SelfPayRates
Hospital Beckley, WV

Montgomery General Hospital

Montgomery General Hospital in Montgomery, WV publishes cash prices for 256 common procedures listed here, from its own machine-readable price file updated Feb 17, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the West Virginia median for 162 of 250 procedures and above it for 81. By typical cash price it ranks #1 of 27 West Virginia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

401 6th Avenue, Montgomery, West Virginia 25136, United States Collected Sep 27, 2026 Source price file (304) 442-5151

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 511318 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Montgomery General Hospital in Montgomery, WV:

  • Sep 20, 2024 Corrective action plan requested
  • Jan 8, 2025 Corrective action plan requested
  • Apr 8, 2025 Case closed

Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE/JOINT WHOLE BODY $424.49 $565.99 $408.43–$633.07 49% below 25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE/JOINT WHOLE BODY $424.49 $565.99 $408.43–$551.38 — 25%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST(S) BILATERAL $500.57 $667.42 — — 25%
CT scan of the abdomen without contrast CPT 74150 CT ABD ALL ORGANS (S) $625.15 $833.53 — 13% below 25%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD ALL ORGANS (S) $625.15 $833.53 — — 25%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL (S) $276.75 $369.00 — 58% below 25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL (S) $276.75 $369.00 — — 25%
CT scan of the head without and with contrast CPT 70470 CT HEAD (C&S) $722.67 $963.57 — 39% below 25%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD (C&S) $722.67 $963.57 — — 25%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS (C) $625.15 $833.53 — 35% below 25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS (C) $625.15 $833.53 — — 25%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG FET&MAT EVAL FET ANATO $249.71 $332.95 $243.77–$377.84 45% below 25%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG FET&MAT EVAL FET ANATO $249.71 $332.95 $243.77–$329.09 — 25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST (C) $686.56 $915.41 — 38% below 25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST (C) $686.56 $915.41 — — 25%
Duplex ultrasound of the leg veins, both legs CPT 93970 USD EXT VENOUS W/ COMPRES BILA $340.48 $453.97 $243.77–$377.84 39% below 25%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 USD EXT VENOUS W/ COMPRES BILA $340.48 $453.97 $243.77–$329.09 — 25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY W/O PARM $382.00 $509.34 $408.43–$633.07 53% below 25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY W/O PARM $382.00 $509.34 $408.43–$551.38 — 25%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP STUDY $309.00 $412.00 $220.60–$341.93 12% below 25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY SLEEP TITRA $1,004.25 $1,339.00 $877.34–$1,359.88 61% below 25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LOW DOSE CT-LUNG SCREENING $200.85 $267.80 $106.81–$165.56 67% above 25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LOW DOSE CT-LUNG SCREENING $200.85 $267.80 $106.81–$144.19 — 25%
MRI of the abdomen without contrast CPT 74181 MRI MRCP W/O (S) $856.70 $1,142.27 — 30% below 25%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI KIDNEY (C&S) $998.26 $1,331.02 — 49% below 25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI KIDNEY (C&S) $998.26 $1,331.02 — — 25%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR (C&S) $1,712.05 $2,282.74 — 9% below 25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR (C&S) $1,712.05 $2,282.74 — — 25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC CORD (S) $856.70 $1,142.27 — 36% below 25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC CORD (S) $856.70 $1,142.27 — — 25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL (C&S) $1,712.05 $2,282.74 — 10% below 25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL (C&S) $1,712.05 $2,282.74 — — 25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM C-V SPECT MULTIPLE $1,703.36 $2,271.15 $1,322.69–$2,050.17 39% below 25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM C-V SPECT MULTIPLE $1,703.36 $2,271.15 $1,322.69–$1,785.63 — 25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED OR FOLLOW-UP $204.52 $272.69 $106.81–$165.56 28% below 25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED OR FOLLOW-UP $204.52 $272.69 $106.81–$144.19 — 25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG AFTER 1ST TRIM>14 WKS $163.58 $218.10 $106.81–$165.56 61% below 25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG AFTER 1ST TRIM>14 WKS $163.58 $218.10 $106.81–$144.19 — 25%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY SLEEP STUDY $927.00 $1,236.00 $877.34–$1,359.88 61% below 25%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG TRANSVAGINAL $161.84 $215.79 $106.81–$165.56 40% below 25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG TRANSVAGINAL $161.84 $215.79 $106.81–$144.19 — 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 USD EXT VENOUS W/COMPRES UNILA $233.68 $311.58 $106.81–$165.56 31% below 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS FLOW UNILAT $233.68 $311.58 $106.81–$165.56 31% below 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 USD EXT VENOUS W/COMPRES UNILA $233.68 $311.58 $106.81–$144.19 — 25%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VENOUS FLOW UNILAT $233.68 $311.58 $106.81–$144.19 — 25%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN DECUB ONLY $124.57 $166.09 $88.91–$137.81 32% below 25%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN DECUB ONLY $124.57 $166.09 $88.91–$120.03 — 25%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2V $106.03 $141.37 $88.91–$137.81 39% below 25%
X-ray of the ankle, 2 views inpatient CPT 73600 ANKLE 2V $106.03 $141.37 $88.91–$120.03 — 25%

Lab tests

ProcedureCash price List priceInsurers payvs West VirginiaOff list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT) $34.18 $45.58 $5.30–$8.21 18% above 25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) $34.18 $45.58 $5.30–$7.16 — 25%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST) $34.18 $45.58 $5.18–$8.03 at median 25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) $34.18 $45.58 $5.18–$6.99 — 25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL $220.36 $293.81 — at median 25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL $220.36 $293.81 — — 25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPECIFIC IGE $34.18 $45.58 $5.22–$8.09 71% above 25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPECIFIC IGE $34.18 $45.58 $5.22–$7.05 — 25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEP AB $170.34 $227.12 — 326% above 25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEP AB $170.34 $227.12 — — 25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA #6254 $55.23 $73.65 $12.09–$18.74 13% below 25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA #6254 $55.23 $73.65 $12.09–$16.32 — 25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-NATRIURETIC PEPTIDE $121.28 $161.71 — 1% above 25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-NATRIURETIC PEPTIDE $121.28 $161.71 — — 25%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $100.04 $133.39 — 138% above 25%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $100.04 $133.39 — — 25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW ASP CELL BLOCK $118.39 $157.85 $53.24–$82.52 17% above 25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK - NON GENITAL $118.39 $157.85 $53.24–$82.52 17% above 25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BONE MARROW BX/INTERP $141.17 $188.23 — 40% above 25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK - NON GENITAL $118.39 $157.85 $53.24–$71.87 — 25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW ASP CELL BLOCK $118.39 $157.85 $53.24–$71.87 — 25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BONE MARROW BX/INTERP $141.17 $188.23 — — 25%
