Hospital Altus, OK

Jackson County Memorial Hospital

Jackson County Memorial Hospital in Altus, OK publishes cash prices for 228 common procedures listed here, from its own machine-readable price file updated Dec 31, 2025. Compared with other hospitals in the state, its outpatient cash prices are above the Oklahoma median for 119 of 224 procedures and below it for 103. By typical cash price it ranks #28 of 43 Oklahoma hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1200 E Pecan St, Altus, OK 73521 Collected Sep 27, 2026 Source price file (580) 379-5500

Acute care hospital Emergency department CMS star rating 3 of 5 CCN 370022 · CMS hospital register

The price file shows no self-pay discount

For 848 of the 848 prices listed here, the cash price in Jackson County Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.

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 4 actions for a hospital named Jackson County Memorial Hospital in Altus, OK:

Mar 22, 2023 Warning notice
Jul 11, 2023 Case closed
Feb 18, 2026 Warning notice
May 20, 2026 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 Oklahoma	Off list
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL esophagus	$546.60	$546.60	$99.99–$519.27	91% above	—
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL esophagus	$546.60	$546.60	$99.99–$519.27	—	—
Bone scan, whole body (nuclear medicine) CPT 78306 NM bone scan whole body	$2,883.30	$2,883.30	$409.37–$2,739.13	214% above	—
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM bone scan whole body	$2,883.30	$2,883.30	$409.37–$2,739.13	—	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT angiogram chest	$1,982.00	$1,982.00	$181.36–$1,882.90	32% above	—
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT angio chest PE protocol	$2,919.00	$2,919.00	$181.36–$2,773.05	95% above	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT angiogram chest	$1,982.00	$1,982.00	$181.36–$1,882.90	—	—
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT angio chest PE protocol	$2,919.00	$2,919.00	$181.36–$2,773.05	—	—
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT heart wo cont calcium score	$192.00	$192.00	$89.70–$830.88	93% above	—
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT heart wo cont calcium score	$192.00	$192.00	$89.70–$830.88	—	—
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT abdomen pelvis wo con	$2,392.00	$2,392.00	$246.25–$2,272.40	79% above	—
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT abdomen pelvis wo con	$2,392.00	$2,392.00	$246.25–$2,272.40	—	—
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT abdomen pelvis w con	$3,200.00	$3,200.00	$363.83–$3,040.00	99% above	—
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT abdomen pelvis w con	$3,200.00	$3,200.00	$363.83–$3,040.00	—	—
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT abdomen pelvis wo/w con	$4,318.00	$4,318.00	$363.83–$4,102.10	128% above	—
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT abdomen pelvis wo/w con	$4,318.00	$4,318.00	$363.83–$4,102.10	—	—
CT scan of the abdomen with contrast CPT 74160 CT abdomen w con	$1,727.25	$1,727.25	$181.36–$1,640.88	54% above	—
CT scan of the abdomen with contrast inpatient CPT 74160 CT abdomen w con	$1,727.25	$1,727.25	$181.36–$1,640.88	—	—
CT scan of the abdomen without contrast CPT 74150 CT abdomen wo con	$1,570.80	$1,570.80	$108.33–$1,492.26	56% above	—
CT scan of the abdomen without contrast inpatient CPT 74150 CT abdomen wo con	$1,570.80	$1,570.80	$108.33–$1,492.26	—	—
CT scan of the face and sinuses, no contrast dye CPT 70486 CT facial wo con	$1,257.90	$1,257.90	$108.33–$1,195.00	43% above	—
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT facial wo con	$1,257.90	$1,257.90	$108.33–$1,195.00	—	—
CT scan of the head or brain, no contrast dye CPT 70450 CT head/brain wo con	$2,314.00	$2,314.00	$108.33–$2,198.30	146% above	—
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT head/brain wo con	$2,314.00	$2,314.00	$108.33–$2,198.30	—	—
CT scan of the head with contrast CPT 70460 CT head/brain w con	$4,148.50	$4,148.50	$181.36–$3,941.07	243% above	—
CT scan of the head with contrast inpatient CPT 70460 CT head/brain w con	$4,148.50	$4,148.50	$181.36–$3,941.07	—	—
CT scan of the head without and with contrast CPT 70470 CT head/brain wo/w con	$2,411.00	$2,411.00	$181.36–$2,290.45	88% above	—
CT scan of the head without and with contrast inpatient CPT 70470 CT head/brain wo/w con	$2,411.00	$2,411.00	$181.36–$2,290.45	—	—
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT lumbar spine wo con	$1,756.65	$1,756.65	$108.33–$1,668.81	74% above	—
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT lumbar spine wo con	$1,756.65	$1,756.65	$108.33–$1,668.81	—	—
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT cervical spine wo con	$1,739.85	$1,739.85	$108.33–$1,652.85	77% above	—
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT cervical spine wo con	$1,739.85	$1,739.85	$108.33–$1,652.85	—	—
CT scan of the pelvis, with contrast dye CPT 72193 CT pelvis w con	$1,601.25	$1,601.25	$181.36–$1,521.18	48% above	—
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT pelvis w con	$1,601.25	$1,601.25	$181.36–$1,521.18	—	—
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US carotid doppler BI	$1,144.50	$1,144.50	$246.25–$1,087.27	—	—
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US carotid doppler BI	$1,144.50	$1,144.50	$246.25–$1,087.27	—	—
Chest X-ray, 2 views CPT 71046 XR chest 2V	$325.00	$325.00	$89.70–$308.75	174% above	—
Chest X-ray, 2 views inpatient CPT 71046 XR chest 2V	$325.00	$325.00	$89.70–$308.75	—	—
Chest X-ray, single view CPT 71045 XR chest 1V	$239.40	$239.40	$89.70–$227.43	36% above	—
Chest X-ray, single view inpatient CPT 71045 XR chest 1V	$239.40	$239.40	$89.70–$227.43	—	—
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US abd aorta/renal complete	$956.55	$956.55	$108.33–$908.72	139% above	—
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US abd aorta/renal complete	$956.55	$956.55	$108.33–$908.72	—	—
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA - bone density	$336.21	$336.21	$108.33–$319.39	207% above	—
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA - bone density	$336.21	$336.21	$108.33–$319.39	—	—
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 XR DEXA appendicular skeleton	$239.40	$239.40	$89.70–$227.43	131% above	—
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 XR DEXA appendicular skeleton	$239.40	$239.40	$89.70–$227.43	—	—
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT chest wo con	$1,681.05	$1,681.05	$108.33–$1,596.99	76% above	—
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT chest wo con	$1,681.05	$1,681.05	$108.33–$1,596.99	—	—
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT chest w con	$1,834.35	$1,834.35	$181.36–$1,742.63	63% above	—
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT chest w con	$1,834.35	$1,834.35	$181.36–$1,742.63	—	—
Diagnostic mammogram, both breasts both sides CPT 77066 MAM diagnostic mammo BI	$498.75	$498.75	$299.25–$508.22	—	—
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAM diagnostic mammo BI	$498.75	$498.75	$299.25–$508.22	—	—
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US arterial duplex LE BI	$847.35	$847.35	$246.25–$804.98	—	—
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US arterial duplex LE BI	$847.35	$847.35	$246.25–$804.98	—	—
Duplex ultrasound of the leg veins, both legs CPT 93970 US venous doppler LE	$1,224.30	$1,224.30	$246.25–$1,163.08	102% above	—
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US venous doppler LE	$1,224.30	$1,224.30	$246.25–$1,163.08	—	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W/Doppler Complete	$371.00	$371.00	$222.60–$836.83	66% below	—
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo	$2,478.00	$2,478.00	$558.58–$2,354.10	128% above	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 Tte W/Doppler Complete	$371.00	$371.00	$222.60–$836.83	—	—
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo	$2,478.00	$2,478.00	$558.58–$2,354.10	—	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM hida scan	$2,598.75	$2,598.75	$409.37–$2,468.81	125% above	—
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM hida scan	$2,598.75	$2,598.75	$409.37–$2,468.81	—	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG/TITR OVER 6 Y/O	$3,350.00	$3,350.00	$1,036.47–$3,182.50	7% above	—
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG/TITR OVER 6 Y/O	$3,350.00	$3,350.00	$1,036.47–$3,182.50	—	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US abdomen limted per quadrant	$724.50	$724.50	$108.33–$688.27	88% above	—
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US abdomen limted per quadrant	$724.50	$724.50	$108.33–$688.27	—	—
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Screening	$229.89	$229.89	$108.33–$218.39	30% below	—
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Screening	$229.89	$229.89	$108.33–$218.39	—	—
MRI of the abdomen without contrast CPT 74181 MRI abdomen wo con	$2,935.80	$2,935.80	$246.25–$2,789.01	180% above	—
MRI of the abdomen without contrast inpatient CPT 74181 MRI abdomen wo con	$2,935.80	$2,935.80	$246.25–$2,789.01	—	—
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI abdomen wo/w con	$4,053.00	$4,053.00	$363.83–$3,850.35	108% above	—
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI abdomen wo/w con	$4,053.00	$4,053.00	$363.83–$3,850.35	—	—
MRI of the brain, no contrast dye CPT 70551 MRI brain wo con	$3,111.15	$3,111.15	$246.25–$2,955.59	219% above	—
MRI of the brain, no contrast dye inpatient CPT 70551 MRI brain wo con	$3,111.15	$3,111.15	$246.25–$2,955.59	—	—
MRI of the brain, with and without contrast dye CPT 70553 MRI brain wo/w con	$4,761.75	$4,761.75	$363.83–$4,523.66	237% above	—
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI brain wo/w con	$4,761.75	$4,761.75	$363.83–$4,523.66	—	—
MRI of the lower back, no contrast dye CPT 72148 MRI lumbar spine wo con	$3,567.90	$3,567.90	$246.25–$3,389.50	205% above	—
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI lumbar spine wo con	$3,567.90	$3,567.90	$246.25–$3,389.50	—	—
MRI of the lower back, without and then with contrast dye CPT 72158 MRI lumbar spine wo/w con	$4,688.25	$4,688.25	$363.83–$4,453.83	205% above	—
