	61% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST PE with CONTRAST	$583.92	$1,167.84	$92.80–$942.79	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT AH A/P W/ORAL CONTRAST	$515.04	$1,030.08	$89.17–$798.31	77% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT A/P W/O CONTRAST	$515.04	$1,030.08	$89.17–$798.31	77% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT AH A/P W/O CONTRAST	$515.04	$1,030.08	$89.17–$798.31	77% below	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT AH A/P W/ORAL CONTRAST	$515.04	$1,030.08	$89.17–$798.31	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT AH A/P W/O CONTRAST	$515.04	$1,030.08	$89.17–$798.31	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT A/P W/O CONTRAST	$515.04	$1,030.08	$89.17–$798.31	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT A/P w/IV CONTRAST	$403.20	$806.40	$93.13–$651.00	83% below	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT A/P w/ORAL CONTRAST	$403.20	$806.40	$93.13–$651.00	83% below	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT A/P w/ORAL CONTRAST	$403.20	$806.40	$93.13–$651.00	—	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT A/P w/IV CONTRAST	$403.20	$806.40	$93.13–$651.00	—	50%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$343.00	$686.00	$251.08–$531.65	80% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONTRAST	$343.00	$686.00	$251.08–$531.65	—	50%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTRAST	$293.75	$587.50	$215.02–$455.31	77% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTRAST	$293.75	$587.50	$215.02–$455.31	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$256.80	$513.60	$47.66–$414.62	75% below	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST	$256.80	$513.60	$47.66–$414.62	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$311.52	$623.04	$50.52–$502.98	76% below	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST	$311.52	$623.04	$50.52–$502.98	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$311.52	$623.04	$50.52–$502.98	74% below	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST	$311.52	$623.04	$50.52–$502.98	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST	$338.25	$676.50	$247.60–$524.29	79% below	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST	$338.25	$676.50	$247.60–$524.29	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER	$110.40	$220.80	$80.81–$171.12	80% below	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DOPPLER	$110.40	$220.80	$80.81–$171.12	—	50%
Chest CT scan without and with contrast CPT 71270 CT THORAX W & W/O CONTRAST	$258.50	$517.00	$189.22–$400.68	86% below	50%
Chest CT scan without and with contrast inpatient CPT 71270 CT THORAX W & W/O CONTRAST	$258.50	$517.00	$189.22–$400.68	—	50%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS FRONTAL & LATERAL	$336.79	$673.57	$11.19–$522.02	50% above	50%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS FRONTAL & LATERAL	$336.79	$673.57	$11.19–$522.02	—	50%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW FRONTAL	$60.48	$120.96	$9.37–$97.65	65% below	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW FRONTAL	$60.48	$120.96	$9.37–$97.65	—	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMPLETE RIGHT	$50.50	$101.00	$8.63–$78.28	79% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE, COMPLETE, RIGHT	$50.50	$101.00	$8.63–$78.28	79% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE COMPLETE LEFT	$50.50	$101.00	$8.63–$78.28	79% below	50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE, COMPLETE, LEFT	$50.50	$101.00	$8.63–$78.28	79% below	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE, COMPLETE, LEFT	$50.50	$101.00	$8.63–$78.28	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE, COMPLETE, RIGHT	$50.50	$101.00	$8.63–$78.28	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE COMPLETE LEFT	$50.50	$101.00	$8.63–$78.28	—	50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE COMPLETE RIGHT	$50.50	$101.00	$8.63–$78.28	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$69.25	$138.50	$50.69–$107.34	86% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$69.25	$138.50	$50.69–$107.34	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD DEXA STUD ONE OR MORE SITES AXIA SKEL	$54.50	$109.00	$39.89–$84.48	86% below	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD DEXA STUD ONE OR MORE SITES AXIA SKEL	$54.50	$109.00	$39.89–$84.48	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX W/O CONTRAST	$159.60	$319.20	$55.24–$257.69	84% below	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX W/O CONTRAST	$159.60	$319.20	$55.24–$257.69	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W/CONTRAST	$711.45	$1,422.90	$59.52–$1,102.75	54% below	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W/CONTRAST	$711.45	$1,422.90	$59.52–$1,102.75	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 MM DIAGNOSTIC MAMMO BILATERAL W/CAD	$530.94	$1,061.88	$388.65–$822.96	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM DIAGNOSTIC MAMMO BILATERAL W/CAD	$530.94	$1,061.88	$388.65–$822.96	—	50%
Diagnostic mammogram, one breast one side CPT 77065 MM DIAGNOSTIC MAMMO UNILATERAL W/CAD R	$398.25	$796.50	$291.52–$617.29	61% above	50%
Diagnostic mammogram, one breast one side CPT 77065 MM DIAGNOSTIC MAMMO UNILATERAL W/CAD L	$398.25	$796.50	$291.52–$617.29	61% above	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAGNOSTIC MAMMO UNILATERAL W/CAD L	$398.25	$796.50	$291.52–$617.29	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM DIAGNOSTIC MAMMO UNILATERAL W/CAD R	$398.25	$796.50	$291.52–$617.29	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US LOWER EXTREM ARTERY BILATE	$241.75	$483.50	$176.96–$374.71	59% below	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US LOWER EXTREM ARTERY BILATE	$241.75	$483.50	$176.96–$374.71	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS EXTREMITY BILATERAL	$195.50	$391.00	$35.52–$303.03	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS EXTREMITY BILATERAL	$195.50	$391.00	$35.52–$303.03	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO TRANSTHORACIC COMP W/DOP & COLOR	$231.84	$463.68	$169.71–$359.35	85% below	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO TRANSTHORACIC COMP W/DOP & COLOR	$231.84	$463.68	$169.71–$359.35	—	50%
Elbow X-ray, 2 views one side CPT 73070 ELBOW AP & LAT RIGHT	$139.25	$278.50	$101.93–$215.84	28% below	50%
Elbow X-ray, 2 views one side CPT 73070 ELBOW AP & LAT LEFT	$139.25	$278.50	$101.93–$215.84	28% below	50%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEW RIGHT	$139.25	$278.50	$101.93–$215.84	28% below	50%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEW LEFT	$139.25	$278.50	$101.93–$215.84	28% below	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP & LAT RIGHT	$139.25	$278.50	$101.93–$215.84	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW LEFT	$139.25	$278.50	$101.93–$215.84	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW RIGHT	$139.25	$278.50	$101.93–$215.84	—	50%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW AP & LAT LEFT	$139.25	$278.50	$101.93–$215.84	—	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW, 3 VIEWS, RIGHT	$182.50	$365.00	$9.00–$480.89	30% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 ELBOW, 3 VIEWS, LEFT	$182.50	$365.00	$9.00–$480.89	30% below	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS LEFT	$310.25	$620.50	$9.00–$480.89	19% above	50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS RIGHT	$310.25	$620.50	$9.00–$480.89	19% above	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW, 3 VIEWS, RIGHT	$182.50	$365.00	$9.00–$480.89	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 ELBOW, 3 VIEWS, LEFT	$182.50	$365.00	$9.00–$480.89	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS RIGHT	$310.25	$620.50	$9.00–$480.89	—	50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS LEFT	$310.25	$620.50	$9.00–$480.89	—	50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT W/O CONTRAST	$186.00	$372.00	$136.15–$288.30	83% below	50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT W/O CONTRAST	$186.00	$372.00	$136.15–$288.30	—	50%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPLETE 3 VIEWS	$65.50	$131.00	$13.33–$101.52	79% below	50%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMPLETE 3 VIEWS	$65.50	$131.00	$13.33–$101.52	—	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM AP & LAT LEFT	$321.75	$643.50	$8.30–$566.58	36% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 FOREARM AP & LAT RIGHT	$321.75	$643.50	$8.30–$566.58	36% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RIGHT	$365.54	$731.07	$8.30–$566.58	54% above	50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LEFT	$365.54	$731.07	$8.30–$566.58	54% above	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM AP & LAT RIGHT	$321.75	$643.50	$8.30–$566.58	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 FOREARM AP & LAT LEFT	$321.75	$643.50	$8.30–$566.58	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RIGHT	$365.54	$731.07	$8.30–$566.58	—	50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LEFT	$365.54	$731.07	$8.30–$566.58	—	50%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEWS RIGHT	$123.50	$247.00	$90.40–$191.42	46% below	50%
Hand X-ray, 2 views one side CPT 73120 HAND 2 VIEWS LEFT	$123.50	$247.00	$90.40–$191.42	46% below	50%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LEFT	$123.50	$247.00	$90.40–$191.42	46% below	50%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RIGHT	$123.50	$247.00	$90.40–$191.42	46% below	50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LEFT	$123.50	$247.00	$90.40–$191.42	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEWS RIGHT	$123.50	$247.00	$90.40–$191.42	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 HAND 2 VIEWS LEFT	$123.50	$247.00	$90.40–$191.42	—	50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RIGHT	$123.50	$247.00	$90.40–$191.42	—	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL (CALCANEUS) 2 VIEWS LEFT	$132.25	$264.50	$8.30–$204.99	35% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL (CALCANEUS) 2 VIEWS RIGHT	$132.25	$264.50	$8.30–$204.99	35% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL 2 VIEWS RIGHT	$132.25	$264.50	$8.30–$204.99	35% below	50%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HEEL 2 VIEWS LEFT	$132.25	$264.50	$8.30–$204.99	35% below	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL 2 VIEWS RIGHT	$132.25	$264.50	$8.30–$204.99	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL (CALCANEUS) 2 VIEWS LEFT	$132.25	$264.50	$8.30–$204.99	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL (CALCANEUS) 2 VIEWS RIGHT	$132.25	$264.50	$8.30–$204.99	—	50%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 HEEL 2 VIEWS LEFT	$132.25	$264.50	$8.30–$204.99	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY w CPAP	$1,247.00	$2,494.00	$912.80–$1,932.85	50% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY w CPAP	$1,247.00	$2,494.00	$912.80–$1,932.85	—	50%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS LEFT	$361.25	$722.50	$9.70–$663.04	51% above	50%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS RIGHT	$361.25	$722.50	$9.70–$663.04	51% above	50%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LEFT	$427.77	$855.53	$9.70–$663.04	79% above	50%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS RIGHT	$427.77	$855.53	$9.70–$663.04	79% above	50%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS RIGHT	$361.25	$722.50	$9.70–$663.04	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS LEFT	$361.25	$722.50	$9.70–$663.04	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RIGHT	$427.77	$855.53	$9.70–$663.04	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS LEFT	$427.77	$855.53	$9.70–$663.04	—	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMPLETE LEFT	$107.75	$215.50	$78.87–$167.01	61% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMPLETE RIGHT	$107.75	$215.50	$78.87–$167.01	61% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE FOUR OR MORE VIEWS LEFT	$107.75	$215.50	$78.87–$167.01	61% below	50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4 OR MORE VIEWS RIGHT	$107.75	$215.50	$78.87–$167.01	61% below	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMPLETE RIGHT	$107.75	$215.50	$78.87–$167.01	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4 OR MORE VIEWS RIGHT	$107.75	$215.50	$78.87–$167.01	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE