Hospital Eureka-Arcata, CA

Jerold Phelps Community Hospital

Jerold Phelps Community Hospital in Garberville, CA publishes cash prices for 263 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the California median for 157 of 260 procedures and above it for 103. By typical cash price it ranks #71 of 168 California hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

733 Cedar Street, Garberville, CA 95542 Collected Sep 27, 2026 Source price file (707) 923-3921

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 051309 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 HC PRO X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL	$95.86	$119.83	$95.86–$119.83	—	20%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Ankle X-ray, complete, 3 or more views CPT 73610 HC PRO X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
Ankle X-ray, complete, 3 or more views CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC PRO X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	92% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	60% below	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	60% below	20%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 HC PRO X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL	$95.86	$119.83	$95.86–$119.83	—	20%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RADEX ANKLE COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC PRO X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC PRO X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 HC X-RAY ANKLE 3+ VW - XR ANKLE 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC PRO CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT	$770.87	$963.59	$770.87–$963.59	75% below	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$770.87	$963.59	$770.87–$963.59	75% below	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT	$1,641.05	$2,051.31	$1,641.05–$2,051.31	47% below	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST	$770.87	$963.59	$770.87–$963.59	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC PRO CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT	$770.87	$963.59	$770.87–$963.59	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIO, CHEST, COMBO, INCL IMAGE - CT CHEST ANGIO W AND WO IV CONT	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC PRO CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST	$258.70	$323.38	$258.70–$323.38	18% below	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$258.70	$323.38	$258.70–$323.38	18% below	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST	$479.32	$599.15	$479.32–$599.15	53% above	20%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC PRO CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST	$258.70	$323.38	$258.70–$323.38	—	20%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$258.70	$323.38	$258.70–$323.38	—	20%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 HC CT HRT W/O DYE W/CA TEST - CT HEART CALCIUM SCORING WO CONTRAST	$479.32	$599.15	$479.32–$599.15	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$517.32	$646.65	$517.32–$646.65	82% below	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC PRO CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST	$517.32	$646.65	$517.32–$646.65	82% below	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST	$1,917.05	$2,396.31	$1,917.05–$2,396.31	32% below	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC PRO CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST	$517.32	$646.65	$517.32–$646.65	—	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL	$517.32	$646.65	$517.32–$646.65	—	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS W/O CONTRAST - CT ABDOMEN PELVIS WO CONTRAST	$1,917.05	$2,396.31	$1,917.05–$2,396.31	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$798.79	$998.49	$798.79–$998.49	80% below	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC PRO CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$798.79	$998.49	$798.79–$998.49	80% below	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	59% below	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL	$798.79	$998.49	$798.79–$998.49	—	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC PRO CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$798.79	$998.49	$798.79–$998.49	—	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD & PELV W/CONTRAST - CT ABDOMEN PELVIS W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC PRO CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST	$907.86	$1,134.82	$907.86–$1,134.82	80% below	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE	$907.86	$1,134.82	$907.86–$1,134.82	80% below	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST	$2,791.28	$3,489.10	$2,791.28–$3,489.10	37% below	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE	$907.86	$1,134.82	$907.86–$1,134.82	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC PRO CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST	$907.86	$1,134.82	$907.86–$1,134.82	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELV 1/> REGNS - CT ABDOMEN PELVIS W WO CONTRAST	$2,791.28	$3,489.10	$2,791.28–$3,489.10	—	20%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST MATERIAL	$593.40	$741.75	$593.40–$741.75	73% below	20%
CT scan of the abdomen with contrast CPT 74160 HC PRO CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST	$593.40	$741.75	$593.40–$741.75	73% below	20%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	27% below	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC PRO CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST	$593.40	$741.75	$593.40–$741.75	—	20%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST MATERIAL	$593.40	$741.75	$593.40–$741.75	—	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W/DYE - CT ABDOMEN W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST MATERIAL	$385.48	$481.85	$385.48–$481.85	79% below	20%
CT scan of the abdomen without contrast CPT 74150 HC PRO CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST	$385.48	$481.85	$385.48–$481.85	79% below	20%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	54% below	20%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST MATERIAL	$385.48	$481.85	$385.48–$481.85	—	20%
CT scan of the abdomen without contrast inpatient CPT 74150 HC PRO CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST	$385.48	$481.85	$385.48–$481.85	—	20%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN W/O DYE - CT ABDOMEN WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$357.61	$447.01	$357.61–$447.01	84% below	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC PRO CT SCAN,MAXILLOFACIAL W/O CONTRAST	$357.61	$447.01	$357.61–$447.01	84% below	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	60% below	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	60% below	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT	$862.69	$1,078.36	$862.69–$1,078.36	60% below	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL	$357.61	$447.01	$357.61–$447.01	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC PRO CT SCAN,MAXILLOFACIAL W/O CONTRAST	$357.61	$447.01	$357.61–$447.01	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT SCAN,MAXILLOFACIAL W/O CONTRAST - CT SINUS FACIAL BONES WO CONT	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC PRO CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$296.70	$370.88	$296.70–$370.88	87% below	20%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL	$296.70	$370.88	$296.70–$370.88	87% below	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	62% below	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC PRO CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$296.70	$370.88	$296.70–$370.88	—	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL	$296.70	$370.88	$296.70–$370.88	—	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL - CT HEAD WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the head with contrast CPT 70460 HC PRO CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST	$416.94	$521.18	$416.94–$521.18	85% below	20%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/CONTRAST MATERIAL	$416.94	$521.18	$416.94–$521.18	85% below	20%
CT scan of the head with contrast CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	39% below	20%
CT scan of the head with contrast inpatient CPT 70460 HC PRO CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST	$416.94	$521.18	$416.94–$521.18	—	20%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/CONTRAST MATERIAL	$416.94	$521.18	$416.94–$521.18	—	20%
CT scan of the head with contrast inpatient CPT 70460 HC CT SCAN HEAD CONTRAST - CT HEAD W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
CT scan of the head without and with contrast CPT 70470 HC PRO CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST	$494.50	$618.13	$494.50–$618.13	82% below	20%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$494.50	$618.13	$494.50–$618.13	82% below	20%
CT scan of the head without and with contrast CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	42% below	20%
