Hospital Centralia, IL

Salem Township Hospital

Salem Township Hospital in Salem, IL publishes cash prices for 241 common procedures listed here, from its own machine-readable price file updated Dec 3, 2025. Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 165 of 236 procedures and above it for 71. By typical cash price it ranks #35 of 115 Illinois hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1201 Ricker Dr., Salem, IL 62881 Collected Sep 27, 2026 Source price file (618) 548-3194

Critical access hospital (rural, 25 beds or fewer) Emergency department CMS star rating 4 of 5 CCN 141345 · CMS hospital register NPI 1295739548

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Salem Township Hospital in Salem, IL:

May 26, 2023 Warning notice
Sep 11, 2023 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Abdominal CT scan without and with contrast CPT 74170 HC 74170 CT ABDOMEN WO/W CONTRAST	$1,648.90	$4,122.24	$824.45	43% below	60%
Abdominal CT scan without and with contrast inpatient CPT 74170 HC 74170 CT ABDOMEN WO/W CONTRAST	$1,648.90	$4,122.24	$824.45	—	60%
Abdominal X-ray, 2 views CPT 74019 HC 74019 ABDOMEN 2 VIEWS	$216.37	$540.93	$119.00	39% below	60%
Abdominal X-ray, 2 views inpatient CPT 74019 HC 74019 ABDOMEN 2 VIEWS	$216.37	$540.93	$119.00	—	60%
Ankle X-ray, complete, 3 or more views CPT 73610 HC 73610 ANKLE COMPLETE, MIN 3V-BLT	$401.91	$1,004.78	$186.53–$746.11	17% above	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC 73610 ANKLE COMPLETE, MIN 3V-LT	$373.06	$932.64	$186.53–$746.11	9% above	60%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC 73610 ANKLE COMPLETE, MIN 3V-RT	$373.06	$932.64	$186.53–$746.11	9% above	60%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC 73610 ANKLE COMPLETE, MIN 3V-BLT	$401.91	$1,004.78	$186.53–$746.11	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC 73610 ANKLE COMPLETE, MIN 3V-LT	$373.06	$932.64	$186.53–$746.11	—	60%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC 73610 ANKLE COMPLETE, MIN 3V-RT	$373.06	$932.64	$186.53–$746.11	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 HC 93922 PHY STDY UP/LOW EXTREM ART SNGL BILAT	$306.11	$765.28	$563.25	—	60%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 HC 93922 PHY STDY UP/LOW EXTREM ART SNGL BILAT	$306.11	$765.28	$563.25	—	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC 73200 CT UPPER EXTREMITY W/O CONTRAST-LT	$889.83	$2,224.57	$444.91–$489.41	52% below	60%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC 73200 CT UPPER EXTREMITY W/O CONTRAST-RT	$889.83	$2,224.57	$444.91–$489.41	52% below	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC 73200 CT UPPER EXTREMITY W/O CONTRAST-RT	$889.83	$2,224.57	$444.91–$489.41	—	60%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 HC 73200 CT UPPER EXTREMITY W/O CONTRAST-LT	$889.83	$2,224.57	$444.91–$489.41	—	60%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC 74220 ESOPHAGUS	$364.59	$911.47	$182.29–$191.23	44% below	60%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC 74220 ESOPHAGUS	$364.59	$911.47	$182.29–$191.23	—	60%
Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE/JOINT IMAGING, WHOLE BODY	$1,096.58	$2,741.46	$603.12	31% below	60%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE/JOINT IMAGING, WHOLE BODY	$1,096.58	$2,741.46	$603.12	—	60%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US BREAST BILATERAL REAL TIME WITH IMAGE COMPLETE	$301.48	$753.70	$80.07–$94.75	—	60%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL REAL TIME WITH IMAGE COMPLETE - LT	$168.57	$421.43	$80.07–$94.75	68% below	60%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST UNILATERAL REAL TIME WITH IMAGE COMPLETE - RT	$172.28	$430.69	$80.07–$94.75	68% below	60%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 HC US BREAST BILATERAL REAL TIME WITH IMAGE COMPLETE	$301.48	$753.70	$80.07–$94.75	—	60%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL REAL TIME WITH IMAGE COMPLETE - LT	$168.57	$421.43	$80.07–$94.75	—	60%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 HC US BREAST UNILATERAL REAL TIME WITH IMAGE COMPLETE - RT	$172.28	$430.69	$80.07–$94.75	—	60%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US BREAST BILATERAL REAL TIME WITH IMAGE LIMITED	$230.68	$576.70	$60.55–$242.21	—	60%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL REAL TIME WITH IMAGE LIMITED - LT	$121.10	$302.76	$60.55–$242.21	72% below	60%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST UNILATERAL REAL TIME WITH IMAGE LIMITED - RT	$121.10	$302.76	$60.55–$242.21	72% below	60%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 HC US BREAST BILATERAL REAL TIME WITH IMAGE LIMITED	$230.68	$576.70	$60.55–$242.21	—	60%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL REAL TIME WITH IMAGE LIMITED - LT	$121.10	$302.76	$60.55–$242.21	—	60%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 HC US BREAST UNILATERAL REAL TIME WITH IMAGE LIMITED - RT	$121.10	$302.76	$60.55–$242.21	—	60%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC 74174 CT ANGIOGRAPHY ABD/PELVIS W CONTRAST	$2,398.51	$5,996.28	$1,258.02–$1,375.54	39% below	60%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 HC 74174 CT ANGIOGRAPHY ABD/PELVIS W CONTRAST	$2,398.51	$5,996.28	$1,258.02–$1,375.54	—	60%
CT angiography (CTA) of the head CPT 70496 HC 70496 CTA HEAD WO/W CONTRAST	$1,517.38	$3,793.44	$795.86–$3,034.75	41% below	60%
CT angiography (CTA) of the head inpatient CPT 70496 HC 70496 CTA HEAD WO/W CONTRAST	$1,517.38	$3,793.44	$795.86–$3,034.75	—	60%
CT angiography (CTA) of the neck CPT 70498 HC 70498 CT ANGIO NECK WO/W CONTRAST W/ IMAGE PP	$1,572.80	$3,932.00	$824.93–$3,145.60	42% below	60%
CT angiography (CTA) of the neck inpatient CPT 70498 HC 70498 CT ANGIO NECK WO/W CONTRAST W/ IMAGE PP	$1,572.80	$3,932.00	$824.93–$3,145.60	—	60%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC 71275 CT ANGIO CHST,NCRNY WO/W CONT W/ IMG PP	$2,645.84	$6,614.61	$1,190.63–$4,868.35	10% below	60%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC 71275 CT ANGIO CHST,NCRNY WO/W CONT W/ IMG PP	$2,645.84	$6,614.61	$1,190.63–$4,868.35	—	60%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC 74176 CT ABD AND PELVIS, WITHOUT CONTRAST	$3,661.42	$9,153.56	$1,830.71–$7,322.86	2% below	60%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC 74176 CT ABD AND PELVIS, WITHOUT CONTRAST	$3,661.42	$9,153.56	$1,830.71–$7,322.86	—	60%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC 74177 CT ABD AND PELVIS, WITH CONTRAST	$3,878.99	$9,697.48	$1,745.55–$7,757.98	14% below	60%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC 74177 CT ABD AND PELVIS, WITH CONTRAST	$3,878.99	$9,697.48	$1,745.55–$7,757.98	—	60%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC 74178 CT ABD & PLVS W & WO CONT 1 BODY REGN	$4,363.92	$10,909.80	$1,963.76–$8,727.84	16% below	60%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC 74178 CT ABD & PLVS W & WO CONT 1 BODY REGN	$4,363.92	$10,909.80	$1,963.76–$8,727.84	—	60%
CT scan of the abdomen with contrast CPT 74160 HC 74160 CT ABDOMEN W/ CONTRAST	$1,593.79	$3,984.48	$796.90	35% below	60%
CT scan of the abdomen with contrast inpatient CPT 74160 HC 74160 CT ABDOMEN W/ CONTRAST	$1,593.79	$3,984.48	$796.90	—	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC 70486 CT MAXILLOFACIAL W/O CONTRAST, LTD	$1,290.12	$3,225.29	$918.34–$1,225.62	25% below	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC 70486 CT SINUS W/O CONTRAST	$1,290.12	$3,225.29	$918.34–$1,225.62	25% below	60%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC 70486 CT FACIAL BONES W/O CONTRAST	$1,750.89	$4,377.22	$918.34–$1,225.62	2% above	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC 70486 CT MAXILLOFACIAL W/O CONTRAST, LTD	$1,290.12	$3,225.29	$918.34–$1,225.62	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC 70486 CT SINUS W/O CONTRAST	$1,290.12	$3,225.29	$918.34–$1,225.62	—	60%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC 70486 CT FACIAL BONES W/O CONTRAST	$1,750.89	$4,377.22	$918.34–$1,225.62	—	60%
CT scan of the head or brain, no contrast dye CPT 70450 HC 70450 CT HEAD/BRAIN W/O CONTRAST	$1,925.14	$4,812.84	$892.36–$3,850.27	1% above	60%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC 70450 CT HEAD/BRAIN W/O CONTRAST	$1,925.14	$4,812.84	$892.36–$3,850.27	—	60%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC 72131 CT LUMBAR SPINE W/O CONTRAST	$1,313.38	$3,283.45	$656.69–$722.36	42% below	60%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC 72131 CT LUMBAR SPINE W/O CONTRAST	$1,313.38	$3,283.45	$656.69–$722.36	—	60%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC 72125 CT CERVICAL SPINE W/O CONTRAST	$2,459.20	$6,148.00	$1,289.85–$4,918.40	4% above	60%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC 72125 CT CERVICAL SPINE W/O CONTRAST	$2,459.20	$6,148.00	$1,289.85–$4,918.40	—	60%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX EXTRACRN ARTERIES COMP BILAT-FAC	$861.21	$2,153.02	$430.60–$473.66	—	60%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX EXTRACRN ARTERIES COMP BILAT-FAC	$861.21	$2,153.02	$430.60–$473.66	—	60%
Chest CT scan without and with contrast CPT 71270 HC 71270 CT THORAX DIAGNOSTIC WO/W CONTRAST	$1,354.91	$3,387.27	$609.71–$2,723.01	54% below	60%
Chest CT scan without and with contrast inpatient CPT 71270 HC 71270 CT THORAX DIAGNOSTIC WO/W CONTRAST	$1,354.91	$3,387.27	$609.71–$2,723.01	—	60%
Chest X-ray, 2 views CPT 71046 HC 71046 CHEST 2 VIEWS	$319.66	$799.14	$159.83–$639.31	4% above	60%
Chest X-ray, 2 views inpatient CPT 71046 HC 71046 CHEST 2 VIEWS	$319.66	$799.14	$159.83–$639.31	—	60%
Chest X-ray, single view CPT 71045 HC 71045 CHEST SINGLE VIEW	$221.52	$553.80	$110.76–$443.04	11% below	60%
Chest X-ray, single view CPT 71045 HC 71045 CHEST SINGLE VIEW PORTABLE	$221.52	$553.80	$110.76–$443.04	11% below	60%
Chest X-ray, single view inpatient CPT 71045 HC 71045 CHEST SINGLE VIEW	$221.52	$553.80	$110.76–$443.04	—	60%
Chest X-ray, single view inpatient CPT 71045 HC 71045 CHEST SINGLE VIEW PORTABLE	$221.52	$553.80	$110.76–$443.04	—	60%
Collarbone (clavicle) X-ray, complete CPT 73000 HC 73000 CLAVICAL COMPLETE-BLT	$138.99	$347.47	$34.09	54% below	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC 73000 CLAVICAL COMPLETE-LT	$68.17	$170.43	$34.09	77% below	60%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC 73000 CLAVICAL COMPLETE-RT	$68.17	$170.43	$34.09	77% below	60%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 HC 73000 CLAVICAL COMPLETE-BLT	$138.99	$347.47	$34.09	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC 73000 CLAVICAL COMPLETE-LT	$68.17	$170.43	$34.09	—	60%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 HC 73000 CLAVICAL COMPLETE-RT	$68.17	$170.43	$34.09	—	60%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC 76770 US RETROPERITONEAL COMPLETE	$525.95	$1,314.87	$262.97–$301.63	37% below	60%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC 76770 US RETROPERITONEAL COMPLETE	$525.95	$1,314.87	$262.97–$301.63	—	60%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC 77080 DEXA SC, 1 OR MORE SITES, AXIAL SKELETON	$453.79	$1,134.48	$244.60–$907.58	8% below	60%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC 77080 DEXA SC, 1 OR MORE SITES, AXIAL SKELETON	$453.79	$1,134.48	$244.60–$907.58	—	60%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC 71250 CT THORAX DIAGNOSTIC W/O CONTRAST	$1,782.88	$4,457.20	$891.44–$3,565.76	6% below	60%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC 71250 CT THORAX DIAGNOSTIC W/O CONTRAST	$1,782.88	$4,457.20	$891.44–$3,565.76	—	60%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC 71260 CT THORAX DIAGNOSTIC W/ CONTRAST	$1,671.11	$4,177.77	$835.55–$3,342.22	31% below	60%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC 71260 CT THORAX DIAGNOSTIC W/ CONTRAST	$1,671.11	$4,177.77	$835.55–$3,342.22	—	60%