Blood culture for bacteria CPT 87040 CULTURE, BLOOD W/ ISOLATION $60.64 $80.86 $10.32–$16.00 18% below 25%
Blood culture for bacteria inpatient CPT 87040 CULTURE, BLOOD W/ ISOLATION $60.64 $80.86 $10.32–$13.93 — 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BCCSP ROUTINE VENIPUNCTURE $2.51 $3.35 $9.34–$14.48 74% below 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $4.64 $6.18 $9.34–$14.48 52% below 25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SPECIMEN COLLECTION $6.57 $8.76 $9.34–$14.48 32% below 25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SPECIMEN COLLECTION $6.57 $8.76 $9.34–$12.61 — 25%
Blood glucose (sugar) test CPT 82947 GLUCOSE,QUAN(EXCEPT REAGENT ST $33.02 $44.03 — 44% above 25%
Blood glucose (sugar) test CPT 82947 GLUCOSE BODY FLUID $33.02 $44.03 — 44% above 25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE,QUAN(EXCEPT REAGENT ST $33.02 $44.03 — — 25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BODY FLUID $33.02 $44.03 — — 25%
Blood lead test CPT 83655 LEAD, ADULT $51.95 $69.27 $12.11–$18.77 471% above 25%
Blood lead test CPT 83655 LEAD PEDIATRIC $51.95 $69.27 $12.11–$18.77 471% above 25%
Blood lead test inpatient CPT 83655 LEAD PEDIATRIC $51.95 $69.27 $12.11–$16.35 — 25%
Blood lead test inpatient CPT 83655 LEAD, ADULT $51.95 $69.27 $12.11–$16.35 — 25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST (QUAL) $44.03 $58.71 $7.52–$11.66 9% above 25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST (QUAL) $44.03 $58.71 $7.52–$10.15 — 25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPING $29.93 $39.91 $135.93–$210.69 21% below 25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPING $29.93 $39.91 $135.93–$183.51 — 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $33.41 $44.55 $5.18–$8.03 17% above 25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $33.41 $44.55 $5.18–$6.99 — 25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 PCR $115.88 $154.50 — 17% above 25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 PCR $115.88 $154.50 — — 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY THIN PREP $60.83 $81.11 $35.09–$54.39 29% above 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY DNA $64.70 $86.26 $35.09–$54.39 37% above 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIC BY PCR $202.78 $270.38 — 331% above 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY THIN PREP $60.83 $81.11 $35.09–$47.37 — 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY DNA $64.70 $86.26 $35.09–$47.37 — 25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIC BY PCR $202.78 $270.38 — — 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $78.60 $104.80 — 26% above 25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL/CHD RISK $107.57 $143.43 — 72% above 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $78.60 $104.80 — — 25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL/CHD RISK $107.57 $143.43 — — 25%
Complete blood count (CBC) with differential CPT 85025 HEMOGRAM AUTOMATED COMPLETE $25.11 $33.48 $7.77–$12.04 39% below 25%
Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFFERENTIAL $44.03 $58.71 $7.77–$12.04 6% above 25%
Complete blood count (CBC) with differential inpatient CPT 85025 HEMOGRAM AUTOMATED COMPLETE $25.11 $33.48 $7.77–$10.49 — 25%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTO DIFFERENTIAL $44.03 $58.71 $7.77–$10.49 — 25%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $96.76 $129.01 — 97% above 25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL $96.76 $129.01 — — 25%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER SEMI-QUANT $67.01 $89.35 $10.18–$15.78 5% above 25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER SEMI-QUANT $67.01 $89.35 $10.18–$13.74 — 25%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S $112.21 $149.61 — 21% above 25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S $112.21 $149.61 — — 25%
Estradiol blood test CPT 82670 ESTRADIOL $140.02 $186.69 — 63% above 25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL $140.02 $186.69 — — 25%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE $84.59 $112.79 — 1% below 25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE $84.59 $112.79 — — 25%
Ferritin blood test (iron stores) CPT 82728 FERRITIN #4598 $66.24 $88.32 $13.63–$21.13 9% below 25%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN #4598 $66.24 $88.32 $13.63–$18.40 — 25%
Folate (folic acid) blood test CPT 82746 FOLATE #2014 $69.91 $93.22 $14.70–$22.79 at median 25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE #2014 $69.91 $93.22 $14.70–$19.84 — 25%
Free T3 thyroid hormone test CPT 84481 FREE T3 $180.38 $240.51 — 107% above 25%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 $180.38 $240.51 — — 25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 $99.07 $132.10 — 87% above 25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 $99.07 $132.10 — — 25%
Free testosterone test CPT 84402 FREE TESTOSTERONE $129.01 $172.01 — 122% above 25%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE $129.01 $172.01 — — 25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL $210.70 $280.93 — 10% below 25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL $210.70 $280.93 — — 25%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS $53.69 $71.59 $12.87–$19.95 19% below 25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE 3 SPECIMENS $53.69 $71.59 $12.87–$17.37 — 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N GONORRHEA BY THIN PREP $60.83 $81.11 $35.09–$54.39 1% above 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY DNA $64.70 $86.26 $35.09–$54.39 8% above 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE BY PCR $223.06 $297.41 — 272% above 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N GONORRHEA BY THIN PREP $60.83 $81.11 $35.09–$47.37 — 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY DNA $64.70 $86.26 $35.09–$47.37 — 25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE BY PCR $223.06 $297.41 — — 25%
H. pylori antibody blood test CPT 86677 ANTI-HELICOBACTER PYLORI AB $97.72 $130.30 — 104% above 25%
H. pylori antibody blood test inpatient CPT 86677 ANTI-HELICOBACTER PYLORI AB $97.72 $130.30 — — 25%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN $127.85 $170.47 — 138% above 25%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN $127.85 $170.47 — — 25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV BY THIN PREP $162.23 $216.30 — 224% above 25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV BY THIN PREP $162.23 $216.30 — — 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY $64.70 $86.26 $10.74–$16.65 25% above 25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY $64.70 $86.26 $10.74–$14.50 — 25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE ANTIGEN #6510 $34.76 $46.35 $10.33–$16.01 37% below 25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN #6510 $34.76 $46.35 $10.33–$13.95 — 25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY $66.24 $88.32 $14.27–$22.12 11% above 25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY $66.24 $88.32 $14.27–$19.26 — 25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C,QUANT BY PCR $364.23 $485.65 — 79% above 25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV PCR QUANTITATIVE $973.35 $1,297.80 — 378% above 25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C,QUANT BY PCR $364.23 $485.65 — — 25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV PCR QUANTITATIVE $973.35 $1,297.80 — — 25%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG $202.78 $270.38 — 363% above 25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGG $202.78 $270.38 — — 25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGG $202.78 $270.38 — 336% above 25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGG $202.78 $270.38 — — 25%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HIGH SENS. $71.07 $94.76 $12.95–$20.07 15% above 25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HIGH SENS. $71.07 $94.76 $12.95–$17.48 — 25%