CT scan of the head without and with contrast inpatient CPT 70470 HC PRO CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST	$494.50	$618.13	$494.50–$618.13	—	20%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL	$494.50	$618.13	$494.50–$618.13	—	20%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT SCAN HEAD COMBO - CT HEAD W WO CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL	$461.57	$576.96	$461.57–$576.96	84% below	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC PRO CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST	$461.57	$576.96	$461.57–$576.96	84% below	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	69% below	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC PRO CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST	$461.57	$576.96	$461.57–$576.96	—	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL	$461.57	$576.96	$461.57–$576.96	—	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SCAN,LUMBAR SPINE,W/O CONTRAST - CT LUMBAR SPINE WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC PRO CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST	$474.22	$592.77	$474.22–$592.77	84% below	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL	$474.22	$592.77	$474.22–$592.77	84% below	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	70% below	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL	$474.22	$592.77	$474.22–$592.77	—	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC PRO CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST	$474.22	$592.77	$474.22–$592.77	—	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SCAN,CERVICAL SPINE,W/O CONTRAST - CT CERVICAL SPINE WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST MATERIAL	$580.70	$725.88	$580.70–$725.88	77% below	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC PRO CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$580.70	$725.88	$580.70–$725.88	77% below	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	36% below	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC PRO CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$580.70	$725.88	$580.70–$725.88	—	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST MATERIAL	$580.70	$725.88	$580.70–$725.88	—	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT SCAN OF PELVIS CONTRAST - CT PELVIS W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$421.60	$527.00	$421.60–$527.00	—	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX	$540.59	$675.74	$540.59–$675.74	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY	$421.60	$527.00	$421.60–$527.00	—	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC DUPLEX SCAN EXTRACRANIAL,BILAT - CAROTID DUPLEX	$540.59	$675.74	$540.59–$675.74	—	20%
Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
Chest X-ray, 2 views CPT 71046 HC PRO RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
Chest X-ray, 2 views CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS	$165.51	$206.89	$165.51–$206.89	57% below	20%
Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Chest X-ray, 2 views inpatient CPT 71046 HC PRO RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Chest X-ray, 2 views inpatient CPT 71046 HC RADIOLOGIC EXAM CHEST 2 VIEWS - XR CHEST 2 VIEWS	$165.51	$206.89	$165.51–$206.89	—	20%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$27.84	$34.80	$27.84–$34.80	92% below	20%
Chest X-ray, single view CPT 71045 HC PRO RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW	$32.02	$40.02	$32.02–$40.02	91% below	20%
Chest X-ray, single view CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW	$165.51	$206.89	$165.51–$206.89	51% below	20%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST SINGLE VIEW	$27.84	$34.80	$27.84–$34.80	—	20%
Chest X-ray, single view inpatient CPT 71045 HC PRO RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW	$32.02	$40.02	$32.02–$40.02	—	20%
Chest X-ray, single view inpatient CPT 71045 HC RADIOLOGIC EXAM CHEST SINGLE VIEW - XR CHEST 1 VIEW	$165.51	$206.89	$165.51–$206.89	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE	$255.76	$319.70	$255.76–$319.70	70% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE	$260.36	$325.45	$260.36–$325.45	69% below	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - US RENAL COMPLETE	$255.76	$319.70	$255.76–$319.70	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE	$260.36	$325.45	$260.36–$325.45	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$413.08	$516.35	$413.08–$516.35	49% below	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC PRO OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST	$413.08	$516.35	$413.08–$516.35	49% below	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST	$540.50	$675.63	$540.50–$675.63	34% below	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC PRO OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST	$413.08	$516.35	$413.08–$516.35	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION	$413.08	$516.35	$413.08–$516.35	—	20%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 HC OB US DETAILED SNGL FETUS - US OB DETAIL FETAL ANAT SING OR 1ST GEST	$540.50	$675.63	$540.50–$675.63	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC PRO CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST	$464.05	$580.06	$464.05–$580.06	75% below	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$464.05	$580.06	$464.05–$580.06	75% below	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	53% below	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC PRO CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST	$464.05	$580.06	$464.05–$580.06	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST	$464.05	$580.06	$464.05–$580.06	—	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT SCAN,THORAX,W/O CONTRAST - CT CHEST WO CONTRAST	$862.69	$1,078.36	$862.69–$1,078.36	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$590.87	$738.59	$590.87–$738.59	75% below	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC PRO CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST	$590.87	$738.59	$590.87–$738.59	75% below	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	30% below	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST	$590.87	$738.59	$590.87–$738.59	—	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC PRO CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST	$590.87	$738.59	$590.87–$738.59	—	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CAT SCAN OF CHEST CONTRAST - CT CHEST W CONTRAST	$1,641.05	$2,051.31	$1,641.05–$2,051.31	—	20%
Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$117.21	$146.51	$117.21–$146.51	67% below	20%
Diagnostic mammogram, one breast CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC	$117.21	$146.51	$117.21–$146.51	67% below	20%
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT	$305.64	$382.05	$305.64–$382.05	13% below	20%
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT	$305.64	$382.05	$305.64–$382.05	13% below	20%
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT	$350.68	$438.35	$350.68–$438.35	1% below	20%
Diagnostic mammogram, one breast one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT	$350.68	$438.35	$350.68–$438.35	1% below	20%
Diagnostic mammogram, one breast inpatient CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC	$117.21	$146.51	$117.21–$146.51	—	20%
Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI	$117.21	$146.51	$117.21–$146.51	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS LEFT	$305.64	$382.05	$305.64–$382.05	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO ADDITIONAL VIEWS RIGHT	$305.64	$382.05	$305.64–$382.05	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC RIGHT	$350.68	$438.35	$350.68–$438.35	—	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DX MAMMO INCL CAD UNI - MAMMO BREAST DIAGNOSTIC LEFT	$350.68	$438.35	$350.68–$438.35	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$372.80	$466.00	$372.80–$466.00	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - CV US DOPPLER VENOUS LEGS BILATERAL	$470.00	$587.50	$470.00–$587.50	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS BILATERAL	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC EXTREMITY STUDY - US UPPER EXTREMITY VEINS BILATERAL	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY	$372.80	$466.00	$372.80–$466.00	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - CV US DOPPLER VENOUS LEGS BILATERAL	$470.00	$587.50	$470.00–$587.50	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC EXTREMITY STUDY - US UPPER EXTREMITY VEINS BILATERAL	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC VASC DUPLEX EXTREM VENOUS,BILAT	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXTREM VENOUS,BILAT - LOWER EXTREMITY DVT	$540.50	$675.63	$540.50–$675.63	—	20%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC EXTREMITY STUDY - US LOWER EXTREMITY VEINS BILATERAL	$540.50	$675.63	$540.50–$675.63	—	20%
Knee X-ray, 3 views both sides CPT 73562 HC PRO X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL	$103.59	$129.49	$103.59–$129.49	—	20%
Knee X-ray, 3 views both sides CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Knee X-ray, 3 views CPT 73562 HC PRO X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
Knee X-ray, 3 views CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$103.59	$129.49	$103.59–$129.49	74% below	20%
Knee X-ray, 3 views one side CPT 73562 HC PRO X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	92% below	20%
Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	59% below	20%
Knee X-ray, 3 views one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	59% below	20%
Knee X-ray, 3 views inpatient both sides CPT 73562 HC PRO X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL	$103.59	$129.49	$103.59–$129.49	—	20%
Knee X-ray, 3 views inpatient both sides CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Knee X-ray, 3 views inpatient CPT 73562 HC PRO X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Knee X-ray, 3 views inpatient CPT 73562 RADIOLOGIC EXAMINATION KNEE 3 VIEWS	$103.59	$129.49	$103.59–$129.49	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 HC PRO X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