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI lumbar spine wo/w con	$4,688.25	$4,688.25	$363.83–$4,453.83	—	—
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI thoracic spine wo con	$3,756.90	$3,756.90	$246.25–$3,569.05	251% above	—
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI thoracic spine wo con	$3,756.90	$3,756.90	$246.25–$3,569.05	—	—
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI cervical spine wo/w con	$4,527.60	$4,527.60	$363.83–$4,301.22	198% above	—
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI cervical spine wo/w con	$4,527.60	$4,527.60	$363.83–$4,301.22	—	—
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI cervical spine wo con	$3,442.95	$3,442.95	$246.25–$3,270.80	236% above	—
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI cervical spine wo con	$3,442.95	$3,442.95	$246.25–$3,270.80	—	—
MRI of the pelvis without and with contrast CPT 72197 MRI pelvis wo/w con	$4,340.70	$4,340.70	$363.83–$4,123.66	203% above	—
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI pelvis wo/w con	$4,340.70	$4,340.70	$363.83–$4,123.66	—	—
MRI of the pelvis, no contrast dye CPT 72195 MRI testes wo con	$1,371.28	$1,371.28	$246.25–$1,655.79	21% above	—
MRI of the pelvis, no contrast dye CPT 72195 MRI pelvis wo con	$3,112.20	$3,112.20	$246.25–$2,956.59	175% above	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI testes wo con	$1,371.28	$1,371.28	$246.25–$1,655.79	—	—
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI pelvis wo con	$3,112.20	$3,112.20	$246.25–$2,956.59	—	—
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM cardiac stress test	$5,420.10	$5,420.10	$1,329.97–$5,149.09	111% above	—
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM cardiac stress test	$5,420.10	$5,420.10	$1,329.97–$5,149.09	—	—
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US pelvis limited	$579.60	$579.60	$108.33–$550.62	92% above	—
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US pelvis limited	$579.60	$579.60	$108.33–$550.62	—	—
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US pelvis complete	$761.25	$761.25	$108.33–$723.18	57% above	—
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US pelvis complete	$761.25	$761.25	$108.33–$723.18	—	—
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >= 14 weeks fetus	$547.05	$547.05	$108.33–$519.69	29% above	—
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB >= 14 weeks fetus	$547.05	$547.05	$108.33–$519.69	—	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB <= 14 weeks fetus	$505.05	$505.05	$108.33–$479.79	20% above	—
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB <= 14 weeks fetus	$505.05	$505.05	$108.33–$479.79	—	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB limited fetus(s)	$519.75	$519.75	$108.33–$493.76	48% above	—
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB limited fetus(s)	$519.75	$519.75	$108.33–$493.76	—	—
Screening mammogram, both breasts both sides CPT 77067 MAM screening mammo BI	$337.85	$337.85	$202.71–$508.22	—	—
Screening mammogram, both breasts inpatient both sides CPT 77067 MAM screening mammo BI	$337.85	$337.85	$202.71–$508.22	—	—
Sleep study in a lab (polysomnography) CPT 95810 PSG OVER 6 Y/O	$3,843.00	$3,843.00	$1,036.47–$3,650.85	39% above	—
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG OVER 6 Y/O	$3,843.00	$3,843.00	$1,036.47–$3,650.85	—	—
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL barium swallow modified	$546.60	$546.60	$181.36–$519.27	74% above	—
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL barium swallow modified	$546.60	$546.60	$181.36–$519.27	—	—
Transvaginal pelvic ultrasound CPT 76830 US transvaginal	$753.90	$753.90	$108.33–$716.20	99% above	—
Transvaginal pelvic ultrasound inpatient CPT 76830 US transvaginal	$753.90	$753.90	$108.33–$716.20	—	—
Transvaginal ultrasound during pregnancy CPT 76817 US OB transvag	$547.05	$547.05	$108.33–$519.69	93% above	—
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB transvag	$547.05	$547.05	$108.33–$519.69	—	—
Ultrasound of the abdomen, complete CPT 76700 US abdomen complete	$911.40	$911.40	$108.33–$865.83	73% above	—
Ultrasound of the abdomen, complete inpatient CPT 76700 US abdomen complete	$911.40	$911.40	$108.33–$865.83	—	—
Ultrasound of the scrotum and testicles CPT 76870 US scrotum	$675.15	$675.15	$108.33–$641.39	97% above	—
Ultrasound of the scrotum and testicles inpatient CPT 76870 US scrotum	$675.15	$675.15	$108.33–$641.39	—	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US soft tissue head/neck/thyro	$676.20	$676.20	$108.33–$642.39	66% above	—
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US soft tissue head/neck/thyro	$676.20	$676.20	$108.33–$642.39	—	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL upper GI w gastrografin	$546.60	$546.60	$181.36–$519.27	44% above	—
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL upper GI w gastrografin	$546.60	$546.60	$181.36–$519.27	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR hip wo or w pelvis LT	$385.35	$385.35	$89.70–$366.08	108% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR hip wo or w pelvis RT	$385.35	$385.35	$89.70–$366.08	108% above	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR hip wo or w pelvis LT	$385.35	$385.35	$89.70–$366.08	—	—
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR hip wo or w pelvis RT	$385.35	$385.35	$89.70–$366.08	—	—
X-ray of the abdomen, 1 view CPT 74018 XR abdomen 1V	$339.59	$339.59	$89.70–$322.61	98% above	—
X-ray of the abdomen, 1 view inpatient CPT 74018 XR abdomen 1V	$339.59	$339.59	$89.70–$322.61	—	—
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR lumbosacral spine 2-3V	$336.21	$336.21	$99.99–$319.39	59% above	—
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR lumbosacral spine 2-3V	$336.21	$336.21	$99.99–$319.39	—	—
X-ray of the lower back, 4 or more views CPT 72110 XR spine lumbar min 4V	$336.21	$336.21	$99.99–$319.39	16% above	—
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR spine lumbar min 4V	$336.21	$336.21	$99.99–$319.39	—	—
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR thoracic spine 2V	$336.21	$336.21	$99.99–$319.39	79% above	—
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR thoracic spine 2V	$336.21	$336.21	$99.99–$319.39	—	—
X-ray of the nasal bones, 3 or more views CPT 70160 XR nasal bones min 3V	$239.40	$239.40	$89.70–$227.43	47% above	—
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR nasal bones min 3V	$239.40	$239.40	$89.70–$227.43	—	—
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR cervical spine 2-3V	$239.40	$239.40	$89.70–$227.43	20% above	—
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR cervical spine 2-3V	$239.40	$239.40	$89.70–$227.43	—	—
X-ray of the pelvis, 1 or 2 views CPT 72170 XR pelvis 1V	$336.21	$336.21	$99.99–$319.39	77% above	—
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR pelvis 1V	$336.21	$336.21	$99.99–$319.39	—	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR sacrum coccyx min 2V	$239.40	$239.40	$89.70–$227.43	35% above	—
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR sacrum coccyx min 2V	$239.40	$239.40	$89.70–$227.43	—	—

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase ALT	$15.90	$15.90	$5.68–$23.81	51% below	—
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase ALT	$15.90	$15.90	$5.68–$23.81	—	—
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferas	$15.54	$15.54	$5.55–$23.81	59% below	—
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferas	$15.54	$15.54	$5.55–$23.81	—	—
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel 7757	$142.89	$142.89	$49.37–$135.74	23% below	—
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel 7757	$142.89	$142.89	$49.37–$135.74	—	—
Allergy blood test, specific IgE, per allergen CPT 86003 Maize Corn Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Allergy	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Common Pigweed Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Lamb's Quarters Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Common Ragweed Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson Grass Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Corn Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Igg Salmon	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Egg White	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Eggwhite Component Pr	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Gluten	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Oat	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cotton Crude Fibers Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Igg Catfish	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Peanut Component Prof	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Pork	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Recombinant Or Pur C	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Rice	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Rye	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Soybean	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Stachybotrys Chartar	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Yellow Jacket	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cow Dander Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Farinae IgF	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander IgE	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dust Mite Ige D Farinae	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Dust Mite Ige D Pteronys	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Egg Yolk Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Elm Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 EpicoCCUm Purpurascens Ig	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F013 - Ige Peanut	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F017 - Ige Hazelnut (Filbert)	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F020 - Ige Almond	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F201 - Ige Pecan Nut	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F202 - Ige Cashew Nut	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F203 - Ige Pistachio Nut	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 F256 - Ige Walnut	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Fish Cod Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Fo92-Ige