FOUR OR MORE VIEWS LEFT	$107.75	$215.50	$78.87–$167.01	—	50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMPLETE LEFT	$107.75	$215.50	$78.87–$167.01	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD > 2 ORGANS OR QUADRANTS	$796.99	$1,593.97	$30.35–$1,235.33	63% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIMITED (SINGLE ORGAN, F/UP)	$796.99	$1,593.97	$30.35–$1,235.33	63% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD > 2 ORGANS OR QUADRANTS	$796.99	$1,593.97	$30.35–$1,235.33	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIMITED (SINGLE ORGAN, F/UP)	$796.99	$1,593.97	$30.35–$1,235.33	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LOW DOSE FOR LUNG CA SCREENING	$92.64	$185.28	$67.81–$143.59	63% below	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LOW DOSE FOR LUNG CA SCREENING	$92.64	$185.28	$67.81–$143.59	—	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB LEFT	$129.25	$258.50	$8.30–$340.57	42% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB RIGHT	$129.25	$258.50	$8.30–$340.57	42% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS LEFT	$219.73	$439.45	$8.30–$340.57	2% below	50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS RIGHT	$219.73	$439.45	$8.30–$340.57	2% below	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB LEFT	$129.25	$258.50	$8.30–$340.57	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB RIGHT	$129.25	$258.50	$8.30–$340.57	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS LEFT	$219.73	$439.45	$8.30–$340.57	—	50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA 2 VIEWS RIGHT	$219.73	$439.45	$8.30–$340.57	—	50%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST	$473.00	$946.00	$346.24–$733.15	69% below	50%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST	$473.00	$946.00	$346.24–$733.15	—	50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXTREMITY JOINT W/O	$567.50	$1,135.00	$415.41–$879.62	63% below	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXTREMITY JOINT W/O	$567.50	$1,135.00	$415.41–$879.62	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXTREMITY JOINT W & W/O CONT.	$543.75	$1,087.50	$398.02–$842.81	78% below	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXTREMITY JOINT W & W/O CONT.	$543.75	$1,087.50	$398.02–$842.81	—	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$525.00	$1,050.00	$384.30–$813.75	71% below	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$525.00	$1,050.00	$384.30–$813.75	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & W/O CONTRAST	$543.75	$1,087.50	$398.02–$842.81	74% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & W/O CONTRAST	$543.75	$1,087.50	$398.02–$842.81	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$584.50	$1,169.00	$427.85–$905.98	58% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST	$584.50	$1,169.00	$427.85–$905.98	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & W/O CONTRAST	$567.50	$1,135.00	$415.41–$879.62	76% below	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & W/O CONTRAST	$567.50	$1,135.00	$415.41–$879.62	—	50%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W/O CONTRAST	$745.03	$1,490.05	$545.36–$1,154.79	58% below	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR W/O CONTRAST	$745.03	$1,490.05	$545.36–$1,154.79	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC W/O CONTRAST	$473.00	$946.00	$346.24–$733.15	73% below	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC W/O CONTRAST	$473.00	$946.00	$346.24–$733.15	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W & W/O CONTRAST	$710.75	$1,421.50	$520.27–$1,101.66	70% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL W & W/O CONTRAST	$710.75	$1,421.50	$520.27–$1,101.66	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL W/O CONTRAST	$630.00	$1,260.00	$461.16–$976.50	64% below	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL W/O CONTRAST	$630.00	$1,260.00	$461.16–$976.50	—	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W & W/O CONTRAST	$326.25	$652.50	$238.82–$505.69	85% below	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W & W/O CONTRAST	$326.25	$652.50	$238.82–$505.69	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXTREMITY JOINT W/O CONTRAST	$629.75	$1,259.50	$460.98–$976.11	59% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXTREMITY JOINT W/O CONTRAST	$629.75	$1,259.50	$460.98–$976.11	—	50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL MIN 4 VWS	$450.50	$901.00	$14.03–$698.28	8% above	50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL MIN 4 VWS	$450.50	$901.00	$14.03–$698.28	—	50%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$494.75	$989.50	$70.71–$766.86	69% below	50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/CONTRAST	$494.75	$989.50	$70.71–$766.86	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONOBSTETRIC COMPLETE	$364.23	$728.45	$156.83–$564.55	24% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONOBSTETRIC COMPLETE	$364.23	$728.45	$156.83–$564.55	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREGNANT UTERUS COMPL > 14wks0day	$126.24	$252.48	$92.41–$203.82	77% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREGNANT UTERUS COMPL > 14wks0day	$126.24	$252.48	$92.41–$203.82	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANT UTERUS COMP <14wks0days	$213.84	$427.68	$156.53–$331.45	57% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANT UTERUS COMP <14wks0days	$213.84	$427.68	$156.53–$331.45	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGANT UTERUS LIMITED	$49.25	$98.50	$36.05–$76.34	82% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGANT UTERUS LIMITED	$49.25	$98.50	$36.05–$76.34	—	50%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 XR RIBS W/ PA CHEST MIN 3 VWS	$54.50	$109.00	$39.89–$84.48	82% below	50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 XR RIBS W/ PA CHEST MIN 3 VWS	$54.50	$109.00	$39.89–$84.48	—	50%
Screening mammogram, both breasts both sides CPT 77067 MM SCREENING MAMMO BILATERAL 2 V W/CAD	$446.84	$893.67	$327.08–$692.59	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM SCREENING MAMMO BILATERAL 2 V W/CAD	$446.84	$893.67	$327.08–$692.59	—	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 1 VIEW RIGHT	$391.25	$782.50	$9.70–$617.94	80% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 1 VIEW LEFT	$391.25	$782.50	$9.70–$617.94	80% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 2 VIEWS RIGHT	$391.25	$782.50	$9.70–$617.94	80% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER 2 VIEWS LEFT	$391.25	$782.50	$9.70–$617.94	80% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 VIEWS LEFT	$398.67	$797.34	$9.70–$617.94	83% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2 VIEWS RIGHT	$398.67	$797.34	$9.70–$617.94	83% above	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 1 VIEW RIGHT	$391.25	$782.50	$9.70–$617.94	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 1 VIEW LEFT	$391.25	$782.50	$9.70–$617.94	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 2 VIEWS LEFT	$391.25	$782.50	$9.70–$617.94	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER 2 VIEWS RIGHT	$391.25	$782.50	$9.70–$617.94	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2 VIEWS RIGHT	$398.67	$797.34	$9.70–$617.94	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2 VIEWS LEFT	$398.67	$797.34	$9.70–$617.94	—	50%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES PARANASAL COMPLETE 3 VIEWS	$92.00	$184.00	$67.34–$142.60	73% below	50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES PARANASAL COMPLETE 3 VIEWS	$92.00	$184.00	$67.34–$142.60	—	50%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP TEST NPSG	$2,133.25	$4,266.50	$1,561.54–$3,306.54	13% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP TEST NPSG	$2,133.25	$4,266.50	$1,561.54–$3,306.54	—	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2 VIEWS RIGHT	$50.50	$101.00	$9.37–$78.28	78% below	50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2 VIEWS LEFT	$50.50	$101.00	$9.37–$78.28	78% below	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2 VIEWS LEFT	$50.50	$101.00	$9.37–$78.28	—	50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2 VIEWS RIGHT	$50.50	$101.00	$9.37–$78.28	—	50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE W/O CONTRAST	$315.00	$630.00	$50.52–$488.25	75% below	50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST	$315.00	$630.00	$50.52–$488.25	—	50%
Toe X-ray, 2 or more views CPT 73660 TOE(S) 2 VIEWS	$34.75	$69.50	$25.44–$53.86	81% below	50%
Toe X-ray, 2 or more views CPT 73660 XR TOE OR TOES MIN 2 VWS	$34.75	$69.50	$25.44–$53.86	81% below	50%
Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE OR TOES MIN 2 VWS	$34.75	$69.50	$25.44–$53.86	—	50%
Toe X-ray, 2 or more views inpatient CPT 73660 TOE(S) 2 VIEWS	$34.75	$69.50	$25.44–$53.86	—	50%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$324.00	$648.00	$237.17–$502.20	34% below	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$324.00	$648.00	$237.17–$502.20	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANT UTERUS TRANSVAGINAL	$144.00	$288.00	$105.41–$223.20	63% below	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT UTERUS TRANSVAGINAL	$144.00	$288.00	$105.41–$223.20	—	50%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$204.00	$408.00	$41.15–$316.20	72% below	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$204.00	$408.00	$41.15–$316.20	—	50%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$498.00	$996.00	$364.54–$771.90	17% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$498.00	$996.00	$364.54–$771.90	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUES HEAD & NECK	$809.71	$1,619.42	$510.39–$1,255.05	32% above	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUES HEAD & NECK	$809.71	$1,619.42	$510.39–$1,255.05	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XA GI TRACT UPPER W/O KUB	$70.00	$140.00	$51.24–$108.50	85% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XA GI TRACT UPPER W/SMALL BOWEL	$70.00	$140.00	$51.24–$108.50	85% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XA GI TRACT UPPER W/SMALL BOWEL	$70.00	$140.00	$51.24–$108.50	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XA GI TRACT UPPER W/O KUB	$70.00	$140.00	$51.24–$108.50	—	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEWS RIGHT	$128.75	$257.50	$8.63–$199.56	45% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 VIEWS RIGHT	$128.75	$257.50	$8.63–$199.56	45% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMERUS 2 VIEWS LEFT	$128.75	$257.50	$8.63–$199.56	45% below	50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS 2 VIEWS LEFT	$128.75	$257.50	$8.63–$199.56	45% below	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEWS RIGHT	$128.75	$257.50	$8.63–$199.56	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMERUS 2 VIEWS LEFT	$128.75	$257.50	$8.63–$199.56	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2 VIEWS LEFT	$128.75	$257.50	$8.63–$199.56	—	50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS 2 VIEWS RIGHT	$128.75	$257.50	$8.63–$199.56	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS EXTREMITY UNILATERAL	$401.20	$802.40	$22.85–$621.86	32% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS EXTREMITY UNILATERAL	$401.20	$802.40	$22.85–$621.86	—	50%
Wrist X-ray, 2 views one side CPT 73100 WRIST AP & LAT LEFT	$31.75	$63.50	$23.24–$49.21	83% below	50%