Homocysteine blood test CPT 83090 HOMOCYSTINE $179.41 $239.22 — 104% above 25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE $179.41 $239.22 — — 25%
Insulin blood test CPT 83525 INSULIN TOTAL $59.29 $79.05 $11.43–$17.72 7% above 25%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL $59.29 $79.05 $11.43–$15.43 — 25%
Iron blood test (serum iron) CPT 83540 IRON $56.01 $74.68 — 33% above 25%
Iron blood test (serum iron) inpatient CPT 83540 IRON $56.01 $74.68 — — 25%
Iron-binding capacity (TIBC) test CPT 83550 IBC $56.01 $74.68 $8.74–$13.55 36% above 25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IBC $56.01 $74.68 $8.74–$11.80 — 25%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $90.19 $120.25 — 125% above 25%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $90.19 $120.25 — — 25%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE $84.01 $112.01 — 8% below 25%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE $84.01 $112.01 — — 25%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE #1404 $37.85 $50.47 $6.89–$10.68 10% below 25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE #1404 $37.85 $50.47 $6.89–$9.30 — 25%
Liver function blood test panel CPT 80076 HEPATIC PROFILE $90.38 $120.51 — 138% above 25%
Liver function blood test panel inpatient CPT 80076 HEPATIC PROFILE $90.38 $120.51 — — 25%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL ANTIBODIES $134.22 $178.96 — 355% above 25%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL ANTIBODIES $134.22 $178.96 — — 25%
Magnesium blood test CPT 83735 MAGNESIUM $49.44 $65.92 $6.70–$10.38 266% above 25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM $49.44 $65.92 $6.70–$9.05 — 25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA $54.08 $72.10 $12.88–$19.96 69% above 25%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA $54.08 $72.10 $12.88–$17.39 — 25%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST SCREEN $43.26 $57.68 — 24% above 25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST SCREEN $43.26 $57.68 — — 25%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA $102.94 $137.25 — 72% above 25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA $102.94 $137.25 — — 25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPEC ANTIGEN #10322 $64.31 $85.75 $18.39–$28.50 at median 25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPEC ANTIGEN #10322 $64.31 $85.75 $18.39–$24.83 — 25%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT $193.13 $257.50 — 27% above 25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT $193.13 $257.50 — — 25%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT PLASMA/WHOLE BLOOD $38.05 $50.73 $6.01–$9.32 13% below 25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT PLASMA/WHOLE BLOOD $38.05 $50.73 $6.01–$8.11 — 25%
Progesterone blood test CPT 84144 PROGESTERONE $79.76 $106.35 — 25% below 25%
Progesterone blood test inpatient CPT 84144 PROGESTERONE $79.76 $106.35 — — 25%
Prolactin blood test CPT 84146 PROLACTIN $96.95 $129.27 — 43% above 25%
Prolactin blood test inpatient CPT 84146 PROLACTIN $96.95 $129.27 — — 25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $37.66 $50.21 — 39% above 25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $37.66 $50.21 — — 25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A&B (MONT PEDS) $34.76 $46.35 $16.55–$25.65 22% below 25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A $63.92 $85.23 $16.55–$25.65 44% above 25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA B $63.92 $85.23 $16.55–$25.65 44% above 25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA B $63.92 $85.23 $16.55–$22.34 — 25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A $63.92 $85.23 $16.55–$22.34 — 25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC $15.45 $20.60 $16.53–$25.62 62% below 25%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN $28.78 $38.37 $16.53–$25.62 28% below 25%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN $28.78 $38.37 $16.53–$22.32 — 25%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR TITER QUANT. $16.61 $22.15 $5.67–$8.79 54% below 25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR TITER QUANT. $16.61 $22.15 $5.67–$7.65 — 25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN #6197 $48.47 $64.63 $14.39–$22.30 2% below 25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA SCREEN #6197 $48.47 $64.63 $14.39–$19.43 — 25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HEMOCCULT-MEDICARE $12.17 $16.22 $4.38–$6.79 19% below 25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 (MEDICARE) HEMOCULT $12.94 $17.25 $4.38–$6.79 14% below 25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN 3CARDS QL $28.78 $38.37 $4.38–$6.79 92% above 25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN 3CARDS QL $28.78 $38.37 $4.38–$5.91 — 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILLIS TEST QUAL. $36.11 $48.15 — 29% above 25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILLIS TEST QUAL. $36.11 $48.15 — — 25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD $154.50 $206.00 — 12% below 25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD $154.50 $206.00 — 12% below 25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE $116.07 $154.76 — 44% above 25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE $116.07 $154.76 — — 25%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PERIOXIDASE AB $80.53 $107.38 — 3% above 25%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID ANTIMICROSOMAL AB $80.53 $107.38 — 3% above 25%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-LKM $80.53 $107.38 — 3% above 25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID ANTIMICROSOMAL AB $80.53 $107.38 — — 25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PERIOXIDASE AB $80.53 $107.38 — — 25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-LKM $80.53 $107.38 — — 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (ULTRASENSITIVE) $70.10 $93.47 $16.80–$26.04 9% above 25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 3RD GENERATION TSH $80.53 $107.38 — 25% above 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (ULTRASENSITIVE) $70.10 $93.47 $16.80–$22.68 — 25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 3RD GENERATION TSH $80.53 $107.38 — — 25%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis $64.70 $86.26 $35.09–$54.39 11% below 25%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Vaginalis $64.70 $86.26 $35.09–$47.37 — 25%
Uric acid blood test CPT 84550 URIC ACID BLOOD $51.76 $69.01 — 57% above 25%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD $51.76 $69.01 — — 25%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS/MICRO $37.66 $50.21 — 28% above 25%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS/MICRO $37.66 $50.21 — — 25%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS W/MICRO $16.22 $21.63 $4.02–$6.23 1% above 25%
Urinalysis without microscope exam, automated CPT 81003 Urine Dip (Automated) $7.73 $10.30 $2.25–$3.49 51% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE BILIRUBIN $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE SPECIFIC GRAVITY $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE PH $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE UROBILINOGEN $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE ALBUMIN $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE SUGAR/ACETONE $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE SUGAR / ACETONE $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 URINE DIP $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated CPT 81003 BLOOD IN URINE $15.64 $20.86 $2.25–$3.49 2% below 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE UROBILINOGEN $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 BLOOD IN URINE $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SUGAR/ACETONE $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SPECIFIC GRAVITY $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE SUGAR / ACETONE $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE BILIRUBIN $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE ALBUMIN $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE DIP $15.64 $20.86 $2.25–$3.04 — 25%