Banana	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Fusarium Moniliforme Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Helminthosporium Halodes	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Horse Dander Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 House Dust-Greer Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Hymenoptera Venom Panel 2	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 I001- Ige Honey Bee	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 I002-Ige Hornet White Fa	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 I004- Ige Paper Wasp	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 I005-Ige Hornet Yellow	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 I070- Ige Fire Ant	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 IGE Crude Allergen Extract	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Barley	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Beef	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Buckwheat	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige CedarRed	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 1071 IGE Mosquito	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 White Pine Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Chicken	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ige Dockweed Yellow	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 1073 IGE Midge	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Stemphylium Botryosum Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternata Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Tenuis Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigatus Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Sheep Sorrel Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Avocado Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Russian Thistle Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Marshelde Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Plantain English Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Box-Elder Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Phoma Betae Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 C001-Ige Penicillin G	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Perenial Rye Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 C002-Ige Penicillin V	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium Notatum Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 C232 Ige Lidocaine	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan/Hickory Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Milk Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Candida Albicans Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Ocean Perch Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Oak Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Epithelium Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mugwort Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cedar Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mugwort (Sage) Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosperium Herbarum Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mucor Racemosus Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 C284 Ige Novacaine/Procai	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mesquite Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Meadow Grass Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Clam Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Meadow Fescue Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Cocklebur Ige	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Mold Allergen Panel	$15.66	$15.66	$5.59–$39.77	37% below	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile Shellfi	$93.96	$93.96	$5.59–$89.26	279% above	—
Allergy blood test, specific IgE, per allergen CPT 86003 Allergan Profile Area 10 x26	$407.16	$407.16	$5.59–$386.80	1542% above	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dust Mite Ige D Farinae	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Pine Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wheat Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy Grass Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Stemphylium Botryosum Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Soybean Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sheep Sorrel Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Russian Thistle Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Rough Marshelde Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Plantain English Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Phoma Betae Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Perenial Rye Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillium Notatum Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pecan/Hickory Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ocean Perch Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mugwort Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mugwort (Sage) Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mucor Racemosus Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mold Allergen Panel	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Milk Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mesquite Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Meadow Grass Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Meadow Fescue Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Maize Corn Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Latex Allergy	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lamb's Quarters Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson Grass Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Igg Salmon	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Igg Catfish	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Yellow Jacket	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Stachybotrys Chartar	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Soybean	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Rye	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Rice	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Recombinant Or Pur C	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Pork	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Peanut Component Prof	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Oat	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Gluten	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Eggwhite Component Pr	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Egg White	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Dockweed Yellow	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Chicken	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige CedarRed	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Buckwheat	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Beef	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Ige Barley	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE Crude Allergen Extract	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I070- Ige Fire Ant	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I005-Ige Hornet Yellow	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I004- Ige Paper Wasp	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I002-Ige Hornet White Fa	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 I001- Ige Honey Bee	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hymenoptera Venom Panel 2	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 House Dust-Greer Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Horse Dander Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Helminthosporium Halodes	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fusarium Moniliforme Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fo92-Ige Banana	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Fish Cod Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256 - Ige Walnut	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F203 - Ige Pistachio Nut	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F202 - Ige Cashew Nut	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F201 - Ige Pecan Nut	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F020 - Ige Almond	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F017 - Ige Hazelnut (Filbert)	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013 - Ige Peanut	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EpicoCCUm Purpurascens Ig	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg Yolk Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Egg White Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dust Mite Ige D Pteronys	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog Dander IgE	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dermatophagoides Farinae IgF	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cow Dander Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cottonwood Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cotton Crude Fibers Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Corn Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Ragweed Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Pigweed Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Codfish	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cocklebur Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Clam Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosperium Herbarum Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cedar Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Epithelium Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat Dander Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Candida Albicans Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C284 Ige Novacaine/Procai	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C232 Ige Lidocaine	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C002-Ige Penicillin V	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 C001-Ige Penicillin G	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Box-Elder Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda Grass Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Avocado Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus Fumigatus Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Tenuis Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria Alternata Ige	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 1073 IGE Midge	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 1071 IGE Mosquito	$15.66	$15.66	$5.59–$39.77	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile Shellfi	$93.96	$93.96	$5.59–$89.26	—	—