Wrist X-ray, 2 views one side CPT 73100 WRIST AP & LAT RIGHT	$31.75	$63.50	$23.24–$49.21	83% below	50%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LEFT	$31.75	$63.50	$23.24–$49.21	83% below	50%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RIGHT	$31.75	$63.50	$23.24–$49.21	83% below	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RIGHT	$31.75	$63.50	$23.24–$49.21	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LEFT	$31.75	$63.50	$23.24–$49.21	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP & LAT RIGHT	$31.75	$63.50	$23.24–$49.21	—	50%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST AP & LAT LEFT	$31.75	$63.50	$23.24–$49.21	—	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEWS LEFT	$193.00	$386.00	$9.00–$543.66	18% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST 3 VIEWS RIGHT	$193.00	$386.00	$9.00–$543.66	18% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS RIGHT	$350.75	$701.50	$9.00–$543.66	49% above	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS LEFT	$350.75	$701.50	$9.00–$543.66	49% above	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS LEFT	$193.00	$386.00	$9.00–$543.66	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS RIGHT	$193.00	$386.00	$9.00–$543.66	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS LEFT	$350.75	$701.50	$9.00–$543.66	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS RIGHT	$350.75	$701.50	$9.00–$543.66	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNILATERAL 2-3 VIEWS LEFT	$110.64	$221.28	$9.00–$171.49	46% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNILATERAL COMPLETE RIGHT 2-3view	$110.64	$221.28	$9.00–$171.49	46% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNILATERAL 2-3 VIEWS LEFT	$110.64	$221.28	$9.00–$171.49	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNILATERAL COMPLETE RIGHT 2-3view	$110.64	$221.28	$9.00–$171.49	—	50%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN SINGLE ANTEROPOSTERIOR VIEW	$229.92	$459.84	$9.37–$356.38	6% above	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN SINGLE ANTEROPOSTERIOR VIEW	$229.92	$459.84	$9.37–$356.38	—	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE; AP & LAT RIGHT	$50.50	$101.00	$36.97–$78.28	76% below	50%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LEFT	$50.50	$101.00	$36.97–$78.28	76% below	50%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RIGHT	$50.50	$101.00	$36.97–$78.28	76% below	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE; AP & LAT LEFT	$50.50	$101.00	$36.97–$78.28	76% below	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RIGHT	$50.50	$101.00	$36.97–$78.28	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE; AP & LAT RIGHT	$50.50	$101.00	$36.97–$78.28	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE; AP & LAT LEFT	$50.50	$101.00	$36.97–$78.28	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LEFT	$50.50	$101.00	$36.97–$78.28	—	50%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER 2 VIEWS	$138.25	$276.50	$7.18–$364.29	29% below	50%
X-ray of the finger(s), 2 or more views CPT 73140 XR FINGERS MIN 2 VWS	$235.03	$470.05	$7.18–$364.29	22% above	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 FINGER 2 VIEWS	$138.25	$276.50	$7.18–$364.29	—	50%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGERS MIN 2 VWS	$235.03	$470.05	$7.18–$364.29	—	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT AP & LAT LEFT	$112.25	$224.50	$82.17–$173.99	40% below	50%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT COMPLETE 2 VIEWS LEFT	$112.25	$224.50	$82.17–$173.99	40% below	50%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT COMPLETE TWO VIEWS RT	$112.25	$224.50	$82.17–$173.99	40% below	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT AP & LAT RIGHT	$112.25	$224.50	$82.17–$173.99	40% below	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT AP & LAT LEFT	$112.25	$224.50	$82.17–$173.99	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT COMPLETE TWO VIEWS RT	$112.25	$224.50	$82.17–$173.99	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT AP & LAT RIGHT	$112.25	$224.50	$82.17–$173.99	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT COMPLETE 2 VIEWS LEFT	$112.25	$224.50	$82.17–$173.99	—	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 3 VIEWS RIGHT	$350.75	$701.50	$8.67–$569.66	46% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT 3 VIEWS LEFT	$350.75	$701.50	$8.67–$569.66	46% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE 3 VIEWS LEFT	$367.52	$735.04	$8.67–$569.66	53% above	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE 3 VIEWS RIGHT	$367.52	$735.04	$8.67–$569.66	53% above	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT 3 VIEWS RIGHT	$350.75	$701.50	$8.67–$569.66	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT 3 VIEWS LEFT	$350.75	$701.50	$8.67–$569.66	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMPLETE 3 VIEWS RIGHT	$367.52	$735.04	$8.67–$569.66	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMPLETE 3 VIEWS LEFT	$367.52	$735.04	$8.67–$569.66	—	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MIN 3 VIEWS RIGHT	$175.00	$350.00	$9.00–$620.29	30% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEWS RIGHT	$361.25	$722.50	$9.00–$620.29	45% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND 3 VIEWS LEFT	$361.25	$722.50	$9.00–$620.29	45% above	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MINIMUM 3 VIEWS LEFT	$400.19	$800.37	$9.00–$620.29	61% above	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND MIN 3 VIEWS RIGHT	$175.00	$350.00	$9.00–$620.29	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEWS RIGHT	$361.25	$722.50	$9.00–$620.29	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND 3 VIEWS LEFT	$361.25	$722.50	$9.00–$620.29	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND MINIMUM 3 VIEWS LEFT	$400.19	$800.37	$9.00–$620.29	—	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE AP & LAT RIGHT	$154.00	$308.00	$112.73–$238.70	18% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 VIEWS LEFT	$154.00	$308.00	$112.73–$238.70	18% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1 OR 2 VIEWS RIGHT	$154.00	$308.00	$112.73–$238.70	18% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE AP & LAT LEFT	$154.00	$308.00	$112.73–$238.70	18% below	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE AP & LAT RIGHT	$154.00	$308.00	$112.73–$238.70	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 OR 2 VIEWS LEFT	$154.00	$308.00	$112.73–$238.70	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE AP & LAT LEFT	$154.00	$308.00	$112.73–$238.70	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1 OR 2 VIEWS RIGHT	$154.00	$308.00	$112.73–$238.70	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VWS	$503.34	$1,006.68	$11.52–$780.18	47% above	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2 OR 3 VWS	$503.34	$1,006.68	$11.52–$780.18	—	50%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MIN 4 VWS	$607.25	$1,214.50	$13.33–$941.24	37% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MIN 4 VWS	$607.25	$1,214.50	$13.33–$941.24	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS	$115.60	$231.20	$49.78–$179.18	57% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS	$115.60	$231.20	$49.78–$179.18	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2 0R 3 VWS	$456.00	$912.00	$11.52–$706.80	60% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2 0R 3 VWS	$456.00	$912.00	$11.52–$706.80	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR AH PELVIS 1 OR 2 VIEWS	$54.50	$109.00	$9.00–$143.61	74% below	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$92.65	$185.30	$9.00–$143.61	56% below	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR AH PELVIS 1 OR 2 VIEWS	$54.50	$109.00	$9.00–$143.61	—	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS	$92.65	$185.30	$9.00–$143.61	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$24.25	$48.50	$17.75–$37.59	86% below	50%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE (ACTH)	$24.25	$48.50	$17.75–$37.59	—	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT; ALANINE AMINO (SGPT)	$30.75	$61.50	$22.51–$47.66	4% below	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT; ALANINE AMINO (SGPT)	$30.75	$61.50	$22.51–$47.66	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST; ASPARATATE AMINO (SGOT)	$34.00	$68.00	$24.89–$52.70	9% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST; ASPARATATE AMINO (SGOT)	$34.00	$68.00	$24.89–$52.70	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$126.25	$252.50	$92.42–$195.69	55% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$126.25	$252.50	$92.42–$195.69	—	50%
Albumin blood test CPT 82040 ALBUMIN; SERUM	$3.75	$7.50	$2.74–$5.81	90% below	50%
Albumin blood test inpatient CPT 82040 ALBUMIN; SERUM	$3.75	$7.50	$2.74–$5.81	—	50%
Aldosterone blood test CPT 82088 ALDOSTERONE	$87.75	$175.50	$64.23–$136.01	46% below	50%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$87.75	$175.50	$64.23–$136.01	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 SOUTHEASTERN RESP ALLERGY PANEL	$3.25	$6.50	$2.38–$5.04	88% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ALLERGEN	$3.25	$6.50	$2.38–$5.04	88% below	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX ALLERGEN	$3.25	$6.50	$2.38–$5.04	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOUTHEASTERN RESP ALLERGY PANEL	$3.25	$6.50	$2.38–$5.04	—	50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN (AFP) TUMOR MARKER	$11.00	$22.00	$8.05–$17.05	88% below	50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN (AFP) TUMOR MARKER	$11.00	$22.00	$8.05–$17.05	—	50%
Amylase blood test CPT 82150 AMYLASE BODY FLUID	$30.75	$61.50	$22.51–$47.66	60% below	50%
Amylase blood test CPT 82150 AMYLASE	$30.75	$61.50	$22.51–$47.66	60% below	50%
Amylase blood test inpatient CPT 82150 AMYLASE	$30.75	$61.50	$22.51–$47.66	—	50%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID	$30.75	$61.50	$22.51–$47.66	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE (CCP) IGG	$8.00	$16.00	$5.86–$12.40	92% below	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE (CCP) IGG	$8.00	$16.00	$5.86–$12.40	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH REFLEX TITER AND PATTERN	$17.25	$34.50	$12.63–$26.74	81% below	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH REFLEX TITER AND PATTERN	$17.25	$34.50	$12.63–$26.74	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP	$28.75	$57.50	$21.04–$44.56	76% below	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$28.75	$57.50	$21.04–$44.56	76% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO-BNP	$28.75	$57.50	$21.04–$44.56	—	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BRAIN NATRIURETIC PEPTIDE	$28.75	$57.50	$21.04–$44.56	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC ROUTINE	$13.00	$26.00	$9.52–$20.15	84% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE, BODY FLUID	$13.00	$26.00	$9.52–$20.15	84% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 SPUTUM CULTURE	$13.00	$26.00	$9.52–$20.15	84% below	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 SPUTUM CULTURE	$13.00	$26.00	$9.52–$20.15	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE, BODY FLUID	$13.00	$26.00	$9.52–$20.15	—	50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC ROUTINE	$13.00	$26.00	$9.52–$20.15	—	50%
Bilirubin blood test, total CPT 82247 BILIRUBIN; TOTAL	$5.00	$10.00	$3.66–$7.75	89% below	50%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN; TOTAL	$5.00	$10.00	$3.66–$7.75	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL IV	$41.75	$83.50	$30.56–$64.71	48% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL IV	$41.75	$83.50	$30.56–$64.71	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$2.25	$4.50	$1.65–$3.49	83% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$2.25	$4.50	$1.65–$3.49	—	50%
Blood glucose (sugar) test CPT 82947 GLUCOSE,SERUM	$4.50	$9.00	$3.29–$6.98	88% below	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE,SERUM	$4.50	$9.00	$3.29–$6.98	—	50%
Blood lead test CPT 83655 LEAD BLOOD (DO NOT USE)	$43.50	$87.00	$31.84–$67.42	36% below	50%
Blood lead test CPT 83655 LEAD BLOOD, VENIPUNCTURE	$43.50	$87.00	$31.84–$67.42	36% below	50%
Blood lead test inpatient CPT 83655 LEAD BLOOD (DO NOT USE)	$43.50	$87.00	$31.84–$67.42	—	50%
Blood lead test inpatient CPT 83655 LEAD BLOOD, VENIPUNCTURE	$43.50	$87.00	$31.84–$67.42	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO, BLOOD TYPE	$56.00	$112.00	$40.99–$86.80	1% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO, BLOOD TYPE	$56.00	$112.00	$40.99–$86.80	—	50%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN;QUANT (BUN) SERUM	$6.80	$13.60	$4.98–$10.54	77% below	50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN;QUANT (BUN) SERUM	$6.80	$13.60	$4.98–$10.54	—	50%