Urinalysis without microscope exam, manual CPT 81002 Urine Dip $8.50 $11.33 $3.48–$5.39 32% below 25%
Urine culture for bacteria, with colony count CPT 87086 CULTURE,URINE QUANT $56.78 $75.71 $8.07–$12.51 6% below 25%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE,URINE QUANT $56.78 $75.71 $8.07–$10.89 — 25%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST/URINE $12.17 $16.22 $8.61–$13.35 41% below 25%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 #1503 $72.81 $97.08 $15.08–$23.37 10% below 25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 #1503 $72.81 $97.08 $15.08–$20.36 — 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25(OH) VITAMIN D $195.25 $260.33 — 173% above 25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25(OH) VITAMIN D $195.25 $260.33 — — 25%
Zinc blood test CPT 84630 ZINC $57.36 $76.48 $11.39–$17.65 59% above 25%
Zinc blood test inpatient CPT 84630 ZINC $57.36 $76.48 $11.39–$15.38 — 25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE $81.69 $108.92 — at median 25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE $81.69 $108.92 — — 25%

Surgery and procedures

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY - RUPTURED INFECT $1,931.25 $2,575.00 — — 25%
Appendectomy, open surgery CPT 44950 OPEN APPENDECTOMY $1,236.00 $1,648.00 — 87% below 25%
Appendectomy, open surgery CPT 44950 44950-OPEN APPENDECTOMY $1,236.00 $1,648.00 — 87% below 25%
Appendectomy, open surgery CPT 44950 APPENDECTOMY - OPEN $3,862.50 $5,150.00 $6,614.04–$10,251.76 60% below 25%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Arthroscopy, Knee w/ACL Repair $12,746.25 $16,995.00 $7,413.38–$11,490.74 — 25%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 Arthro Rotator Cuff Repair $2,124.38 $2,832.50 $7,413.38–$11,490.74 64% below 25%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 Arthro Rotator Cuff Repair- LT $13,132.50 $17,510.00 $7,413.38–$11,490.74 125% above 25%
Arthroscopic rotator cuff repair of the shoulder one side CPT 29827 Arthro Rotator Cuff Repair- RT $13,132.50 $17,510.00 $7,413.38–$11,490.74 125% above 25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 PREOP PLAC NDLE LOC WIRE BREAS $2,703.75 $3,605.00 $1,687.37–$2,615.42 5% above 25%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 PREOP PLAC NDLE LOC WIRE BREAS $2,703.75 $3,605.00 $1,687.37–$2,277.95 — 25%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FX-W/O MAN $181.34 $241.79 $252.01–$390.62 42% below 25%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TR CL METATAR SAL FX NO MAN $181.34 $241.79 $252.01–$390.62 28% below 25%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION $811.13 $1,081.50 $675.26–$1,046.65 20% below 25%
Carpal tunnel release, open surgery CPT 64721 Rel/Reloc Median Nerve Hand $3,476.25 $4,635.00 $1,995.02–$3,092.28 19% above 25%
Cataract surgery with lens implant CPT 66984 CATARACT $2,317.50 $3,090.00 $2,357.81–$3,654.61 29% below 25%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION $447.28 $596.37 — 83% below 25%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION $202.78 $270.38 — 89% below 25%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/U CLSD $181.34 $241.79 $252.01–$390.62 50% below 25%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY;SNARE TECHNIQUE $1,123.41 $1,497.88 $1,222.56–$1,894.97 23% below 25%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY SNARE $1,429.13 $1,905.50 $1,222.56–$1,894.97 2% below 25%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY;W/BIOPSY.SING.MULT $989.57 $1,319.43 $1,222.56–$1,894.97 13% below 25%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY $1,390.50 $1,854.00 $1,222.56–$1,894.97 22% above 25%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY;DIAGNOSTIC $897.26 $1,196.35 $950.10–$1,472.65 21% below 25%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY/DIAGNOSTIC $1,236.00 $1,648.00 $950.10–$1,472.65 9% above 25%
Complex cataract surgery with lens implant CPT 66982 CATARACT - COMPLEX $3,090.00 $4,120.00 $2,357.81–$3,654.61 24% below 25%
Cystoscopy with ureteral stent placement CPT 52332 CYSTO w/ STENT INSERTION $1,388.38 $1,851.17 $3,601.33–$5,582.06 66% below 25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY $154.50 $206.00 — 81% below 25%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy $1,236.00 $1,648.00 $712.40–$1,104.22 53% above 25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HISTOFREEZER (1) $68.95 $91.93 $204.98–$317.72 67% below 25%
Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 BILAT-IRRIG-REMOVE IMP WAX $57.94 $77.25 $60.27–$93.42 — 25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM INPACT CERUMEN:IRR.UNI $95.60 $127.46 $60.27–$93.42 17% above 25%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN $87.10 $116.13 $60.27–$93.42 28% above 25%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN $95.60 $127.46 $60.27–$93.42 41% above 25%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Init.Hern.RPR/Mesh 3-10cm,redu $7,029.75 $9,373.00 $6,614.04–$10,251.76 15% below 25%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR Abd.Hernia; any approach $7,029.75 $9,373.00 $6,614.04–$10,251.76 61% below 25%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Init.Hernia RPR/Mesh <3cm,redu $7,029.75 $9,373.00 $3,657.95–$5,669.82 28% above 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY,FLEX;DIAGNOSTIC $214.95 $286.60 — 75% below 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY,FLEX;DIAGNO $772.50 $1,030.00 $950.10–$1,472.65 10% below 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 OR SCREEN FLEX SIGMOID W/O MAC $1,135.58 $1,514.10 $950.10–$1,472.65 33% above 25%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy $1,545.00 $2,060.00 $950.10–$1,472.65 81% above 25%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY,SURG:CHOLECYSTECT $1,388.57 $1,851.43 — 86% below 25%
Gallbladder removal, laparoscopic CPT 47562 CHOLECYSTECTOMY - LAP $6,566.25 $8,755.00 $6,176.47–$9,573.53 32% below 25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY,CHOLE.W/CHOLANGIOG $1,236.00 $1,648.00 — 85% below 25%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY,CHOLE.W/CHOLANGIOG $8,111.25 $10,815.00 $6,176.47–$9,573.53 4% below 25%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY $2,317.50 $3,090.00 — — 25%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY - OPEN $2,703.75 $3,605.00 — — 25%
Hammertoe correction surgery CPT 28285 Hammertoe Repair/Correction $1,248.75 $1,665.00 $3,342.87–$5,181.45 70% below 25%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMMORRHOID LIGATION $340.67 $454.23 $950.10–$1,472.65 73% below 25%
Hemorrhoid banding (rubber band ligation) CPT 46221 Rem.Ext.Hemorr-Rubber Banding $463.50 $618.00 $950.10–$1,472.65 64% below 25%
Hemorrhoid banding (rubber band ligation) CPT 46221 Rem.Ext.Hemorr-Rubber Banding $1,622.25 $2,163.00 $950.10–$1,472.65 28% above 25%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORRHOIDECTOMY,INT/EXT SIMP $1,255.31 $1,673.75 $2,835.78–$4,395.46 76% below 25%
Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Int/Ext $5,021.25 $6,695.00 $2,835.78–$4,395.46 3% below 25%
Hip replacement after an earlier hip surgery (conversion to total hip) CPT 27132 Convers.Prev.HipSur-Total Hip $24,720.00 $32,960.00 $13,116.76–$20,330.98 — 25%