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergan Profile Area 10 x26	$407.16	$407.16	$5.59–$386.80	—	—
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Cit Peptide Igg	$25.20	$25.20	$13.87–$39.77	64% below	—
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Cit Peptide Igg	$25.20	$25.20	$13.87–$39.77	—	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Antibodies	$24.94	$24.94	$12.95–$39.77	42% below	—
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Antinuclear Antibodies	$36.27	$36.27	$12.95–$39.77	15% below	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Antibodies	$24.94	$24.94	$12.95–$39.77	—	—
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Antinuclear Antibodies	$36.27	$36.27	$12.95–$39.77	—	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B - Natriuretic Peptide	$117.78	$117.78	$42.05–$138.33	5% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Chf Nt - Pro - Anp 1-98	$268.80	$268.80	$42.05–$255.36	140% above	—
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Chf Nt-Pro-Bnp 8-29	$268.80	$268.80	$42.05–$255.36	140% above	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B - Natriuretic Peptide	$117.78	$117.78	$42.05–$138.33	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Chf Nt-Pro-Bnp 8-29	$268.80	$268.80	$42.05–$255.36	—	—
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 Chf Nt - Pro - Anp 1-98	$268.80	$268.80	$42.05–$255.36	—	—
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$25.38	$25.38	$9.06–$49.37	20% below	—
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$25.38	$25.38	$9.06–$49.37	—	—
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bone Marrow Surgical Path	$148.38	$148.38	$54.43–$140.96	17% above	—
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bone Marrow Surgical Path	$148.38	$148.38	$54.43–$140.96	—	—
Blood culture for bacteria CPT 87040 Blood Culture	$30.96	$30.96	$11.05–$129.09	50% below	—
Blood culture for bacteria inpatient CPT 87040 Blood Culture	$30.96	$30.96	$11.05–$129.09	—	—
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$9.00	$9.00	$5.40–$9.74	5% below	—
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$9.00	$9.00	$5.40–$9.74	—	—
Blood glucose (sugar) test CPT 82947 Glucose Serum Or Plasma	$11.79	$11.79	$4.21–$23.81	53% below	—
Blood glucose (sugar) test inpatient CPT 82947 Glucose Serum Or Plasma	$11.79	$11.79	$4.21–$23.81	—	—
Blood lead test CPT 83655 Assay Of Lead	$36.33	$36.33	$12.97–$67.59	14% below	—
Blood lead test CPT 83655 Pediatric Lead	$113.40	$113.40	$12.97–$107.73	168% above	—
Blood lead test CPT 83655 Lead - Assay	$113.40	$113.40	$12.97–$107.73	168% above	—
Blood lead test inpatient CPT 83655 Assay Of Lead	$36.33	$36.33	$12.97–$67.59	—	—
Blood lead test inpatient CPT 83655 Pediatric Lead	$113.40	$113.40	$12.97–$107.73	—	—
Blood lead test inpatient CPT 83655 Lead - Assay	$113.40	$113.40	$12.97–$107.73	—	—
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Screen	$22.56	$22.56	$8.05–$45.57	44% below	—
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Screen	$22.56	$22.56	$8.05–$45.57	—	—
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type	$102.90	$102.90	$13.53–$131.32	80% above	—
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Type	$102.90	$102.90	$13.53–$131.32	—	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein (Crp)	$15.54	$15.54	$5.55–$39.77	43% below	—
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein (Crp)	$15.54	$15.54	$5.55–$39.77	—	—
C. difficile toxin gene test (stool PCR) CPT 87493 Nucleic Acid - C Diff	$111.81	$111.81	$39.77–$106.21	24% above	—
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Nucleic Acid - C Diff	$111.81	$111.81	$39.77–$106.21	—	—
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$62.43	$62.43	$22.29–$129.09	32% below	—
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$62.43	$62.43	$22.29–$129.09	—	—
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125	$62.43	$62.43	$22.29–$129.09	2% above	—
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Ca 125	$62.43	$62.43	$22.29–$129.09	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS Cov 2 xpert	$154.00	$154.00	$54.95–$146.30	110% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus 2019 Novel NAA	$154.00	$154.00	$54.95–$146.30	110% above	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus 2019 Novel NAA	$154.00	$154.00	$54.95–$146.30	—	—
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS Cov 2 xpert	$154.00	$154.00	$54.95–$146.30	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia amp probe REF	$105.27	$105.27	$37.58–$100.00	35% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Amp Probe	$105.27	$105.27	$37.58–$100.00	35% above	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Amp Probe	$105.27	$105.27	$37.58–$100.00	—	—
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia amp probe REF	$105.27	$105.27	$37.58–$100.00	—	—
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$40.17	$40.17	$14.34–$49.37	39% below	—
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$40.17	$40.17	$14.34–$49.37	—	—
Complete blood count (CBC) with differential CPT 85025 CBC - Automated Differential	$23.31	$23.31	$8.32–$33.51	49% below	—
Complete blood count (CBC) with differential inpatient CPT 85025 CBC - Automated Differential	$23.31	$23.31	$8.32–$33.51	—	—
Complete blood count (CBC), no differential CPT 85027 CBC - No Differential	$19.41	$19.41	$6.93–$33.51	35% below	—
Complete blood count (CBC), no differential inpatient CPT 85027 CBC - No Differential	$19.41	$19.41	$6.93–$33.51	—	—
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$31.68	$31.68	$11.31–$49.37	30% below	—
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$31.68	$31.68	$11.31–$49.37	—	—
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quant	$30.54	$30.54	$10.90–$57.42	66% below	—
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer Quant	$30.54	$30.54	$10.90–$57.42	—	—
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate	$66.69	$66.69	$23.81–$98.66	12% below	—
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate	$66.69	$66.69	$23.81–$98.66	—	—
Estradiol blood test CPT 82670 Estradiol Sensitive	$37.80	$37.80	$22.68–$98.66	49% below	—
Estradiol blood test CPT 82670 Estradiol	$83.82	$83.82	$29.92–$98.66	12% above	—
Estradiol blood test inpatient CPT 82670 Estradiol Sensitive	$37.80	$37.80	$22.68–$98.66	—	—
Estradiol blood test inpatient CPT 82670 Estradiol	$83.82	$83.82	$29.92–$98.66	—	—
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$55.74	$55.74	$19.90–$98.66	18% below	—
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$55.74	$55.74	$19.90–$98.66	—	—
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal	$240.00	$240.00	$21.02–$228.00	100% above	—
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Fecal	$240.00	$240.00	$21.02–$228.00	—	—
Ferritin blood test (iron stores) CPT 82728 Ferritin Level	$40.89	$40.89	$14.60–$45.57	16% below	—
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Level	$40.89	$40.89	$14.60–$45.57	—	—
Folate (folic acid) blood test CPT 82746 Folate Folic Acid	$44.10	$44.10	$15.74–$45.57	24% below	—
Folate (folic acid) blood test inpatient CPT 82746 Folate Folic Acid	$44.10	$44.10	$15.74–$45.57	—	—
Free T3 thyroid hormone test CPT 84481 Free T3	$77.11	$77.11	$18.14–$74.32	14% below	—
Free T3 thyroid hormone test inpatient CPT 84481 Free T3	$77.11	$77.11	$18.14–$74.32	—	—
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4	$27.06	$27.06	$9.66–$74.32	56% below	—
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4	$27.06	$27.06	$9.66–$74.32	—	—
Free testosterone test CPT 84402 Free Testosterone	$76.41	$76.41	$27.28–$98.66	11% below	—
Free testosterone test inpatient CPT 84402 Free Testosterone	$76.41	$76.41	$27.28–$98.66	—	—
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 hr Post Gluc Dose	$14.25	$14.25	$5.09–$23.81	51% below	—
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 hr Post Gluc Dose	$14.25	$14.25	$5.09–$23.81	—	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance 2nd Hr	$38.61	$38.61	$13.78–$45.57	41% below	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Basic	$38.61	$38.61	$13.78–$45.57	41% below	—
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance In Pane	$53.97	$53.97	$13.78–$51.27	17% below	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Basic	$38.61	$38.61	$13.78–$45.57	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance 2nd Hr	$38.61	$38.61	$13.78–$45.57	—	—
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance In Pane	$53.97	$53.97	$13.78–$51.27	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gc Pcr Swab	$105.27	$105.27	$37.58–$129.09	37% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC Amp Probe	$105.27	$105.27	$37.58–$129.09	37% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonorrhea NG amp probe REF	$105.27	$105.27	$37.58–$129.09	37% above	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gonorrhea NG amp probe REF	$105.27	$105.27	$37.58–$129.09	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC Amp Probe	$105.27	$105.27	$37.58–$129.09	—	—
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Gc Pcr Swab	$105.27	$105.27	$37.58–$129.09	—	—
H. pylori stool antigen test CPT 87338 H Pylori Stool	$43.14	$43.14	$15.40–$40.98	62% below	—
H. pylori stool antigen test inpatient CPT 87338 H Pylori Stool	$43.14	$43.14	$15.40–$40.98	—	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV Viral Load	$463.20	$463.20	$91.14–$440.04	138% above	—
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 PCR	$490.80	$490.80	$91.14–$466.26	152% above	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV Viral Load	$463.20	$463.20	$91.14–$440.04	—	—
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 PCR	$490.80	$490.80	$91.14–$466.26	—	—
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1 and 2 Antibodies	$41.13	$41.13	$14.68–$39.77	10% below	—
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1 and 2 Antibodies	$41.13	$41.13	$14.68–$39.77	—	—