Knee X-ray, 3 views inpatient one side CPT 73562 HC X-RAY KNEE 3 VIEW - XR KNEE 3 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC PRO US, ABDOMEN LIMITED - US ABDOMEN LIMITED	$209.76	$262.20	$209.76–$262.20	75% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED	$209.76	$262.20	$209.76–$262.20	75% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED	$255.76	$319.70	$255.76–$319.70	69% below	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC PRO US, ABDOMEN LIMITED - US ABDOMEN LIMITED	$209.76	$262.20	$209.76–$262.20	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL REAL TIME W/IMAGE LIMITED	$209.76	$262.20	$209.76–$262.20	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US, ABDOMEN LIMITED - US ABDOMEN LIMITED	$255.76	$319.70	$255.76–$319.70	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT CHEST LOW DOSE LUNG CANCER SCREENING	$479.32	$599.15	$479.32–$599.15	21% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC PRO CT CHEST LOW DOSE LUNG CANCER SCREENING	$649.15	$811.44	$649.15–$811.44	63% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$649.15	$811.44	$649.15–$811.44	63% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT CHEST LOW DOSE LUNG CANCER SCREENING	$479.32	$599.15	$479.32–$599.15	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC PRO CT CHEST LOW DOSE LUNG CANCER SCREENING	$649.15	$811.44	$649.15–$811.44	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$649.15	$811.44	$649.15–$811.44	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$113.16	$141.45	$113.16–$141.45	78% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC PRO SONO PELVIS LIMITED - US PELVIS LIMITED	$113.16	$141.45	$113.16–$141.45	78% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED BLADDER	$255.76	$319.70	$255.76–$319.70	51% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED	$255.76	$319.70	$255.76–$319.70	51% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U	$113.16	$141.45	$113.16–$141.45	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC PRO SONO PELVIS LIMITED - US PELVIS LIMITED	$113.16	$141.45	$113.16–$141.45	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED	$255.76	$319.70	$255.76–$319.70	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC SONO PELVIS LIMITED - US PELVIS LIMITED BLADDER	$255.76	$319.70	$255.76–$319.70	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US EXAM PELVIC COMPLETE	$253.92	$317.40	$253.92–$317.40	73% below	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$253.92	$317.40	$253.92–$317.40	73% below	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS	$255.76	$319.70	$255.76–$319.70	73% below	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US EXAM PELVIC COMPLETE	$253.92	$317.40	$253.92–$317.40	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE	$253.92	$317.40	$253.92–$317.40	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC ECHO,PELVIC (NONOBSTETRIC) - US PELVIS	$255.76	$319.70	$255.76–$319.70	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST	$255.76	$319.70	$255.76–$319.70	65% below	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC PRO OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST	$322.00	$402.50	$322.00–$402.50	56% below	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$322.00	$402.50	$322.00–$402.50	56% below	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST	$255.76	$319.70	$255.76–$319.70	—	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC PRO OB US >/= 14 WKS SNGL FETUS - US OB 14+ WEEKS SINGLE OR FIRST GEST	$322.00	$402.50	$322.00–$402.50	—	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION	$322.00	$402.50	$322.00–$402.50	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST	$255.76	$319.70	$255.76–$319.70	63% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC PRO OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST	$280.14	$350.18	$280.14–$350.18	60% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$280.14	$350.18	$280.14–$350.18	60% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST	$255.76	$319.70	$255.76–$319.70	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC PRO OB US < 14 WKS SINGLE FETUS - US OB < 14 WEEKS SINGLE OR FIRST GEST	$280.14	$350.18	$280.14–$350.18	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT	$280.14	$350.18	$280.14–$350.18	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC PRO OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES	$194.12	$242.65	$194.12–$242.65	62% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES	$194.12	$242.65	$194.12–$242.65	62% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES	$255.76	$319.70	$255.76–$319.70	49% below	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIMITED 1/> FETUSES	$194.12	$242.65	$194.12–$242.65	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC PRO OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES	$194.12	$242.65	$194.12–$242.65	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC OB US LIMITED FETUS(S) - US OB LIMITED 1+ FETUSES	$255.76	$319.70	$255.76–$319.70	—	20%
Screening mammogram, both breasts both sides CPT 77067 HC PRO SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL	$124.43	$155.54	$124.43–$155.54	—	20%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$124.43	$155.54	$124.43–$155.54	—	20%
Screening mammogram, both breasts both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL	$354.94	$443.67	$354.94–$443.67	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC PRO SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL	$124.43	$155.54	$124.43–$155.54	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD	$124.43	$155.54	$124.43–$155.54	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCR MAMMO BI INCL CAD - MAMMO BREAST SCREENING BILATERAL	$354.94	$443.67	$354.94–$443.67	—	20%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$32.02	$40.02	$32.02–$40.02	94% below	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC PRO X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS	$32.02	$40.02	$32.02–$40.02	94% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC PRO X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT	$32.02	$40.02	$32.02–$40.02	94% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC PRO X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	94% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	68% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	68% below	20%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC PRO X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC PRO X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC PRO X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT	$32.02	$40.02	$32.02–$40.02	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 HC X-RAY SHOULDER 2+ VW - XR SHOULDER 2+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL	$255.76	$319.70	$255.76–$319.70	54% below	20%
Transvaginal pelvic ultrasound CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL	$255.76	$319.70	$255.76–$319.70	54% below	20%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$287.04	$358.80	$287.04–$358.80	49% below	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL - US PELVIS TRANSVAGINAL	$255.76	$319.70	$255.76–$319.70	—	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC ECHOGRAPHY,TRANSVAGINAL	$255.76	$319.70	$255.76–$319.70	—	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$287.04	$358.80	$287.04–$358.80	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$199.64	$249.55	$199.64–$249.55	65% below	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC PRO TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL	$221.72	$277.15	$221.72–$277.15	62% below	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL	$255.76	$319.70	$255.76–$319.70	56% below	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG	$199.64	$249.55	$199.64–$249.55	—	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC PRO TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL	$221.72	$277.15	$221.72–$277.15	—	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC TRANSVAGINAL US OBSTETRIC - US OB TRANSVAGINAL	$255.76	$319.70	$255.76–$319.70	—	20%
Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE	$255.76	$319.70	$255.76–$319.70	74% below	20%
Ultrasound of the abdomen, complete CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$255.76	$319.70	$255.76–$319.70	74% below	20%
Ultrasound of the abdomen, complete CPT 76700 HC PRO US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$280.60	$350.75	$280.60–$350.75	72% below	20%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$280.60	$350.75	$280.60–$350.75	72% below	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$255.76	$319.70	$255.76–$319.70	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN COMPLETE	$255.76	$319.70	$255.76–$319.70	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC PRO US, ABDOM,B-SCAN &/OR REAL TIME,COMPLETE - US ABDOMEN	$280.60	$350.75	$280.60–$350.75	—	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION	$280.60	$350.75	$280.60–$350.75	—	20%
Ultrasound of the scrotum and testicles CPT 76870 HC ECHO,SCROTUM & CONTENTS - US SCROTUM	$255.76	$319.70	$255.76–$319.70	71% below	20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM & CONTENTS	$260.36	$325.45	$260.36–$325.45	71% below	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC ECHO,SCROTUM & CONTENTS - US SCROTUM	$255.76	$319.70	$255.76–$319.70	—	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM & CONTENTS	$260.36	$325.45	$260.36–$325.45	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE	$255.76	$319.70	$255.76–$319.70	69% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US THYROID	$255.76	$319.70	$255.76–$319.70	69% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$268.18	$335.23	$268.18–$335.23	68% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC PRO US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE	$280.60	$350.75	$280.60–$350.75	66% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US THYROID	$255.76	$319.70	$255.76–$319.70	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE	$255.76	$319.70	$255.76–$319.70	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM	$268.18	$335.23	$268.18–$335.23	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC PRO US, HEAD/NECK TISSUES,REAL TIME - US HEAD NECK SOFT TISSUE	$280.60	$350.75	$280.60–$350.75	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD	$255.76	$319.70	$255.76–$319.70	70% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC EXTREMITY STUDY - RT US VEINS UNILATERAL	$255.76	$319.70	$255.76–$319.70	70% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC EXTREMITY STUDY - LT US VEINS UNILATERAL	$255.76	$319.70	$255.76–$319.70	70% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$285.66	$357.08	$285.66–$357.08	66% below	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXTREM VENOUS,UNI OR LTD	$255.76	$319.70	$255.76–$319.70	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC EXTREMITY STUDY - LT US VEINS UNILATERAL	$255.76	$319.70	$255.76–$319.70	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC EXTREMITY STUDY - RT US VEINS UNILATERAL	$255.76	$319.70	$255.76–$319.70	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY	$285.66	$357.08	$285.66–$357.08	—	20%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 HC PRO X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL	$48.02	$60.03	$48.02–$60.03	—	20%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Wrist X-ray, complete, 3 or more views CPT 73110 HC PRO X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	93% below	20%