C-peptide blood test CPT 84681 C-PEPTIDE	$13.00	$26.00	$9.52–$20.15	87% below	50%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$13.00	$26.00	$9.52–$20.15	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN 19-9	$26.75	$53.50	$19.58–$41.46	72% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN 19-9	$26.75	$53.50	$19.58–$41.46	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$13.00	$26.00	$9.52–$20.15	92% below	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125	$13.00	$26.00	$9.52–$20.15	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV2 COVID-19 AMPLIFIED PROBE TECHN	$100.00	$200.00	$73.20–$155.00	16% above	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV2 COVID-19 AMPLIFIED PROBE TECHN	$100.00	$200.00	$73.20–$155.00	—	50%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$28.50	$57.00	$20.86–$44.18	71% below	50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN (CEA)	$28.50	$57.00	$20.86–$44.18	—	50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER IGM	$46.50	$93.00	$34.04–$72.08	38% below	50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER IGM	$46.50	$93.00	$34.04–$72.08	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED URINE	$29.75	$59.50	$21.78–$46.11	64% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA AMPLIFIED SWAB	$29.75	$59.50	$21.78–$46.11	64% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFIED SWAB	$29.75	$59.50	$21.78–$46.11	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA AMPLIFIED URINE	$29.75	$59.50	$21.78–$46.11	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$9.75	$19.50	$7.14–$15.11	87% below	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$9.75	$19.50	$7.14–$15.11	—	50%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO 5 part DIFF & PLT	$8.50	$17.00	$6.22–$13.18	86% below	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO 5 part DIFF & PLT	$8.50	$17.00	$6.22–$13.18	—	50%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL; SERUM	$35.50	$71.00	$25.99–$55.02	65% below	50%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL; SERUM	$35.50	$71.00	$25.99–$55.02	—	50%
Creatine kinase (CK) blood test, total CPT 82550 CK; CREATINE KINASE, TOTAL, SERUM	$5.75	$11.50	$4.21–$8.91	89% below	50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK; CREATINE KINASE, TOTAL, SERUM	$5.75	$11.50	$4.21–$8.91	—	50%
Creatinine blood test CPT 82565 CREATININE; SERUM	$5.25	$10.50	$3.84–$8.14	74% below	50%
Creatinine blood test inpatient CPT 82565 CREATININE; SERUM	$5.25	$10.50	$3.84–$8.14	—	50%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG QUANT	$25.25	$50.50	$18.48–$39.14	75% below	50%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG QUANT	$25.25	$50.50	$18.48–$39.14	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$28.75	$57.50	$21.04–$44.56	71% below	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$28.75	$57.50	$21.04–$44.56	—	50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST(s) presumptive SCREENING	$271.25	$542.50	$198.56–$420.44	111% above	50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG TEST(s) presumptive SCREENING	$271.25	$542.50	$198.56–$420.44	—	50%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$25.00	$50.00	$18.30–$38.75	72% below	50%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$25.00	$50.00	$18.30–$38.75	—	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VCA IGM	$28.25	$56.50	$20.68–$43.79	66% below	50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN BARR VCA IGG	$28.25	$56.50	$20.68–$43.79	66% below	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VCA IGM	$28.25	$56.50	$20.68–$43.79	—	50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN BARR VCA IGG	$28.25	$56.50	$20.68–$43.79	—	50%
Estradiol blood test CPT 82670 ESTRADIOL	$17.50	$35.00	$12.81–$27.12	85% below	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$17.50	$35.00	$12.81–$27.12	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE (FSH)	$105.25	$210.50	$77.04–$163.14	17% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE (FSH)	$105.25	$210.50	$77.04–$163.14	—	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$10.00	$20.00	$7.32–$15.50	89% below	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$10.00	$20.00	$7.32–$15.50	—	50%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$56.00	$112.00	$40.99–$86.80	36% below	50%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$56.00	$112.00	$40.99–$86.80	—	50%
Free T3 thyroid hormone test CPT 84481 FREE T3	$55.75	$111.50	$40.81–$86.41	47% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$55.75	$111.50	$40.81–$86.41	—	50%
Free testosterone test CPT 84402 TESTOSTERONE; FREE DON'T ORDER	$74.40	$148.80	$54.46–$115.32	54% below	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE DON'T ORDER	$74.40	$148.80	$54.46–$115.32	—	50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GLUTAMYLTRANSFERASE,GAMMA (GGT)	$15.50	$31.00	$11.35–$24.02	73% below	50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GLUTAMYLTRANSFERASE,GAMMA (GGT)	$15.50	$31.00	$11.35–$24.02	—	50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$147.50	$295.00	$107.97–$228.62	41% below	50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$147.50	$295.00	$107.97–$228.62	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE; POST GLUCOSE DOSE	$5.50	$11.00	$4.03–$8.52	91% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE; POST GLUCOSE DOSE	$5.50	$11.00	$4.03–$8.52	—	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$29.75	$59.50	$21.78–$46.11	64% below	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT) 3 SPECIMENS	$29.75	$59.50	$21.78–$46.11	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED SWAB	$54.40	$108.80	$39.82–$84.32	34% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED URINE	$54.40	$108.80	$39.82–$84.32	34% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED URINE	$54.40	$108.80	$39.82–$84.32	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, AMPLIFIED SWAB	$54.40	$108.80	$39.82–$84.32	—	50%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI ANTIGEN ,STOOL	$23.50	$47.00	$17.20–$36.43	81% below	50%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI ANTIGEN ,STOOL	$23.50	$47.00	$17.20–$36.43	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 PCR QUANTITATIVE	$185.25	$370.50	$135.60–$287.14	46% below	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 PCR QUANTITATIVE	$185.25	$370.50	$135.60–$287.14	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 SCREEN W REFLX	$17.50	$35.00	$12.81–$27.12	84% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 SCREEN W REFLX	$17.50	$35.00	$12.81–$27.12	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C)	$7.00	$14.00	$5.12–$10.85	87% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN; GLYCOSYLATED (A1C)	$7.00	$14.00	$5.12–$10.85	—	50%
Hemoglobin blood test CPT 85018 HEMOGLOBIN	$3.00	$6.00	$2.20–$4.65	87% below	50%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN	$3.00	$6.00	$2.20–$4.65	—	50%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE ANTIBODIES, TOTAL	$11.00	$22.00	$8.05–$17.05	88% below	50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE ANTIBODIES, TOTAL	$11.00	$22.00	$8.05–$17.05	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBsAb)	$14.00	$28.00	$10.25–$21.70	82% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBsAb)	$14.00	$28.00	$10.25–$21.70	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN (HBsAg)	$31.75	$63.50	$23.24–$49.21	51% below	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN (HBsAg)	$31.75	$63.50	$23.24–$49.21	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$14.50	$29.00	$10.61–$22.48	88% below	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$14.50	$29.00	$10.61–$22.48	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT	$26.75	$53.50	$19.58–$41.46	90% below	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT	$26.75	$53.50	$19.58–$41.46	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES VIRUS TYPE 1 IGG SERUM	$8.25	$16.50	$6.04–$12.79	88% below	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES VIRUS TYPE 1 IGG SERUM	$8.25	$16.50	$6.04–$12.79	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES VIRUS TYPE 2 IGG SERUM	$25.00	$50.00	$18.30–$38.75	60% below	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES VIRUS TYPE 2 IGG SERUM	$25.00	$50.00	$18.30–$38.75	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY	$21.25	$42.50	$15.56–$32.94	76% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENSITIVITY	$21.25	$42.50	$15.56–$32.94	—	50%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$16.50	$33.00	$12.08–$25.58	89% below	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$16.50	$33.00	$12.08–$25.58	—	50%
Insulin blood test CPT 83525 INSULIN; TOTAL	$72.25	$144.50	$52.89–$111.99	1% below	50%
Insulin blood test inpatient CPT 83525 INSULIN; TOTAL	$72.25	$144.50	$52.89–$111.99	—	50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$6.50	$13.00	$4.76–$10.08	89% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$6.50	$13.00	$4.76–$10.08	—	50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$13.00	$26.00	$9.52–$20.15	85% below	50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$13.00	$26.00	$9.52–$20.15	—	50%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH)	$112.50	$225.00	$82.35–$174.38	59% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE (LH)	$112.50	$225.00	$82.35–$174.38	—	50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID PLASMA	$8.50	$17.00	$6.22–$13.18	91% below	50%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID PLASMA	$8.50	$17.00	$6.22–$13.18	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$38.50	$77.00	$28.18–$59.68	56% below	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$38.50	$77.00	$28.18–$59.68	—	50%
Lyme disease antibody test CPT 86618 B BURGDORFERI Ab REFLX IMMUNOBLOT	$10.75	$21.50	$7.87–$16.66	89% below	50%
Lyme disease antibody test inpatient CPT 86618 B BURGDORFERI Ab REFLX IMMUNOBLOT	$10.75	$21.50	$7.87–$16.66	—	50%
Measles (rubeola) antibody test CPT 86765 MEASLES VIRUS IGG	$46.50	$93.00	$34.04–$72.08	42% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES VIRUS IGG	$46.50	$93.00	$34.04–$72.08	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS SCREEN, QUALITATIVE	$8.00	$16.00	$5.86–$12.40	87% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS SCREEN, QUALITATIVE	$8.00	$16.00	$5.86–$12.40	—	50%
Mumps immunity blood test CPT 86735 MUMPS VIRUS IGG	$47.00	$94.00	$34.40–$72.85	22% below	50%
Mumps immunity blood test inpatient CPT 86735 MUMPS VIRUS IGG	$47.00	$94.00	$34.40–$72.85	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC ANTIGEN (PSA);FREE	$27.50	$55.00	$20.13–$42.62	64% below	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE SPECIFIC ANTIGEN (PSA);FREE	$27.50	$55.00	$20.13–$42.62	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL	$13.50	$27.00	$9.88–$20.92	87% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA; TOTAL	$13.50	$27.00	$9.88–$20.92	87% below	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA; TOTAL	$13.50	$27.00	$9.88–$20.92	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN (PSA); TOTAL	$13.50	$27.00	$9.88–$20.92	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 THIN PREP	$94.50	$189.00	$69.17–$146.48	102% above	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP	$94.50	$189.00	$69.17–$146.48	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT	$20.75	$41.50	$15.19–$32.16	87% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE INTACT	$20.75	$41.50	$15.19–$32.16	—	50%
Potassium blood test CPT 84132 POTASSIUM; SERUM	$4.75	$9.50	$3.48–$7.36	86% below	50%
Potassium blood test inpatient CPT 84132 POTASSIUM; SERUM	$4.75	$9.50	$3.48–$7.36	—	50%
Progesterone blood test CPT 84144 PROGESTERONE	$85.44	$170.88	$62.54–$132.43	11% below	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$85.44	$170.88	$62.54–$132.43	—	50%
Prolactin blood test CPT 84146 PROLACTIN	$97.75	$195.50	$71.55–$151.51	19% below	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$97.75	$195.50	$71.55–$151.51	—	50%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B	$23.50	$47.00	$17.20–$36.43	68% below	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B	$23.50	$47.00	$17.20–$36.43	—	50%
Renin blood test CPT 84244 RENIN ACTIVITY	$47.50	$95.00	$34.77–$73.62	53% below	50%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY	$47.50	$95.00	$34.77–$73.62	—	50%
Rh blood typing CPT 86901 RH, BLOOD TYPE	$17.00	$34.00	$12.44–$26.35	66% below	50%
Rh blood typing inpatient CPT 86901 RH, BLOOD TYPE	$17.00	$34.00	$12.44–$26.35	—	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TEST	$5.75	$11.50	$4.21–$8.91	92% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TEST	$5.75	$11.50	$4.21–$8.91	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG	$10.50	$21.00	$7.69–$16.28	85% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG	$10.50	$21.00	$7.69–$16.28	—	50%
Stool ova and parasites exam CPT 87177 OVA & PARASITES MICROSCOPIC	$13.25	$26.50	$9.70–$20.54	84% below	50%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES MICROSCOPIC	$13.25	$26.50	$9.70–$20.54	—	50%