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4Th Generation Wrflx	$72.24	$72.24	$25.79–$68.62	50% above	—
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4Th Generation Wrflx	$72.24	$72.24	$25.79–$68.62	—	—
HPV test for high-risk types, one combined (pooled) result CPT 87624 High Risk HPV	$105.27	$105.27	$37.58–$129.09	at median	—
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 High Risk HPV	$105.27	$105.27	$37.58–$129.09	—	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C Glycosylated	$29.13	$29.13	$10.40–$45.57	32% below	—
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C Glycosylated	$29.13	$29.13	$10.40–$45.57	—	—
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antib	$32.22	$32.22	$11.50–$39.77	26% below	—
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antib	$32.22	$32.22	$11.50–$39.77	—	—
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antig	$30.99	$30.99	$11.06–$39.77	21% below	—
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antig	$30.99	$30.99	$11.06–$39.77	—	—
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody	$42.81	$42.81	$15.28–$66.02	13% below	—
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody	$42.81	$42.81	$15.28–$66.02	—	—
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV Quantitative PCR nongraph	$128.52	$128.52	$45.88–$129.09	42% below	—
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Rna Ultra Qua	$132.00	$132.00	$45.88–$129.09	41% below	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV Quantitative PCR nongraph	$128.52	$128.52	$45.88–$129.09	—	—
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Hepatitis C Rna Ultra Qua	$132.00	$132.00	$45.88–$129.09	—	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes I Igm	$46.32	$46.32	$14.13–$66.02	24% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Antbdy I Simplex Oral	$46.32	$46.32	$14.13–$66.02	24% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes I Igg	$46.32	$46.32	$14.13–$66.02	24% below	—
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1	$46.32	$46.32	$14.13–$66.02	24% below	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Antbdy I Simplex Oral	$46.32	$46.32	$14.13–$66.02	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes I Igm	$46.32	$46.32	$14.13–$66.02	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes I Igg	$46.32	$46.32	$14.13–$66.02	—	—
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Herpes Simplex Type 1	$46.32	$46.32	$14.13–$66.02	—	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Antibdy II Smplx Gentl	$46.32	$46.32	$20.72–$44.00	29% below	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes II IgM	$46.32	$46.32	$20.72–$44.00	29% below	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes II Igg	$46.32	$46.32	$20.72–$44.00	29% below	—
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2	$46.32	$46.32	$20.72–$44.00	29% below	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Antibdy II Smplx Gentl	$46.32	$46.32	$20.72–$44.00	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Type 2	$46.32	$46.32	$20.72–$44.00	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes II Igg	$46.32	$46.32	$20.72–$44.00	—	—
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes II IgM	$46.32	$46.32	$20.72–$44.00	—	—
High-sensitivity CRP (hs-CRP) test CPT 86141 Crp High Sensitivity	$38.85	$38.85	$13.87–$39.77	24% below	—
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Crp High Sensitivity	$38.85	$38.85	$13.87–$39.77	—	—
Homocysteine blood test CPT 83090 Homocysteine	$44.16	$44.16	$19.19–$98.66	65% below	—
Homocysteine blood test inpatient CPT 83090 Homocysteine	$44.16	$44.16	$19.19–$98.66	—	—
Insulin blood test CPT 83525 Insulin	$34.29	$34.29	$12.24–$74.32	23% below	—
Insulin blood test CPT 83525 Insulin In Panel	$108.00	$108.00	$12.24–$102.60	142% above	—
Insulin blood test CPT 83525 Bound Insulin	$108.00	$108.00	$12.24–$102.60	142% above	—
Insulin blood test inpatient CPT 83525 Insulin	$34.29	$34.29	$12.24–$74.32	—	—
Insulin blood test inpatient CPT 83525 Bound Insulin	$108.00	$108.00	$12.24–$102.60	—	—
Insulin blood test inpatient CPT 83525 Insulin In Panel	$108.00	$108.00	$12.24–$102.60	—	—
Iron blood test (serum iron) CPT 83540 Iron Total Serum	$19.41	$19.41	$6.93–$23.81	39% below	—
Iron blood test (serum iron) CPT 83540 Iron Urine	$140.70	$140.70	$6.93–$133.66	340% above	—
Iron blood test (serum iron) inpatient CPT 83540 Iron Total Serum	$19.41	$19.41	$6.93–$23.81	—	—
Iron blood test (serum iron) inpatient CPT 83540 Iron Urine	$140.70	$140.70	$6.93–$133.66	—	—
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity Total	$26.22	$26.22	$9.36–$45.57	33% below	—
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity Total	$26.22	$26.22	$9.36–$45.57	—	—
Kidney function blood test panel CPT 80069 Renal Function Panel	$26.04	$26.04	$9.30–$49.37	51% below	—
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$26.04	$26.04	$9.30–$49.37	—	—
LH (luteinizing hormone) test CPT 83002 LH	$55.56	$55.56	$19.83–$98.66	24% below	—
LH (luteinizing hormone) test inpatient CPT 83002 LH	$55.56	$55.56	$19.83–$98.66	—	—
Lipase blood test (pancreas enzyme) CPT 83690 Lipase	$20.67	$20.67	$7.38–$23.81	52% below	—
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase	$20.67	$20.67	$7.38–$23.81	—	—
Liver function blood test panel CPT 80076 Hepatic Function Panel	$24.51	$24.51	$8.75–$49.37	45% below	—
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel	$24.51	$24.51	$8.75–$49.37	—	—
Lyme disease antibody test CPT 86618 Lyme Disease Titer	$34.80	$34.80	$18.24–$66.02	51% below	—
Lyme disease antibody test inpatient CPT 86618 Lyme Disease Titer	$34.80	$34.80	$18.24–$66.02	—	—
Magnesium blood test CPT 83735 Magnesium Serum	$20.10	$20.10	$7.18–$23.81	28% below	—
Magnesium blood test CPT 83735 Magnesium Urine	$25.20	$25.20	$7.18–$23.94	10% below	—
Magnesium blood test CPT 83735 Magnesium Rbc	$25.20	$25.20	$7.18–$23.94	10% below	—
Magnesium blood test inpatient CPT 83735 Magnesium Serum	$20.10	$20.10	$7.18–$23.81	—	—
Magnesium blood test inpatient CPT 83735 Magnesium Rbc	$25.20	$25.20	$7.18–$23.94	—	—
Magnesium blood test inpatient CPT 83735 Magnesium Urine	$25.20	$25.20	$7.18–$23.94	—	—
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Igg 877	$38.64	$38.64	$13.79–$39.77	15% below	—
Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies Igm	$128.83	$128.83	$13.79–$122.38	183% above	—
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Igg 877	$38.64	$38.64	$13.79–$39.77	—	—
Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies Igm	$128.83	$128.83	$13.79–$122.38	—	—
Mono test (heterophile antibody, Monospot) CPT 86308 Monotest	$15.54	$15.54	$5.55–$39.77	53% below	—
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Monotest	$15.54	$15.54	$5.55–$39.77	—	—
Obstetric blood test panel CPT 80055 OB Panel	$143.43	$143.43	$49.37–$136.25	9% above	—
Obstetric blood test panel inpatient CPT 80055 OB Panel	$143.43	$143.43	$49.37–$136.25	—	—
PSA (prostate-specific antigen) blood test, free CPT 84154 Free PSA	$20.16	$20.16	$12.09–$45.57	80% below	—
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Free PSA	$20.16	$20.16	$12.09–$45.57	—	—
PSA (prostate-specific antigen) blood test, total CPT 84153 Diagnostic PSA	$55.17	$55.17	$19.70–$52.41	28% below	—
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Diagnostic PSA	$55.17	$55.17	$19.70–$52.41	—	—
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopath Cerv Vag Man Screen	$60.78	$60.78	$21.70–$70.35	13% below	—
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytopath Cerv Vag Man Screen	$60.78	$60.78	$21.70–$70.35	—	—
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone	$123.84	$123.84	$44.21–$117.64	11% below	—
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone	$123.84	$123.84	$44.21–$117.64	—	—
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$18.03	$18.03	$6.44–$17.83	42% below	—
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$18.03	$18.03	$6.44–$17.83	—	—
Progesterone blood test CPT 84144 Progesterone	$62.58	$62.58	$22.34–$74.32	18% below	—
Progesterone blood test inpatient CPT 84144 Progesterone	$62.58	$62.58	$22.34–$74.32	—	—
Prolactin blood test CPT 84146 Prolactin	$58.14	$58.14	$20.76–$98.66	32% below	—
Prolactin blood test CPT 84146 Macroprolactin	$106.80	$106.80	$20.76–$101.46	26% above	—
Prolactin blood test inpatient CPT 84146 Prolactin	$58.14	$58.14	$20.76–$98.66	—	—
Prolactin blood test inpatient CPT 84146 Macroprolactin	$106.80	$106.80	$20.76–$101.46	—	—
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time With INR	$12.87	$12.87	$4.59–$17.83	42% below	—
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time With INR	$12.87	$12.87	$4.59–$17.83	—	—
Rheumatoid factor (RF) test CPT 86431 Ra Factor Quantitative	$7.20	$7.20	$4.32–$39.77	73% below	—
Rheumatoid factor (RF) test CPT 86431 Ra Test Titer	$17.01	$17.01	$6.07–$39.77	35% below	—
Rheumatoid factor (RF) test CPT 86431 Ra Test Screen	$17.01	$17.01	$6.07–$39.77	35% below	—
Rheumatoid factor (RF) test inpatient CPT 86431 Ra Factor Quantitative	$7.20	$7.20	$4.32–$39.77	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Ra Test Screen	$17.01	$17.01	$6.07–$39.77	—	—
Rheumatoid factor (RF) test inpatient CPT 86431 Ra Test Titer	$17.01	$17.01	$6.07–$39.77	—	—
Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Titer (I	$43.17	$43.17	$15.41–$41.01	16% below	—
Rubella antibody test (immunity check) CPT 86762 Rubella Screen	$43.17	$43.17	$15.41–$41.01	16% below	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Screen	$43.17	$43.17	$15.41–$41.01	—	—
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody Titer (I	$43.17	$43.17	$15.41–$41.01	—	—
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate Automated	$8.10	$8.10	$2.89–$33.51	61% below	—
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Sedimentation Rate Automated	$8.10	$8.10	$2.89–$33.51	—	—
Semen analysis: volume, sperm count, motility and morphology CPT 89320 Sperm Analysis	$144.00	$144.00	$13.18–$136.80	20% above	—
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 Sperm Analysis	$144.00	$144.00	$13.18–$136.80	—	—
Stool ova and parasites exam CPT 87177 Ova & Parasite Identific Feces	$26.70	$26.70	$9.53–$35.55	54% below	—
Stool ova and parasites exam inpatient CPT 87177 Ova & Parasite Identific Feces	$26.70	$26.70	$9.53–$35.55	—	—