Wrist X-ray, complete, 3 or more views CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	93% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC PRO X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	93% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	62% below	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	62% below	20%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 HC PRO X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL	$48.02	$60.03	$48.02–$60.03	—	20%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RADEX WRIST COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC PRO X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC PRO X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 HC X-RAY WRIST 3+ VW - XR WRIST 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC PRO X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC PRO X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT	$165.51	$206.89	$165.51–$206.89	57% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT	$165.51	$206.89	$165.51–$206.89	57% below	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC PRO X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC PRO X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS - XR HIP 2 OR 3 VW LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the abdomen, 1 view CPT 74018 HC PRO RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the abdomen, 1 view CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW	$165.51	$206.89	$165.51–$206.89	45% below	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC PRO RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABDOMEN 1 VIEW	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC RADIOLOGIC EXAM ABDOMEN 1 VIEW - XR ABDOMEN 1 VIEW	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the ankle, 2 views both sides CPT 73600 HC PRO X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL	$63.94	$79.93	$63.94–$79.93	—	20%
X-ray of the ankle, 2 views both sides CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the ankle, 2 views CPT 73600 HC PRO X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the ankle, 2 views CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the ankle, 2 views one side CPT 73600 HC PRO X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	45% below	20%
X-ray of the ankle, 2 views one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	45% below	20%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC PRO X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL	$63.94	$79.93	$63.94–$79.93	—	20%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the ankle, 2 views inpatient CPT 73600 HC PRO X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the ankle, 2 views inpatient CPT 73600 RADIOLOGIC EXAMINATION ANKLE 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC PRO X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the ankle, 2 views inpatient one side CPT 73600 HC X-RAY ANKLE 2 VW - XR ANKLE 2 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the finger(s), 2 or more views CPT 73140 HC PRO X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS	$32.02	$40.02	$32.02–$40.02	88% below	20%
X-ray of the finger(s), 2 or more views CPT 73140 RADEX FINGR MINIMUM 2 VIEWS	$32.02	$40.02	$32.02–$40.02	88% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC PRO X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT	$32.02	$40.02	$32.02–$40.02	88% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	38% below	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	38% below	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC PRO X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RADEX FINGR MINIMUM 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC PRO X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HC X-RAY EXAM OF FINGER(S) - XR FINGERS 2+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the foot, 2 views both sides CPT 73620 HC PRO X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL	$84.46	$105.57	$84.46–$105.57	—	20%
X-ray of the foot, 2 views both sides CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the foot, 2 views CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the foot, 2 views CPT 73620 HC PRO X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the foot, 2 views one side CPT 73620 HC PRO X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	89% below	20%
X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	45% below	20%
X-ray of the foot, 2 views one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	45% below	20%
X-ray of the foot, 2 views inpatient both sides CPT 73620 HC PRO X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL	$84.46	$105.57	$84.46–$105.57	—	20%
X-ray of the foot, 2 views inpatient both sides CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the foot, 2 views inpatient CPT 73620 HC PRO X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the foot, 2 views inpatient CPT 73620 RADIOLOGIC EXAMINATION FOOT 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC PRO X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the foot, 2 views inpatient one side CPT 73620 HC X-RAY FOOT 2 VW - XR FOOT 1-2 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 HC PRO X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL	$92.00	$115.00	$92.00–$115.00	—	20%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the foot, complete, 3 or more views CPT 73630 HC PRO X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the foot, complete, 3 or more views CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC PRO X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	58% below	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	58% below	20%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 HC PRO X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL	$92.00	$115.00	$92.00–$115.00	—	20%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC PRO X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RADEX FOOT COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC PRO X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 HC X-RAY FOOT 3+ VW - XR FOOT 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the hand, 3 or more views both sides CPT 73130 HC PRO X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL	$48.02	$60.03	$48.02–$60.03	—	20%
X-ray of the hand, 3 or more views both sides CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the hand, 3 or more views CPT 73130 HC PRO X-RAY HAND 3+ VW - XR HAND 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the hand, 3 or more views CPT 73130 RADEX HAND MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC PRO X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	61% below	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	61% below	20%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HC PRO X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL	$48.02	$60.03	$48.02–$60.03	—	20%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS BILATERAL	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC PRO X-RAY HAND 3+ VW - XR HAND 3+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 RADEX HAND MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC PRO X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HC X-RAY HAND 3+ VW - XR HAND 3+ VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the knee, 1 or 2 views both sides CPT 73560 HC PRO X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT	$92.00	$115.00	$92.00–$115.00	—	20%
X-ray of the knee, 1 or 2 views both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the knee, 1 or 2 views CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC PRO X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC PRO X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	51% below	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	51% below	20%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 HC PRO X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT	$92.00	$115.00	$92.00–$115.00	—	20%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS BILAT	$330.88	$413.60	$330.88–$413.60	—	20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC PRO X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC PRO X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS RIGHT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 HC X-RAY KNEE 1 OR 2 VIEW - XR KNEE 1-2 VIEWS LEFT	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC PRO X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS	$32.02	$40.02	$32.02–$40.02	93% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$32.02	$40.02	$32.02–$40.02	93% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS	$316.21	$395.26	$316.21–$395.26	31% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC PRO X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RADEX SPINE LUMBOSACRAL 2/3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC X-RAY LUMBAR SPINE 2/3 VW - XR LUMBAR SPINE 2-3 VIEWS	$316.21	$395.26	$316.21–$395.26	—	20%
X-ray of the lower back, 4 or more views CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$43.19	$53.99	$43.19–$53.99	93% below	20%
X-ray of the lower back, 4 or more views CPT 72110 HC PRO X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$43.19	$53.99	$43.19–$53.99	93% below	20%