Diagnostic mammogram, both breasts both sides CPT 77066 HC 77066 MAMMOGRAM,DIAGNOSTIC,+/- CAD,BILATERAL	$184.80	$461.99	$92.40–$369.59	—	60%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC 77066 MAMMOGRAM,DIAGNOSTIC,+/- CAD,BILATERAL	$184.80	$461.99	$92.40–$369.59	—	60%
Diagnostic mammogram, one breast one side CPT 77065 HC 77065 MAMMOGRAM,DIAGNOSTIC,+/- CAD,UNI-LT	$84.06	$210.16	$39.93–$168.13	74% below	60%
Diagnostic mammogram, one breast one side CPT 77065 HC 77065 MAMMOGRAM,DIAGNOSTIC,+/- CAD,UNI-RT	$84.06	$210.16	$39.93–$168.13	74% below	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC 77065 MAMMOGRAM,DIAGNOSTIC,+/- CAD,UNI-LT	$84.06	$210.16	$39.93–$168.13	—	60%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC 77065 MAMMOGRAM,DIAGNOSTIC,+/- CAD,UNI-RT	$84.06	$210.16	$39.93–$168.13	—	60%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LOW EXTREM ARTER/BPG COMP BILAT	$710.59	$1,776.47	$390.82	—	60%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LOW EXTREM ARTER/BPG COMP BILAT	$710.59	$1,776.47	$390.82	—	60%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC 93970 DUPLEX EXTREM VEINS COMPLETE BILAT	$683.11	$1,707.78	$358.29–$480.94	—	60%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC 93970 DUPLEX EXTREM VEINS COMPLETE BILAT	$683.11	$1,707.78	$358.29–$480.94	—	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D COMPLETE W/DOPPLER & COLOR FLOW	$2,147.39	$5,368.48	$1,126.31–$1,231.53	at median	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D COMP W/DOPPLER WO/W CONTRAST	$2,278.22	$5,695.54	$1,126.31–$1,396.40	6% above	60%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC ECHO TTE 2D COMP W/DOPPLER W CONTRAST	$2,278.22	$5,695.54	$1,126.31–$1,396.40	6% above	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D COMPLETE W/DOPPLER & COLOR FLOW	$2,147.39	$5,368.48	$1,126.31–$1,231.53	—	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D COMP W/DOPPLER W CONTRAST	$2,278.22	$5,695.54	$1,126.31–$1,396.40	—	60%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC ECHO TTE 2D COMP W/DOPPLER WO/W CONTRAST	$2,278.22	$5,695.54	$1,126.31–$1,396.40	—	60%
Elbow X-ray, 2 views CPT 73070 HC 73070 ELBOW 2 VIEWS-BLT	$149.63	$374.07	$36.66–$40.33	48% below	60%
Elbow X-ray, 2 views one side CPT 73070 HC 73070 ELBOW 2 VIEWS-LT	$73.33	$183.32	$36.66–$40.33	74% below	60%
Elbow X-ray, 2 views one side CPT 73070 HC 73070 ELBOW 2 VIEWS-RT	$73.33	$183.32	$36.66–$40.33	74% below	60%
Elbow X-ray, 2 views inpatient CPT 73070 HC 73070 ELBOW 2 VIEWS-BLT	$149.63	$374.07	$36.66–$40.33	—	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC 73070 ELBOW 2 VIEWS-RT	$73.33	$183.32	$36.66–$40.33	—	60%
Elbow X-ray, 2 views inpatient one side CPT 73070 HC 73070 ELBOW 2 VIEWS-LT	$73.33	$183.32	$36.66–$40.33	—	60%
Elbow X-ray, complete, 3 or more views CPT 73080 HC 73080 ELBOW COMPLETE, MIN 3V-BLT	$218.94	$547.34	$61.55–$64.55	37% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC 73080 ELBOW COMPLETE, MIN 3V-RT	$117.36	$293.39	$61.55–$64.55	66% below	60%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC 73080 ELBOW COMPLETE, MIN 3V-LT	$117.36	$293.39	$61.55–$64.55	66% below	60%
Elbow X-ray, complete, 3 or more views inpatient CPT 73080 HC 73080 ELBOW COMPLETE, MIN 3V-BLT	$218.94	$547.34	$61.55–$64.55	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC 73080 ELBOW COMPLETE, MIN 3V-RT	$117.36	$293.39	$61.55–$64.55	—	60%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 HC 73080 ELBOW COMPLETE, MIN 3V-LT	$117.36	$293.39	$61.55–$64.55	—	60%
Eye socket (orbit) CT scan without contrast CPT 70480 HC 70480 CT ORBITS W/O CONTRAST	$1,067.79	$2,669.48	$569.60–$626.56	38% below	60%
Eye socket (orbit) CT scan without contrast CPT 70480 HC 70480 CT INTRACRANIAL W/O CONTRAST	$1,139.20	$2,847.99	$569.60–$626.56	34% below	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC 70480 CT ORBITS W/O CONTRAST	$1,067.79	$2,669.48	$569.60–$626.56	—	60%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 HC 70480 CT INTRACRANIAL W/O CONTRAST	$1,139.20	$2,847.99	$569.60–$626.56	—	60%
Forearm X-ray (radius and ulna), 2 views CPT 73090 HC 73090 FOREARM 2 VIEWS-BLT	$184.41	$461.02	$47.44–$189.77	43% below	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC 73090 FOREARM 2 VIEWS-RT	$94.88	$237.21	$47.44–$189.77	71% below	60%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC 73090 FOREARM 2 VIEWS-LT	$94.88	$237.21	$47.44–$189.77	71% below	60%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 HC 73090 FOREARM 2 VIEWS-BLT	$184.41	$461.02	$47.44–$189.77	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC 73090 FOREARM 2 VIEWS-RT	$94.88	$237.21	$47.44–$189.77	—	60%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 HC 73090 FOREARM 2 VIEWS-LT	$94.88	$237.21	$47.44–$189.77	—	60%
Hand X-ray, 2 views CPT 73120 HC 73120 HAND 2 VIEWS-BLT	$157.75	$394.38	$40.52–$43.38	45% below	60%
Hand X-ray, 2 views one side CPT 73120 HC 73120 HAND 2 VIEWS-RT	$77.25	$193.12	$40.52–$43.38	73% below	60%
Hand X-ray, 2 views one side CPT 73120 HC 73120 HAND 2 VIEWS-LT	$77.25	$193.12	$40.52–$43.38	73% below	60%
Hand X-ray, 2 views inpatient CPT 73120 HC 73120 HAND 2 VIEWS-BLT	$157.75	$394.38	$40.52–$43.38	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HC 73120 HAND 2 VIEWS-RT	$77.25	$193.12	$40.52–$43.38	—	60%
Hand X-ray, 2 views inpatient one side CPT 73120 HC 73120 HAND 2 VIEWS-LT	$77.25	$193.12	$40.52–$43.38	—	60%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC 95806 SLEEP STUDY, UNATTENDED BY TECH	$476.40	$1,191.00	$238.20–$952.80	18% below	60%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC 95806 SLEEP STUDY, UNATTENDED BY TECH	$476.40	$1,191.00	$238.20–$952.80	—	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC 95811 POLYSOMNOGRAPH W/ CPAP	$2,866.00	$7,165.00	$1,576.30	40% below	60%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC 95811 POLYSOMNOGRAPH W/ CPAP	$2,866.00	$7,165.00	$1,576.30	—	60%
Knee X-ray, 3 views CPT 73562 HC 73562 KNEE 3 VIEWS-BLT	$503.14	$1,257.84	$209.54–$735.09	32% above	60%
Knee X-ray, 3 views one side CPT 73562 HC 73562 KNEE 3 VIEWS-LT	$399.50	$998.76	$209.54–$735.09	5% above	60%
Knee X-ray, 3 views one side CPT 73562 HC 73562 KNEE 3 VIEWS-RT	$399.50	$998.76	$209.54–$735.09	5% above	60%
Knee X-ray, 3 views inpatient CPT 73562 HC 73562 KNEE 3 VIEWS-BLT	$503.14	$1,257.84	$209.54–$735.09	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 HC 73562 KNEE 3 VIEWS-RT	$399.50	$998.76	$209.54–$735.09	—	60%
Knee X-ray, 3 views inpatient one side CPT 73562 HC 73562 KNEE 3 VIEWS-LT	$399.50	$998.76	$209.54–$735.09	—	60%
Knee X-ray, complete, 4 or more views CPT 73564 HC 73564 KNEE COMPLETE, MIN 4V-BLT	$286.96	$717.41	$75.32–$301.30	38% below	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC 73564 KNEE COMPLETE, MIN 4V-LT	$150.65	$376.62	$75.32–$301.30	67% below	60%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC 73564 KNEE COMPLETE, MIN 4V-RT	$150.65	$376.62	$75.32–$301.30	67% below	60%
Knee X-ray, complete, 4 or more views inpatient CPT 73564 HC 73564 KNEE COMPLETE, MIN 4V-BLT	$286.96	$717.41	$75.32–$301.30	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC 73564 KNEE COMPLETE, MIN 4V-LT	$150.65	$376.62	$75.32–$301.30	—	60%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 HC 73564 KNEE COMPLETE, MIN 4V-RT	$150.65	$376.62	$75.32–$301.30	—	60%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 HC 73700 CT LOWER EXTREM W/O CONTRAST BLT	$3,084.92	$7,712.30	$772.50–$3,090.02	69% above	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC 73700 CT LOWER EXTREM W/O CONTRAST RT	$1,545.01	$3,862.52	$772.50–$3,090.02	15% below	60%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC 73700 CT LOWER EXTREM W/O CONTRAST LT	$1,545.01	$3,862.52	$772.50–$3,090.02	15% below	60%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 HC 73700 CT LOWER EXTREM W/O CONTRAST BLT	$3,084.92	$7,712.30	$772.50–$3,090.02	—	60%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC 73700 CT LOWER EXTREM W/O CONTRAST LT	$1,545.01	$3,862.52	$772.50–$3,090.02	—	60%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 HC 73700 CT LOWER EXTREM W/O CONTRAST RT	$1,545.01	$3,862.52	$772.50–$3,090.02	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED, LEVEL III	$590.89	$1,477.23	$295.45–$1,087.24	17% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LIMITED, LEVEL II	$590.89	$1,477.23	$295.45–$1,087.24	17% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC 76705 US ABDOMEN LIMITED LEVEL I	$590.89	$1,477.23	$295.45–$1,087.24	17% below	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC 76705 US ABDOMEN LIMITED LEVEL I	$590.89	$1,477.23	$295.45–$1,087.24	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED, LEVEL III	$590.89	$1,477.23	$295.45–$1,087.24	—	60%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ABDOMEN LIMITED, LEVEL II	$590.89	$1,477.23	$295.45–$1,087.24	—	60%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC 76882 US EXTR NONVASC REALTIME LIMITED - BLT	$198.18	$495.45	$51.97–$54.50	51% below	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC 76882 US EXTR NONVASC REALTIME LIMITED - LT	$99.09	$247.72	$51.97–$54.50	76% below	60%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC 76882 US EXTR NONVASC REALTIME LIMITED - RT	$99.09	$247.72	$51.97–$54.50	76% below	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 HC 76882 US EXTR NONVASC REALTIME LIMITED - BLT	$198.18	$495.45	$51.97–$54.50	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC 76882 US EXTR NONVASC REALTIME LIMITED - RT	$99.09	$247.72	$51.97–$54.50	—	60%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 HC 76882 US EXTR NONVASC REALTIME LIMITED - LT	$99.09	$247.72	$51.97–$54.50	—	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC 71271 CT THORAX W/O CONTRAST - SCREENING	$593.95	$1,484.88	$305.58–$1,187.90	5% above	60%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC 71271 CT THORAX W/O CONTRAST - SCREENING	$593.95	$1,484.88	$305.58–$1,187.90	—	60%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 HC 73590 TIBIA & FIBULA 2 VIEWS-BLT	$187.87	$469.68	$51.73–$197.26	42% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC 73590 TIBIA & FIBULA 2 VIEWS-RT	$98.63	$246.57	$51.73–$197.26	70% below	60%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC 73590 TIBIA & FIBULA 2 VIEWS-LT	$98.63	$246.57	$51.73–$197.26	70% below	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 HC 73590 TIBIA & FIBULA 2 VIEWS-BLT	$187.87	$469.68	$51.73–$197.26	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC 73590 TIBIA & FIBULA 2 VIEWS-RT	$98.63	$246.57	$51.73–$197.26	—	60%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 HC 73590 TIBIA & FIBULA 2 VIEWS-LT	$98.63	$246.57	$51.73–$197.26	—	60%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC 73721 MRI LOW EXTREM, JOINT, W/O CONTRAST - BLT	$2,440.71	$6,101.78	$673.16–$2,566.85	15% below	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC 73721 MRI LOW EXTREM, JOINT, W/O CONTRAST - LT	$1,283.42	$3,208.56	$673.16–$2,566.85	55% below	60%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC 73721 MRI LOW EXTREM, JOINT, W/O CONTRAST - RT	$1,283.42	$3,208.56	$673.16–$2,566.85	55% below	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC 73721 MRI LOW EXTREM, JOINT, W/O CONTRAST - BLT	$2,440.71	$6,101.78	$673.16–$2,566.85	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC 73721 MRI LOW EXTREM, JOINT, W/O CONTRAST - LT	$1,283.42	$3,208.56	$673.16–$2,566.85	—	60%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HC 73721 MRI LOW EXTREM, JOINT, W/O CONTRAST - RT	$1,283.42	$3,208.56	$673.16–$2,566.85	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI LOW EXTREM, JOINT, WO/W CONTRAST-RT	$1,504.23	$3,760.57	$1,073.35	59% below	60%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI LOW EXTREM, JOINT, WO/W CONTRAST-LT	$1,533.36	$3,833.40	$1,073.35	59% below	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI LOW EXTREM, JOINT, WO/W CONTRAST-RT	$1,504.23	$3,760.57	$1,073.35	—	60%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 HC MRI LOW EXTREM, JOINT, WO/W CONTRAST-LT	$1,533.36	$3,833.40	$1,073.35	—	60%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,252.93	$3,132.32	$689.11	55% below	60%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN W/O CONTRAST	$1,252.93	$3,132.32	$689.11	—	60%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN WO/W CONTRAST	$2,170.38	$5,425.94	$1,085.19–$1,244.71	42% below	60%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN WO/W CONTRAST	$2,170.38	$5,425.94	$1,085.19–$1,244.71	—	60%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STEM W/O CONTRAST-SNGL PLANE	$1,242.59	$3,106.47	$878.20–$3,348.71	58% below	60%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN INC STEM W/O CONTRAST	$1,674.36	$4,185.89	$878.20–$3,348.71	43% below	60%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN STEM W/O CONTRAST-SNGL PLANE	$1,242.59	$3,106.47	$878.20–$3,348.71	—	60%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN INC STEM W/O CONTRAST	$1,674.36	$4,185.89	$878.20–$3,348.71	—	60%