Syphilis antibody test (Treponema pallidum) CPT 86780 T PALLIDUM AB	$8.25	$16.50	$6.04–$12.79	88% below	50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 T PALLIDUM AB	$8.25	$16.50	$6.04–$12.79	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST; RPR W/ FTA-ABS REFLEX	$4.25	$8.50	$3.11–$6.59	90% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL, SERUM WITH REFLEX TITER	$4.25	$8.50	$3.11–$6.59	90% below	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST; RPR W/ FTA-ABS REFLEX	$4.25	$8.50	$3.11–$6.59	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL, SERUM WITH REFLEX TITER	$4.25	$8.50	$3.11–$6.59	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD PLUS	$160.50	$321.00	$117.49–$248.78	3% below	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD PLUS	$160.50	$321.00	$117.49–$248.78	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE;TOTAL	$54.25	$108.50	$39.71–$84.09	59% below	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE;TOTAL	$54.25	$108.50	$39.71–$84.09	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE ANTIBODY (TPO)	$21.75	$43.50	$15.92–$33.71	76% below	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE ANTIBODY (TPO)	$21.75	$43.50	$15.92–$33.71	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$12.50	$25.00	$9.15–$19.38	86% below	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$12.50	$25.00	$9.15–$19.38	—	50%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E	$90.00	$180.00	$65.88–$139.50	19% above	50%
Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E	$90.00	$180.00	$65.88–$139.50	—	50%
Total cholesterol blood test CPT 82465 CHOLESTEROL,TOTAL;SERUM	$16.00	$32.00	$11.71–$24.80	57% below	50%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL,TOTAL;SERUM	$16.00	$32.00	$11.71–$24.80	—	50%
Total thyroxine (T4) blood test CPT 84436 T-4 TOTAL (THYROXINE)	$18.00	$36.00	$13.18–$27.90	66% below	50%
Total thyroxine (T4) blood test inpatient CPT 84436 T-4 TOTAL (THYROXINE)	$18.00	$36.00	$13.18–$27.90	—	50%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$79.44	$158.88	$58.15–$123.13	5% below	50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$79.44	$158.88	$58.15–$123.13	—	50%
Transferrin blood test CPT 84466 TRANSFERRIN	$77.25	$154.50	$56.55–$119.74	12% below	50%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$77.25	$154.50	$56.55–$119.74	—	50%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$7.50	$15.00	$5.49–$11.62	81% below	50%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$7.50	$15.00	$5.49–$11.62	—	50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, DIP STICK	$5.50	$11.00	$4.03–$8.52	85% below	50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, DIP STICK	$5.50	$11.00	$4.03–$8.52	—	50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST, QUALITATIVE	$148.41	$296.81	$108.63–$230.03	86% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST, QUALITATIVE	$148.41	$296.81	$108.63–$230.03	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$11.00	$22.00	$8.05–$17.05	86% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$11.00	$22.00	$8.05–$17.05	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 OH TOTAL	$14.75	$29.50	$10.80–$22.86	85% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 OH TOTAL	$14.75	$29.50	$10.80–$22.86	—	50%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1,25-DIHYDROXY	$24.00	$48.00	$17.57–$37.20	84% below	50%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1,25-DIHYDROXY	$24.00	$48.00	$17.57–$37.20	—	50%
Zinc blood test CPT 84630 ZINC SERUM/PLASMA	$7.00	$14.00	$5.12–$10.85	89% below	50%
Zinc blood test inpatient CPT 84630 ZINC SERUM/PLASMA	$7.00	$14.00	$5.12–$10.85	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN, (HCG); QUANTITATIVE	$13.18	$26.35	$9.64–$20.42	89% below	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN, (HCG); QUANTITATIVE	$13.18	$26.35	$9.64–$20.42	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$797.00	$1,594.00	$583.40–$1,235.35	78% below	50%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$797.00	$1,594.00	$583.40–$1,235.35	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TX DISTAL FIB FX W/O MANIPULATION	$209.25	$418.50	$153.17–$324.34	62% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TX DISTAL FIB FX W/O MANIPULATION	$209.25	$418.50	$153.17–$324.34	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION;EXTERNAL	$623.75	$1,247.50	$456.58–$966.81	58% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION;EXTERNAL	$623.75	$1,247.50	$456.58–$966.81	—	50%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY; CARPAL TUNNEL	$2,098.75	$4,197.50	$1,536.28–$3,253.06	21% above	50%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY; CARPAL TUNNEL	$2,098.75	$4,197.50	$1,536.28–$3,253.06	—	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION	$200.00	$400.00	$146.40–$310.00	96% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION; EXCEPT NEWBORN	$200.00	$400.00	$146.40–$310.00	96% below	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION; EXCEPT NEWBORN	$200.00	$400.00	$146.40–$310.00	—	50%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION	$200.00	$400.00	$146.40–$310.00	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX DISTAL RADIAL FX	$209.25	$418.50	$153.17–$324.34	66% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX DISTAL RADIAL FX	$209.25	$418.50	$153.17–$324.34	—	50%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/REMOVAL BY SNARE TECHNIQUE	$1,507.50	$3,015.00	$1,103.49–$2,336.62	1% below	50%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/REMOVAL TUM POLYP LESIO	$1,507.50	$3,015.00	$1,103.49–$2,336.62	1% below	50%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/REMOVAL TUM POLYP LESIO	$1,507.50	$3,015.00	$1,103.49–$2,336.62	—	50%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/REMOVAL BY SNARE TECHNIQUE	$1,507.50	$3,015.00	$1,103.49–$2,336.62	—	50%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY	$1,981.35	$3,962.70	$1,450.35–$3,071.09	42% above	50%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY	$1,981.35	$3,962.70	$1,450.35–$3,071.09	—	50%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY I/P	$1,975.00	$3,950.00	$1,445.70–$4,117.42	50% below	50%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY W OR W/O SPECIMEN WASH/BRUSH	$2,656.40	$5,312.80	$1,445.70–$4,117.42	33% below	50%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY I/P	$1,975.00	$3,950.00	$1,445.70–$4,117.42	—	50%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY W OR W/O SPECIMEN WASH/BRUSH	$2,656.40	$5,312.80	$1,445.70–$4,117.42	—	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C	$319.00	$638.00	$233.51–$494.45	92% below	50%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C NON-PREGANT	$319.00	$638.00	$233.51–$494.45	92% below	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D & C NON-PREGANT	$319.00	$638.00	$233.51–$494.45	—	50%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D & C	$319.00	$638.00	$233.51–$494.45	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION 1ST LESION, BENIGN OR MALIG	$47.50	$95.00	$34.77–$73.62	69% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION BENIGN LESION, FIRST LESION	$47.50	$95.00	$34.77–$73.62	69% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION BENIGN LESION, FIRST LESION	$47.50	$95.00	$34.77–$73.62	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION 1ST LESION, BENIGN OR MALIG	$47.50	$95.00	$34.77–$73.62	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATIO	$21.50	$43.00	$15.74–$33.33	79% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATIO	$21.50	$43.00	$15.74–$33.33	—	50%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN	$21.00	$42.00	$15.37–$32.55	94% below	50%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CERUMEN	$21.00	$42.00	$15.37–$32.55	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY	$1,195.00	$2,390.00	$874.74–$1,852.25	6% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY, FLEXIBLE	$1,195.00	$2,390.00	$874.74–$1,852.25	6% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY W OR W/O SPECIMEN	$1,195.00	$2,390.00	$874.74–$1,852.25	6% below	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY	$1,195.00	$2,390.00	$874.74–$1,852.25	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY W OR W/O SPECIMEN	$1,195.00	$2,390.00	$874.74–$1,852.25	—	50%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY, FLEXIBLE	$1,195.00	$2,390.00	$874.74–$1,852.25	—	50%
Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY, LAPAROSCOPY	$6,782.25	$13,564.50	$4,964.61–$10,512.49	53% below	50%
Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY, LAPAROSCOPY	$6,782.25	$13,564.50	$4,964.61–$10,512.49	—	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPE CHOLECYSTECTOMY	$863.50	$1,727.00	$632.08–$1,338.42	94% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY, SURGICAL; CHOLECYS W/CHOLAN	$863.50	$1,727.00	$632.08–$1,338.42	94% below	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPAROSCOPE CHOLECYSTECTOMY	$863.50	$1,727.00	$632.08–$1,338.42	—	50%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPAROSCOPY, SURGICAL; CHOLECYS W/CHOLAN	$863.50	$1,727.00	$632.08–$1,338.42	—	50%
Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER	$1,129.50	$2,259.00	$826.79–$1,750.72	95% below	50%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY (IP ONLY)	$1,129.50	$2,259.00	$826.79–$1,750.72	95% below	50%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 REMOVAL OF GALLBLADDER	$1,129.50	$2,259.00	$826.79–$1,750.72	—	50%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY (IP ONLY)	$1,129.50	$2,259.00	$826.79–$1,750.72	—	50%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY BY SIMPLE LIGATURE	$342.50	$685.00	$250.71–$530.88	75% below	50%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY BY SIMPLE LIGATURE	$342.50	$685.00	$250.71–$530.88	—	50%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY, INTERNAL & EXT, SIMPLE	$713.75	$1,427.50	$522.46–$1,106.31	74% below	50%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORRHOIDECTOMY, INTERNAL & EXT, SIMPLE	$713.75	$1,427.50	$522.46–$1,106.31	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE SIMPLE	$81.25	$162.50	$59.48–$125.94	87% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS; SIMPLE OR SINGLE	$81.25	$162.50	$59.48–$125.94	87% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE SIMPLE OR SINGLE	$81.25	$162.50	$59.48–$125.94	87% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS; SIMPLE OR SINGLE	$81.25	$162.50	$59.48–$125.94	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE SIMPLE OR SINGLE	$81.25	$162.50	$59.48–$125.94	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE SIMPLE	$81.25	$162.50	$59.48–$125.94	—	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 >	$678.00	$1,356.00	$496.30–$1,050.90	91% below	50%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR OF INGUINAL HERINA	$678.00	$1,356.00	$496.30–$1,050.90	91% below	50%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR OF INGUINAL HERINA	$678.00	$1,356.00	$496.30–$1,050.90	—	50%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INITIAL INGUINAL HERNIA, AGE 5 >	$678.00	$1,356.00	$496.30–$1,050.90	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH, LIG,APON	$285.25	$570.50	$208.80–$442.14	76% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION SINGLE TENDON SHEATH LIG APON	$285.25	$570.50	$208.80–$442.14	76% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH, LIG,APON	$285.25	$570.50	$208.80–$442.14	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION SINGLE TENDON SHEATH LIG APON	$285.25	$570.50	$208.80–$442.14	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS,INTERMEDIATE JOINT	$285.25	$570.50	$208.80–$442.14	62% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, INTERMEDIATE JOINT	$285.25	$570.50	$208.80–$442.14	62% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS, ASP/INJ INT JOINT	$285.25	$570.50	$208.80–$442.14	62% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, INTERMEDIATE JOINT	$285.25	$570.50	$208.80–$442.14	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS, ASP/INJ INT JOINT	$285.25	$570.50	$208.80–$442.14	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS,INTERMEDIATE JOINT	$285.25	$570.50	$208.80–$442.14	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS, SMALL JOINT(FING/TOES)	$285.25	$570.50	$208.80–$442.14	43% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS, ASP/INJ SMALL JOINT	$285.25	$570.50	$208.80–$442.14	43% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,SMALL JOINT	$285.25	$570.50	$208.80–$442.14	43% below	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS,SMALL JOINT	$285.25	$570.50	$208.80–$442.14	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS, SMALL JOINT(FING/TOES)	$285.25	$570.50	$208.80–$442.14	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS, ASP/INJ SMALL JOINT	$285.25	$570.50	$208.80–$442.14	—	50%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP RMVL ADNEXAL STRUXS	$5,442.25	$10,884.50	$3,983.73–$8,435.49	42% below	50%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP RMVL ADNEXAL STRUXS	$5,442.25	$10,884.50	$3,983.73–$8,435.49	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE 2.5CM OR LESS SCALP/AXIL/E	$373.00	$746.00	$273.04–$578.15	22% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE (SCALP/AXILLAE/TRUNK/EXTRM	$373.00	$746.00	$273.04–$578.15	22% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE 2.5CM OR LESS	$373.00	$746.00	$273.04–$578.15	22% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE 2.5CM OR LESS SCALP/AXIL/E	$373.00	$746.00	$273.04–$578.15	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE (SCALP/AXILLAE/TRUNK/EXTRM	$373.00	$746.00	$273.04–$578.15	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE 2.5CM OR LESS	$373.00	$746.00	$273.04–$578.15	—	50%