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Feces Screening	$13.14	$13.14	$4.69–$23.81	42% below	—
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Feces Screening	$13.14	$13.14	$4.69–$23.81	—	—
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood Fit	$47.76	$47.76	$17.05–$45.57	18% below	—
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood Fit	$47.76	$47.76	$17.05–$45.57	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$12.81	$12.81	$4.57–$39.77	50% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl (Spinal Fluid Only)	$12.81	$12.81	$4.57–$39.77	50% below	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Vdrl (Spinal Fluid Only)	$12.81	$12.81	$4.57–$39.77	—	—
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$12.81	$12.81	$4.57–$39.77	—	—
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Tb Gold (In Tube)	$69.36	$69.36	$41.61–$66.38	58% below	—
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Quantiferon Tb Gold (In Tube)	$69.36	$69.36	$41.61–$66.38	—	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total	$77.43	$77.43	$27.64–$98.66	5% below	—
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone For Fai	$280.80	$280.80	$27.64–$266.76	244% above	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total	$77.43	$77.43	$27.64–$98.66	—	—
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone For Fai	$280.80	$280.80	$27.64–$266.76	—	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Anti-Microsomal Antibody	$25.08	$25.08	$15.04–$98.66	55% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Cytosol (Lc-1) Auto	$25.08	$25.08	$15.04–$98.66	55% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Perokidase	$25.08	$25.08	$15.04–$98.66	55% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Abs	$25.08	$25.08	$15.04–$98.66	55% below	—
Thyroid peroxidase (TPO) antibody test CPT 86376 Anti-Thy Microsomal Antibodies	$43.65	$43.65	$15.58–$98.66	21% below	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase Abs	$25.08	$25.08	$15.04–$98.66	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver Cytosol (Lc-1) Auto	$25.08	$25.08	$15.04–$98.66	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Perokidase	$25.08	$25.08	$15.04–$98.66	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-Microsomal Antibody	$25.08	$25.08	$15.04–$98.66	—	—
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Anti-Thy Microsomal Antibodies	$43.65	$43.65	$15.58–$98.66	—	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Tsh Nbsc	$50.40	$50.40	$17.99–$74.32	13% above	—
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$50.40	$50.40	$17.99–$74.32	13% above	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$50.40	$50.40	$17.99–$74.32	—	—
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Tsh Nbsc	$50.40	$50.40	$17.99–$74.32	—	—
Trichomonas test (NAAT) CPT 87661 Trich amp probe REF	$105.27	$105.27	$37.58–$129.09	20% above	—
Trichomonas test (NAAT) inpatient CPT 87661 Trich amp probe REF	$105.27	$105.27	$37.58–$129.09	—	—
Uric acid blood test CPT 84550 Uric Acid Serum	$13.56	$13.56	$4.84–$23.81	46% below	—
Uric acid blood test inpatient CPT 84550 Uric Acid Serum	$13.56	$13.56	$4.84–$23.81	—	—
Urinalysis with microscope exam, automated CPT 81001 Urinalysis	$9.51	$9.51	$3.40–$14.43	61% below	—
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis	$9.51	$9.51	$3.40–$14.43	—	—
Urinalysis with microscope exam, manual CPT 81000 Urinalysis (Dipstick)	$17.54	$17.54	$4.31–$16.66	4% above	—
Urinalysis with microscope exam, manual inpatient CPT 81000 Urinalysis (Dipstick)	$17.54	$17.54	$4.31–$16.66	—	—
Urinalysis without microscope exam, automated CPT 81003 UA Dipstick Only	$6.75	$6.75	$2.41–$10.17	41% below	—
Urinalysis without microscope exam, automated inpatient CPT 81003 UA Dipstick Only	$6.75	$6.75	$2.41–$10.17	—	—
Urinalysis without microscope exam, manual CPT 81002 Urine Bile	$10.44	$10.44	$3.73–$10.17	40% below	—
Urinalysis without microscope exam, manual CPT 81002 Urine Acetone (Qual)	$10.44	$10.44	$3.73–$10.17	40% below	—
Urinalysis without microscope exam, manual CPT 81002 Anc Urine Protein/Glucose	$10.44	$10.44	$3.73–$10.17	40% below	—
Urinalysis without microscope exam, manual CPT 81002 Urine Protein Qualitative	$10.44	$10.44	$3.73–$10.17	40% below	—
Urinalysis without microscope exam, manual CPT 81002 Rhc Ua W/O Microscopy Non	$10.44	$10.44	$3.73–$10.17	40% below	—
Urinalysis without microscope exam, manual CPT 81002 Urine Glucose Qualitative	$10.44	$10.44	$3.73–$10.17	40% below	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Acetone (Qual)	$10.44	$10.44	$3.73–$10.17	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Glucose Qualitative	$10.44	$10.44	$3.73–$10.17	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Rhc Ua W/O Microscopy Non	$10.44	$10.44	$3.73–$10.17	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Protein Qualitative	$10.44	$10.44	$3.73–$10.17	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Anc Urine Protein/Glucose	$10.44	$10.44	$3.73–$10.17	—	—
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Bile	$10.44	$10.44	$3.73–$10.17	—	—
Urine culture for bacteria, with colony count CPT 87086 Urine Culture	$24.21	$24.21	$8.64–$35.55	49% below	—
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture	$24.21	$24.21	$8.64–$35.55	—	—
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12 Assay	$45.24	$45.24	$16.15–$74.32	24% below	—
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B-12 Assay	$45.24	$45.24	$16.15–$74.32	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-Hydroxy	$88.80	$88.80	$31.70–$138.33	32% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D25 D2 D3	$117.84	$117.84	$31.70–$138.33	10% below	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25-Hydroxy	$88.80	$88.80	$31.70–$138.33	—	—
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D25 D2 D3	$117.84	$117.84	$31.70–$138.33	—	—
Zinc blood test CPT 84630 Zinc Plasma	$34.17	$34.17	$12.20–$67.59	41% below	—
Zinc blood test CPT 84630 Zinc Whole Blood LC	$111.00	$111.00	$12.20–$105.45	92% above	—
Zinc blood test inpatient CPT 84630 Zinc Plasma	$34.17	$34.17	$12.20–$67.59	—	—
Zinc blood test inpatient CPT 84630 Zinc Whole Blood LC	$111.00	$111.00	$12.20–$105.45	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg	$45.15	$45.15	$16.12–$74.32	16% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Pgcn Quantitative Hcg	$45.15	$45.15	$16.12–$74.32	16% below	—
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg	$56.76	$56.76	$16.12–$74.32	5% above	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta Hcg	$45.15	$45.15	$16.12–$74.32	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Pgcn Quantitative Hcg	$45.15	$45.15	$16.12–$74.32	—	—
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Hcg	$56.76	$56.76	$16.12–$74.32	—	—

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Electric Ext Pro	$457.05	$457.05	$274.23–$5,090.34	18% below	—
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion Electric Ext	$1,609.20	$1,609.20	$666.65–$5,090.34	190% above	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Electric Ext Pro	$457.05	$457.05	$274.23–$5,090.34	—	—
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion Electric Ext	$1,609.20	$1,609.20	$666.65–$5,090.34	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circ By Clamp Or Other Device	$395.00	$395.00	$237.00–$11,588.18	2% below	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circ by Clamp or Other Device	$500.00	$500.00	$300.00–$11,588.18	24% above	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circ By Clamp Or Other Device	$395.00	$395.00	$237.00–$11,588.18	—	—
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circ by Clamp or Other Device	$500.00	$500.00	$300.00–$11,588.18	—	—
Circumcision, surgical, older than a newborn CPT 54160 Curcumcision Surgical Excision	$419.00	$419.00	$251.40–$11,588.18	11% below	—
Circumcision, surgical, older than a newborn inpatient CPT 54160 Curcumcision Surgical Excision	$419.00	$419.00	$251.40–$11,588.18	—	—
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy	$550.00	$550.00	$330.00–$12,919.45	15% below	—
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 Cystoscopy	$550.00	$550.00	$330.00–$12,919.45	—	—
Earwax removal by irrigation (rinsing), one ear CPT 69209 Ceremen Rem Irrigate Lav Hosp	$132.00	$132.00	$60.51–$214.05	113% above	—
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 Ceremen Rem Irrigate Lav Hosp	$132.00	$132.00	$60.51–$214.05	—	—
Earwax removal with instruments, one ear CPT 69210 Rem Imp Cerumen Instrumen Pro	$137.82	$137.82	$60.51–$214.05	87% above	—
Earwax removal with instruments, one ear CPT 69210 Cerumen Removal Instrument UNI	$165.03	$165.03	$60.51–$214.05	124% above	—
Earwax removal with instruments, one ear inpatient CPT 69210 Rem Imp Cerumen Instrumen Pro	$137.82	$137.82	$60.51–$214.05	—	—
Earwax removal with instruments, one ear inpatient CPT 69210 Cerumen Removal Instrument UNI	$165.03	$165.03	$60.51–$214.05	—	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 ESI IL Cervical/Thoracic PF	$310.00	$310.00	$186.00–$3,934.66	53% below	—
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 ESI IL Thoracic TC	$1,970.00	$1,970.00	$705.51–$3,934.66	198% above	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 ESI IL Cervical/Thoracic PF	$310.00	$310.00	$186.00–$3,934.66	—	—
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 ESI IL Thoracic TC	$1,970.00	$1,970.00	$705.51–$3,934.66	—	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 FL cath&intro contrast hsg CE	$494.43	$494.43	$296.65–$830.88	159% above	—
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 FL cath&intro contrast hsg CE	$494.43	$494.43	$296.65–$830.88	—	—
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Of Skin Abscess Pro	$344.79	$344.79	$202.43–$2,127.51	61% above	—
Incision and drainage of a simple or single skin abscess CPT 10060 Drainage Of Skin Abscess	$524.13	$524.13	$202.43–$2,127.51	145% above	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Of Skin Abscess Pro	$344.79	$344.79	$202.43–$2,127.51	—	—