MRI of the brain, with and without contrast dye CPT 70553 HC 70553 MRI BRAIN (INC BRAIN STEM) WO/W CONTRAST	$2,364.78	$5,911.94	$1,182.39–$1,655.34	43% below	60%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC 70553 MRI BRAIN (INC BRAIN STEM) WO/W CONTRAST	$2,364.78	$5,911.94	$1,182.39–$1,655.34	—	60%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMB SPINE W/O CONTRAST-SNGL PLANE	$866.70	$2,166.74	$1,005.37–$4,021.47	72% below	60%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST	$2,010.74	$5,026.84	$1,005.37–$4,021.47	34% below	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMB SPINE W/O CONTRAST-SNGL PLANE	$866.70	$2,166.74	$1,005.37–$4,021.47	—	60%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI LUMBAR SPINE W/O CONTRAST	$2,010.74	$5,026.84	$1,005.37–$4,021.47	—	60%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SPINE WO/W CONTRAST	$2,251.01	$5,627.53	$960.22–$1,180.65	46% below	60%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI LUMBAR SPINE WO/W CONTRAST	$2,251.01	$5,627.53	$960.22–$1,180.65	—	60%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST	$1,647.01	$4,117.52	$905.85–$3,294.02	45% below	60%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI THORACIC SPINE W/O CONTRAST	$1,647.01	$4,117.52	$905.85–$3,294.02	—	60%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERV SPINE WO/W CONTRAST	$2,219.38	$5,548.44	$1,109.69	46% below	60%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI CERV SPINE WO/W CONTRAST	$2,219.38	$5,548.44	$1,109.69	—	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERV SPINE W/O CONTRAST-SNGL PLANE	$884.28	$2,210.71	$884.28–$3,537.14	71% below	60%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST	$1,768.57	$4,421.42	$884.28–$3,537.14	41% below	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERV SPINE W/O CONTRAST-SNGL PLANE	$884.28	$2,210.71	$884.28–$3,537.14	—	60%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI CERVICAL SPINE W/O CONTRAST	$1,768.57	$4,421.42	$884.28–$3,537.14	—	60%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS WO/W CON	$2,057.28	$5,143.19	$1,028.64	45% below	60%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS WO/W CON	$2,057.28	$5,143.19	$1,028.64	—	60%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONTRAST	$1,513.30	$3,783.26	$3,026.61	44% below	60%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS W/O CONTRAST	$1,513.30	$3,783.26	$3,026.61	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC 73221 MRI UP EXTREM, ANY JOINT, W/O CONTRAST - BLT	$2,494.34	$6,235.85	$698.76–$705.88	14% below	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC 73221 MRI UP EXTREM, ANY JOINT, W/O CONTRAST - LT	$1,222.37	$3,055.92	$698.76–$705.88	58% below	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC 73221 MRI UP EXTREM, ANY JOINT, W/O CONTRAST - RT	$1,283.42	$3,208.56	$698.76–$705.88	56% below	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC 73221 MRI UP EXTREM, ANY JOINT, W/O CONTRAST - BLT	$2,494.34	$6,235.85	$698.76–$705.88	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC 73221 MRI UP EXTREM, ANY JOINT, W/O CONTRAST - LT	$1,222.37	$3,055.92	$698.76–$705.88	—	60%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 HC 73221 MRI UP EXTREM, ANY JOINT, W/O CONTRAST - RT	$1,283.42	$3,208.56	$698.76–$705.88	—	60%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC 72050 SPINE CERVICAL 4 OR 5 VIEWS	$393.45	$983.62	$206.36–$786.90	28% below	60%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 HC 72050 SPINE CERVICAL 4 OR 5 VIEWS	$393.45	$983.62	$206.36–$786.90	—	60%
Neck soft tissue CT scan with contrast CPT 70491 HC 70491 CT SOFT TISSUE NECK W/ CONTRAST	$1,381.20	$3,453.01	$621.54–$2,762.41	37% below	60%
Neck soft tissue CT scan with contrast inpatient CPT 70491 HC 70491 CT SOFT TISSUE NECK W/ CONTRAST	$1,381.20	$3,453.01	$621.54–$2,762.41	—	60%
Neck soft tissue CT scan without contrast CPT 70490 HC 70490 CT SOFT TISSUE NECK W/O CONTRAST	$975.35	$2,438.38	$487.68	47% below	60%
Neck soft tissue CT scan without contrast inpatient CPT 70490 HC 70490 CT SOFT TISSUE NECK W/O CONTRAST	$975.35	$2,438.38	$487.68	—	60%
Neck soft tissue X-ray CPT 70360 HC 70360 NECK SOFT TISSUE	$93.15	$232.87	$48.85	65% below	60%
Neck soft tissue X-ray inpatient CPT 70360 HC 70360 NECK SOFT TISSUE	$93.15	$232.87	$48.85	—	60%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM MYOCARDIAL PERFUS,SPECT,MLTP STDY R/E	$2,968.38	$7,420.96	$1,702.37–$5,936.77	21% below	60%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM MYOCARDIAL PERFUS,SPECT,MLTP STDY R/E	$2,968.38	$7,420.96	$1,702.37–$5,936.77	—	60%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC PET CT-SKULL BASE TO MID THIGH	$3,492.80	$8,732.00	$1,746.40–$2,444.96	41% below	60%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC PET CT-SKULL BASE TO MID THIGH	$3,492.80	$8,732.00	$1,746.40–$2,444.96	—	60%
Pelvic CT scan without contrast CPT 72192 HC 72192 CT PELVIS W/O CONTRAST	$1,078.77	$2,696.93	$539.39–$593.32	44% below	60%
Pelvic CT scan without contrast inpatient CPT 72192 HC 72192 CT PELVIS W/O CONTRAST	$1,078.77	$2,696.93	$539.39–$593.32	—	60%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC 76857 US PELVIS (NON-OB), LIMITED OR FOLLOWUP	$366.25	$915.62	$183.12	34% below	60%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC 76857 US PELVIS (NON-OB), LIMITED OR FOLLOWUP	$366.25	$915.62	$183.12	—	60%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC 76856 US PELVIS (NON-OBSTETRIC) COMPLETE	$744.05	$1,860.13	$372.03–$1,488.10	9% below	60%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC 76856 US PELVIS (NON-OBSTETRIC) COMPLETE	$744.05	$1,860.13	$372.03–$1,488.10	—	60%
Rib X-ray, one side, 2 views one side CPT 71100 HC 71100 RIBS UNILAT, 2 VIEWS-RT	$121.29	$303.22	$60.64–$84.90	66% below	60%
Rib X-ray, one side, 2 views one side CPT 71100 HC 71100 RIBS UNILAT, 2 VIEWS-LT	$127.34	$318.36	$60.64–$84.90	64% below	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC 71100 RIBS UNILAT, 2 VIEWS-RT	$121.29	$303.22	$60.64–$84.90	—	60%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 HC 71100 RIBS UNILAT, 2 VIEWS-LT	$127.34	$318.36	$60.64–$84.90	—	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC 71101 RIBS UNILAT, MIN 3V, W/ PA CHEST-LT	$158.97	$397.43	$83.38–$317.94	67% below	60%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC 71101 RIBS UNILAT, MIN 3V, W/ PA CHEST-RT	$158.97	$397.43	$83.38–$317.94	67% below	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC 71101 RIBS UNILAT, MIN 3V, W/ PA CHEST-LT	$158.97	$397.43	$83.38–$317.94	—	60%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 HC 71101 RIBS UNILAT, MIN 3V, W/ PA CHEST-RT	$158.97	$397.43	$83.38–$317.94	—	60%
Screening mammogram, both breasts both sides CPT 77067 HC 77067 MAMMOGRAM SCREENING,+/- CAD,BILATERAL	$283.02	$707.55	$80.23–$693.40	—	60%
Screening mammogram, both breasts one side CPT 77067 HC 77067 MAMMOGRAM SCRN,+/- CAD,UNI-LT	$35.67	$89.18	$80.23–$693.40	87% below	60%
Screening mammogram, both breasts one side CPT 77067 HC 77067 MAMMOGRAM SCRN,+/- CAD,UNI-RT	$35.67	$89.18	$80.23–$693.40	87% below	60%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC 77067 MAMMOGRAM SCREENING,+/- CAD,BILATERAL	$283.02	$707.55	$80.23–$693.40	—	60%
Screening mammogram, both breasts inpatient one side CPT 77067 HC 77067 MAMMOGRAM SCRN,+/- CAD,UNI-RT	$35.67	$89.18	$80.23–$693.40	—	60%
Screening mammogram, both breasts inpatient one side CPT 77067 HC 77067 MAMMOGRAM SCRN,+/- CAD,UNI-LT	$35.67	$89.18	$80.23–$693.40	—	60%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC 73030 SHOULDER COMPLETE, MIN 2V-BLT	$455.82	$1,139.54	$195.53–$215.08	25% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC 73030 SHOULDER COMPLETE, MIN 2V-LT	$391.06	$977.65	$195.53–$215.08	7% above	60%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC 73030 SHOULDER COMPLETE, MIN 2V-RT	$391.06	$977.65	$195.53–$215.08	7% above	60%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC 73030 SHOULDER COMPLETE, MIN 2V-BLT	$455.82	$1,139.54	$195.53–$215.08	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC 73030 SHOULDER COMPLETE, MIN 2V-RT	$391.06	$977.65	$195.53–$215.08	—	60%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC 73030 SHOULDER COMPLETE, MIN 2V-LT	$391.06	$977.65	$195.53–$215.08	—	60%
Sleep study in a lab (polysomnography) CPT 95810 HC 95810 POLYSOMNOGRAPHY, 4 OR > PARAM	$2,663.95	$6,659.87	$1,397.24–$1,864.76	34% below	60%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC 95810 POLYSOMNOGRAPHY, 4 OR > PARAM	$2,663.95	$6,659.87	$1,397.24–$1,864.76	—	60%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 HC 73552 FEMUR MIN 2 VIEW - BLT	$184.00	$460.00	$46.97–$65.76	35% below	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC 73552 FEMUR MIN 2 VIEW - RT	$93.94	$234.84	$46.97–$65.76	67% below	60%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC 73552 FEMUR MIN 2 VIEW - LT	$93.94	$234.84	$46.97–$65.76	67% below	60%
Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 HC 73552 FEMUR MIN 2 VIEW - BLT	$184.00	$460.00	$46.97–$65.76	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC 73552 FEMUR MIN 2 VIEW - RT	$93.94	$234.84	$46.97–$65.76	—	60%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 HC 73552 FEMUR MIN 2 VIEW - LT	$93.94	$234.84	$46.97–$65.76	—	60%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC 72128 CT THORACIC SPINE W/O CONTRAST	$1,047.36	$2,618.41	$576.05	52% below	60%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 HC 72128 CT THORACIC SPINE W/O CONTRAST	$1,047.36	$2,618.41	$576.05	—	60%
Transvaginal pelvic ultrasound CPT 76830 HC 76830 US TRANSVAGINAL	$470.79	$1,176.98	$235.40–$258.94	29% below	60%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC 76830 US TRANSVAGINAL	$470.79	$1,176.98	$235.40–$258.94	—	60%
Ultrasound of the abdomen, complete CPT 76700 HC 76700 US ABDOMEN COMPLETE	$749.82	$1,874.56	$393.28–$1,499.65	29% below	60%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC 76700 US ABDOMEN COMPLETE	$749.82	$1,874.56	$393.28–$1,499.65	—	60%
Ultrasound of the scrotum and testicles CPT 76870 HC 76870 US SCROTUM AND CONTENTS	$497.51	$1,243.78	$273.63	34% below	60%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC 76870 US SCROTUM AND CONTENTS	$497.51	$1,243.78	$273.63	—	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC 76536 US SOFT TISSUE HEAD/NECK	$681.62	$1,704.04	$340.81–$576.21	1% below	60%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC 76536 US SOFT TISSUE HEAD/NECK	$681.62	$1,704.04	$340.81–$576.21	—	60%