Lower-back epidural injection, without imaging guidance CPT 62322 INJECTION SINGLE LUMBAR,SACRAL	$883.00	$1,766.00	$646.36–$1,368.65	47% below	50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJECTION SINGLE LUMBAR,SACRAL	$883.00	$1,766.00	$646.36–$1,368.65	—	50%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL	$2,907.00	$5,814.00	$2,127.92–$4,505.85	63% below	50%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL	$2,907.00	$5,814.00	$2,127.92–$4,505.85	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION, BENIGN LESION 0.5CM OR LESS	$51.00	$102.00	$37.33–$79.05	96% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 MOLE REMOVAL 0.5 CM OR LESS	$51.00	$102.00	$37.33–$79.05	96% below	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 MOLE REMOVAL 0.5 CM OR LESS	$51.00	$102.00	$37.33–$79.05	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION, BENIGN LESION 0.5CM OR LESS	$51.00	$102.00	$37.33–$79.05	—	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXCISION, BENIGN LESION, DIAM 0.50 OR LE	$525.50	$1,051.00	$384.67–$814.52	14% below	50%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXCISION, BENIGN LESION, DIAM 0.50 OR LE	$525.50	$1,051.00	$384.67–$814.52	—	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE, SIMPLE; SINGLE	$51.25	$102.50	$37.52–$79.44	92% below	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION,NAIL PLATE, PART OR COMP,SIMPLE	$51.25	$102.50	$37.52–$79.44	92% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION,NAIL PLATE, PART OR COMP,SIMPLE	$51.25	$102.50	$37.52–$79.44	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE, SIMPLE; SINGLE	$51.25	$102.50	$37.52–$79.44	—	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS DIAG/THERAP W/IMAGING G	$393.00	$786.00	$287.68–$609.15	74% below	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS DIAG/THERAP W/IMAGING G	$393.00	$786.00	$287.68–$609.15	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL & NAIL MATRIX; PART/COM	$525.50	$1,051.00	$384.67–$814.52	44% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAIL & MATRIX; PART OR COMPL	$525.50	$1,051.00	$384.67–$814.52	44% below	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL & NAIL MATRIX; PART/COM	$525.50	$1,051.00	$384.67–$814.52	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAIL & MATRIX; PART OR COMPL	$525.50	$1,051.00	$384.67–$814.52	—	50%
Removal of a breast lump, open surgery CPT 19120 EXCISION OF CYST,FIBROADENOMA OR BENIGN	$2,907.00	$5,814.00	$2,127.92–$4,505.85	56% below	50%
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION OF CYST,FIBROADENOMA OR BENIGN	$2,907.00	$5,814.00	$2,127.92–$4,505.85	—	50%
Removal of a foreign object under the skin, simple CPT 10120 SKIN INCIS & FB REMOVAL	$51.00	$102.00	$37.33–$79.05	95% below	50%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY	$51.00	$102.00	$37.33–$79.05	95% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUB T SI	$51.00	$102.00	$37.33–$79.05	95% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB SUBCU TISSUE SIMP	$51.00	$102.00	$37.33–$79.05	95% below	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FB SUBCU TISSUE SIMP	$51.00	$102.00	$37.33–$79.05	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 SKIN INCIS & FB REMOVAL	$51.00	$102.00	$37.33–$79.05	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY	$51.00	$102.00	$37.33–$79.05	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUB T SI	$51.00	$102.00	$37.33–$79.05	—	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY COLORECTAL CA SCREENING	$397.00	$794.00	$290.60–$615.35	74% below	50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLONOSCOPY COLORECTAL CA SCREENING	$397.00	$794.00	$290.60–$615.35	—	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CA SCREEN;COLONOSCOPY HI RSK	$397.00	$794.00	$290.60–$615.35	74% below	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL CA SCREEN;COLONOSCOPY HI RSK	$397.00	$794.00	$290.60–$615.35	—	50%
Short arm cast (elbow to hand) CPT 29075 APPLICATION,CAST,ELBOW TO FINGER	$43.50	$87.00	$31.84–$67.42	95% below	50%
Short arm cast (elbow to hand) CPT 29075 SHORT ARM CAST	$43.50	$87.00	$31.84–$67.42	95% below	50%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION,CAST,ELBOW TO FINGER	$43.50	$87.00	$31.84–$67.42	—	50%
Short arm cast (elbow to hand) inpatient CPT 29075 SHORT ARM CAST	$43.50	$87.00	$31.84–$67.42	—	50%
Short arm splint (forearm and hand) CPT 29125 WRIST SPLINT	$100.50	$201.00	$73.57–$264.82	74% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT; STATIC	$100.50	$201.00	$73.57–$264.82	74% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT;STATIC	$170.85	$341.70	$73.57–$264.82	56% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT; STATIC	$100.50	$201.00	$73.57–$264.82	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 WRIST SPLINT	$100.50	$201.00	$73.57–$264.82	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT;STATIC	$170.85	$341.70	$73.57–$264.82	—	50%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST	$57.00	$114.00	$41.72–$88.35	82% below	50%
Short leg cast (below the knee) CPT 29405 APPL SHORT LEG CAST BELOW KNEE	$57.00	$114.00	$41.72–$88.35	82% below	50%
Short leg cast (below the knee) CPT 29405 SHORT LEG CAST	$57.00	$114.00	$41.72–$88.35	82% below	50%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST	$57.00	$114.00	$41.72–$88.35	—	50%
Short leg cast (below the knee) inpatient CPT 29405 SHORT LEG CAST	$57.00	$114.00	$41.72–$88.35	—	50%
Short leg cast (below the knee) inpatient CPT 29405 APPL SHORT LEG CAST BELOW KNEE	$57.00	$114.00	$41.72–$88.35	—	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF TO FOO	$133.25	$266.50	$97.54–$206.54	65% below	50%
Short leg splint (calf to foot) CPT 29515 APPL SHORT LEG SPLINT	$133.25	$266.50	$97.54–$206.54	65% below	50%
Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT	$133.25	$266.50	$97.54–$206.54	65% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF TO FOO	$133.25	$266.50	$97.54–$206.54	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPL SHORT LEG SPLINT	$133.25	$266.50	$97.54–$206.54	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT	$133.25	$266.50	$97.54–$206.54	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SUPERFICIAL WOUND;2.5CM <	$264.50	$529.00	$193.61–$696.96	14% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER SUTURE 2.5 OR LESS	$264.50	$529.00	$193.61–$696.96	14% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SUTURES 2.5 OR LESS	$264.50	$529.00	$193.61–$696.96	14% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMP REPAIR (SCALP/NECK/AXIL/TRUNK/EXTRE	$264.50	$529.00	$193.61–$696.96	14% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE 2.5CM OR LESS SCALP/NCK/AXIL/TRK/	$449.65	$899.30	$193.61–$696.96	45% above	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ER SUTURE 2.5 OR LESS	$264.50	$529.00	$193.61–$696.96	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMP REPAIR (SCALP/NECK/AXIL/TRUNK/EXTRE	$264.50	$529.00	$193.61–$696.96	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SUTURES 2.5 OR LESS	$264.50	$529.00	$193.61–$696.96	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SUPERFICIAL WOUND;2.5CM <	$264.50	$529.00	$193.61–$696.96	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE 2.5CM OR LESS SCALP/NCK/AXIL/TRK/	$449.65	$899.30	$193.61–$696.96	—	50%
Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REMOVAL	$37.50	$75.00	$27.45–$58.12	88% below	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS	$37.50	$75.00	$27.45–$58.12	88% below	50%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS/MULTIPLE TAGS	$37.50	$75.00	$27.45–$58.12	88% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REMOVAL	$37.50	$75.00	$27.45–$58.12	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS	$37.50	$75.00	$27.45–$58.12	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS/MULTIPLE TAGS	$37.50	$75.00	$27.45–$58.12	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$220.25	$440.50	$161.22–$341.39	83% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$220.25	$440.50	$161.22–$341.39	83% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAG	$220.25	$440.50	$161.22–$341.39	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$220.25	$440.50	$161.22–$341.39	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR 2.6cm TO 7.5cm	$294.00	$588.00	$215.21–$774.69	26% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SUTURES 2.6 TO 7.5	$294.00	$588.00	$215.21–$774.69	26% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER SUTURE 2.6 TO 7.5	$294.00	$588.00	$215.21–$774.69	26% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE 2.6CM-7.5CM SCALP/NCK/AXIL/TRK/EX	$499.80	$999.60	$215.21–$774.69	25% above	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ER SUTURE 2.6 TO 7.5	$294.00	$588.00	$215.21–$774.69	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE REPAIR 2.6cm TO 7.5cm	$294.00	$588.00	$215.21–$774.69	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SUTURES 2.6 TO 7.5	$294.00	$588.00	$215.21–$774.69	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE 2.6CM-7.5CM SCALP/NCK/AXIL/TRK/EX	$499.80	$999.60	$215.21–$774.69	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE 2.5CM OR LESS FACE/EAR/EYELD/LIPS	$93.36	$186.72	$68.34–$150.74	74% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMP REPAIR (FACE/EARS/EYELIDS/NOSE/LIPS	$97.25	$194.50	$68.34–$150.74	73% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR 2.5/LESS F,ER,EY,N,LIP,MM	$97.25	$194.50	$68.34–$150.74	73% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR 2.5CM OR LESS	$97.25	$194.50	$68.34–$150.74	73% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE 2.5CM OR LESS FACE/EAR/EYELD/LIPS	$93.36	$186.72	$68.34–$150.74	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMP REPAIR (FACE/EARS/EYELIDS/NOSE/LIPS	$97.25	$194.50	$68.34–$150.74	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR 2.5/LESS F,ER,EY,N,LIP,MM	$97.25	$194.50	$68.34–$150.74	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR 2.5CM OR LESS	$97.25	$194.50	$68.34–$150.74	—	50%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY,PRIMARY/SECONDARY; 12 OR >	$2,808.75	$5,617.50	$2,056.00–$4,353.56	71% below	50%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY,PRIMARY/SECONDARY; 12 OR >	$2,808.75	$5,617.50	$2,056.00–$4,353.56	—	50%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTOMY,PRIMARY/SECONDARY; 12 OR <	$508.75	$1,017.50	$372.40–$788.56	95% below	50%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTOMY,PRIMARY/SECONDARY; 12 OR <	$508.75	$1,017.50	$372.40–$788.56	—	50%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$1,850.50	$3,701.00	$1,354.57–$2,868.28	58% below	50%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$1,850.50	$3,701.00	$1,354.57–$2,868.28	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE OR MULT TRIGGER POINTS	$285.25	$570.50	$208.80–$442.14	76% below	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE OR MULT TRIGGER POINTS	$285.25	$570.50	$208.80–$442.14	—	50%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 TUBAL LIGATION	$499.00	$998.00	$365.27–$773.45	94% below	50%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 TUBAL LIGATION	$499.00	$998.00	$365.27–$773.45	—	50%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI WITH BIOPSY	$1,738.00	$3,476.00	$1,272.22–$2,693.90	24% above	50%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI WITH BIOPSY	$1,738.00	$3,476.00	$1,272.22–$2,693.90	—	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION	$1,238.25	$2,476.50	$906.40–$1,919.29	33% below	50%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION	$1,238.25	$2,476.50	$906.40–$1,919.29	—	50%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDO DIAG BRUSH / WASH	$516.00	$1,032.00	$377.71–$799.80	62% below	50%