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 Drainage Of Skin Abscess	$524.13	$524.13	$202.43–$2,127.51	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint Pro	$179.31	$179.31	$107.58–$2,671.12	24% below	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint	$785.22	$785.22	$300.73–$2,671.12	231% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 FL Arthro Inj Asp Major Joint	$785.22	$785.22	$300.73–$2,671.12	231% above	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Major Joint Pro	$179.31	$179.31	$107.58–$2,671.12	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 FL Arthro Inj Asp Major Joint	$785.22	$785.22	$300.73–$2,671.12	—	—
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocentesis Major Joint	$785.22	$785.22	$300.73–$2,671.12	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Interm Jt Pro	$151.14	$151.14	$90.68–$2,671.12	34% below	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Interm Jt	$785.22	$785.22	$300.73–$2,671.12	245% above	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Interm Jt Pro	$151.14	$151.14	$90.68–$2,671.12	—	—
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis Interm Jt	$785.22	$785.22	$300.73–$2,671.12	—	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DrainInject JointBursa Pro	$146.10	$146.10	$87.66–$2,671.12	17% below	—
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DrainInject JointBursa	$785.22	$785.22	$300.73–$2,671.12	344% above	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DrainInject JointBursa Pro	$146.10	$146.10	$87.66–$2,671.12	—	—
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DrainInject JointBursa	$785.22	$785.22	$300.73–$2,671.12	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layer Close Wnd Scalp Trnk PF	$711.96	$711.96	$407.02–$1,964.04	128% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Layer Closure Wnd Scalp Trnk	$958.44	$958.44	$407.02–$1,964.04	207% above	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Layer Close Wnd Scalp Trnk PF	$711.96	$711.96	$407.02–$1,964.04	—	—
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 Layer Closure Wnd Scalp Trnk	$958.44	$958.44	$407.02–$1,964.04	—	—
Lower-back epidural injection, with imaging guidance CPT 62323 ESI IL Lumbar/Sacral PF	$287.00	$287.00	$172.20–$3,934.66	57% below	—
Lower-back epidural injection, with imaging guidance CPT 62323 ESI IL Lumbar/Sacral TC	$1,970.00	$1,970.00	$705.51–$3,934.66	198% above	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ESI IL Lumbar/Sacral PF	$287.00	$287.00	$172.20–$3,934.66	—	—
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ESI IL Lumbar/Sacral TC	$1,970.00	$1,970.00	$705.51–$3,934.66	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Lesion Trunk < .5 Cm Pro	$353.34	$353.34	$212.00–$6,629.69	22% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Exc Lesion 0.5cm or less	$1,829.82	$1,829.82	$716.79–$6,629.69	533% above	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Lesion Trunk < .5 Cm Pro	$353.34	$353.34	$212.00–$6,629.69	—	—
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Exc Lesion 0.5cm or less	$1,829.82	$1,829.82	$716.79–$6,629.69	—	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate Pro	$313.98	$313.98	$188.38–$1,964.04	102% above	—
Nail removal (partial or complete), one nail CPT 11730 Avulsion Of Nail Plate	$524.13	$524.13	$202.43–$1,964.04	237% above	—
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate Pro	$313.98	$313.98	$188.38–$1,964.04	—	—
Nail removal (partial or complete), one nail inpatient CPT 11730 Avulsion Of Nail Plate	$524.13	$524.13	$202.43–$1,964.04	—	—
Paracentesis with imaging guidance CPT 49083 US guide paracentesis	$821.27	$821.27	$492.76–$5,605.86	12% below	—
Paracentesis with imaging guidance inpatient CPT 49083 US guide paracentesis	$821.27	$821.27	$492.76–$5,605.86	—	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Toenail Removal Pro	$446.13	$446.13	$267.67–$6,629.69	23% above	—
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Toenail Removal	$958.44	$958.44	$407.02–$6,629.69	165% above	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Toenail Removal Pro	$446.13	$446.13	$267.67–$6,629.69	—	—
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 Toenail Removal	$958.44	$958.44	$407.02–$6,629.69	—	—
Removal of a foreign object under the skin, simple CPT 10120 Incision Removal Of FB Sub Pro	$428.25	$428.25	$256.95–$2,127.51	74% above	—
Removal of a foreign object under the skin, simple CPT 10120 Incision Removal Of FB Sub	$920.34	$920.34	$407.02–$2,127.51	275% above	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision Removal Of FB Sub Pro	$428.25	$428.25	$256.95–$2,127.51	—	—
Removal of a foreign object under the skin, simple inpatient CPT 10120 Incision Removal Of FB Sub	$920.34	$920.34	$407.02–$2,127.51	—	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy	$9,054.60	$9,054.60	$3,513.66–$31,235.31	2% below	—
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 Lithotripsy	$9,054.60	$9,054.60	$3,513.66–$31,235.31	—	—
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint Pro	$180.57	$180.57	$108.34–$1,803.22	40% above	—
Short arm splint (forearm and hand) CPT 29125 Apply Forearm Splint	$327.06	$327.06	$131.32–$1,803.22	154% above	—
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint Pro	$180.57	$180.57	$108.34–$1,803.22	—	—
Short arm splint (forearm and hand) inpatient CPT 29125 Apply Forearm Splint	$327.06	$327.06	$131.32–$1,803.22	—	—
Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint PF	$201.60	$201.60	$120.96–$1,803.22	44% above	—
Short leg splint (calf to foot) CPT 29515 Application Lower Leg Splint	$401.16	$401.16	$160.75–$1,803.22	186% above	—
Short leg splint (calf to foot) inpatient CPT 29515 Apply Lower Leg Splint PF	$201.60	$201.60	$120.96–$1,803.22	—	—
Short leg splint (calf to foot) inpatient CPT 29515 Application Lower Leg Splint	$401.16	$401.16	$160.75–$1,803.22	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Lac Rep Up To 2.5 cm PF	$257.55	$257.55	$154.53–$1,964.04	31% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Laceration Repair Up To 2.5 Cm	$524.13	$524.13	$202.43–$1,964.04	167% above	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Lac Rep Up To 2.5 cm PF	$257.55	$257.55	$154.53–$1,964.04	—	—
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 Laceration Repair Up To 2.5 Cm	$524.13	$524.13	$202.43–$1,964.04	—	—
Skin tag removal, up to 15 tags CPT 11200 Rmvl Skin Tags Up To 15 Pro	$251.67	$251.67	$151.00–$1,889.49	62% above	—
Skin tag removal, up to 15 tags CPT 11200 Rmvl Skin Tags Up To 15	$524.13	$524.13	$202.43–$1,889.49	237% above	—
Skin tag removal, up to 15 tags inpatient CPT 11200 Rmvl Skin Tags Up To 15 Pro	$251.67	$251.67	$151.00–$1,889.49	—	—
Skin tag removal, up to 15 tags inpatient CPT 11200 Rmvl Skin Tags Up To 15	$524.13	$524.13	$202.43–$1,889.49	—	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Fluid Tap Diagnostic PF	$432.00	$432.00	$259.20–$4,293.29	28% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Fluid Tap Diagnostc	$432.10	$432.10	$259.26–$4,293.29	28% below	—
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Fluid Tap Diagnostic	$1,874.94	$1,874.94	$705.51–$4,293.29	214% above	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Fluid Tap Diagnostic PF	$432.00	$432.00	$259.20–$4,293.29	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Fluid Tap Diagnostc	$432.10	$432.10	$259.26–$4,293.29	—	—
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spinal Fluid Tap Diagnostic	$1,874.94	$1,874.94	$705.51–$4,293.29	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Lac Rep 2.6-7.5 cm PF	$316.77	$316.77	$190.06–$1,964.04	54% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Laceration Rep 2.6 To 7.5 Cm	$524.13	$524.13	$202.43–$1,964.04	155% above	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Lac Rep 2.6-7.5 cm PF	$316.77	$316.77	$190.06–$1,964.04	—	—
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 Laceration Rep 2.6 To 7.5 Cm	$524.13	$524.13	$202.43–$1,964.04	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Facial Lac Rep Up To 2.5 cm PF	$314.97	$314.97	$188.98–$1,964.04	49% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Facial Lac Repair Up To 2.5 Cm	$524.13	$524.13	$202.43–$1,964.04	148% above	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Facial Lac Rep Up To 2.5 cm PF	$314.97	$314.97	$188.98–$1,964.04	—	—
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 Facial Lac Repair Up To 2.5 Cm	$524.13	$524.13	$202.43–$1,964.04	—	—
Thoracentesis with imaging guidance CPT 32555 CT Guided Thoracentesis	$1,400.00	$1,400.00	$629.86–$5,605.86	108% above	—
Thoracentesis with imaging guidance CPT 32555 US Guided Thoracentesis	$1,400.00	$1,400.00	$629.86–$5,605.86	108% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Pleura WImage	$1,400.00	$1,400.00	$629.86–$5,605.86	108% above	—
Thoracentesis with imaging guidance CPT 32555 Thoracentesis Pleura WImag PF	$1,891.32	$1,891.32	$629.86–$5,605.86	181% above	—
Thoracentesis with imaging guidance inpatient CPT 32555 CT Guided Thoracentesis	$1,400.00	$1,400.00	$629.86–$5,605.86	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Pleura WImage	$1,400.00	$1,400.00	$629.86–$5,605.86	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 US Guided Thoracentesis	$1,400.00	$1,400.00	$629.86–$5,605.86	—	—
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis Pleura WImag PF	$1,891.32	$1,891.32	$629.86–$5,605.86	—	—
Trigger point injections, 1 or 2 muscles CPT 20552 TPI 1-2 Muscles PF	$109.00	$109.00	$65.40–$2,671.12	52% below	—
Trigger point injections, 1 or 2 muscles CPT 20552 TPI 1-2 Muscles TC	$811.00	$811.00	$300.73–$2,671.12	257% above	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TPI 1-2 Muscles PF	$109.00	$109.00	$65.40–$2,671.12	—	—
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TPI 1-2 Muscles TC	$811.00	$811.00	$300.73–$2,671.12	—	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride SkinTissue Pro	$354.69	$354.69	$212.81–$1,889.49	13% below	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin Tissue	$441.00	$441.00	$264.60–$1,889.49	9% above	—
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride SkinTissue	$958.44	$958.44	$407.02–$1,889.49	136% above	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride SkinTissue Pro	$354.69	$354.69	$212.81–$1,889.49	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride Skin Tissue	$441.00	$441.00	$264.60–$1,889.49	—	—
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debride SkinTissue	$958.44	$958.44	$407.02–$1,889.49	—	—