Upper arm X-ray (humerus), 2 views CPT 73060 HC 73060 HUMERUS MIN 2V-BLT	$191.69	$479.22	$44.38–$197.26	39% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC 73060 HUMERUS MIN 2V-LT	$98.63	$246.57	$44.38–$197.26	68% below	60%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC 73060 HUMERUS MIN 2V-RT	$98.63	$246.57	$44.38–$197.26	68% below	60%
Upper arm X-ray (humerus), 2 views inpatient CPT 73060 HC 73060 HUMERUS MIN 2V-BLT	$191.69	$479.22	$44.38–$197.26	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC 73060 HUMERUS MIN 2V-LT	$98.63	$246.57	$44.38–$197.26	—	60%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HC 73060 HUMERUS MIN 2V-RT	$98.63	$246.57	$44.38–$197.26	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC 93971 DUPLEX EXTREM VEINS UNILAT/LIMITED-RT	$279.04	$697.59	$139.52–$585.94	63% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC 93971 DUPLEX EXTREM VEINS UNILAT/LIMITED-LT	$292.97	$732.43	$139.52–$585.94	62% below	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC 93971 DUPLEX EXTREM VEINS UNILAT/LIMITED-RT	$279.04	$697.59	$139.52–$585.94	—	60%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC 93971 DUPLEX EXTREM VEINS UNILAT/LIMITED-LT	$292.97	$732.43	$139.52–$585.94	—	60%
Wrist X-ray, complete, 3 or more views CPT 73110 HC 73110 WRIST COMPLETE, MIN 3V-BLT	$187.87	$469.68	$55.54–$273.25	43% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC 73110 WRIST COMPLETE, MIN 3V-LT	$111.08	$277.69	$55.54–$273.25	67% below	60%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC 73110 WRIST COMPLETE, MIN 3V-RT	$111.08	$277.69	$55.54–$273.25	67% below	60%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC 73110 WRIST COMPLETE, MIN 3V-BLT	$187.87	$469.68	$55.54–$273.25	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC 73110 WRIST COMPLETE, MIN 3V-LT	$111.08	$277.69	$55.54–$273.25	—	60%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC 73110 WRIST COMPLETE, MIN 3V-RT	$111.08	$277.69	$55.54–$273.25	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC 73502 HIP 2/3 VIEW (W PELVIS) - LT	$351.71	$879.28	$175.86–$703.42	14% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC 73502 HIP 2/3 VIEW (W PELVIS) -RT	$351.71	$879.28	$175.86–$703.42	14% above	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC 73502 HIP 2/3 VIEW (W PELVIS) -RT	$351.71	$879.28	$175.86–$703.42	—	60%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC 73502 HIP 2/3 VIEW (W PELVIS) - LT	$351.71	$879.28	$175.86–$703.42	—	60%
X-ray of the abdomen, 1 view CPT 74018 HC 74018 ABDOMEN SINGLE VIEW	$302.99	$757.48	$151.50–$173.77	13% above	60%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC 74018 ABDOMEN SINGLE VIEW	$302.99	$757.48	$151.50–$173.77	—	60%
X-ray of the ankle, 2 views CPT 73600 HC 73600 ANKLE 2 VIEWS-BLT	$154.50	$386.25	$42.49–$142.14	45% below	60%
X-ray of the ankle, 2 views one side CPT 73600 HC 73600 ANKLE 2 VIEWS-LT	$77.25	$193.12	$42.49–$142.14	73% below	60%
X-ray of the ankle, 2 views one side CPT 73600 HC 73600 ANKLE 2 VIEWS-RT	$77.25	$193.12	$42.49–$142.14	73% below	60%
X-ray of the ankle, 2 views inpatient CPT 73600 HC 73600 ANKLE 2 VIEWS-BLT	$154.50	$386.25	$42.49–$142.14	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC 73600 ANKLE 2 VIEWS-RT	$77.25	$193.12	$42.49–$142.14	—	60%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC 73600 ANKLE 2 VIEWS-LT	$77.25	$193.12	$42.49–$142.14	—	60%
X-ray of the finger(s), 2 or more views CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS	$82.66	$206.65	$43.36–$57.86	69% below	60%
X-ray of the finger(s), 2 or more views CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS BLT	$165.20	$413.00	$43.36–$57.86	38% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS RT	$82.66	$206.65	$43.36–$57.86	69% below	60%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS LT	$82.66	$206.65	$43.36–$57.86	69% below	60%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS	$82.66	$206.65	$43.36–$57.86	—	60%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS BLT	$165.20	$413.00	$43.36–$57.86	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS RT	$82.66	$206.65	$43.36–$57.86	—	60%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC 73140 FINGER(S) MIN 2 VIEWS LT	$82.66	$206.65	$43.36–$57.86	—	60%
X-ray of the foot, complete, 3 or more views CPT 73630 HC 73630 FOOT COMPLETE, MIN 3V-BLT	$420.14	$1,050.36	$183.05–$732.19	22% above	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC 73630 FOOT COMPLETE, MIN 3V-LT	$366.10	$915.24	$183.05–$732.19	6% above	60%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC 73630 FOOT COMPLETE, MIN 3V-RT	$366.10	$915.24	$183.05–$732.19	6% above	60%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC 73630 FOOT COMPLETE, MIN 3V-BLT	$420.14	$1,050.36	$183.05–$732.19	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC 73630 FOOT COMPLETE, MIN 3V-RT	$366.10	$915.24	$183.05–$732.19	—	60%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC 73630 FOOT COMPLETE, MIN 3V-LT	$366.10	$915.24	$183.05–$732.19	—	60%
X-ray of the hand, 3 or more views CPT 73130 HC 73130 HAND MIN 3 VIEWS-BLT	$423.31	$1,058.27	$180.57–$802.54	22% above	60%
X-ray of the hand, 3 or more views one side CPT 73130 HC 73130 HAND MIN 3 VIEWS-RT	$401.27	$1,003.17	$180.57–$802.54	15% above	60%
X-ray of the hand, 3 or more views one side CPT 73130 HC 73130 HAND MIN 3 VIEWS-LT	$401.27	$1,003.17	$180.57–$802.54	15% above	60%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC 73130 HAND MIN 3 VIEWS-BLT	$423.31	$1,058.27	$180.57–$802.54	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC 73130 HAND MIN 3 VIEWS-LT	$401.27	$1,003.17	$180.57–$802.54	—	60%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC 73130 HAND MIN 3 VIEWS-RT	$401.27	$1,003.17	$180.57–$802.54	—	60%
X-ray of the knee, 1 or 2 views CPT 73560 HC 73560 KNEE 1 OR 2 VIEWS-BLT	$154.50	$386.25	$39.44–$145.13	48% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC 73560 KNEE 1 OR 2 VIEWS-RT	$78.88	$197.19	$39.44–$145.13	74% below	60%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC 73560 KNEE 1 OR 2 VIEWS-LT	$82.82	$207.04	$39.44–$145.13	72% below	60%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC 73560 KNEE 1 OR 2 VIEWS-BLT	$154.50	$386.25	$39.44–$145.13	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC 73560 KNEE 1 OR 2 VIEWS-RT	$78.88	$197.19	$39.44–$145.13	—	60%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC 73560 KNEE 1 OR 2 VIEWS-LT	$82.82	$207.04	$39.44–$145.13	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC 72100 SPINE LUMBAR 2 OR 3 VIEWS-PORTABLE	$266.17	$665.43	$133.09–$532.34	41% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC 72100 SPINE LUMBAR 2 OR 3 VIEWS	$266.17	$665.43	$133.09–$532.34	41% below	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC 72100 SPINE LUMBAR 2 OR 3 VIEWS-PORTABLE	$266.17	$665.43	$133.09–$532.34	—	60%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC 72100 SPINE LUMBAR 2 OR 3 VIEWS	$266.17	$665.43	$133.09–$532.34	—	60%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC 72070 SPINE THORACIC 2 VIEWS	$92.63	$231.57	$46.31–$196.39	76% below	60%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC 72070 SPINE THORACIC 2 VIEWS	$92.63	$231.57	$46.31–$196.39	—	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC 72040 SPINE CERVICAL 2 OR 3 VIEWS	$105.36	$263.40	$52.68–$210.72	71% below	60%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC 72040 SPINE CERVICAL 2 OR 3 VIEWS PORTABLE	$105.36	$263.40	$52.68–$210.72	71% below	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC 72040 SPINE CERVICAL 2 OR 3 VIEWS	$105.36	$263.40	$52.68–$210.72	—	60%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC 72040 SPINE CERVICAL 2 OR 3 VIEWS PORTABLE	$105.36	$263.40	$52.68–$210.72	—	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC 72170 PELVIS 1 OR 2 VIEWS-PORTABLE	$194.44	$486.09	$87.50–$106.94	44% below	60%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC 72170 PELVIS 1 OR 2 VIEWS	$194.44	$486.09	$87.50–$106.94	44% below	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC 72170 PELVIS 1 OR 2 VIEWS	$194.44	$486.09	$87.50–$106.94	—	60%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC 72170 PELVIS 1 OR 2 VIEWS-PORTABLE	$194.44	$486.09	$87.50–$106.94	—	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC 72220 SACRUM & COCCYX MIN 2V	$251.26	$628.16	$175.88	30% below	60%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC 72220 SACRUM & COCCYX MIN 2V	$251.26	$628.16	$175.88	—	60%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ACTH blood test CPT 82024 HC ASSAY, ADRENOCORTICOTROPIC HORMONE	$168.10	$420.25	$411.84	14% below	60%
ACTH blood test CPT 82024 HC SO ASSAY, ADRENOCORTICOTROPIC HORMONE; ACTH	$168.10	$420.25	$411.84	14% below	60%
ACTH blood test inpatient CPT 82024 HC ASSAY, ADRENOCORTICOTROPIC HORMONE	$168.10	$420.25	$411.84	—	60%
ACTH blood test inpatient CPT 82024 HC SO ASSAY, ADRENOCORTICOTROPIC HORMONE; ACTH	$168.10	$420.25	$411.84	—	60%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE; ALANINE AMINO (ALT/SGPT)	$42.24	$105.61	$20.70–$23.23	20% below	60%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE; ALANINE AMINO (ALT/SGPT)	$42.24	$105.61	$20.70–$23.23	—	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SO MISC TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)	$43.90	$109.75	$21.51–$24.15	16% below	60%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE; ASPARTATE AMINO (AST/SGOT)	$43.90	$109.75	$21.51–$24.15	16% below	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE; ASPARTATE AMINO (AST/SGOT)	$43.90	$109.75	$21.51–$24.15	—	60%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC SO MISC TRANSFERASE; ASPARTATE AMINO (AST) (SGOT)	$43.90	$109.75	$21.51–$24.15	—	60%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC SFMC/DMH ACUTE HEPATITIS PANEL LAB TEST	$340.10	$850.24	$515.22	30% above	60%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC SFMC/DMH ACUTE HEPATITIS PANEL LAB TEST	$340.10	$850.24	$515.22	—	60%
Aldosterone blood test CPT 82088 HC SO ASSAY OF ALDOSTERONE ALDS	$234.20	$585.50	$573.79	46% above	60%
Aldosterone blood test CPT 82088 HC SO ASSAY OF ALDOSTERONE; ALDU	$234.20	$585.50	$573.79	46% above	60%
Aldosterone blood test inpatient CPT 82088 HC SO ASSAY OF ALDOSTERONE; ALDU	$234.20	$585.50	$573.79	—	60%
Aldosterone blood test inpatient CPT 82088 HC SO ASSAY OF ALDOSTERONE ALDS	$234.20	$585.50	$573.79	—	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO MISC ALLERGEN SPECIFIC IGE	$6.19	$15.48	$11.39–$16.87	76% below	60%
Allergy blood test, specific IgE, per allergen CPT 86003 HC SO ALLERGEN SPECIFIC IGE	$30.67	$76.68	$11.39–$16.87	18% above	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO MISC ALLERGEN SPECIFIC IGE	$6.19	$15.48	$11.39–$16.87	—	60%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC SO ALLERGEN SPECIFIC IGE	$30.67	$76.68	$11.39–$16.87	—	60%
Ammonia blood test CPT 82140 HC AMMONIA	$99.90	$249.74	$14.28–$54.94	6% below	60%
Ammonia blood test inpatient CPT 82140 HC AMMONIA	$99.90	$249.74	$14.28–$54.94	—	60%
Amylase blood test CPT 82150 HC AMYLASE	$97.99	$244.98	$48.02–$180.31	20% above	60%