X-ray of the lower back, 4 or more views CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$316.21	$395.26	$316.21–$395.26	46% below	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS	$43.19	$53.99	$43.19–$53.99	—	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC PRO X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$43.19	$53.99	$43.19–$53.99	—	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC X-RAY LUMBAR SPINE 4 VW - XR LUMBAR SPINE COMPLETE 4+ VIEWS	$316.21	$395.26	$316.21–$395.26	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RADEX SPINE THORACIC 2 VIEWS	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC PRO X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS	$316.21	$395.26	$316.21–$395.26	12% below	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RADEX SPINE THORACIC 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC PRO X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC X-RAY THORACIC SPINE 2 VW - XR THORACIC SPINE 2 VIEWS	$316.21	$395.26	$316.21–$395.26	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC PRO X-RAY NASAL BONES - XR NASAL BONES	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the nasal bones, 3 or more views CPT 70160 RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES	$165.51	$206.89	$165.51–$206.89	56% below	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC PRO X-RAY NASAL BONES - XR NASAL BONES	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC X-RAY NASAL BONES - XR NASAL BONES	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC PRO RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS	$32.02	$40.02	$32.02–$40.02	93% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS	$32.02	$40.02	$32.02–$40.02	93% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 1 VIEW	$165.51	$206.89	$165.51–$206.89	62% below	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS	$165.51	$206.89	$165.51–$206.89	62% below	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC PRO RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RADEX SPINE CERVICAL 2 OR 3 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 1 VIEW	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC RADEX SPINE CERVICAL 2 OR 3 VIEWS - XR CERVICAL SPINE 2-3 VIEWS	$165.51	$206.89	$165.51–$206.89	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PRO X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS	$32.02	$40.02	$32.02–$40.02	91% below	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS	$316.21	$395.26	$316.21–$395.26	13% below	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PRO X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC X-RAY PELVIS 1/2 VW - XR PELVIS 1-2 VIEWS	$316.21	$395.26	$316.21–$395.26	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC PRO X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS	$32.02	$40.02	$32.02–$40.02	92% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS	$165.51	$206.89	$165.51–$206.89	61% below	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC PRO X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RADEX SACRUM & COCCYX MINIMUM 2 VIEWS	$32.02	$40.02	$32.02–$40.02	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC X-RAY SACRUM/COCCYX 2+ VW - XR SACRUM COCCYX 2+ VIEWS	$165.51	$206.89	$165.51–$206.89	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs California	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT)	$45.54	$56.93	$45.54–$56.93	6% above	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 HC TRANSFERASE ALANINE AMINO (ALT) (SGPT) - ALT (SGPT)	$45.54	$56.93	$45.54–$56.93	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT)	$40.76	$50.95	$40.76–$50.95	8% below	20%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 HC TRANSFERASE ASPARTATE AMINO (AST) (SGOT) - AST (SGOT)	$40.76	$50.95	$40.76–$50.95	—	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE	$155.85	$194.81	$155.85–$194.81	36% below	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HC HEPATITIS PANEL,ACUTE - BUNDLED CHARGE	$155.85	$194.81	$155.85–$194.81	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN EA QUEST REF	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE	$17.16	$21.45	$17.16–$21.45	106% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN MILK IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN ALMONDS IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CASHEW IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN CODFISH IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN EGG WHITE IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SCALLOP IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN HAZELNUT	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN PEANUT IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN EA QUEST REF	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SALMON IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN TUNA IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SOYBEAN IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SHRIMP IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HC ALLERGEN SPEC IGE - ALLERGEN SESAME SEED IGE	$17.16	$21.45	$17.16–$21.45	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY	$42.60	$53.25	$42.60–$53.25	110% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 HC CYCLIC CIRULLINATED PEPTIDE ANTIBODY - CYCLIC CITRUL PEPTIDE ANTIBDY	$42.60	$53.25	$42.60–$53.25	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES)	$39.84	$49.80	$39.84–$49.80	14% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 HC ANTINUCLEAR ANTIBODIES - ANA (ANTINUCLEAR ANTIBODIES)	$39.84	$49.80	$39.84–$49.80	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)	$664.19	$830.24	$664.19–$830.24	276% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)	$664.19	$830.24	$664.19–$830.24	—	20%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL	$191.54	$239.43	$191.54–$239.43	1% below	20%
Basic metabolic panel (blood test) inpatient CPT 80048 HC BASIC METABOLIC PANEL CALCIUM TOTAL	$191.54	$239.43	$191.54–$239.43	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV	$119.05	$148.81	$119.05–$148.81	22% below	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH,LEVEL IV - LAB SURG PATH,LEVEL IV	$119.05	$148.81	$119.05–$148.81	—	20%
Blood culture for bacteria CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$33.95	$42.44	$33.95–$42.44	86% below	20%
Blood culture for bacteria inpatient CPT 87040 HC BLOOD CULTURE FOR BACTERIA	$33.95	$42.44	$33.95–$42.44	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE	$40.76	$50.95	$40.76–$50.95	68% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC CHG COLLECTION VENOUS BLOOD,VENIPUNCTURE	$40.76	$50.95	$40.76–$50.95	—	20%
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM	$65.87	$82.34	$65.87–$82.34	76% above	20%
Blood glucose (sugar) test CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING	$65.87	$82.34	$65.87–$82.34	76% above	20%
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GTT FASTING	$65.87	$82.34	$65.87–$82.34	—	20%
Blood glucose (sugar) test inpatient CPT 82947 HC ASSAY QUANTITATIVE,BLOOD GLUCOSE - GLUCOSE RANDOM	$65.87	$82.34	$65.87–$82.34	—	20%
Blood lead test CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD	$39.84	$49.80	$39.84–$49.80	180% above	20%
Blood lead test inpatient CPT 83655 HC ASSAY OF LEAD - LEAD BLOOD	$39.84	$49.80	$39.84–$49.80	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE	$147.34	$184.17	$147.34–$184.17	4% below	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE	$147.34	$184.17	$147.34–$184.17	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE	$76.46	$95.57	$76.46–$95.57	at median	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC BLOOD TYPING SEROLOGIC ABO	$76.46	$95.57	$76.46–$95.57	at median	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO	$76.46	$95.57	$76.46–$95.57	—	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 HC BLOOD TYPING SEROLOGIC ABO - ABO/RH TYPE	$76.46	$95.57	$76.46–$95.57	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN	$21.16	$26.45	$21.16–$26.45	55% below	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 HC C-REACTIVE PROTEIN - C-REACTIVE PROTEIN	$21.16	$26.45	$21.16–$26.45	—	20%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFF AMPLIFIED PROBE	$115.37	$144.21	$115.37–$144.21	25% below	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 HC C DIFF AMPLIFIED PROBE	$115.37	$144.21	$115.37–$144.21	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9	$68.50	$85.62	$68.50–$85.62	38% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 19-9 - CANCER ANTIGEN 19-9	$68.50	$85.62	$68.50–$85.62	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125	$68.50	$85.62	$68.50–$85.62	28% below	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 HC IMMUNOASSAY, TUMOR ANTIGEN, CA 125 - CA 125	$68.50	$85.62	$68.50–$85.62	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR	$128.80	$161.00	$128.80–$161.00	84% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ - SARS-COV-2 RT PCR	$128.80	$161.00	$128.80–$161.00	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR	$115.37	$144.21	$115.37–$144.21	111% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 HC CHYLMD TRACH, DNA, AMP PROBE - CHLAMYDIA DNA PCR	$115.37	$144.21	$115.37–$144.21	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL - BUNDLED CHARGE	$247.80	$309.75	$247.80–$309.75	144% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL - BUNDLED CHARGE	$247.80	$309.75	$247.80–$309.75	—	20%
Complete blood count (CBC) with differential CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC	$173.70	$217.12	$173.70–$217.12	57% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPLETE CBC & AUTO DIFF WBC	$173.70	$217.12	$173.70–$217.12	—	20%
Complete blood count (CBC), no differential CPT 85027 HC COMPLETE CBC - CBC	$137.77	$172.21	$137.77–$172.21	81% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 HC COMPLETE CBC - CBC	$137.77	$172.21	$137.77–$172.21	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE	$227.42	$284.28	$227.42–$284.28	11% below	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC METABOLIC PANEL,COMPREHENSIVE	$227.42	$284.28	$227.42–$284.28	—	20%