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Transfusion Service	$1,164.00	$1,164.00	$445.38–$6,677.04	75% above	—
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Transfusion Service	$1,164.00	$1,164.00	$445.38–$6,677.04	—	—
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Nebulizer Treatment	$551.82	$551.82	$207.20–$2,028.96	345% above	—
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Nebulizer Treatment	$551.82	$551.82	$207.20–$2,028.96	—	—
Chemotherapy IV infusion, first hour CPT 96413 Highly Complex Drug Adm IV 1Hr	$896.70	$896.70	$337.91–$851.86	157% above	—
Chemotherapy IV infusion, first hour inpatient CPT 96413 Highly Complex Drug Adm IV 1Hr	$896.70	$896.70	$337.91–$851.86	—	—
Critical care, first 30 to 74 minutes CPT 99291 Critical Care First Hour Pro	$811.62	$811.62	$486.97–$858.41	at median	—
Critical care, first 30 to 74 minutes CPT 99291 Critical Care First Hour	$1,999.74	$1,999.74	$858.41–$1,899.75	146% above	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care First Hour Pro	$811.62	$811.62	$486.97–$858.41	—	—
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care First Hour	$1,999.74	$1,999.74	$858.41–$1,899.75	—	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG Tracing Only	$165.03	$165.03	$43.53–$156.77	41% above	—
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG Tracing Only	$165.03	$165.03	$43.53–$156.77	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Level 1 Pro	$67.23	$67.23	$40.33–$89.70	41% below	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emergency Level 1	$280.00	$280.00	$89.70–$266.00	147% above	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Level 1 Pro	$67.23	$67.23	$40.33–$89.70	—	—
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 Emergency Level 1	$280.00	$280.00	$89.70–$266.00	—	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Level 2 Pro	$129.30	$129.30	$77.58–$161.33	24% below	—
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emergency Level 2	$500.00	$500.00	$161.33–$475.00	195% above	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Level 2 Pro	$129.30	$129.30	$77.58–$161.33	—	—
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 Emergency Level 2	$500.00	$500.00	$161.33–$475.00	—	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Level 3 Pro	$193.77	$193.77	$116.26–$282.08	34% below	—
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emergency Level 3	$850.00	$850.00	$282.08–$807.50	190% above	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Level 3 Pro	$193.77	$193.77	$116.26–$282.08	—	—
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 Emergency Level 3	$850.00	$850.00	$282.08–$807.50	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Level 4 Pro	$355.80	$355.80	$213.48–$433.81	19% below	—
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emergency Level 4	$1,055.25	$1,055.25	$433.81–$1,002.48	139% above	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Level 4 Pro	$355.80	$355.80	$213.48–$433.81	—	—
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 Emergency Level 4	$1,055.25	$1,055.25	$433.81–$1,002.48	—	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Level 5 Pro	$517.11	$517.11	$310.26–$624.60	19% below	—
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emergency Level 5	$1,513.38	$1,513.38	$624.60–$1,437.71	136% above	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Level 5 Pro	$517.11	$517.11	$310.26–$624.60	—	—
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 Emergency Level 5	$1,513.38	$1,513.38	$624.60–$1,437.71	—	—
Exercise stress test, tracing only, the hospital charge CPT 93017 Rt - Treadmill Charge	$759.21	$759.21	$201.05–$721.24	102% above	—
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Rt - Treadmill Charge	$759.21	$759.21	$201.05–$721.24	—	—
Family therapy with the patient, 50 minutes CPT 90847 Family Psytx W/ Pt 50 Min	$394.05	$394.05	$163.68–$874.64	24% above	—
Family therapy with the patient, 50 minutes inpatient CPT 90847 Family Psytx W/ Pt 50 Min	$394.05	$394.05	$163.68–$874.64	—	—
Family therapy without the patient, 50 minutes CPT 90846 Family Psytx W/O Pt 50 Min	$302.85	$302.85	$163.68–$874.64	3% above	—
Family therapy without the patient, 50 minutes inpatient CPT 90846 Family Psytx W/O Pt 50 Min	$302.85	$302.85	$163.68–$874.64	—	—
Group psychotherapy session CPT 90853 Group Psychotherapy	$74.40	$74.40	$44.64–$546.34	62% below	—
Group psychotherapy session inpatient CPT 90853 Group Psychotherapy	$74.40	$74.40	$44.64–$546.34	—	—
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Infuse Hydrat 31Min to 1Hr	$551.16	$551.16	$214.64–$609.98	238% above	—
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV Infuse Hydrat 31Min to 1Hr	$551.16	$551.16	$214.64–$609.98	—	—
IV infusion of a medicine, first hour CPT 96365 TherProphDiag IV Inf Init	$443.10	$443.10	$214.64–$609.98	93% above	—
IV infusion of a medicine, first hour CPT 96365 TherProphDiag Iv Inf Init	$551.16	$551.16	$214.64–$609.98	140% above	—
IV infusion of a medicine, first hour inpatient CPT 96365 TherProphDiag IV Inf Init	$443.10	$443.10	$214.64–$609.98	—	—
IV infusion of a medicine, first hour inpatient CPT 96365 TherProphDiag Iv Inf Init	$551.16	$551.16	$214.64–$609.98	—	—
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection IM SQ	$181.38	$181.38	$72.50–$172.31	171% above	—
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection IM SQ	$181.38	$181.38	$72.50–$172.31	—	—
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psych Diagnostic Evaluation	$376.38	$376.38	$163.68–$709.33	166% above	—
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psych Diagnostic Evaluation	$376.38	$376.38	$163.68–$709.33	—	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT Initial EA 15 min	$98.58	$98.58	$59.14–$306.47	104% above	—
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT Initial EA 15 min	$98.58	$98.58	$59.14–$306.47	—	—
Psychotherapy session, 30 minutes CPT 90832 Psychtx Pt &Family 30 Mins	$188.00	$188.00	$112.80–$178.60	13% below	—
Psychotherapy session, 30 minutes inpatient CPT 90832 Psychtx Pt &Family 30 Mins	$188.00	$188.00	$112.80–$178.60	—	—
Psychotherapy session, 45 minutes CPT 90834 Psychtx Pt &Family 45 Min	$251.00	$251.00	$150.60–$238.45	4% below	—
Psychotherapy session, 45 minutes inpatient CPT 90834 Psychtx Pt &Family 45 Min	$251.00	$251.00	$150.60–$238.45	—	—
Psychotherapy session, 60 minutes CPT 90837 Psychtx Pt &Family 45 Mins	$375.00	$375.00	$163.68–$356.25	39% above	—
Psychotherapy session, 60 minutes inpatient CPT 90837 Psychtx Pt &Family 45 Mins	$375.00	$375.00	$163.68–$356.25	—	—
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Established Patient Level 5	$495.93	$495.93	$297.55–$471.13	126% above	—
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Established Patient Level 5	$495.93	$495.93	$297.55–$471.13	—	—
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Established Patient Level 3	$297.80	$297.80	$178.68–$282.91	123% above	—
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Established Patient Level 3	$297.80	$297.80	$178.68–$282.91	—	—
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Established Patient Level 4	$396.26	$396.26	$237.75–$376.44	134% above	—
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Established Patient Level 4	$396.26	$396.26	$237.75–$376.44	—	—
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Established Patient Level 2	$198.14	$198.14	$118.88–$188.23	136% above	—
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Established Patient Level 2	$198.14	$198.14	$118.88–$188.23	—	—
Spirometry (breathing test) CPT 94010 Pre Bronchodilator Spirometry	$414.99	$414.99	$159.39–$394.24	187% above	—
Spirometry (breathing test) inpatient CPT 94010 Pre Bronchodilator Spirometry	$414.99	$414.99	$159.39–$394.24	—	—
Spirometry before and after a bronchodilator CPT 94060 PRE/POST Broncho Spirometry	$759.21	$759.21	$216.55–$721.24	93% above	—
Spirometry before and after a bronchodilator inpatient CPT 94060 PRE/POST Broncho Spirometry	$759.21	$759.21	$216.55–$721.24	—	—
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Phlebotomy Therapeutic	$234.15	$234.15	$131.32–$562.23	87% above	—
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Phlebotomy Therapeutic	$234.15	$234.15	$131.32–$562.23	—	—

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Oklahoma	Off list
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menveo	$332.41	$332.41	$199.44–$315.78	107% above	—
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Menveo	$332.41	$332.41	$199.44–$315.78	—	—
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal B Vaccine Series	$494.54	$494.54	$296.72–$469.81	151% above	—
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal B Vaccine Series	$494.54	$494.54	$296.72–$469.81	—	—
Rabies vaccine, one dose CPT 90675 Rabiverti1	$908.09	$908.09	$83.92–$862.68	32% above	—
Rabies vaccine, one dose CPT 90675 Rabivaxi1	$1,118.43	$1,118.43	$83.92–$1,062.50	62% above	—
Rabies vaccine, one dose inpatient CPT 90675 Rabiverti1	$908.09	$908.09	$83.92–$862.68	—	—
Rabies vaccine, one dose inpatient CPT 90675 Rabivaxi1	$1,118.43	$1,118.43	$83.92–$1,062.50	—	—
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus & diph Td Adult	$106.54	$106.54	$63.92–$101.21	20% above	—
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus & diph Td Adult	$106.54	$106.54	$63.92–$101.21	—	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix TDAP Vaccine	$139.56	$139.56	$83.73–$132.58	79% above	—
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Boostrix TDAP Vaccine	$139.56	$139.56	$83.73–$132.58	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Adm Of Ped Hep B Vaccine	$19.58	$19.58	$11.74–$72.50	67% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immunization Single	$181.38	$181.38	$72.50–$172.31	202% above	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Adm Of Ped Hep B Vaccine	$19.58	$19.58	$11.74–$72.50	—	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Immunization Single	$181.38	$181.38	$72.50–$172.31	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immunization Two Or More	$94.50	$94.50	$56.70–$89.77	228% above	—
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Immunization Two Or More	$94.50	$94.50	$56.70–$89.77	—	—

Source file: https://mrfs.hyvehealthcare.com/JacksonCountyMemorialHospital/730568956_jackson-county-memorial-hospital_standardcharges.json