Amylase blood test inpatient CPT 82150 HC AMYLASE	$97.99	$244.98	$48.02–$180.31	—	60%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC SO MISC CCP AB	$29.40	$73.50	$15.13–$58.80	65% below	60%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC SO MISC CCP AB	$29.40	$73.50	$15.13–$58.80	—	60%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC SO MISC ANA	$80.00	$200.00	$44.00–$160.00	11% below	60%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC SO MISC ANA	$80.00	$200.00	$44.00–$160.00	—	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC SO NT-PRO B TYPE NATRIURETIC PEPTIDE, PBNP	$204.59	$511.48	$100.25–$501.25	8% above	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC SO NATRIURETIC PEPTIDE, PBNP1	$204.59	$511.48	$100.25–$501.25	8% above	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE (BNP), NTPROBNP	$204.59	$511.48	$100.25–$501.25	8% above	60%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC SO MISC NATRIURETIC PEPTIDE	$204.59	$511.48	$100.25–$501.25	8% above	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC SO NATRIURETIC PEPTIDE, PBNP1	$204.59	$511.48	$100.25–$501.25	—	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC SO MISC NATRIURETIC PEPTIDE	$204.59	$511.48	$100.25–$501.25	—	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC SO NT-PRO B TYPE NATRIURETIC PEPTIDE, PBNP	$204.59	$511.48	$100.25–$501.25	—	60%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE (BNP), NTPROBNP	$204.59	$511.48	$100.25–$501.25	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, BACTERIA, OTHER	$148.01	$370.03	$72.53–$431.29	64% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE, BACTERIA, OTHER	$215.64	$539.11	$72.53–$431.29	140% above	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, BACTERIA, OTHER	$148.01	$370.03	$72.53–$431.29	—	60%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 HC CULTURE, BACTERIA, OTHER	$215.64	$539.11	$72.53–$431.29	—	60%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL W TOTAL CALCIUM	$148.83	$372.08	$72.93–$297.66	16% above	60%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL W TOTAL CALCIUM	$148.83	$372.08	$72.93–$297.66	—	60%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL IV SURG PATH GROSS & MICRO	$48.25	$120.62	$21.71–$96.50	80% below	60%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC LEVEL IV SURG PATH GROSS & MICRO	$48.25	$120.62	$21.71–$96.50	—	60%
Blood culture for bacteria CPT 87040 HC CULTURE; BLOOD (W/ ANAEROBIC SCREEN)	$160.83	$402.08	$70.93–$321.67	5% above	60%
Blood culture for bacteria inpatient CPT 87040 HC CULTURE; BLOOD (W/ ANAEROBIC SCREEN)	$160.83	$402.08	$70.93–$321.67	—	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD,VENIPUNCTURE	$17.50	$43.76	$10.04–$50.92	26% below	60%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC VENIPUNCTURE-BLOOD DRAW	$20.50	$51.25	$10.04–$50.92	13% below	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLOOD,VENIPUNCTURE	$17.50	$43.76	$10.04–$50.92	—	60%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC VENIPUNCTURE-BLOOD DRAW	$20.50	$51.25	$10.04–$50.92	—	60%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC GONADOTROPIN, CHORIONIC (HCG), QUAL	$108.55	$271.37	$53.18–$59.70	19% above	60%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC GONADOTROPIN, CHORIONIC (HCG), QUAL	$108.55	$271.37	$53.18–$59.70	—	60%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING; ABO	$88.44	$221.10	$39.00–$49.83	5% above	60%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING; ABO	$88.44	$221.10	$39.00–$49.83	—	60%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN	$42.02	$105.06	$20.59–$102.96	19% below	60%
Blood urea nitrogen (BUN) test CPT 84520 HC ASSAY OF UREA NITROGEN	$42.02	$105.06	$20.59–$102.96	19% below	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN	$42.02	$105.06	$20.59–$102.96	—	60%
Blood urea nitrogen (BUN) test inpatient CPT 84520 HC ASSAY OF UREA NITROGEN	$42.02	$105.06	$20.59–$102.96	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC SO C-RE1 PROTEIN,PROM IBD CRP	$72.69	$181.73	$35.62–$145.38	1% below	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-RE1 PROTEIN	$72.69	$181.73	$35.62–$145.38	1% below	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC SO MISC C-RE1 PROTEIN	$72.69	$181.73	$35.62–$145.38	1% below	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-RE1 PROTEIN	$72.69	$181.73	$35.62–$145.38	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC SO C-RE1 PROTEIN,PROM IBD CRP	$72.69	$181.73	$35.62–$145.38	—	60%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC SO MISC C-RE1 PROTEIN	$72.69	$181.73	$35.62–$145.38	—	60%
CA 19-9 blood test (tumor marker) CPT 86301 HC SO IMMUNOASSAY, TUMOR CA 19-9; CA19	$130.31	$325.78	$71.67	18% above	60%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC SO IMMUNOASSAY, TUMOR CA 19-9; CA19	$130.31	$325.78	$71.67	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC OSF 87635 SARS-COV-2 RNA RT PCR, COVID 19	$69.60	$174.00	$34.10–$139.20	40% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC SO 87635 SARS-COV-2 RNA RT PCR, COVID 19	$69.60	$174.00	$34.10–$139.20	40% below	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC SO 87635 SARS-COV-2 RNA RT PCR, COVID 19	$69.60	$174.00	$34.10–$139.20	—	60%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC OSF 87635 SARS-COV-2 RNA RT PCR, COVID 19	$69.60	$174.00	$34.10–$139.20	—	60%
Calcium blood test, total CPT 82310 HC CALCIUM; TOTAL	$55.39	$138.48	$28.50–$30.47	22% above	60%
Calcium blood test, total inpatient CPT 82310 HC CALCIUM; TOTAL	$55.39	$138.48	$28.50–$30.47	—	60%
Carcinoembryonic antigen (CEA) test CPT 82378 HC SO MISC CARCINOEMBRYONIC ANTIGEN (CEA)	$52.64	$131.61	$28.95	63% below	60%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 HC SO MISC CARCINOEMBRYONIC ANTIGEN (CEA)	$52.64	$131.61	$28.95	—	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC SO MISC CHLAMYDIA TRACH DNA AMP PROBE	$84.40	$210.99	$46.42–$168.79	32% below	60%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC SO MISC CHLAMYDIA TRACH DNA AMP PROBE	$84.40	$210.99	$46.42–$168.79	—	60%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$123.51	$308.78	$60.52–$302.60	4% below	60%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL	$123.51	$308.78	$60.52–$302.60	—	60%
Complete blood count (CBC) with differential CPT 85025 HC CBC - BLOOD COUNT; DIFFERENTIAL WBC	$86.92	$217.30	$42.59–$212.95	11% above	60%
Complete blood count (CBC) with differential inpatient CPT 85025 HC CBC - BLOOD COUNT; DIFFERENTIAL WBC	$86.92	$217.30	$42.59–$212.95	—	60%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$211.56	$528.90	$93.30–$518.32	33% above	60%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$211.56	$528.90	$93.30–$518.32	—	60%
Cortisol blood test, total CPT 82533 HC TOTAL CORTISOL	$84.90	$212.25	$40.06–$208.00	23% below	60%
Cortisol blood test, total inpatient CPT 82533 HC TOTAL CORTISOL	$84.90	$212.25	$40.06–$208.00	—	60%
Creatine kinase (CK) blood test, total CPT 82550 HC SO MISC CREATINE KINASE (CK), (CPK); TOTAL	$87.33	$218.33	$38.51–$174.66	42% above	60%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE (CPK); TOTAL	$87.33	$218.33	$38.51–$174.66	42% above	60%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE (CPK); TOTAL	$87.33	$218.33	$38.51–$174.66	42% above	60%
Creatine kinase (CK) blood test, total CPT 82550 HC SO CREATINE KINASE ISOENZYME REFLEX, CKELR	$87.33	$218.33	$38.51–$174.66	42% above	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE (CPK); TOTAL	$87.33	$218.33	$38.51–$174.66	—	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC SO CREATINE KINASE ISOENZYME REFLEX, CKELR	$87.33	$218.33	$38.51–$174.66	—	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC SO MISC CREATINE KINASE (CK), (CPK); TOTAL	$87.33	$218.33	$38.51–$174.66	—	60%
Creatine kinase (CK) blood test, total inpatient CPT 82550 HC CREATINE KINASE (CPK); TOTAL	$87.33	$218.33	$38.51–$174.66	—	60%
Creatinine blood test CPT 82565 HC POCT CREATININE	$51.36	$128.41	$25.17–$125.84	3% above	60%
Creatinine blood test CPT 82565 HC CREATININE; BLOOD	$51.36	$128.41	$25.17–$125.84	3% above	60%
Creatinine blood test inpatient CPT 82565 HC CREATININE; BLOOD	$51.36	$128.41	$25.17–$125.84	—	60%
Creatinine blood test inpatient CPT 82565 HC POCT CREATININE	$51.36	$128.41	$25.17–$125.84	—	60%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER; QUANTITATIVE	$153.75	$384.38	$67.81–$307.50	27% above	60%
D-dimer blood test (blood clot marker) CPT 85379 HC SO MISC FIBRIN DEGRADATION QUANT	$153.75	$384.38	$67.81–$307.50	27% above	60%
D-dimer blood test (blood clot marker) CPT 85379 HC SO FIB DEGRADTION ,DIMER, AATHR	$153.75	$384.38	$67.81–$307.50	27% above	60%
D-dimer blood test (blood clot marker) CPT 85379 HC SO D-DIMER, THRMP	$153.75	$384.38	$67.81–$307.50	27% above	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC SO FIB DEGRADTION ,DIMER, AATHR	$153.75	$384.38	$67.81–$307.50	—	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC D-DIMER; QUANTITATIVE	$153.75	$384.38	$67.81–$307.50	—	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC SO MISC FIBRIN DEGRADATION QUANT	$153.75	$384.38	$67.81–$307.50	—	60%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC SO D-DIMER, THRMP	$153.75	$384.38	$67.81–$307.50	—	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC SO MISC DRUG TEST PRSMV CHEM ANLYZR	$20.00	$50.00	$11.00	79% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC SO DRUG TEST PRSMV CHEM ANLYZR, CSMP	$27.71	$69.28	$11.00	72% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST, PRESUMPTIVE,URINE DRUG SCREENING W/O CONFIRMATION	$56.88	$142.21	$11.00	42% below	60%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC 80307 DRUG TEST, PRESUMPTIVE, CHEM ANALYZERS, PER DOS	$148.00	$370.01	$11.00	52% above	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC SO MISC DRUG TEST PRSMV CHEM ANLYZR	$20.00	$50.00	$11.00	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC SO DRUG TEST PRSMV CHEM ANLYZR, CSMP	$27.71	$69.28	$11.00	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC DRUG TEST, PRESUMPTIVE,URINE DRUG SCREENING W/O CONFIRMATION	$56.88	$142.21	$11.00	—	60%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 HC 80307 DRUG TEST, PRESUMPTIVE, CHEM ANALYZERS, PER DOS	$148.00	$370.01	$11.00	—	60%
Estradiol blood test CPT 82670 HC SO MISC ASSAY OF ESTRADIOL	$42.11	$105.28	$46.26–$77.49	60% below	60%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL	$66.08	$165.21	$46.26–$77.49	38% below	60%
Estradiol blood test inpatient CPT 82670 HC SO MISC ASSAY OF ESTRADIOL	$42.11	$105.28	$46.26–$77.49	—	60%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL	$66.08	$165.21	$46.26–$77.49	—	60%
FSH (follicle-stimulating hormone) test CPT 83001 HC SO GONADOTROPIN FOLLICLE STIM HRMN, FSHPED	$163.75	$409.37	$90.06–$301.30	38% above	60%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN (FSH)	$163.75	$409.37	$90.06–$301.30	38% above	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN (FSH)	$163.75	$409.37	$90.06–$301.30	—	60%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC SO GONADOTROPIN FOLLICLE STIM HRMN, FSHPED	$163.75	$409.37	$90.06–$301.30	—	60%
Fecal calprotectin (stool inflammation test) CPT 83993 HC SO CALPROTECTIN, FECAL CALPR	$179.98	$449.95	$92.60–$125.99	4% above	60%
Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPROTECTIN, FECAL	$179.98	$449.95	$92.60–$125.99	4% above	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC SO CALPROTECTIN, FECAL CALPR	$179.98	$449.95	$92.60–$125.99	—	60%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC CALPROTECTIN, FECAL	$179.98	$449.95	$92.60–$125.99	—	60%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$113.98	$284.95	$58.64–$227.96	14% below	60%
Ferritin blood test (iron stores) CPT 82728 HC SO MISC ASSAY OF FERRITIN	$113.98	$284.95	$58.64–$227.96	14% below	60%
Ferritin blood test (iron stores) CPT 82728 HC SO ASSAY OF FERRITIN, THEV1	$113.98	$284.95	$58.64–$227.96	14% below	60%
Ferritin blood test (iron stores) inpatient CPT 82728 HC SO MISC ASSAY OF FERRITIN	$113.98	$284.95	$58.64–$227.96	—	60%
Ferritin blood test (iron stores) inpatient CPT 82728 HC SO ASSAY OF FERRITIN, THEV1	$113.98	$284.95	$58.64–$227.96	—	60%
Ferritin blood test (iron stores) inpatient CPT 82728 HC FERRITIN	$113.98	$284.95	$58.64–$227.96	—	60%
Folate (folic acid) blood test CPT 82746 HC FOLIC ACID; SERUM	$103.32	$258.29	$53.16–$206.63	8% below	60%
Folate (folic acid) blood test inpatient CPT 82746 HC FOLIC ACID; SERUM	$103.32	$258.29	$53.16–$206.63	—	60%
Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE T3; FREE	$183.87	$459.67	$90.09–$367.74	54% above	60%
Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE T3; FREE	$183.87	$459.67	$90.09–$367.74	—	60%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE	$98.28	$245.71	$48.16–$240.80	16% below	60%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE	$98.28	$245.71	$48.16–$240.80	—	60%
Free testosterone test CPT 84402 HC SO MISC FREE TESTOSTERONE	$70.47	$176.18	$34.54–$172.66	42% below	60%
Free testosterone test inpatient CPT 84402 HC SO MISC FREE TESTOSTERONE	$70.47	$176.18	$34.54–$172.66	—	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC SO MISC ASSAY OF GGT 82977	$42.24	$105.61	$23.23	28% below	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC SO ASSAY OF GLUTAMYLTRASE GAMMA FLFFT	$42.24	$105.61	$23.23	28% below	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC SO GAMMA GLUTAMYITRANSFERASE FIBRO GGT	$42.24	$105.61	$23.23	28% below	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY GLUTAMYLTRASE GAMMA FHIB	$42.24	$105.61	$23.23	28% below	60%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC ASSAY OF GGT, GAMMA GT	$42.24	$105.61	$23.23	28% below	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC SO MISC ASSAY OF GGT 82977	$42.24	$105.61	$23.23	—	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY OF GGT, GAMMA GT	$42.24	$105.61	$23.23	—	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC ASSAY GLUTAMYLTRASE GAMMA FHIB	$42.24	$105.61	$23.23	—	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC SO GAMMA GLUTAMYITRANSFERASE FIBRO GGT	$42.24	$105.61	$23.23	—	60%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 HC SO ASSAY OF GLUTAMYLTRASE GAMMA FLFFT	$42.24	$105.61	$23.23	—	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC SO MISC N GONORRHOEAE DNA AMP PROBE	$107.22	$268.06	$58.97–$214.45	13% below	60%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC SO MISC N GONORRHOEAE DNA AMP PROBE	$107.22	$268.06	$58.97–$214.45	—	60%
H. pylori stool antigen test CPT 87338 HC HELICOBACTER PYLORI-STOOL, ANTIGEN, EIA	$98.28	$245.71	$48.16–$68.80	15% below	60%
H. pylori stool antigen test inpatient CPT 87338 HC HELICOBACTER PYLORI-STOOL, ANTIGEN, EIA	$98.28	$245.71	$48.16–$68.80	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC SFMC/DMH� HIV 1&2 SINGLE RESULT LAB TEST	$100.61	$251.52	$64.72–$235.34	11% below	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV AG/AB WITH REFLEX	$117.67	$294.18	$64.72–$235.34	5% above	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC SFMC/DMH� HIV 1&2 SINGLE RESULT LAB TEST	$100.61	$251.52	$64.72–$235.34	—	60%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV AG/AB WITH REFLEX	$117.67	$294.18	$64.72–$235.34	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC POCT HEMOGLOBIN GLYCOSYLATED HBA1C	$81.36	$203.41	$39.87–$162.73	9% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC SO HEMOGLOBIN; GLYCOSYLATED; HBA1C	$81.36	$203.41	$39.87–$162.73	9% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN; GLYCOSYLATED	$81.36	$203.41	$39.87–$162.73	9% below	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC POCT HEMOGLOBIN GLYCOSYLATED HBA1C	$81.36	$203.41	$39.87–$162.73	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC SO HEMOGLOBIN; GLYCOSYLATED; HBA1C	$81.36	$203.41	$39.87–$162.73	—	60%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN; GLYCOSYLATED	$81.36	$203.41	$39.87–$162.73	—	60%
Hemoglobin blood test CPT 85018 HC BLOOD COUNT; HEMOGLOBIN	$34.85	$87.13	$15.37–$19.17	11% above	60%
Hemoglobin blood test inpatient CPT 85018 HC BLOOD COUNT; HEMOGLOBIN	$34.85	$87.13	$15.37–$19.17	—	60%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE ANTIBODY; TOTAL	$8.96	$22.40	$4.93–$17.92	88% below	60%
Hepatitis B core antibody test (total) inpatient CPT 86704 HC HEPATITIS B CORE ANTIBODY; TOTAL	$8.96	$22.40	$4.93–$17.92	—	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC SFMC HEP B SURF AB LAB TEST	$109.17	$272.92	$218.34	16% above	60%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC SFMC HEP B SURF AB LAB TEST	$109.17	$272.92	$218.34	—	60%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC SO MISC HEP B SURFACE AG IA	$112.13	$280.32	$61.67–$224.26	26% above	60%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC SO MISC HEP B SURFACE AG IA	$112.13	$280.32	$61.67–$224.26	—	60%
Hepatitis C antibody blood test (screening) CPT 86803 HC SFMC HEP C AB LAB TEST	$18.40	$46.00	$9.02–$36.80	84% below	60%
Hepatitis C antibody blood test (screening) CPT 86803 HC SO MISC HEP C AB TEST	$45.70	$114.24	$9.02–$36.80	59% below	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC SFMC HEP C AB LAB TEST	$18.40	$46.00	$9.02–$36.80	—	60%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC SO MISC HEP C AB TEST	$45.70	$114.24	$9.02–$36.80	—	60%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC SFMC/DMH HEP C QUANT RNA PCR LAB TEST	$178.35	$445.88	$98.09	33% below	60%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC SFMC/DMH HEP C QUANT RNA PCR LAB TEST	$178.35	$445.88	$98.09	—	60%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-RE1 PROTEIN; HIGH SENS	$78.96	$197.39	$38.69–$43.43	15% below	60%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-RE1 PROTEIN; HIGH SENS	$78.96	$197.39	$38.69–$43.43	—	60%
Insulin blood test CPT 83525 HC SO INSULIN TOTAL, INSFT	$100.00	$249.99	$70.00	37% above	60%
Insulin blood test CPT 83525 HC SFMC/DMH INSULIN LEVEL LAB TEST	$100.00	$249.99	$70.00	37% above	60%
Insulin blood test inpatient CPT 83525 HC SFMC/DMH INSULIN LEVEL LAB TEST	$100.00	$249.99	$70.00	—	60%
Insulin blood test inpatient CPT 83525 HC SO INSULIN TOTAL, INSFT	$100.00	$249.99	$70.00	—	60%
Iron blood test (serum iron) CPT 83540 HC IRON	$59.03	$147.58	$28.93–$118.06	25% below	60%
Iron blood test (serum iron) CPT 83540 HC SO MISC ASSAY OF IRON	$59.03	$147.58	$28.93–$118.06	25% below	60%
Iron blood test (serum iron) inpatient CPT 83540 HC SO MISC ASSAY OF IRON	$59.03	$147.58	$28.93–$118.06	—	60%
Iron blood test (serum iron) inpatient CPT 83540 HC IRON	$59.03	$147.58	$28.93–$118.06	—	60%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$70.66	$176.65	$34.62–$141.32	6% below	60%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING CAPACITY	$70.66	$176.65	$34.62–$141.32	—	60%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL	$147.60	$369.00	$72.32–$195.75	1% below	60%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL	$147.60	$369.00	$72.32–$195.75	—	60%
LH (luteinizing hormone) test CPT 83002 HC SO GONADOTROPIN; LUTEINIZING HORMONE (LH), 83002	$170.89	$427.22	$119.62–$314.43	49% above	60%
LH (luteinizing hormone) test CPT 83002 HC SO ASSAY OF GONADOTROPIN LH, LHPED	$170.89	$427.22	$119.62–$314.43	49% above	60%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN (LH)	$170.89	$427.22	$119.62–$314.43	49% above	60%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN (LH)	$170.89	$427.22	$119.62–$314.43	—	60%
LH (luteinizing hormone) test inpatient CPT 83002 HC SO GONADOTROPIN; LUTEINIZING HORMONE (LH), 83002	$170.89	$427.22	$119.62–$314.43	—	60%
LH (luteinizing hormone) test inpatient CPT 83002 HC SO ASSAY OF GONADOTROPIN LH, LHPED	$170.89	$427.22	$119.62–$314.43	—	60%
Lactate (lactic acid) blood test CPT 83605 HC SO ASSY OF LACTIC ACID CSF, LASF1	$120.54	$301.35	$53.16–$241.08	34% above	60%
Lactate (lactic acid) blood test CPT 83605 HC SO NON INTERF CSF PED MET07 LAB TEST	$120.54	$301.35	$53.16–$241.08	34% above	60%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID	$120.54	$301.35	$53.16–$241.08	34% above	60%
Lactate (lactic acid) blood test CPT 83605 HC ASSAY OF LACTIC ACID	$120.54	$301.35	$53.16–$241.08	34% above	60%
Lactate (lactic acid) blood test CPT 83605 HC SO MISC LACTIC ACID 83605	$120.54	$301.35	$53.16–$241.08	34% above	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC SO NON INTERF CSF PED MET07 LAB TEST	$120.54	$301.35	$53.16–$241.08	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID	$120.54	$301.35	$53.16–$241.08	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC ASSAY OF LACTIC ACID	$120.54	$301.35	$53.16–$241.08	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC SO MISC LACTIC ACID 83605	$120.54	$301.35	$53.16–$241.08	—	60%
Lactate (lactic acid) blood test inpatient CPT 83605 HC SO ASSY OF LACTIC ACID CSF, LASF1	$120.54	$301.35	$53.16–$241.08	—	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE (LDH)	$61.91	$154.78	$30.34–$69.99	8% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LACTATE DEHYDROGENASE (LDH)	$61.91	$154.78	$30.34–$69.99	8% above	60%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC SO LACTATE DEHYDROGENAS LDH	$61.91	$154.78	$30.34–$69.99	8% above	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE (LDH)	$61.91	$154.78	$30.34–$69.99	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC LACTATE DEHYDROGENASE (LDH)	$61.91	$154.78	$30.34–$69.99	—	60%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 HC SO LACTATE DEHYDROGENAS LDH	$61.91	$154.78	$30.34–$69.99	—	60%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE	$124.44	$311.09	$60.98–$248.87	33% above	60%
Lipase blood test (pancreas enzyme) CPT 83690 HC SO LIPASE BF, LPSBF	$124.44	$311.09	$60.98–$248.87	33% above	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC SO LIPASE BF, LPSBF	$124.44	$311.09	$60.98–$248.87	—	60%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC LIPASE	$124.44	$311.09	$60.98–$248.87	—	60%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$136.53	$341.33	$66.90–$273.06	1% below	60%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$136.53	$341.33	$66.90–$273.06	—	60%
Lyme disease antibody test CPT 86618 HC SO MISC LYME DISEASE ANTIBODY	$144.86	$362.14	$79.67	100% above	60%
Lyme disease antibody test inpatient CPT 86618 HC SO MISC LYME DISEASE ANTIBODY	$144.86	$362.14	$79.67	—	60%
Magnesium blood test CPT 83735 HC MAGNESIUM	$82.00	$205.00	$40.18–$164.00	17% above	60%
Magnesium blood test inpatient CPT 83735 HC MAGNESIUM	$82.00	$205.00	$40.18–$164.00	—	60%
Measles (rubeola) antibody test CPT 86765 HC SO MISC RUBEOLA ANTIBODY	$148.42	$371.04	$296.83	105% above	60%
Measles (rubeola) antibody test inpatient CPT 86765 HC SO MISC RUBEOLA ANTIBODY	$148.42	$371.04	$296.83	—	60%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES; SCREEN	$106.76	$266.90	$54.93–$213.52	32% above	60%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES; SCREEN	$106.76	$266.90	$54.93–$213.52	—	60%
Mumps immunity blood test CPT 86735 HC SO MISC MUMPS ANTIBODY	$176.32	$440.80	$352.64	143% above	60%
Mumps immunity blood test inpatient CPT 86735 HC SO MISC MUMPS ANTIBODY	$176.32	$440.80	$352.64	—	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC SO MISC ASSAY PSA TOTAL	$107.33	$268.32	$67.10	5% below	60%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC LAB PSA TOTAL	$122.00	$305.00	$67.10	8% above	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC SO MISC ASSAY PSA TOTAL	$107.33	$268.32	$67.10	—	60%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC LAB PSA TOTAL	$122.00	$305.00	$67.10	—	60%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTO,THIN LAYER PREP;AUTO SCN MAN RESCN	$147.84	$369.60	$81.31	8% above	60%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTO,THIN LAYER PREP;AUTO SCN MAN RESCN	$147.84	$369.60	$81.31	—	60%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE	$216.48	$541.20	$106.08–$119.06	at median	60%
Parathyroid hormone (PTH) blood test CPT 83970 HC PARATHORMONE	$216.48	$541.20	$106.08–$119.06	at median	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE	$216.48	$541.20	$106.08–$119.06	—	60%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC PARATHORMONE	$216.48	$541.20	$106.08–$119.06	—	60%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLASTIN TIME, PARTIAL (PTT)	$158.71	$396.78	$77.77–$317.42	128% above	60%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLASTIN TIME, PARTIAL (PTT)	$158.71	$396.78	$77.77–$317.42	—	60%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS	$57.40	$143.50	$29.54–$31.57	8% below	60%