D-dimer blood test (blood clot marker) CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE	$326.78	$408.48	$326.78–$408.48	174% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 HC FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT - D-DIMER,QUANTITATIVE	$326.78	$408.48	$326.78–$408.48	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE	$73.14	$91.43	$73.14–$91.43	4% below	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 HC DEHYDROEPIANDROSTERONE-SULFATE - DHEA-SULFATE	$73.14	$91.43	$73.14–$91.43	—	20%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL HIGH SENSITIVE	$91.82	$114.77	$91.82–$114.77	47% above	20%
Estradiol blood test CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL	$91.82	$114.77	$91.82–$114.77	47% above	20%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL	$91.82	$114.77	$91.82–$114.77	—	20%
Estradiol blood test inpatient CPT 82670 HC ASSAY OF ESTRADIOL - ESTRADIOL HIGH SENSITIVE	$91.82	$114.77	$91.82–$114.77	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 HC GONADOTROPIN (FSH) - FSH	$61.09	$76.36	$61.09–$76.36	31% below	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 HC GONADOTROPIN (FSH) - FSH	$61.09	$76.36	$61.09–$76.36	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 HC ASSAY OF CALPROTECTIN FECAL	$167.86	$209.82	$167.86–$209.82	131% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 HC ASSAY OF CALPROTECTIN FECAL	$167.86	$209.82	$167.86–$209.82	—	20%
Ferritin blood test (iron stores) CPT 82728 HC ASSAY OF FERRITIN - FERRITIN	$44.81	$56.01	$44.81–$56.01	46% below	20%
Ferritin blood test (iron stores) inpatient CPT 82728 HC ASSAY OF FERRITIN - FERRITIN	$44.81	$56.01	$44.81–$56.01	—	20%
Folate (folic acid) blood test CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE	$48.30	$60.38	$48.30–$60.38	44% below	20%
Folate (folic acid) blood test inpatient CPT 82746 HC BLOOD FOLIC ACID SERUM - FOLATE	$48.30	$60.38	$48.30–$60.38	—	20%
Free T3 thyroid hormone test CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE	$55.70	$69.63	$55.70–$69.63	12% below	20%
Free T3 thyroid hormone test inpatient CPT 84481 HC TRIIODOTHYRONINE FREE ASSAY (FT-3) - T3 FREE	$55.70	$69.63	$55.70–$69.63	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE	$187.91	$234.89	$187.91–$234.89	176% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 HC ASSAY OF FREE THYROXINE - T4 FREE	$187.91	$234.89	$187.91–$234.89	—	20%
Free testosterone test CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE	$83.77	$104.71	$83.77–$104.71	101% above	20%
Free testosterone test inpatient CPT 84402 HC ASSAY OF TESTOSTERONE - TESTOSTERONE TOTAL FREE	$83.77	$104.71	$83.77–$104.71	—	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE	$600.00	$750.00	$600.00–$750.00	116% above	20%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 HC GENERAL HEALTH PANEL - BUNDLED CHARGE	$600.00	$750.00	$600.00–$750.00	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR	$69.50	$86.88	$69.50–$86.88	57% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 HC GLUCOSE TEST - GTT 1 HOUR	$69.50	$86.88	$69.50–$86.88	—	20%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR	$251.34	$314.18	$251.34–$314.18	115% above	20%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - LACTOSE INTOLERANCE	$251.34	$314.18	$251.34–$314.18	115% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - LACTOSE INTOLERANCE	$251.34	$314.18	$251.34–$314.18	—	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 HC GLUCOSE TOLERANCE TEST (GTT) - GTT 2 HOUR	$251.34	$314.18	$251.34–$314.18	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR	$115.37	$144.21	$115.37–$144.21	117% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 HC N.GONORRHOEAE, DNA, AMP PROB - GC DNA PCR	$115.37	$144.21	$115.37–$144.21	—	20%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA	$47.75	$59.69	$47.75–$59.69	58% below	20%
H. pylori antibody blood test inpatient CPT 86677 HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA	$47.75	$59.69	$47.75–$59.69	—	20%
H. pylori stool antigen test CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL	$47.29	$59.11	$47.29–$59.11	36% below	20%
H. pylori stool antigen test inpatient CPT 87338 HC IAAD IA HPYLORI STOOL - H PYLORI ANTIGEN STOOL	$47.29	$59.11	$47.29–$59.11	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR	$279.78	$349.72	$279.78–$349.72	229% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HC HIV-1 QUANT&REVRSE TRNSCRPJ - HIV RNA, QUANTITATIVE, PCR	$279.78	$349.72	$279.78–$349.72	—	20%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN	$45.03	$56.29	$45.03–$56.29	8% above	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HC HIV-1/HIV-2, SINGLE ASSAY - RAPID HIV 1 AND 2 SCREEN	$45.03	$56.29	$45.03–$56.29	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 ANTIGENS W/HIV 1 & 2 ANTIBODY	$79.12	$98.90	$79.12–$98.90	31% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 ANTIGENS W/HIV 1 & 2 ANTIBODY	$79.12	$98.90	$79.12–$98.90	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP	$115.36	$144.20	$115.36–$144.20	15% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV HIGH RISK PCR	$115.36	$144.20	$115.36–$144.20	15% below	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP/DIRECT/PCR	$115.37	$144.21	$115.37–$144.21	15% below	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP	$115.36	$144.20	$115.36–$144.20	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV HIGH RISK PCR	$115.36	$144.20	$115.36–$144.20	—	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, AMP/DIRECT/PCR	$115.37	$144.21	$115.37–$144.21	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C	$187.91	$234.89	$187.91–$234.89	191% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC GLYCOSYLATED HEMOGLOBIN TEST - HEMOGLOBIN A1C	$187.91	$234.89	$187.91–$234.89	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY	$35.33	$44.16	$35.33–$44.16	8% below	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC HEPATITIS B SURFACE AB TEST - HEPATITIS B SURFACE ANTIBODY	$35.33	$44.16	$35.33–$44.16	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN	$33.95	$42.44	$33.95–$42.44	45% below	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HC IAAD IA HEPATITIS B SURFACE ANTIGEN - HEPATITIS B SURFACE ANTIGEN	$33.95	$42.44	$33.95–$42.44	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY	$46.87	$58.59	$46.87–$58.59	10% below	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HC HEPATITIS C AB TEST - HEPATITIS C ANTIBODY	$46.87	$58.59	$46.87–$58.59	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$140.81	$176.01	$140.81–$176.01	80% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR	$140.81	$176.01	$140.81–$176.01	80% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION	$140.81	$176.01	$140.81–$176.01	—	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR	$140.81	$176.01	$140.81–$176.01	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY	$43.38	$54.22	$43.38–$54.22	131% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HC HERPES SIMPLEX TEST, TYPE 1 - HSV 1 IGG ANTIBODY	$43.38	$54.22	$43.38–$54.22	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY	$63.66	$79.58	$63.66–$79.58	139% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HC HERPES SIMPLEX TEST, TYPE 2 - HSV 2 IGG ANTIBODY	$63.66	$79.58	$63.66–$79.58	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP	$253.78	$317.23	$253.78–$317.23	442% above	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HC C-REACTIVE PROTEIN,HIGH SENSITIVITY - HIGH SENSITIVITY CRP	$253.78	$317.23	$253.78–$317.23	—	20%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE	$55.48	$69.35	$55.48–$69.35	35% above	20%
Homocysteine blood test CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE TOTAL	$55.48	$69.35	$55.48–$69.35	35% above	20%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE	$55.48	$69.35	$55.48–$69.35	—	20%
Homocysteine blood test inpatient CPT 83090 HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE TOTAL	$55.48	$69.35	$55.48–$69.35	—	20%
Insulin blood test CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING	$37.58	$46.98	$37.58–$46.98	12% above	20%
Insulin blood test inpatient CPT 83525 HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING	$37.58	$46.98	$37.58–$46.98	—	20%
Iron blood test (serum iron) CPT 83540 HC ASSAY OF IRON - IRON	$21.34	$26.68	$21.34–$26.68	52% below	20%
Iron blood test (serum iron) inpatient CPT 83540 HC ASSAY OF IRON - IRON	$21.34	$26.68	$21.34–$26.68	—	20%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST - IRON + TRANSFERRIN + TIBC	$28.80	$36.00	$28.80–$36.00	48% below	20%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING TEST - IRON AND IRON BINDING CAPACITY PANEL - SR OR PL	$28.80	$36.00	$28.80–$36.00	48% below	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING TEST - IRON + TRANSFERRIN + TIBC	$28.80	$36.00	$28.80–$36.00	—	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 HC IRON BINDING TEST - IRON AND IRON BINDING CAPACITY PANEL - SR OR PL	$28.80	$36.00	$28.80–$36.00	—	20%
Kidney function blood test panel CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE	$228.66	$285.83	$228.66–$285.83	62% above	20%
Kidney function blood test panel inpatient CPT 80069 HC RENAL FUNCTION PANEL - BUNDLED CHARGE	$228.66	$285.83	$228.66–$285.83	—	20%
LH (luteinizing hormone) test CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE	$60.90	$76.13	$60.90–$76.13	24% below	20%
LH (luteinizing hormone) test inpatient CPT 83002 HC GONADOTROPIN (LH) - LUTEINIZING HORMONE	$60.90	$76.13	$60.90–$76.13	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 HC ASSAY OF LIPASE - LIPASE	$135.42	$169.28	$135.42–$169.28	79% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 HC ASSAY OF LIPASE - LIPASE	$135.42	$169.28	$135.42–$169.28	—	20%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$161.65	$202.06	$161.65–$202.06	21% above	20%
Liver function blood test panel inpatient CPT 80076 HC HEPATIC FUNCTION PANEL	$161.65	$202.06	$161.65–$202.06	—	20%
Lyme disease antibody test CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES	$56.03	$70.04	$56.03–$70.04	134% above	20%
Lyme disease antibody test inpatient CPT 86618 HC LYME DISEASE ANTIBODY - B. BURGDORFERI ANTIBODIES	$56.03	$70.04	$56.03–$70.04	—	20%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE	$11.96	$14.95	$11.96–$14.95	79% below	20%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM	$129.35	$161.69	$129.35–$161.69	123% above	20%