Incision and drainage of a simple or single skin abscess CPT 10060 ABSCESS/SIMPLE $127.85 $170.47 $204.98–$317.72 45% below 25%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ONYCHIA/PARONYCHIA SG $167.63 $223.51 $204.98–$317.72 27% below 25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SIMPLE (3-S) $173.81 $231.75 $204.98–$317.72 25% below 25%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABCESS - SIMPLE $193.13 $257.50 $204.98–$317.72 16% below 25%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE-SIMPLE $231.75 $309.00 $204.98–$317.72 at median 25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SIMPLE (3-S) $173.81 $231.75 $204.98–$276.72 — 25%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA REPAIR, INGUINAL. >5YR $741.99 $989.32 — 89% below 25%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA REPAIR, INGUINAL.>5YR $2,703.75 $3,605.00 $3,657.95–$5,669.82 59% below 25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER INJ - TENDON SHEATH $67.40 $89.87 $313.60–$486.08 80% below 25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION;TENDON SHEATH,LIGAME $144.84 $193.13 $313.60–$486.08 56% below 25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Trigger Finger Injection (SUR) $450.00 $600.00 $313.60–$486.08 36% above 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 KNEE JOINT ASPIRATION $85.17 $113.56 $313.60–$486.08 75% below 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 LRG JT/BRSA ARTHROCENT $176.52 $235.36 $313.60–$486.08 49% below 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inj/Aspiration Major Jt.(3S) $468.75 $625.00 $313.60–$486.08 35% above 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJECT MAJOR JOINT OR BURSA $521.44 $695.25 $313.60–$486.08 50% above 25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Inject/Aspiration Major Joint $540.75 $721.00 $313.60–$486.08 56% above 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT JOINT/BURSA $93.86 $125.15 $313.60–$486.08 73% below 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTN JT/BURSA ARTHROCENT $176.52 $235.36 $313.60–$486.08 49% below 25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT JOINT/BURSA $540.75 $721.00 $313.60–$486.08 56% above 25%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS,SMALL $540.75 $721.00 $313.60–$486.08 54% above 25%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthro/Meniscus Rpr/Med OR Lat $1,390.50 $1,854.00 $3,342.87–$5,181.45 81% below 25%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthro/Meniscus Rpr/Med OR Lat $5,793.75 $7,725.00 $3,342.87–$5,181.45 22% below 25%
Knee arthroscopy with meniscus trim CPT 29881 Rem. Knee Cartilage/Endoscope $1,081.50 $1,442.00 $3,342.87–$5,181.45 89% below 25%
Knee arthroscopy with meniscus trim one side CPT 29881 Arthrs Knee w/Meniscectomy-LT $5,793.75 $7,725.00 $3,342.87–$5,181.45 39% below 25%
Knee arthroscopy with meniscus trim one side CPT 29881 Arthrs Knee w/Meniscectomy-RT $5,793.75 $7,725.00 $3,342.87–$5,181.45 39% below 25%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 Arthroscopy w/ Meniscectomy $5,793.75 $7,725.00 $3,342.87–$5,181.45 at median 25%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 Chrondroplasty $5,793.75 $7,725.00 $3,342.87–$5,181.45 10% above 25%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY, APPENDECTOMY $1,158.75 $1,545.00 — 84% below 25%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 APPENDECTOMY - LAP $4,635.00 $6,180.00 $6,176.47–$9,573.53 37% below 25%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP REPAIR INITIAL ING HERNIA $813.64 $1,084.85 — 91% below 25%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP;REPAIR INITIAL ING HERNIA $5,793.75 $7,725.00 $6,176.47–$9,573.53 39% below 25%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP SUG:REPR RECUR ING HERNIA $753.57 $1,004.77 — 96% below 25%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP;Part./Total Oophor/Salping $9,656.25 $12,875.00 $6,176.47–$9,573.53 54% above 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 I/R SCALP/AX/TRK/EXT <2.5 $203.36 $271.15 $415.32–$643.75 49% below 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMED TR/EXT 2.5 CM OR LESS $204.52 $272.69 $415.32–$643.75 49% below 25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR SCALP,TRUNK,ARM,LEG2.5CM/< $579.38 $772.50 $415.32–$643.75 44% above 25%
Lumpectomy (partial mastectomy) CPT 19301 BREAST,MASTECTOMY,SEGMENTAL $618.19 $824.26 — 90% below 25%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY,SIMPLE,COMPLETE $1,931.25 $2,575.00 $6,783.99–$10,515.18 66% below 25%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC.BE.TRUNK,ARMS,LEGS, 0.5CM $540.75 $721.00 $723.47–$1,121.38 10% below 25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BE FACE,EAR,NOSE 0.6-1.0CM $186.56 $248.75 $723.47–$1,121.38 72% below 25%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC.BE/F/E/N 0.5 CM OR LESS $502.13 $669.50 $723.47–$1,121.38 24% below 25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION/NAIL/SIMP $102.36 $136.48 $204.98–$317.72 57% below 25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PL, SING/SIMP $106.61 $142.14 $204.98–$317.72 55% below 25%
Nail removal (partial or complete), one nail CPT 11730 SIMP.SEPAR NAIL/NAILBED,1st $193.13 $257.50 $204.98–$317.72 18% below 25%
Nail removal (partial or complete), one nail CPT 11730 SIMP.SEPAR NAIL/NAILBED,1st $424.88 $566.50 $204.98–$317.72 80% above 25%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES AGENT GREATER OCCIPIT $154.50 $206.00 $313.60–$486.08 58% below 25%
Paracentesis with imaging guidance CPT 49083 Paracentesis w/Imaging Guidanc $579.38 $772.50 $926.63–$1,436.28 57% below 25%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGING GUID-3S $927.00 $1,236.00 $926.63–$1,436.28 30% below 25%
Paracentesis with imaging guidance CPT 49083 Paracentesis w/Imag. Guide-ER $1,699.50 $2,266.00 $926.63–$1,436.28 27% above 25%
Paracentesis with imaging guidance CPT 49083 Paracentesis w/ Imaging Guide $1,699.50 $2,266.00 $926.63–$1,436.28 27% above 25%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGING GUID-3S $927.00 $1,236.00 $926.63–$1,250.95 — 25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED $333.72 $444.96 $415.32–$643.75 16% below 25%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL & MATRIX $695.25 $927.00 $415.32–$643.75 75% above 25%
Removal of a breast lump, open surgery CPT 19120 BREAST,EXCIS BX.BREAST MASS $4,635.00 $6,180.00 $4,000.24–$6,200.37 1% below 25%
Removal of a foreign object under the skin, simple CPT 10120 FB REMOVAL SUB-Q $95.02 $126.69 — 76% below 25%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY $140.60 $187.46 $415.32–$643.75 64% below 25%
Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY REMOVAL SMPL $167.63 $223.51 $415.32–$643.75 57% below 25%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLONOSCOPY SCR (NOT HIGH RISK $772.50 $1,030.00 $950.10–$1,472.65 39% below 25%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY COLORECTAL CA SCRE $849.75 $1,133.00 $950.10–$1,472.65 38% below 25%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY - ESWL $1,158.75 $1,545.00 $3,601.33–$5,582.06 86% below 25%
Short arm cast (elbow to hand) CPT 29075 Application of forearm cast $386.25 $515.00 $285.75–$442.91 37% above 25%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST $386.25 $515.00 $285.75–$442.91 37% above 25%
Short arm splint (forearm and hand) CPT 29125 Apply Short Arm Splint;Static $193.13 $257.50 $135.93–$210.69 11% above 25%
Short arm splint (forearm and hand) CPT 29125 APLICATION OF SHORT ARM SPLINT $193.13 $257.50 $135.93–$210.69 11% above 25%
Short arm splint (forearm and hand) CPT 29125 APP OF SHORT ARM SPLINT;STATIC $193.13 $257.50 $135.93–$210.69 11% above 25%
Short leg cast (below the knee) CPT 29405 Application of Short Leg Cast $386.25 $515.00 $285.75–$442.91 21% above 25%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST $386.25 $515.00 $285.75–$442.91 21% above 25%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLIN $163.77 $218.36 $166.02–$257.33 30% below 25%