Phosphorus (phosphate) blood test inpatient CPT 84100 HC PHOSPHORUS	$57.40	$143.50	$29.54–$31.57	—	60%
Potassium blood test CPT 84132 HC POTASSIUM; SERUM	$27.59	$68.98	$15.18	38% below	60%
Potassium blood test inpatient CPT 84132 HC POTASSIUM; SERUM	$27.59	$68.98	$15.18	—	60%
Progesterone blood test CPT 84144 HC SO ASSAY OF PROGESTERONE, FFCAH	$108.55	$271.37	$199.73	20% below	60%
Progesterone blood test CPT 84144 HC PED PROF ASSAY OF PROGESTERONE	$108.55	$271.37	$199.73	20% below	60%
Progesterone blood test CPT 84144 HC SO PROGESTERONE PGSN	$108.55	$271.37	$199.73	20% below	60%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE	$108.55	$271.37	$199.73	20% below	60%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE	$108.55	$271.37	$199.73	—	60%
Progesterone blood test inpatient CPT 84144 HC PED PROF ASSAY OF PROGESTERONE	$108.55	$271.37	$199.73	—	60%
Progesterone blood test inpatient CPT 84144 HC SO PROGESTERONE PGSN	$108.55	$271.37	$199.73	—	60%
Progesterone blood test inpatient CPT 84144 HC SO ASSAY OF PROGESTERONE, FFCAH	$108.55	$271.37	$199.73	—	60%
Prolactin blood test CPT 84146 HC SO MISC PROLACTIN	$158.71	$396.78	$87.29	25% above	60%
Prolactin blood test inpatient CPT 84146 HC SO MISC PROLACTIN	$158.71	$396.78	$87.29	—	60%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME	$35.24	$88.09	$15.54–$70.47	8% below	60%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME-FINGER STICK	$58.22	$145.55	$15.54–$70.47	51% above	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME	$35.24	$88.09	$15.54–$70.47	—	60%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME-FINGER STICK	$58.22	$145.55	$15.54–$70.47	—	60%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC 80305 DRUG TEST, PRESUMPTIVE, DIRECT OBSERV, PER DOS	$23.51	$58.78	$11.52–$57.60	71% below	60%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC 80305 DRUG TEST, PRESUMPTIVE, DIRECT OBSERV, PER DOS	$23.51	$58.78	$11.52–$57.60	—	60%
Renin blood test CPT 84244 HC ASSAY OF RENIN	$181.97	$454.93	$445.83	62% above	60%
Renin blood test CPT 84244 HC SO ASSAY OF RENIN; PRA	$181.97	$454.93	$445.83	62% above	60%
Renin blood test inpatient CPT 84244 HC SO ASSAY OF RENIN; PRA	$181.97	$454.93	$445.83	—	60%
Renin blood test inpatient CPT 84244 HC ASSAY OF RENIN	$181.97	$454.93	$445.83	—	60%
Rh blood typing CPT 86901 HC BLOOD TYPING; RH (D)	$78.72	$196.80	$34.71–$44.35	15% above	60%
Rh blood typing inpatient CPT 86901 HC BLOOD TYPING; RH (D)	$78.72	$196.80	$34.71–$44.35	—	60%
Rheumatoid factor (RF) test CPT 86431 HC SO MISC RHEUMATOID FACTOR QUANT	$225.29	$563.23	$123.91	256% above	60%
Rheumatoid factor (RF) test inpatient CPT 86431 HC SO MISC RHEUMATOID FACTOR QUANT	$225.29	$563.23	$123.91	—	60%
Rubella antibody test (immunity check) CPT 86762 HC SFMC RUBELLA IGM LAB TEST	$14.86	$37.16	$81.69	81% below	60%
Rubella antibody test (immunity check) CPT 86762 HC SFMC/DMH RUBELLA AB 1ST LAB TEST	$40.84	$102.11	$81.69	46% below	60%
Rubella antibody test (immunity check) inpatient CPT 86762 HC SFMC RUBELLA IGM LAB TEST	$14.86	$37.16	$81.69	—	60%
Rubella antibody test (immunity check) inpatient CPT 86762 HC SFMC/DMH RUBELLA AB 1ST LAB TEST	$40.84	$102.11	$81.69	—	60%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE, ERYTHROCYTE; AUTO	$55.76	$139.40	$27.32–$111.52	21% above	60%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC SEDIMENTATION RATE, ERYTHROCYTE; AUTO	$55.76	$139.40	$27.32–$111.52	—	60%
Sodium blood test CPT 84295 HC SODIUM; SERUM	$26.92	$67.30	$13.85	45% below	60%
Sodium blood test inpatient CPT 84295 HC SODIUM; SERUM	$26.92	$67.30	$13.85	—	60%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC QUALITATIVE FECAL BLOOD IMMUNOASSAY	$37.10	$92.74	$20.40–$20.90	49% below	60%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC QUALITATIVE FECAL BLOOD IMMUNOASSAY	$37.10	$92.74	$20.40–$20.90	—	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SO VDRL CSF SYPHILIS TEST, VDRL	$11.87	$29.68	$6.53–$23.74	77% below	60%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SO VDRL CSF SYPHILIS TEST, VDRL	$11.87	$29.68	$6.53–$23.74	—	60%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QFT-TB PLUS	$80.00	$200.00	$44.00–$89.17	64% below	60%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC QFT-TB PLUS	$80.00	$200.00	$44.00–$89.17	—	60%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE	$10.21	$25.52	$58.70–$239.61	92% below	60%
Testosterone blood test, total (not free testosterone) CPT 84403 HC SO MISC TOTAL TESTOSTERONE	$119.80	$299.51	$58.70–$239.61	4% below	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE	$10.21	$25.52	$58.70–$239.61	—	60%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC SO MISC TOTAL TESTOSTERONE	$119.80	$299.51	$58.70–$239.61	—	60%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC SO MISC MICROSOMAL ANTIBODY EACH	$102.39	$255.98	$16.16–$56.32	28% above	60%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC SO MISC MICROSOMAL ANTIBODY EACH	$102.39	$255.98	$16.16–$56.32	—	60%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE	$41.94	$104.86	$20.55–$102.76	67% below	60%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE	$41.94	$104.86	$20.55–$102.76	—	60%
Total IgE blood test CPT 82785 HC SFMC IGE LAB TEST	$87.02	$217.56	$47.86–$174.05	2% above	60%
Total IgE blood test CPT 82785 HC SFMC/DMH IGE LAB TEST	$87.02	$217.56	$47.86–$174.05	2% above	60%
Total IgE blood test CPT 82785 HC SO MISC ASSAY GAMMGLOBULIN IGE	$87.02	$217.56	$47.86–$174.05	2% above	60%
Total IgE blood test inpatient CPT 82785 HC SFMC/DMH IGE LAB TEST	$87.02	$217.56	$47.86–$174.05	—	60%
Total IgE blood test inpatient CPT 82785 HC SFMC IGE LAB TEST	$87.02	$217.56	$47.86–$174.05	—	60%
Total IgE blood test inpatient CPT 82785 HC SO MISC ASSAY GAMMGLOBULIN IGE	$87.02	$217.56	$47.86–$174.05	—	60%
Total thyroxine (T4) blood test CPT 84436 HC ASSAY OF TOTAL THYROXINE	$43.90	$109.75	$21.51–$80.78	46% below	60%
Total thyroxine (T4) blood test inpatient CPT 84436 HC ASSAY OF TOTAL THYROXINE	$43.90	$109.75	$21.51–$80.78	—	60%
Total triiodothyronine (T3) blood test CPT 84480 HC TRIIODOTHYRONINE T3; TOTAL (TT-3)	$102.44	$256.10	$50.20–$204.88	5% above	60%
Total triiodothyronine (T3) blood test inpatient CPT 84480 HC TRIIODOTHYRONINE T3; TOTAL (TT-3)	$102.44	$256.10	$50.20–$204.88	—	60%
Transferrin blood test CPT 84466 HC ASSAY OF TRANSFERRIN	$84.05	$210.13	$46.23	13% below	60%
Transferrin blood test inpatient CPT 84466 HC ASSAY OF TRANSFERRIN	$84.05	$210.13	$46.23	—	60%
Trichomonas test (NAAT) CPT 87661 HC SO MISC TRICHOMONAS VAGINALIS AMPLIF	$133.54	$333.85	$73.45–$267.08	7% above	60%
Trichomonas test (NAAT) inpatient CPT 87661 HC SO MISC TRICHOMONAS VAGINALIS AMPLIF	$133.54	$333.85	$73.45–$267.08	—	60%
Troponin test, quantitative CPT 84484 HC TROPONIN, QUANTITATIVE	$182.53	$456.33	$80.50–$415.45	16% above	60%
Troponin test, quantitative inpatient CPT 84484 HC TROPONIN, QUANTITATIVE	$182.53	$456.33	$80.50–$415.45	—	60%
Uric acid blood test CPT 84550 HC URIC ACID; BLOOD	$49.20	$123.00	$24.11–$90.53	33% below	60%
Uric acid blood test inpatient CPT 84550 HC URIC ACID; BLOOD	$49.20	$123.00	$24.11–$90.53	—	60%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO W/SCOPE	$63.14	$157.85	$11.02–$34.73	2% below	60%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO W/SCOPE	$63.14	$157.85	$11.02–$34.73	—	60%
Urinalysis without microscope exam, automated CPT 81003 HC POCT URINALYSIS MACROSCOPIC ONLY AUTO	$19.96	$49.89	$19.24–$117.17	20% below	60%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO W/O SCOPE	$58.58	$146.46	$19.24–$117.17	134% above	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC POCT URINALYSIS MACROSCOPIC ONLY AUTO	$19.96	$49.89	$19.24–$117.17	—	60%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO W/O SCOPE	$58.58	$146.46	$19.24–$117.17	—	60%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE; QUANT COLONY COUNT, URINE	$165.85	$414.63	$73.14–$331.70	81% above	60%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC CULTURE; QUANT COLONY COUNT, URINE	$165.85	$414.63	$73.14–$331.70	—	60%
Urine microalbumin (albumin) test CPT 82043 HC MICROALBUMIN, QUANTITATIVE	$69.57	$173.92	$34.08–$139.14	8% above	60%
Urine microalbumin (albumin) test inpatient CPT 82043 HC MICROALBUMIN, QUANTITATIVE	$69.57	$173.92	$34.08–$139.14	—	60%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST, QUAL	$102.11	$255.27	$56.16–$204.22	38% above	60%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST, QUAL POC	$102.11	$255.27	$56.16–$204.22	38% above	60%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST, QUAL	$102.11	$255.27	$56.16–$204.22	—	60%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST, QUAL POC	$102.11	$255.27	$56.16–$204.22	—	60%
Vitamin B12 (cobalamin) blood test CPT 82607 HC CYANOCOBALAMIN (VITAMIN B-12)	$120.54	$301.35	$59.06–$241.08	7% below	60%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC CYANOCOBALAMIN (VITAMIN B-12)	$120.54	$301.35	$59.06–$241.08	—	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC ASSAY OF VITAMIN D	$190.63	$476.58	$93.41–$467.05	5% above	60%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC ASSAY OF VITAMIN D	$190.63	$476.58	$93.41–$467.05	—	60%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC DIHYDROXYVITAMIN D, 1,25	$200.03	$500.07	$110.02–$400.06	3% above	60%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC SO VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED, 82652	$200.03	$500.07	$110.02–$400.06	3% above	60%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC SO DIHYDROXYVITAMIN D, 1,25; DHVD	$200.03	$500.07	$110.02–$400.06	3% above	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC SO DIHYDROXYVITAMIN D, 1,25; DHVD	$200.03	$500.07	$110.02–$400.06	—	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC SO VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED, 82652	$200.03	$500.07	$110.02–$400.06	—	60%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 HC DIHYDROXYVITAMIN D, 1,25	$200.03	$500.07	$110.02–$400.06	—	60%
Zinc blood test CPT 84630 HC ASSAY OF ZINC	$98.88	$247.20	$197.76	41% above	60%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC	$98.88	$247.20	$197.76	—	60%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT LARGE JOINT/BURSA	$100.80	$252.00	$243.27–$248.55	78% below	60%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT LARGE JOINT/BURSA	$100.80	$252.00	$243.27–$248.55	—	60%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC 36430 BLOOD TRANSFUSION ADMIN LEVEL II	$530.96	$1,327.41	$238.93–$292.03	43% below	60%
Blood transfusion (giving blood or blood components) CPT 36430 HC 36430 BLOOD TRANSFUSION	$530.96	$1,327.41	$238.93–$292.03	43% below	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC 36430 BLOOD TRANSFUSION ADMIN LEVEL II	$530.96	$1,327.41	$238.93–$292.03	—	60%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC 36430 BLOOD TRANSFUSION	$530.96	$1,327.41	$238.93–$292.03	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 MDI TREATMENT SUBSEQUENT	$89.55	$223.87	$103.36–$459.37	52% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 NEBULIZER TX SUBSEQUENT	$89.55	$223.87	$103.36–$459.37	52% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT SUBSQ	$89.55	$223.87	$103.36–$459.37	52% below	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 MDI TREATMENT INITIAL	$229.68	$574.21	$103.36–$459.37	22% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT INITIAL	$229.68	$574.21	$103.36–$459.37	22% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC 94640 NEBULIZER TX INITIAL	$229.68	$574.21	$103.36–$459.37	22% above	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 NEBULIZER TX SUBSEQUENT	$89.55	$223.87	$103.36–$459.37	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT SUBSQ	$89.55	$223.87	$103.36–$459.37	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 MDI TREATMENT SUBSEQUENT	$89.55	$223.87	$103.36–$459.37	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 MDI TREATMENT INITIAL	$229.68	$574.21	$103.36–$459.37	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 NEBULIZER TX INITIAL	$229.68	$574.21	$103.36–$459.37	—	60%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC 94640 AIRWAY INHALATION TREATMENT INITIAL	$229.68	$574.21	$103.36–$459.37	—	60%