Magnesium blood test CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM RBC	$129.35	$161.69	$129.35–$161.69	123% above	20%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM URINE	$11.96	$14.95	$11.96–$14.95	—	20%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM RBC	$129.35	$161.69	$129.35–$161.69	—	20%
Magnesium blood test inpatient CPT 83735 HC ASSAY OF MAGNESIUM - MAGNESIUM	$129.35	$161.69	$129.35–$161.69	—	20%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY	$42.37	$52.96	$42.37–$52.96	103% above	20%
Measles (rubeola) antibody test CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG	$42.37	$52.96	$42.37–$52.96	103% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY	$42.37	$52.96	$42.37–$52.96	—	20%
Measles (rubeola) antibody test inpatient CPT 86765 HC RUBEOLA - RUBEOLA ANTIBODY IGG	$42.37	$52.96	$42.37–$52.96	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN	$101.94	$127.42	$101.94–$127.42	10% above	20%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HC HETEROPHILE ANTIBODIES,SCREEN - MONONUCLEOSIS SCREEN	$101.94	$127.42	$101.94–$127.42	—	20%
Obstetric blood test panel CPT 80055 HC OBSTETRIC PANEL	$381.90	$477.37	$381.90–$477.37	54% above	20%
Obstetric blood test panel inpatient CPT 80055 HC OBSTETRIC PANEL	$381.90	$477.37	$381.90–$477.37	—	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$60.49	$75.61	$60.49–$75.61	74% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC PSA FREE	$60.49	$75.61	$60.49–$75.61	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE	$233.41	$291.76	$233.41–$291.76	399% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$233.41	$291.76	$233.41–$291.76	399% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA TOTAL AND FREE	$233.41	$291.76	$233.41–$291.76	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC PROSTATE SPECIFIC ANTIGEN,TOTAL - PSA	$233.41	$291.76	$233.41–$291.76	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER	$87.13	$108.91	$87.13–$108.91	5% below	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 HC CYTOPATH C/V AUTO FLUID REDO - LAB CYTOPAT,CER/VAG,THIN LAYER,INTER	$87.13	$108.91	$87.13–$108.91	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC CYTOPATH C/V THIN LAYER - LAB CYTOPATH CERV/VAG THIN LAYER	$66.61	$83.26	$66.61–$83.26	27% below	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC CYTOPATH C/V THIN LAYER - LAB CYTOPATH CERV/VAG THIN LAYER	$66.61	$83.26	$66.61–$83.26	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE	$135.74	$169.68	$135.74–$169.68	31% above	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT	$135.74	$169.68	$135.74–$169.68	31% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE	$135.74	$169.68	$135.74–$169.68	—	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 HC ASSAY OF PARATHORMONE - PTH INTACT	$135.74	$169.68	$135.74–$169.68	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC THROMBOPLAS TIME PARTIAL (APTT) - PLASMA/WHOLE BLOOD	$208.29	$260.36	$208.29–$260.36	452% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT - LA SCREEN	$208.29	$260.36	$208.29–$260.36	452% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC THROMBOPLAS TIME PARTIAL (APTT) - PLASMA/WHOLE BLOOD	$208.29	$260.36	$208.29–$260.36	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC PTT - LA SCREEN	$208.29	$260.36	$208.29–$260.36	—	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$1,746.16	$2,182.70	$1,746.16–$2,182.70	1% above	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 HC FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS	$1,746.16	$2,182.70	$1,746.16–$2,182.70	—	20%
Progesterone blood test CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE	$68.63	$85.79	$68.63–$85.79	25% above	20%
Progesterone blood test inpatient CPT 84144 HC ASSAY OF PROGESTERONE - PROGESTERONE	$68.63	$85.79	$68.63–$85.79	—	20%
Prolactin blood test CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN	$63.71	$79.64	$63.71–$79.64	29% below	20%
Prolactin blood test inpatient CPT 84146 HC ASSAY OF PROLACTIN - PROLACTIN	$63.71	$79.64	$63.71–$79.64	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR	$183.22	$229.02	$183.22–$229.02	284% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTHROMBIN MIXING STUDY	$183.22	$229.02	$183.22–$229.02	284% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK	$183.22	$229.02	$183.22–$229.02	284% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME - ADDITIONAL CHARGE	$183.22	$229.02	$183.22–$229.02	284% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - ADDITIONAL CHARGE	$183.22	$229.02	$183.22–$229.02	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR, FINGERSTICK	$183.22	$229.02	$183.22–$229.02	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTHROMBIN MIXING STUDY	$183.22	$229.02	$183.22–$229.02	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME - PROTIME-INR	$183.22	$229.02	$183.22–$229.02	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - TOXICOLOGY SCREEN URINE	$28.98	$36.23	$28.98–$36.23	66% below	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 HC DRUG TEST PRSMV DIR OPT OBS - TOXICOLOGY SCREEN URINE	$28.98	$36.23	$28.98–$36.23	—	20%
Rapid flu test (influenza antigen) CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA	$95.78	$119.72	$95.78–$119.72	27% above	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 HC DETECT AGENT,IMMUN,DIR OBS,INFLUENZA	$95.78	$119.72	$95.78–$119.72	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN	$176.00	$220.00	$176.00–$220.00	66% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC - RAPID STREP A SCREEN	$176.00	$220.00	$176.00–$220.00	—	20%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR	$18.68	$23.35	$18.68–$23.35	44% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 HC RHEUMATOID FACTOR, QUANT - RHEUMATOID FACTOR	$18.68	$23.35	$18.68–$23.35	—	20%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM	$47.29	$59.11	$47.29–$59.11	19% above	20%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG	$47.29	$59.11	$47.29–$59.11	19% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGG	$47.29	$59.11	$47.29–$59.11	—	20%
Rubella antibody test (immunity check) inpatient CPT 86762 HC RUBELLA - RUBELLA ANTIBODY, IGM	$47.29	$59.11	$47.29–$59.11	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED	$77.93	$97.41	$77.93–$97.41	73% above	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 HC RBC SED RATE, AUTO - SEDIMENTATION RATE, AUTOMATED	$77.93	$97.41	$77.93–$97.41	—	20%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION	$29.26	$36.57	$29.26–$36.57	63% above	20%
Stool ova and parasites exam inpatient CPT 87177 HC OVA AND PARASITES SMEARS - OVA AND PARASITE EXAMINATION	$29.26	$36.57	$29.26–$36.57	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN - OCCULT BLD	$83.82	$104.77	$83.82–$104.77	115% above	20%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 HC BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN - OCCULT BLD	$83.82	$104.77	$83.82–$104.77	—	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC BLOOD OCCULT FECAL IMMUNOASSAY	$60.63	$75.79	$60.63–$75.79	69% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC BLOOD OCCULT FECAL IMMUNOASSAY	$60.63	$75.79	$60.63–$75.79	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL	$10.35	$12.94	$10.35–$12.94	31% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP	$14.03	$17.54	$14.03–$17.54	6% below	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL	$10.35	$12.94	$10.35–$12.94	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP	$14.03	$17.54	$14.03–$17.54	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST	$203.78	$254.73	$203.78–$254.73	188% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 HC TB TEST, CELL MEDIATED ANTIGEN RESPONSE,GAMMA INTERFRON - TB TEST	$203.78	$254.73	$203.78–$254.73	—	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE	$84.87	$106.09	$84.87–$106.09	112% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 HC ASSAY OF TOTAL TESTOSTERONE - TESTOSTERONE	$84.87	$106.09	$84.87–$106.09	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB	$47.84	$59.80	$47.84–$59.80	109% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY	$47.84	$59.80	$47.84–$59.80	109% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - ANTI-MICROSOMAL AB	$47.84	$59.80	$47.84–$59.80	—	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 HC MICROSOMAL ANTIBODY - THYROID PEROXIDASE ANTIBODY	$47.84	$59.80	$47.84–$59.80	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$329.18	$411.47	$329.18–$411.47	294% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC ASSAY THYROID STIM HORMONE - THYROID STIMULATING HORMONE	$329.18	$411.47	$329.18–$411.47	—	20%
Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS DNA AMP PROB	$108.79	$135.99	$108.79–$135.99	23% above	20%
Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS DNA AMP PROB	$108.79	$135.99	$108.79–$135.99	—	20%
Uric acid blood test CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID	$14.90	$18.63	$14.90–$18.63	76% below	20%
Uric acid blood test inpatient CPT 84550 HC ASSAY OF URIC ACID, BLOOD - URIC ACID	$14.90	$18.63	$14.90–$18.63	—	20%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC	$142.55	$178.19	$142.55–$178.19	72% above	20%
Urinalysis with microscope exam, automated inpatient CPT 81001 HC URINALYSIS, AUTO, W/SCOPE - URINALYSIS MICROSCOPIC	$142.55	$178.19	$142.55–$178.19	—	20%
Urinalysis with microscope exam, manual CPT 81000 HC URINALYSIS, NONAUTO, W/SCOPE	$65.87	$82.34	$65.87–$82.34	53% above	20%
Urinalysis with microscope exam, manual inpatient CPT 81000 HC URINALYSIS, NONAUTO, W/SCOPE	$65.87	$82.34	$65.87–$82.34	—	20%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY	$122.22	$152.78	$122.22–$152.78	118% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 HC URINALYSIS, AUTO, W/O SCOPE - URINALYSIS CHEM ONLY	$122.22	$152.78	$122.22–$152.78	—	20%
Urinalysis without microscope exam, manual CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE	$28.80	$36.00	$28.80–$36.00	4% above	20%
Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$28.80	$36.00	$28.80–$36.00	4% above	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 HC URINALYSIS NONAUTO W/O SCOPE	$28.80	$36.00	$28.80–$36.00	—	20%