Short leg splint (calf to foot) CPT 29515 Application Lower Leg Splint $231.75 $309.00 $166.02–$257.33 1% below 25%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 Distal Claviculectomy-Mumford $4,557.75 $6,077.00 $3,342.87–$5,181.45 — 25%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shave Shld Bone/Rpr Lig/Endosc $309.00 $412.00 — 82% below 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE EXT TO 2.5 CM $166.09 $221.45 $204.98–$317.72 34% below 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 S/R SCALP/BODY/EXT < 2.5 $203.36 $271.15 $204.98–$317.72 19% below 25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SUTURES 1 TO 2.5 CM $212.63 $283.51 $204.98–$317.72 15% below 25%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY-SINGLE LESION $193.13 $257.50 $415.32–$643.75 49% below 25%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC.MAL.TRUNK,ARMS,LEGS < 0.6 $212.63 $283.51 $723.47–$1,121.38 74% below 25%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS, UP TO 15 $110.85 $147.81 $204.98–$317.72 42% below 25%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UP TO 15 $309.00 $412.00 $204.98–$317.72 61% above 25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP DIAGNSTC $110.85 $147.81 — 88% below 25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE $243.34 $324.45 $721.17–$1,117.81 74% below 25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG $249.90 $333.21 $721.17–$1,117.81 73% below 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE EXT 2.6 CM TO 7.5 CM $170.34 $227.12 $204.98–$317.72 31% below 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 S/R SCALP/BODY/EXT 2.6-7.5 $203.36 $271.15 $204.98–$317.72 18% below 25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SUTURES 2.6 TO 7.5 CM $227.12 $302.82 $204.98–$317.72 8% below 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE MUC MEM TO 2.5 CM $170.34 $227.12 $204.98–$317.72 33% below 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 S/R FACE/EENT/MUC MEM < 2.5 $203.36 $271.15 $204.98–$317.72 20% below 25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SUTURES > 2.5 CM FACE.EARS. $225.57 $300.76 $204.98–$317.72 11% below 25%
TURP (transurethral resection of the prostate) CPT 52601 TRANS RESECTION OF PROSTATE $675.94 $901.25 — 86% below 25%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 SHAVE BIOPSY - SINGLE LESION $154.50 $206.00 $415.32–$643.75 46% below 25%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS with imagining $303.79 $405.05 $640.89–$993.38 76% below 25%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/Imag.Guide-ER $1,158.75 $1,545.00 $640.89–$993.38 10% below 25%
Total hip replacement CPT 27130 27130-Total Hip Arthroplasty $3,090.00 $4,120.00 — 64% below 25%
Total knee replacement CPT 27447 Total Knee Arthroplasty $3,090.00 $4,120.00 — 71% below 25%
Total knee replacement one side CPT 27447 Total Knee Arthroplasty RT $24,720.00 $32,960.00 $13,116.76–$20,330.98 134% above 25%
Total knee replacement one side CPT 27447 Total Knee Arthroplasty LT $24,720.00 $32,960.00 $13,116.76–$20,330.98 134% above 25%
Total shoulder replacement CPT 23472 Shoulder Arthroplasty-Total $2,858.25 $3,811.00 — 72% below 25%
Total shoulder replacement CPT 23472 Shoulder Arthroplasty-Total BL $25,492.50 $33,990.00 $17,913.59–$27,766.06 151% above 25%
Total shoulder replacement one side CPT 23472 Shoulder Arthroplasty-Total LT $25,492.50 $33,990.00 $17,913.59–$27,766.06 151% above 25%
Total shoulder replacement one side CPT 23472 Shoulder Arthroplasty-Total RT $25,492.50 $33,990.00 $17,913.59–$27,766.06 151% above 25%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY,TOTAL OR COMPLET $1,494.21 $1,992.28 — 83% below 25%
Trigger finger release surgery CPT 26055 Trigger Finger Release $1,313.25 $1,751.00 $1,642.82–$2,546.37 29% below 25%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT 1 OR 2 MUSCLES $89.22 $118.97 $313.60–$486.08 70% below 25%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT -1 OR 2 MUSCLES $115.88 $154.50 $313.60–$486.08 61% below 25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UPPER GAST ENDO:BALL DIL<30MOD $347.24 $462.99 — 77% below 25%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD;BALLOON DIL<30 $2,085.75 $2,781.00 $1,960.47–$3,038.73 39% above 25%
Upper endoscopy (EGD) with biopsy CPT 43239 ENDO EVAL-SM INT POUCH W/BIOPS $618.00 $824.00 $926.63–$1,436.28 40% below 25%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD;W/BIOPSY $733.88 $978.50 $926.63–$1,436.28 29% below 25%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GAST ENDO;W/BIOPSY $1,351.88 $1,802.50 $926.63–$1,436.28 31% above 25%
Upper endoscopy (EGD) with biopsy CPT 43239 Esophagogastroduodenosc w/Biop $1,622.25 $2,163.00 $926.63–$1,436.28 58% above 25%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPPER GAST ENDO;SNARE TECHNIQU $1,931.25 $2,575.00 $1,960.47–$3,038.73 60% above 25%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UPPER GAST ENDO;W/INSERT OF GW $264.58 $352.78 $926.63–$1,436.28 79% below 25%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GAST ENDOSCOPY-DIAGNOSTI $588.07 $784.09 $926.63–$1,436.28 29% below 25%
Upper endoscopy (EGD), diagnostic CPT 43235 Upper Gast Endoscopy-Diagnosti $588.07 $784.09 $926.63–$1,436.28 29% below 25%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD-DIAGNOSTIC $1,158.75 $1,545.00 $926.63–$1,436.28 40% above 25%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY $386.25 $515.00 — 83% below 25%
Wart removal, up to 14 warts CPT 17110 VERUCA PLANA.MILIA.MOLL TO 15L $81.11 $108.15 $204.98–$317.72 60% below 25%
Wart removal, up to 14 warts CPT 17110 VERUCA PLANA,MILIA MOLL TO 15L $204.71 $272.95 $204.98–$317.72 2% above 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID, SKIN PART THICK $147.55 $196.73 $415.32–$643.75 55% below 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE $294.71 $392.95 $415.32–$643.75 9% below 25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUB-Q $386.25 $515.00 $415.32–$643.75 19% above 25%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 ORIF-Dis.Radial/Ex-Art.Fx $12,746.25 $16,995.00 $7,413.38–$11,490.74 50% above 25%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD/PRODUCTS $558.32 $744.43 $450.73–$698.63 11% below 25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION OF BLOOD/PRODUCTS $558.32 $744.43 $450.73–$608.49 — 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION THERAPY (2/MORE) $52.72 $70.30 $223.72–$346.77 69% below 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX $461.96 $615.94 $223.72–$346.77 171% above 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL TX $461.96 $615.94 $223.72–$346.77 171% above 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TX $461.96 $615.94 $223.72–$302.02 — 25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX $461.96 $615.94 $223.72–$302.02 — 25%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY ADM,INTRA INF/1HR $324.45 $432.60 $337.46–$523.06 47% below 25%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN $340.67 $454.23 $843.92–$1,308.08 68% below 25%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Time Initial $830.44 $1,107.25 $843.92–$1,308.08 23% below 25%
Critical care, first 30 to 74 minutes CPT 99291 E/R CRITICAL CARE 30-74 MIN $830.44 $1,107.25 $843.92–$1,308.08 23% below 25%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG-AWAKE & DROWSY $488.03 $650.70 $220.60–$341.93 21% below 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG - SUITE 301 $110.85 $147.81 $60.27–$93.42 8% below 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG-PEDS $110.85 $147.81 $60.27–$93.42 8% below 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG $110.85 $147.81 $60.27–$93.42 8% below 25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG $110.85 $147.81 $60.27–$81.36 — 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 E/R PROFESS LEVEL 1 $42.68 $56.91 $86.15–$133.53 70% below 25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 E/R LEVEL 1 $127.85 $170.47 $86.15–$133.53 10% below 25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E/R PROFESS LEVEL 2 $63.92 $85.23 $156.87–$243.15 75% below 25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 E/R LEVEL 2 $213.02 $284.02 $156.87–$243.15 16% below 25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY ROOM VISIT 3 $68.95 $91.93 $278.89–$432.28 82% below 25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E/R PROFESS LEVEL 3 $106.61 $142.14 $278.89–$432.28 72% below 25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 E/R LEVEL 3 $298.19 $397.58 $278.89–$432.28 23% below 25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 E/R PROFESS LEVEL 4 $170.34 $227.12 $426.30–$660.76 72% below 25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 E/R LEVEL 4 $405.56 $540.75 $426.30–$660.76 33% below 25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E/R PROFESS LEVEL 5 $255.50 $340.67 $608.43–$943.07 69% below 25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 E/R LEVEL 5 $544.61 $726.15 $608.43–$943.07 33% below 25%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY $23.18 $30.90 $103.79–$160.87 70% below 25%