Chemotherapy IV infusion, first hour CPT 96413 HC 96413 CHEMO;IV INF;SNGL/INITL UP TO 1HR	$468.18	$1,170.44	$222.38–$257.50	26% below	60%
Chemotherapy IV infusion, first hour inpatient CPT 96413 HC 96413 CHEMO;IV INF;SNGL/INITL UP TO 1HR	$468.18	$1,170.44	$222.38–$257.50	—	60%
Critical care, first 30 to 74 minutes CPT 99291 HC 99291 CRITICAL CARE FIRST 30-74 MIN	$1,866.08	$4,665.19	$839.73–$1,026.34	3% below	60%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC 99291 CRITICAL CARE FIRST 30-74 MIN	$1,866.08	$4,665.19	$839.73–$1,026.34	—	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ECG 12 LEAD, TRACING ONLY	$285.18	$712.94	$142.59–$570.35	23% above	60%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ECG 12 LEAD, TRACING ONLY	$285.18	$712.94	$142.59–$570.35	—	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC 99281 ED VISIT LEVEL I	$93.64	$234.10	$46.82–$53.70	55% below	60%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC 99281 ED VISIT LEVEL I	$93.64	$234.10	$46.82–$53.70	—	60%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC 99282 ED VISIT, LEVEL II	$534.36	$1,335.90	$51.50–$1,068.72	37% above	60%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC 99282 ED VISIT, LEVEL II	$534.36	$1,335.90	$51.50–$1,068.72	—	60%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC 99283 ED VISIT, LEVEL III	$929.04	$2,322.61	$418.07–$1,858.09	34% above	60%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC 99283 ED VISIT, LEVEL III	$929.04	$2,322.61	$418.07–$1,858.09	—	60%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC 99284 ED VISIT, LEVEL IV	$1,467.05	$3,667.63	$733.53–$4,054.43	30% above	60%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC 99284 ED VISIT, LEVEL IV	$1,467.05	$3,667.63	$733.53–$4,054.43	—	60%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC 99285 ED VISIT, LEVEL V	$2,027.22	$5,068.04	$912.25–$4,969.18	21% above	60%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC 99285 ED VISIT, LEVEL V	$2,027.22	$5,068.04	$912.25–$4,969.18	—	60%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC 93017 CARDIO STRESS TEST TRACING ONLY	$805.26	$2,013.16	$402.63–$1,610.53	16% below	60%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC 93017 CARDIO STRESS TEST TRACING ONLY	$805.26	$2,013.16	$402.63–$1,610.53	—	60%
Group psychotherapy session CPT 90853 HC 90853 GROUP THERAPY	$194.88	$487.20	$97.44–$105.47	59% above	60%
Group psychotherapy session inpatient CPT 90853 HC 90853 GROUP THERAPY	$194.88	$487.20	$97.44–$105.47	—	60%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC 96360 IV INF,HYDR;INIT 31 MIN TO 1 HOUR	$112.96	$282.41	$79.07	68% below	60%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC 96360 IV INF,HYDR;INIT 31 MIN TO 1 HOUR	$112.96	$282.41	$79.07	—	60%
IV infusion of a medicine, first hour CPT 96365 HC 96365 IV INFUS TH/PRO/DX, INITIAL, UP TO 1 HR	$468.18	$1,170.44	$222.38–$1,147.03	11% above	60%
IV infusion of a medicine, first hour inpatient CPT 96365 HC 96365 IV INFUS TH/PRO/DX, INITIAL, UP TO 1 HR	$468.18	$1,170.44	$222.38–$1,147.03	—	60%
IV push of a medicine, first drug CPT 96374 HC 96374 IV THER/PROPH/DX, SNGL/INIT PUSH	$119.27	$298.17	$62.56–$65.60	45% below	60%
IV push of a medicine, first drug inpatient CPT 96374 HC 96374 IV THER/PROPH/DX, SNGL/INIT PUSH	$119.27	$298.17	$62.56–$65.60	—	60%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC 96372 INJ,THER,PROPH,DX; SQ OR IM	$87.69	$219.22	$43.84–$161.35	20% below	60%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC 96372 INJ,THER,PROPH,DX; SQ OR IM	$87.69	$219.22	$43.84–$161.35	—	60%
Neuromuscular re-education, 15 minutes CPT 97112 HC 97112 PT NEUROMUSCULAR RE-EDUCATION, EA 15 MIN	$118.90	$297.25	$62.36–$65.40	3% below	60%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC 97112 PT NEUROMUSCULAR RE-EDUCATION, EA 15 MIN	$118.90	$297.25	$62.36–$65.40	—	60%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OP NEW LVL 3 LOW MDM/30-44 MIN	$80.00	$200.00	$181.31–$299.12	63% below	60%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OP NEW LVL 3 LOW MDM/30-44 MIN	$80.00	$200.00	$181.31–$299.12	—	60%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OP NEW LVL 4 MOD MDM/45-59 MIN	$104.00	$260.00	$197.84–$243.27	65% below	60%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OP NEW LVL 4 MOD MDM/45-59 MIN	$104.00	$260.00	$197.84–$243.27	—	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC 97802 MED NUTRITION THERAPY ASSESS EA 15 MIN	$14.00	$35.00	$7.70	74% below	60%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC 97802 MED NUTRITION THERAPY ASSESS EA 15 MIN	$14.00	$35.00	$7.70	—	60%
Occupational therapy evaluation, low complexity CPT 97165 HC 97165 OT EVALUATION, LOW COMPLEXITY	$141.54	$353.86	$67.23	45% below	60%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC 97165 OT EVALUATION, LOW COMPLEXITY	$141.54	$353.86	$67.23	—	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC 97161 PT EVALUATION, LOW COMPLEXITY	$141.54	$353.86	$67.23–$76.29	37% below	60%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC 97161 PT EVALUATION, LOW COMPLEXITY	$141.54	$353.86	$67.23–$76.29	—	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC 97162 PT EVALUATION, MODERATE COMPLEXITY	$191.11	$477.78	$104.92	38% below	60%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC 97162 PT EVALUATION, MODERATE COMPLEXITY	$191.11	$477.78	$104.92	—	60%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC 97140 OT MANUAL THERAPY, EA 15 MIN	$102.18	$255.44	$55.08	27% below	60%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC 97140 PT MANUAL THERAPY, EA 15 MIN	$115.07	$287.68	$57.54–$179.97	18% below	60%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC 97140 OT MANUAL THERAPY, EA 15 MIN	$102.18	$255.44	$55.08	—	60%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC 97140 PT MANUAL THERAPY, EA 15 MIN	$115.07	$287.68	$57.54–$179.97	—	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC 97014 PT ELECTRICAL STIMULATION (UNATTEND)	$77.95	$194.88	$42.87–$174.17	35% below	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC 97110 OT THERAPEUTIC EXERCISE, EA 15 MIN	$111.36	$278.40	$55.68–$61.25	7% below	60%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC 97110 PT THERAPEUTIC EXERCISE, EA 15 MIN	$111.36	$278.40	$55.68–$174.17	7% below	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC 97014 PT ELECTRICAL STIMULATION (UNATTEND)	$77.95	$194.88	$42.87–$174.17	—	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC 97110 OT THERAPEUTIC EXERCISE, EA 15 MIN	$111.36	$278.40	$55.68–$61.25	—	60%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC 97110 PT THERAPEUTIC EXERCISE, EA 15 MIN	$111.36	$278.40	$55.68–$174.17	—	60%
Psychotherapy session, 45 minutes CPT 90834 HC 90834 PSYCHOTHERAPY 45 MIN W/PT	$95.99	$239.98	$50.35	53% below	60%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC 90834 PSYCHOTHERAPY 45 MIN W/PT	$95.99	$239.98	$50.35	—	60%
Psychotherapy session, 60 minutes CPT 90837 HC 90837 PSYCHOTHERAPY 60 MIN W/PT	$139.95	$349.88	$73.40–$76.05	54% below	60%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC 90837 PSYCHOTHERAPY 60 MIN W/PT	$139.95	$349.88	$73.40–$76.05	—	60%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OP EST LVL 5 HIGH MDM/40-54 MIN	$136.00	$340.00	$323.83–$338.66	51% below	60%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OP EST LVL 5 HIGH MDM/40-54 MIN	$136.00	$340.00	$323.83–$338.66	—	60%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OP EST LVL 3 LOW MDM/20-29 MIN	$80.00	$200.00	$181.31–$8,862.38	47% below	60%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OP EST LVL 3 LOW MDM/20-29 MIN	$80.00	$200.00	$181.31–$8,862.38	—	60%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OP EST LVL 4 MOD MDM/30-39 MIN	$104.00	$260.00	$197.84–$243.27	41% below	60%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TCM MOD MDM W/IN 14 DAY DISCH	$119.48	$298.70	$197.84–$250.47	33% below	60%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 TCM HIGH MDM W/IN 7 DAY DISCH	$169.33	$423.33	$197.84–$340.50	5% below	60%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OP EST LVL 4 MOD MDM/30-39 MIN	$104.00	$260.00	$197.84–$243.27	—	60%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TCM MOD MDM W/IN 14 DAY DISCH	$119.48	$298.70	$197.84–$250.47	—	60%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TCM HIGH MDM W/IN 7 DAY DISCH	$169.33	$423.33	$197.84–$340.50	—	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC 97530 OT THERPEUTIC ACTIVITY, DIR EA 15 MIN	$115.07	$287.68	$57.54–$62.02	10% below	60%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC 97530 PT THERAPEUTIC ACTIVITIES,DIRECT,EA 15 M	$115.07	$287.68	$57.54–$179.97	10% below	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC 97530 OT THERPEUTIC ACTIVITY, DIR EA 15 MIN	$115.07	$287.68	$57.54–$62.02	—	60%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC 97530 PT THERAPEUTIC ACTIVITIES,DIRECT,EA 15 M	$115.07	$287.68	$57.54–$179.97	—	60%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 FLU VACCINE ADJUVANT IM	$37.60	$93.99	$92.11	69% below	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY	$158.20	$395.50	$92.11	31% above	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLU VACCINE ADJUVANT IM	$37.60	$93.99	$92.11	—	60%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY	$158.20	$395.50	$92.11	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLU VACC TRIVLNT IIV3 6MO TO 64YRS PF 0.5 ML IM	$16.40	$40.99	$22.76	52% below	60%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$42.36	$105.90	$22.76	23% above	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLU VACC TRIVLNT IIV3 6MO TO 64YRS PF 0.5 ML IM	$16.40	$40.99	$22.76	—	60%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY	$42.36	$105.90	$22.76	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMONIA VACCINE 20 VALENT IM INJ	$492.36	$1,230.90	$306.65	11% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$611.46	$1,528.65	$306.65	38% above	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMONIA VACCINE 20 VALENT IM INJ	$492.36	$1,230.90	$306.65	—	60%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY	$611.46	$1,528.65	$306.65	—	60%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE, PCEC IM SUSR	$938.76	$2,346.90	$1,645.07	25% above	60%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE, PCEC IM SUSR	$938.76	$2,346.90	$1,645.07	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >7 YO, IM	$55.62	$139.05	$52.25–$209.00	45% below	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY	$104.50	$261.25	$52.25–$209.00	4% above	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 YO, IM	$55.62	$139.05	$52.25–$209.00	—	60%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSY	$104.50	$261.25	$52.25–$209.00	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$14.83	$37.08	$19.62	74% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC 90471 IMMUNIZATION ADMIN, ONE VACCINE	$37.40	$93.51	$19.62	35% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC 90471 IMMUNIZATION ADMINISTRAT, ONE VACCINE	$37.40	$93.51	$18.70–$93.51	35% below	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$14.83	$37.08	$19.62	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC 90471 IMMUNIZATION ADMIN, ONE VACCINE	$37.40	$93.51	$19.62	—	60%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC 90471 IMMUNIZATION ADMINISTRAT, ONE VACCINE	$37.40	$93.51	$18.70–$93.51	—	60%

Source file: https://machine-readable-files.com/salem-township-hospital/370925318_salem-township-hospital_standardcharges.csv