Upper endoscopy (EGD), diagnostic CPT 43235 ESOPGAGUS ENDOSCOPY	$516.00	$1,032.00	$377.71–$799.80	62% below	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDO DIAG BRUSH / WASH	$516.00	$1,032.00	$377.71–$799.80	—	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPGAGUS ENDOSCOPY	$516.00	$1,032.00	$377.71–$799.80	—	50%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL	$953.50	$1,907.00	$697.96–$1,477.92	—	50%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY, UNILATERAL OR BILATERAL	$953.50	$1,907.00	$697.96–$1,477.92	—	50%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION OF FLAT WARTS UP TO 14 LESIO	$112.25	$224.50	$82.17–$173.99	90% below	50%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION OF FLAT WARTS UP TO 14 LESIO	$112.25	$224.50	$82.17–$173.99	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$203.88	$407.75	$149.24–$316.01	74% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 ER TRANSFUSION BLOOD OR BLOOD COMPONENTS	$203.88	$407.75	$149.24–$316.01	74% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER TRANSFUSION BLOOD OR BLOOD COMPONENTS	$203.88	$407.75	$149.24–$316.01	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR BLOOD COMPONENTS	$203.88	$407.75	$149.24–$316.01	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL	$70.49	$140.98	$18.30–$148.41	60% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB TREATMENT INITIAL	$95.75	$191.50	$18.30–$148.41	45% below	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL	$70.49	$140.98	$18.30–$148.41	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB TREATMENT INITIAL	$95.75	$191.50	$18.30–$148.41	—	50%
Chemotherapy IV infusion, first hour CPT 96413 IV INFUSION UP TO 1hr, SINGLE DRUG	$117.50	$235.00	$86.01–$182.12	72% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS	$117.50	$235.00	$86.01–$182.12	72% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV INFUSION UP TO 1hr, SINGLE DRUG	$117.50	$235.00	$86.01–$182.12	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY ADMINISTRATION, INTRAVENOUS	$117.50	$235.00	$86.01–$182.12	—	50%
Critical care, first 30 to 74 minutes CPT 99291 EVALUATION & MANAGEMENT CRITICAL CARE(ED	$1,076.75	$2,153.50	$788.18–$1,668.96	41% below	50%
Critical care, first 30 to 74 minutes CPT 99291 EMER DEPT PHYS CRITICAL CARE 30-74 MINS	$1,076.75	$2,153.50	$788.18–$1,668.96	41% below	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EMER DEPT PHYS CRITICAL CARE 30-74 MINS	$1,076.75	$2,153.50	$788.18–$1,668.96	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EVALUATION & MANAGEMENT CRITICAL CARE(ED	$1,076.75	$2,153.50	$788.18–$1,668.96	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG ROUTINE 12 LEAD	$70.06	$140.12	$51.28–$108.59	63% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG ROUTINE 12 LEAD	$70.06	$140.12	$51.28–$108.59	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EVALUATION & MANAGEMENT LEVEL 1 (ED)	$61.00	$122.00	$44.65–$94.55	76% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT PHYSICIAN LEVEL 1	$61.00	$122.00	$44.65–$94.55	76% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT PHYSICIAN LEVEL 1	$61.00	$122.00	$44.65–$94.55	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EVALUATION & MANAGEMENT LEVEL 1 (ED)	$61.00	$122.00	$44.65–$94.55	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EVALUATION & MANAGEMENT LEVEL 2 (ED)	$65.75	$131.50	$48.13–$101.91	83% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT PHYSICIAN LEVEL 2	$65.75	$131.50	$48.13–$101.91	83% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EVALUATION & MANAGEMENT LEVEL 2 (ED)	$65.75	$131.50	$48.13–$101.91	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT PHYSICIAN LEVEL 2	$65.75	$131.50	$48.13–$101.91	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E/M ED LEVEL 3 - ORTHO	$115.75	$231.50	$84.73–$179.41	82% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM CHARGE	$115.75	$231.50	$84.73–$179.41	82% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EVALUATION & MANAGEMENT LEVEL 3 (ED)	$115.75	$231.50	$84.73–$179.41	82% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT PHYSICIAN LEVEL 3 VISIT	$115.75	$231.50	$84.73–$179.41	82% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EVALUATION & MANAGEMENT LEVEL 3 (ED)	$115.75	$231.50	$84.73–$179.41	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 E/M ED LEVEL 3 - ORTHO	$115.75	$231.50	$84.73–$179.41	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT PHYSICIAN LEVEL 3 VISIT	$115.75	$231.50	$84.73–$179.41	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY ROOM CHARGE	$115.75	$231.50	$84.73–$179.41	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY ROOM CHARAGE	$523.50	$1,047.00	$383.20–$811.42	35% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT PHYSICIAN LEVEL 4 VISIT	$523.50	$1,047.00	$383.20–$811.42	35% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EVALUATION & MANAGEMENT LEVEL 4 (ED)	$523.50	$1,047.00	$383.20–$811.42	35% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY ROOM CHARAGE	$523.50	$1,047.00	$383.20–$811.42	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EVALUATION & MANAGEMENT LEVEL 4 (ED)	$523.50	$1,047.00	$383.20–$811.42	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT PHYSICIAN LEVEL 4 VISIT	$523.50	$1,047.00	$383.20–$811.42	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT PHYSICIAN LEVEL 5 VISIT	$376.25	$752.50	$275.42–$583.19	67% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EVALUATION & MANAGEMENT LEVEL 5 (ED)	$376.25	$752.50	$275.42–$583.19	67% below	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY ROOM CHARGE	$376.25	$752.50	$275.42–$583.19	67% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY ROOM CHARGE	$376.25	$752.50	$275.42–$583.19	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT PHYSICIAN LEVEL 5 VISIT	$376.25	$752.50	$275.42–$583.19	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EVALUATION & MANAGEMENT LEVEL 5 (ED)	$376.25	$752.50	$275.42–$583.19	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION, HYDRATION 31mins to 1hr	$181.92	$363.84	$133.17–$293.73	37% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION THERAPY 31mins to 1hr	$189.50	$379.00	$133.17–$293.73	35% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION, HYDRATION 31mins to 1hr	$181.92	$363.84	$133.17–$293.73	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION THERAPY 31mins to 1hr	$189.50	$379.00	$133.17–$293.73	—	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION FOR THERAPY UP TO 1hr	$275.52	$551.04	$201.68–$427.06	6% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION FOR THERAPY UP TO 1hr	$275.52	$551.04	$201.68–$427.06	—	50%
IV push of a medicine, first drug CPT 96374 IV PUSH, SINGLE DRUG	$129.60	$259.20	$94.87–$209.25	39% below	50%
IV push of a medicine, first drug CPT 96374 IV PUSH single or initial DRUG	$129.60	$259.20	$94.87–$209.25	39% below	50%
IV push of a medicine, first drug CPT 96374 IV PUSH SINGLE DRUG	$135.00	$270.00	$94.87–$209.25	36% below	50%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH single or initial DRUG	$129.60	$259.20	$94.87–$209.25	—	50%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH, SINGLE DRUG	$129.60	$259.20	$94.87–$209.25	—	50%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH SINGLE DRUG	$135.00	$270.00	$94.87–$209.25	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM SUB Q INJECTION	$106.08	$212.16	$77.65–$256.46	3% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM SUB Q INJECTION EACH	$165.46	$330.92	$77.65–$256.46	60% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM SUB Q INJECTION	$106.08	$212.16	$77.65–$256.46	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM SUB Q INJECTION EACH	$165.46	$330.92	$77.65–$256.46	—	50%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT - DETAILED - DERMATOLOGY	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 NEW PT LEVEL 2 ONCOLOGY	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 SURG CLINIC - DETAILED - NEW	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 E/M LEVEL 3, DETAILED, NEW PT	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 ORTHO CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 PODIATRY CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 DERM CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT 1st. VISIT MODERATE	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT -1st. VISIT MODERATE	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 CARD CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes CPT 99203 OFFICE VISIT DETAILED	$40.00	$80.00	$29.28–$62.00	75% below	50%
New patient office visit, about 30 minutes inpatient CPT 99203 CARD CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT - DETAILED - DERMATOLOGY	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE VISIT DETAILED	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT 1st. VISIT MODERATE	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 SURG CLINIC - DETAILED - NEW	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT -1st. VISIT MODERATE	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PT LEVEL 2 ONCOLOGY	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 E/M LEVEL 3, DETAILED, NEW PT	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 DERM CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 PODIATRY CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 ORTHO CLINIC NEW PT DETAILED	$40.00	$80.00	$29.28–$62.00	—	50%
New patient office visit, about 45 minutes CPT 99204 ORTHO CLINIC NEW PT COMPREHENSIVE	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes CPT 99204 CARD CLINIC NEW PT MODERATE	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes CPT 99204 OFFICE VISIT COMPREHENSIVE MODERATE	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes CPT 99204 E/M LEVEL 4, COMPREHENSIVE, NEW PT	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes CPT 99204 SURG CLINIC - COMPREHENSIVE - NEW	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT O/P VISIT	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes CPT 99204 NEW PT LEVEL 3 ONCOLOGY	$64.00	$128.00	$46.85–$99.20	68% below	50%
New patient office visit, about 45 minutes inpatient CPT 99204 SURG CLINIC - COMPREHENSIVE - NEW	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 E/M LEVEL 4, COMPREHENSIVE, NEW PT	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 CARD CLINIC NEW PT MODERATE	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE VISIT COMPREHENSIVE MODERATE	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PT LEVEL 3 ONCOLOGY	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT O/P VISIT	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 ORTHO CLINIC NEW PT COMPREHENSIVE	$64.00	$128.00	$46.85–$99.20	—	50%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT FIRST VISIT	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes CPT 99205 OFFICE VISIT COMPREHENSIVE COMPLEX	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes CPT 99205 SURG CLINIC - COMPREHENSIVE - NEW	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes CPT 99205 CARD CLINIC NEW PT COMPREHENSIVE	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes CPT 99205 E/M LEVEL 5, COMPLEX, NEW PT	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes CPT 99205 NEW PT LEVEL 4 ONCOLOGY	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes CPT 99205 ORTHO CLINIC NEW PT COMPREHENSIVE	$83.50	$167.00	$61.12–$129.43	65% below	50%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT FIRST VISIT	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PT LEVEL 4 ONCOLOGY	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 SURG CLINIC - COMPREHENSIVE - NEW	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 E/M LEVEL 5, COMPLEX, NEW PT	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 ORTHO CLINIC NEW PT COMPREHENSIVE	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 CARD CLINIC NEW PT COMPREHENSIVE	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE VISIT COMPREHENSIVE COMPLEX	$83.50	$167.00	$61.12–$129.43	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE VISIT MINIMAL	