Group psychotherapy session CPT 90853 Group Psychotherapy/not family $77.25 $103.00 $103.79–$160.87 2% below 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFU HYDRTN 1 HR $85.17 $113.56 $217.31–$336.83 62% below 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRTN 1 HOUR $151.60 $202.14 $217.31–$336.83 33% below 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION THERAPY INITIAL HR $324.45 $432.60 $217.31–$336.83 44% above 25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION/HYDRATION 31-60min $333.75 $445.00 $217.31–$336.83 48% above 25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION THERAPY INITIAL HR $324.45 $432.60 $217.31–$293.37 — 25%
IV infusion of a medicine, first hour CPT 96365 IV INFUS,PROPHYLAXIS TO 1 HR $127.85 $170.47 $217.31–$336.83 44% below 25%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION > 16 MINS $324.45 $432.60 $217.31–$336.83 42% above 25%
IV infusion of a medicine, first hour CPT 96365 INTRAVENOUS INFUS THERAPY/1 HR $324.45 $432.60 $217.31–$336.83 42% above 25%
IV infusion of a medicine, first hour CPT 96365 FERAHEME $3,000.61 $4,000.81 — 1210% above 25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION > 16 MINS $324.45 $432.60 $217.31–$293.37 — 25%
IV infusion of a medicine, first hour inpatient CPT 96365 FERAHEME $3,000.61 $4,000.81 — — 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION $16.22 $21.63 $73.56–$114.02 76% below 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM INJECTION ANTIBIOTIC $17.19 $22.92 $73.56–$114.02 75% below 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM IM/SQ INJEC $29.93 $39.91 $73.56–$114.02 57% below 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC.PROPHY OR DIAG INJ $29.93 $39.91 $73.56–$114.02 57% below 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC,PROPHY OR DIAG INJ $29.93 $39.91 $73.56–$114.02 57% below 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION (SC)/(IM) $30.32 $40.43 $73.56–$114.02 56% below 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SC INJECTION $81.11 $108.15 $73.56–$114.02 18% above 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SC INJECTION EACH $101.39 $135.19 $73.56–$114.02 47% above 25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF ANTIBIOTIC $132.10 $176.13 $73.56–$114.02 91% above 25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SC INJECTION EACH $101.39 $135.19 $73.56–$99.31 — 25%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diag. Evaluation $193.13 $257.50 $181.34–$281.08 7% below 25%
New patient office visit, about 30 minutes CPT 99203 NP OV DETAILED SVC (MC TECH) $30.71 $40.94 $116.24 55% below 25%
New patient office visit, about 30 minutes CPT 99203 NP OV DETAILED SERVICE (MC) $30.90 $41.20 $116.24 55% below 25%
New patient office visit, about 30 minutes CPT 99203 NP RETURN VISIT LEVEL III $98.11 $130.81 $116.24 43% above 25%
New patient office visit, about 30 minutes CPT 99203 NP OV INTERMEDIATE $153.34 $204.46 $116.24 123% above 25%
New patient office visit, about 30 minutes CPT 99203 E&M NEW PT - INTERMEDIATE $153.34 $204.46 $116.24 123% above 25%
New patient office visit, about 30 minutes CPT 99203 NP OV DETAILED SERVICE $153.34 $204.46 $116.24 123% above 25%
New patient office visit, about 45 minutes CPT 99204 NP OV COMP SVC (MC TECH) $38.63 $51.50 $174.85 43% below 25%
New patient office visit, about 45 minutes CPT 99204 NP OV COMP (MC TECH) $38.63 $51.50 $174.85 43% below 25%
New patient office visit, about 45 minutes CPT 99204 NP OV COMP SERVICE (MC) $38.63 $51.50 $174.85 43% below 25%
New patient office visit, about 45 minutes CPT 99204 NP OV COMPREHENSIVE SERVICE-MC $38.63 $51.50 $174.85 43% below 25%
New patient office visit, about 45 minutes CPT 99204 E&M NEW PT - EXTENDED $192.74 $256.99 $174.85 187% above 25%
New patient office visit, about 45 minutes CPT 99204 NP OV COMP SERVICE $192.74 $256.99 $174.85 187% above 25%
New patient office visit, about 45 minutes CPT 99204 NP OV COMPREHENSIVE $192.74 $256.99 $174.85 187% above 25%
New patient office visit, about 60 minutes CPT 99205 ES OV LIMITED $29.93 $39.91 $232.16 67% below 25%
New patient office visit, about 60 minutes CPT 99205 NP OV COMPLEX (MC) $40.94 $54.59 $232.16 55% below 25%
New patient office visit, about 60 minutes CPT 99205 NP OV HIGH (TECH) $57.94 $77.25 $232.16 36% below 25%
New patient office visit, about 60 minutes CPT 99205 NP OV HIGH (MC TECH) $57.94 $77.25 $232.16 36% below 25%
New patient office visit, about 60 minutes CPT 99205 NP OV HIGH (MC) $57.94 $77.25 $232.16 36% below 25%
New patient office visit, about 60 minutes CPT 99205 NP HIGH COMPLEXITY $204.52 $272.69 $232.16 127% above 25%
New patient office visit, about 60 minutes CPT 99205 E&M NEW PT - COMPLEX $289.69 $386.25 $232.16 222% above 25%
New patient office visit, about 60 minutes CPT 99205 NP OV HIGH $289.69 $386.25 $232.16 222% above 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP OV EXPANDED SVC(MC TECH) $16.03 $21.37 $72.69 75% below 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP OV EXPANDED SVC (MC TECH) $16.03 $21.37 $72.69 75% below 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP OV EXPANDED SERVICE (MC) $16.22 $21.63 $72.69 74% below 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP OV BRIEF $80.92 $107.89 $72.69 28% above 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP OV EXPANDED SERVICE $80.92 $107.89 $72.69 28% above 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 E&M NEW PT - LIMITED $80.92 $107.89 $72.69 28% above 25%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NP RETURN VISIT LEVEL II $89.61 $119.48 $72.69 42% above 25%
Preventive checkup, new patient aged 18–39 CPT 99385 NP WELL CHILD 18-39 $197.18 $262.91 $128.68 139% above 25%
Preventive checkup, new patient aged 40–64 CPT 99386 NP WELLNESS VISIT (40-64) $235.23 $313.64 $148.99 161% above 25%
Preventive checkup, new patient aged 65 or older CPT 99387 NP WELLNESS VISIT (65-OVER) $146.00 $194.67 $161.43 33% above 25%
Preventive checkup, returning patient aged 18–39 CPT 99395 ESTAB WELL CHILD (18-39) $129.78 $173.04 $116.24 97% above 25%
Preventive checkup, returning patient aged 40–64 CPT 99396 ESTAB WELLNESS VISIT (40-64) $199.69 $266.26 $124.10 168% above 25%
Preventive checkup, returning patient aged 65 or older CPT 99397 ESTAB WELLNESS VISIT (65-OVER) $146.00 $194.67 $132.29 118% above 25%
Psychiatric evaluation with medical services CPT 90792 INTAKE $193.13 $257.50 $181.34–$281.08 3% below 25%
Psychiatric evaluation with medical services CPT 90792 Psych Diag. Eval w/Med Service $231.75 $309.00 $181.34–$281.08 17% above 25%
Psychotherapy for crisis, first 60 minutes CPT 90839 Crisis/Psychothera.60m(30-74m) $231.75 $309.00 $181.34–$281.08 1% above 25%
Psychotherapy session, 30 minutes CPT 90832 COUNSELING 30 MIN $139.05 $185.40 $181.34–$281.08 at median 25%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy,30 min(16-37min) $154.50 $206.00 $181.34–$281.08 11% above 25%
Psychotherapy session, 45 minutes CPT 90834 COUNSELING 60 MIN $169.95 $226.60 $181.34–$281.08 at median 25%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy,45 min(38-52min) $193.13 $257.50 $181.34–$281.08 14% above 25%
Psychotherapy session, 60 minutes CPT 90837 COUNSELING $193.13 $257.50 $181.34–$281.08 at median 25%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy,60 min(53+min) $231.75 $309.00 $181.34–$281.08 20% above 25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE COUNSEL 3-10 MIN $12.17 $16.22 $38.28–$59.33 65% below 25%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION,3-10 MINUTES $24.33 $32.45 $38.28–$59.33 29% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ES OV COMP SERVICE (MC TECH) $30.71 $40.94 $185.33 57% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ES OV COMPREHENSIVE SERVICE-MC $30.71 $40.94 $185.33 57% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ES OV COMP SERVICE (MC) $30.71 $40.94 $185.33 57% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ES OV COMPREHENSIVE SERV -(MC) $30.71 $40.94 $185.33 57% below 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ES OV COMP SERVICE $153.34 $204.46 $185.33 114% above 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 ES OV COMPREHENSIVE $153.34 $204.46 $185.33 114% above 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 LEVEL #5 TREATMENT ROOM $159.52 $212.70 $185.33 122% above 25%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 E&M ESTABLISHED PT - COMPLEX $219.97 $293.29 $185.33 207% above 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ES OV EXPANDED SVC (MC TECH) $16.03 $21.37 $92.01 76% below 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ES OV EXPANDED SERVICE (MC) $16.03 $21.37 $92.01 76% below 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ES PAT RETURN VISIT LEV III $68.17 $90.90 $92.01 1% above 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ES OV EXPANDED SERVICE $80.92 $107.89 $92.01 20% above 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ES OV INTERMEDIATE $80.92 $107.89 $92.01 20% above 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 LEVEL #3 TREATMENT ROOM $116.65 $155.53 $92.01 73% above 25%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 E&M ESTABLISHED PT-INTERMEDIAT $143.30 $191.07 $92.01 112% above 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ES OV DETAILED SERVICE (MC) $22.98 $30.64 $129.99 68% below 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ES OV DETAILED SVC (MC TECH) $22.98 $30.64 $129.99 68% below 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ES OV DETAILED $80.92 $107.89 $129.99 14% above 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ES OV DETAILED SERVICES $115.10 $153.47 $129.99 62% above 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ES OV DETAILED SERVICE $115.10 $153.47 $129.99 62% above 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 LEVEL #4 TREATMENT ROOM $138.66 $184.89 $129.99 95% above 25%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E&M ESTABLISHED PT- EXTENDED $173.04 $230.72 $129.99 143% above 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ES OV BRIEF $42.68 $56.91 $56.65 32% below 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ES OV LIMITED SERVICE $42.68 $56.91 $56.65 32% below 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ES PATIENT RETURN VISIT LEV II $55.43 $73.90 $56.65 12% below 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 LEVEL #2 TREATMENT ROOM $94.25 $125.66 $56.65 50% above 25%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E&M ESTABLISHED PT - LIMITED $127.85 $170.47 $56.65 103% above 25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 INIT OFFICE CONSULT LOW (MC) $27.62 $36.82 — 74% below 25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION--OUTPATIENT (MC) $29.93 $39.91 — 71% below 25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 CONSULTATION -- OUTPATIENT (MC $29.93 $39.91 — 71% below 25%
Specialist consultation, low complexity or 30+ minutes CPT 99243 INIT OFFICE CONSULT LOW $130.75 $174.33 — 25% above 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 INIT OFFICE CONSULT MOD (MC) $37.27 $49.70 — 62% below 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION-COUNSELING (MC) $41.91 $55.88 — 57% below 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 CONSULTATION - COUNSELING (MC) $58.90 $78.54 — 40% below 25%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 INIT OFFICE CONSULT MOD $185.79 $247.72 — 89% above 25%
Spirometry before and after a bronchodilator CPT 94060 PFT PRE POST BRONCH INTERP $115.88 $154.50 $381.24–$590.92 65% below 25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY $89.61 $119.48 $135.93–$210.69 39% below 25%

Vaccines

ProcedureCash price List priceInsurers payvs West VirginiaOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA $193.13 $257.50 — at median 25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flulaval (2024-2025) $13.92 $18.56 — 29% below 25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vaccine >6mos $13.92 $18.56 — 29% below 25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluarix (2024-2025) $13.92 $18.56 — 29% below 25%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PERSERVATIVE FREE FLU VAC>3 YR $21.44 $28.58 — 10% above 25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Fluarix (2024-2025) $13.92 $18.56 — — 25%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flulaval (2024-2025) $13.92 $18.56 — — 25%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL VACCINE $386.25 $515.00 — 33% above 25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VACCINE $104.29 $139.05 — 57% above 25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 RECOMBIVAX 10MCG/ML INJ $157.40 $209.86 — 137% above 25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 RECOMBIVAX 10MCG/ML INJ $157.40 $209.86 — — 25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Mobile-High Dose Flu Vaccine $37.50 $50.00 — 53% below 25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACCINE - HIGH DOSE $149.87 $199.82 — 88% above 25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR $52.53 $70.04 — 52% below 25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENVEO $166.09 $221.45 — 6% above 25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA VACCINE $193.13 $257.50 — 23% above 25%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MEN B $251.06 $334.75 — 10% above 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar-20 $386.25 $515.00 — 12% above 25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Prevnar-20 $386.25 $515.00 — — 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Mobile-Pneumonia Vaccine $93.75 $125.00 — 11% below 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE $150.64 $200.85 — 43% above 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNU IMMUNE VACCINE PER INJ $150.64 $200.85 — 43% above 25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNU IMMUNE VACCINE PER INJ $150.64 $200.85 — — 25%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 SHINGRIX VACCINE $309.00 $412.00 — 77% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS & DIPHTHERIA $12.17 $16.22 — 76% below 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX $63.92 $85.23 — 25% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX 0.5 ML $177.10 $236.13 — 245% above 25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX 0.5 ML $177.10 $236.13 — — 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADMIN VACCINE (1) $21.05 $28.07 $73.56–$114.02 56% below 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM IMM/VAC SING OR SING COMB $40.17 $53.56 $73.56–$114.02 16% below 25%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION-INITIAL $101.39 $135.19 $73.56–$114.02 111% above 25%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION-INITIAL $101.39 $135.19 $73.56–$99.31 — 25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IM ADM VACCINE 2/MORE $12.17 $16.22 — 53% below 25%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 VACCINE ADMIN-EACH ADD/SUBSEQ $12.94 $17.25 — 50% below 25%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 VACCINE ADMIN-EACH ADD/SUBSEQ $12.94 $17.25 — — 25%

Source file: https://mghwv.com/front/file/550372580_montgomery-general-hospital-inc_standardcharges.csv