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 E/M LEVEL 2, EXPANDED, NEW PT	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 DERM CLINIC NEW PT EXPANDED	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PODIATRY CLINIC NEW PT EXPANDED	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 ORTHO CLINIC NEW PT EXPANDED	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT - EXPANDED - DERMATOLOGY	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PT LEVEL 1 ONCOLOGY	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SURG CLINIC - EXPANDED - NEW	$30.50	$61.00	$22.33–$47.28	78% below	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT - EXPANDED - DERMATOLOGY	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PODIATRY CLINIC NEW PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ORTHO CLINIC NEW PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PT LEVEL 1 ONCOLOGY	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 E/M LEVEL 2, EXPANDED, NEW PT	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE VISIT MINIMAL	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SURG CLINIC - EXPANDED - NEW	$30.50	$61.00	$22.33–$47.28	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 DERM CLINIC NEW PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING & TOBACCO USE CESSATION VISIT	$16.50	$33.00	$12.08–$25.58	50% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING & TOBACCO USE CESSATION VISIT	$16.50	$33.00	$12.08–$25.58	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SURG CLINIC - COMPREHENSIVE- ESTABLISHED	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT MODERATE COMPLEX	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 RETURN VISIT COMP	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PT LEVEL 4 ONCOLOGY	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ORTHO CLINIC ESTABLISHED PT COMPREHENSIV	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M LEVEL 5, COMPLEX, ESTABLISHED PT	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED O/P VISIT	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 RETURN VISIT COMPREHENSIVE	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CARD CLINIC ESTABLISED PT COMPREHENSIVE	$55.00	$110.00	$40.26–$85.25	74% below	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 E/M LEVEL 5, COMPLEX, ESTABLISHED PT	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RETURN VISIT COMP	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RETURN VISIT COMPREHENSIVE	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT MODERATE COMPLEX	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SURG CLINIC - COMPREHENSIVE- ESTABLISHED	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CARD CLINIC ESTABLISED PT COMPREHENSIVE	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED PT LEVEL 4 ONCOLOGY	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ESTABLISHED O/P VISIT	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ORTHO CLINIC ESTABLISHED PT COMPREHENSIV	$55.00	$110.00	$40.26–$85.25	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT DETAILED	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CARD CLINIC ESTABLISHED PT EXPANDED	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PT LEVEL 2 ONCOLOGY	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SURG CLINIC - EXPANDED - ESTABLISHED	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E/M LEVEL 3, EXPANDED, ESTABLISHED PT	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PODIATRY CLINIC ESTABLISHED PT EXPANDED	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DERM CLINIC ESTABLISHED PT EXPANDED	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ORTHO CLINIC ESTABLISHE PT EXPANDED	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 O.V. - EXPANDED - DERMATOLOGY	$30.50	$61.00	$22.33–$47.28	80% below	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 DERM CLINIC ESTABLISHED PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CARD CLINIC ESTABLISHED PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT DETAILED	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ESTABLISHED PT LEVEL 2 ONCOLOGY	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PODIATRY CLINIC ESTABLISHED PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SURG CLINIC - EXPANDED - ESTABLISHED	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 O.V. - EXPANDED - DERMATOLOGY	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 E/M LEVEL 3, EXPANDED, ESTABLISHED PT	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ORTHO CLINIC ESTABLISHE PT EXPANDED	$30.50	$61.00	$22.33–$47.28	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SURG CLINIC - DETAILED - ESTABLISHED	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PT LEVEL 3	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E/M LEVEL 4, DETAILED, ESTABLISHED PT	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 O.V. - DETAILED - DERMATOLOGY	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ORTHO CLINIC ESTABLISHED PT DETAILED	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PODIATRY CLINIC ESTABLISHED PT DETAILED	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 DERM CLINIC ESTABLISHED PT DETAILED	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RETURN VISIT ROUTINE	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CARD CLINIC ESTABLISHED PT MODERATE	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT MODERATE	$39.00	$78.00	$28.55–$60.45	77% below	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ORTHO CLINIC ESTABLISHED PT DETAILED	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 DERM CLINIC ESTABLISHED PT DETAILED	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT MODERATE	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CARD CLINIC ESTABLISHED PT MODERATE	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PODIATRY CLINIC ESTABLISHED PT DETAILED	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SURG CLINIC - DETAILED - ESTABLISHED	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 E/M LEVEL 4, DETAILED, ESTABLISHED PT	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ESTABLISHED PT LEVEL 3	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 O.V. - DETAILED - DERMATOLOGY	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RETURN VISIT ROUTINE	$39.00	$78.00	$28.55–$60.45	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ORTHO CLINIC ESTABLISHED PT PROBLEM FOCU	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SURG CLINIC - PROBLEM FOC - ESTABLISHED	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CARD CLINIC ESTABLISED PROBLEM FOCUSED	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E/M LEVEL 2, LIMITED, ESTABLISHED PT	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT MINIMAL	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 O.V. - PROBLEM - DERMATOLOGY	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DERM CLINIC ESTABLISHED PT PROBLEM FOCUS	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PODIATRY CLINIC ESTABLISHED PT PROBLEM	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PT LEVEL 1 ONCOLOGY	$27.50	$55.00	$20.13–$42.62	78% below	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT MINIMAL	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 E/M LEVEL 2, LIMITED, ESTABLISHED PT	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 O.V. - PROBLEM - DERMATOLOGY	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SURG CLINIC - PROBLEM FOC - ESTABLISHED	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ORTHO CLINIC ESTABLISHED PT PROBLEM FOCU	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PODIATRY CLINIC ESTABLISHED PT PROBLEM	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ESTABLISHED PT LEVEL 1 ONCOLOGY	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 DERM CLINIC ESTABLISHED PT PROBLEM FOCUS	$27.50	$55.00	$20.13–$42.62	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CARD CLINIC ESTABLISED PROBLEM FOCUSED	$27.50	$55.00	$20.13–$42.62	—	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION OUTPT LOW COMPLEXITY	$52.00	$104.00	$38.06–$80.68	87% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 SURG CLINIC - CONSULT - DETAILED	$52.00	$104.00	$38.06–$80.68	87% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CARD CLINIC CONSULT DETAILED	$52.00	$104.00	$38.06–$80.68	87% below	50%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OP CONSULT LEVEL 2 ONCOLOGY	$52.05	$104.10	$38.06–$80.68	87% below	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CARD CLINIC CONSULT DETAILED	$52.00	$104.00	$38.06–$80.68	—	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 SURG CLINIC - CONSULT - DETAILED	$52.00	$104.00	$38.06–$80.68	—	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 CONSULTATION OUTPT LOW COMPLEXITY	$52.00	$104.00	$38.06–$80.68	—	50%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OP CONSULT LEVEL 2 ONCOLOGY	$52.05	$104.10	$38.06–$80.68	—	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION OUTPT MODERATE COMPLEX	$76.25	$152.50	$55.82–$118.19	89% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OP CONSULT LEVEL 3 ONCOLOGY	$76.25	$152.50	$55.82–$118.19	89% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 SURG CLINIC - CONSULT - COMPREHENSIVE	$76.25	$152.50	$55.82–$118.19	89% below	50%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CARD CLINIC CONSULT EXTENDED	$76.25	$152.50	$55.82–$118.19	89% below	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OP CONSULT LEVEL 3 ONCOLOGY	$76.25	$152.50	$55.82–$118.19	—	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CARD CLINIC CONSULT EXTENDED	$76.25	$152.50	$55.82–$118.19	—	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 CONSULTATION OUTPT MODERATE COMPLEX	$76.25	$152.50	$55.82–$118.19	—	50%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 SURG CLINIC - CONSULT - COMPREHENSIVE	$76.25	$152.50	$55.82–$118.19	—	50%
Spirometry (breathing test) CPT 94010 INCENTIVE SPIROMETRY TREATMENT	$125.00	$250.00	$91.50–$193.75	49% below	50%
Spirometry (breathing test) inpatient CPT 94010 INCENTIVE SPIROMETRY TREATMENT	$125.00	$250.00	$91.50–$193.75	—	50%
Spirometry before and after a bronchodilator CPT 94060 PFT SCREENING	$419.25	$838.50	$306.89–$649.84	at median	50%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE AND POST	$419.25	$838.50	$306.89–$649.84	at median	50%
Spirometry before and after a bronchodilator CPT 94060 PFT EMPLOYMENT	$419.25	$838.50	$306.89–$649.84	at median	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT EMPLOYMENT	$419.25	$838.50	$306.89–$649.84	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT SCREENING	$419.25	$838.50	$306.89–$649.84	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT PRE AND POST	$419.25	$838.50	$306.89–$649.84	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VAX (PNEUMOVAX 23) INJ	$79.00	$158.00	$57.83–$122.45	77% below	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VAX (PNEUMOVAX 23) INJ	$79.00	$158.00	$57.83–$122.45	—	50%
Rabies vaccine, one dose CPT 90675 RABIES VAC IM	$301.00	$602.00	$220.33–$565.75	62% below	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE 2.5 UNIT INJECTION	$365.00	$730.00	$220.33–$565.75	54% below	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC IM	$301.00	$602.00	$220.33–$565.75	—	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE 2.5 UNIT INJECTION	$365.00	$730.00	$220.33–$565.75	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTH (Td; Tenivac) 0.5ML INJ	$32.00	$64.00	$23.42–$49.60	77% below	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTH (Td; Tenivac) 0.5ML INJ	$32.00	$64.00	$23.42–$49.60	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TET, DIPTH, PERTUS (ADACEL, Tdap) 0.5ML	$49.00	$98.00	$35.87–$75.95	50% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TET, DIPTH, PERTUS (ADACEL, Tdap) 0.5ML	$49.00	$98.00	$35.87–$75.95	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1ST VACCINE	$99.42	$198.83	$72.77–$154.09	116% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$99.42	$198.83	$72.77–$154.09	116% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1ST VACCINE	$99.42	$198.83	$72.77–$154.09	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$99.42	$198.83	$72.77–$154.09	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADDN'L VACCINE	$25.50	$51.00	$18.67–$39.52	34% below	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADDN'L VACCINE	$25.50	$51.00	$18.67–$39.52	—	50%

Source file: https://jeffersonhosp.com/wp-content/uploads/2025/01/581309961_JeffersonHospital_StandardCharges.csv