Urinalysis without microscope exam, manual inpatient CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$28.80	$36.00	$28.80–$36.00	—	20%
Urine culture for bacteria, with colony count CPT 87086 HC URINE CULTURE QUANTITATIVE COLONY COUNT	$26.59	$33.24	$26.59–$33.24	81% below	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 HC URINE CULTURE QUANTITATIVE COLONY COUNT	$26.59	$33.24	$26.59–$33.24	—	20%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS	$100.23	$125.29	$100.23–$125.29	17% above	20%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE	$100.56	$125.70	$100.56–$125.70	17% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS	$100.23	$125.29	$100.23–$125.29	—	20%
Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY TEST - PREGNANCY URINE	$100.56	$125.70	$100.56–$125.70	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 - VITAMIN B12	$49.78	$62.22	$49.78–$62.22	19% below	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 HC VITAMIN B-12 - VITAMIN B12	$49.78	$62.22	$49.78–$62.22	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25	$97.29	$121.61	$97.29–$121.61	52% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 HC ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED - VITAMIN D 25	$97.29	$121.61	$97.29–$121.61	—	20%
Zinc blood test CPT 84630 HC ASSAY OF ZINC - ZINC	$37.45	$46.81	$37.45–$46.81	169% above	20%
Zinc blood test inpatient CPT 84630 HC ASSAY OF ZINC - ZINC	$37.45	$46.81	$37.45–$46.81	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD	$55.38	$69.23	$55.38–$69.23	60% below	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD	$55.38	$69.23	$55.38–$69.23	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Botox injections for chronic migraine CPT 64615 HC PRO CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$253.40	$316.75	$253.40–$316.75	71% below	20%
Botox injections for chronic migraine CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$344.08	$430.10	$344.08–$430.10	61% below	20%
Botox injections for chronic migraine inpatient CPT 64615 HC PRO CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$253.40	$316.75	$253.40–$316.75	—	20%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE	$344.08	$430.10	$344.08–$430.10	—	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$478.68	$598.35	$478.68–$598.35	73% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC PRO CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL	$478.68	$598.35	$478.68–$598.35	73% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL	$801.69	$1,002.11	$801.69–$1,002.11	55% below	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$478.68	$598.35	$478.68–$598.35	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC PRO CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL	$478.68	$598.35	$478.68–$598.35	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION ELECTRIC EXT - CARDIOVERSION EXTERNAL	$801.69	$1,002.11	$801.69–$1,002.11	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC CLOSED TX DIST RAD/ULNA FX	$585.30	$731.63	$585.30–$731.63	1% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$859.28	$1,074.10	$859.28–$1,074.10	49% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC PRO CLOSED TX DIST RAD FX/EPIPHYSEAL SEP W/O MANIPULATION	$859.28	$1,074.10	$859.28–$1,074.10	49% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC CLOSED TX DIST RAD/ULNA FX	$585.30	$731.63	$585.30–$731.63	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ	$859.28	$1,074.10	$859.28–$1,074.10	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC PRO CLOSED TX DIST RAD FX/EPIPHYSEAL SEP W/O MANIPULATION	$859.28	$1,074.10	$859.28–$1,074.10	—	20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$716.96	$896.20	$716.96–$896.20	24% below	20%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE	$716.96	$896.20	$716.96–$896.20	—	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$139.02	$173.77	$139.02–$173.77	62% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION PREMALIGNANT LESION 1ST	$139.02	$173.77	$139.02–$173.77	—	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC PRO REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$39.74	$49.68	$39.74–$49.68	78% below	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$39.74	$49.68	$39.74–$49.68	78% below	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$39.74	$49.68	$39.74–$49.68	78% below	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$163.99	$204.99	$163.99–$204.99	8% below	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC PRO REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$39.74	$49.68	$39.74–$49.68	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMV IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$39.74	$49.68	$39.74–$49.68	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$39.74	$49.68	$39.74–$49.68	—	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 HC REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$163.99	$204.99	$163.99–$204.99	—	20%
Earwax removal with instruments, one ear both sides CPT 69210 HC PRO REMV IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT	$130.55	$163.19	$130.55–$163.19	—	20%
Earwax removal with instruments, one ear one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$119.78	$149.73	$119.78–$149.73	32% below	20%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$130.55	$163.19	$130.55–$163.19	26% below	20%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 HC PRO REMV IMPACTED CERUMEN INSTRUMENTATION UNILAT/BILAT	$130.55	$163.19	$130.55–$163.19	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 HC REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$119.78	$149.73	$119.78–$149.73	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$130.55	$163.19	$130.55–$163.19	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$474.03	$592.54	$474.03–$592.54	13% below	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$474.03	$592.54	$474.03–$592.54	—	20%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$202.40	$253.00	$202.40–$253.00	66% below	20%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION INTRAUTERINE DEVICE IUD	$202.40	$253.00	$202.40–$253.00	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$263.35	$329.19	$263.35–$329.19	44% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC PRO INCISION DRAIN SKIN ABSCESS SIMPLE	$274.16	$342.70	$274.16–$342.70	41% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC INCISION DRAIN SKIN ABSCESS SIMPLE	$348.86	$436.08	$348.86–$436.08	25% below	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$263.35	$329.19	$263.35–$329.19	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC PRO INCISION DRAIN SKIN ABSCESS SIMPLE	$274.16	$342.70	$274.16–$342.70	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC INCISION DRAIN SKIN ABSCESS SIMPLE	$348.86	$436.08	$348.86–$436.08	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$266.98	$333.73	$266.98–$333.73	60% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC PRO INJECT TENDON SHEATH/LIGAMENT	$266.98	$333.73	$266.98–$333.73	60% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT	$606.19	$757.74	$606.19–$757.74	8% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$266.98	$333.73	$266.98–$333.73	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC PRO INJECT TENDON SHEATH/LIGAMENT	$266.98	$333.73	$266.98–$333.73	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJECT TENDON SHEATH/LIGAMENT	$606.19	$757.74	$606.19–$757.74	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC PRO ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US	$208.29	$260.36	$208.29–$260.36	71% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$208.29	$260.36	$208.29–$260.36	71% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US	$630.62	$788.27	$630.62–$788.27	13% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC PRO ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US	$208.29	$260.36	$208.29–$260.36	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$208.29	$260.36	$208.29–$260.36	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR INJ MAJOR JT/BURSA W/O US	$630.62	$788.27	$630.62–$788.27	—	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$270.85	$338.56	$270.85–$338.56	3% below	20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$270.85	$338.56	$270.85–$338.56	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$176.00	$220.00	$176.00–$220.00	69% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC PRO ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US	$226.32	$282.90	$226.32–$282.90	60% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US	$625.23	$781.54	$625.23–$781.54	10% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$176.00	$220.00	$176.00–$220.00	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC PRO ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US	$226.32	$282.90	$226.32–$282.90	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC ARTHROCENTESIS ASPIR INJ INTERM JT/BURS W/O US	$625.23	$781.54	$625.23–$781.54	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$170.02	$212.52	$170.02–$212.52	73% below	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$198.77	$248.46	$198.77–$248.46	68% below	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$170.02	$212.52	$170.02–$212.52	—	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 HC PRO ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$198.77	$248.46	$198.77–$248.46	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$453.66	$567.07	$453.66–$567.07	48% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC PRO LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM	$453.66	$567.07	$453.66–$567.07	48% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM	$627.07	$783.84	$627.07–$783.84	28% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$453.66	$567.07	$453.66–$567.07	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC PRO LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM	$453.66	$567.07	$453.66–$567.07	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM	$627.07	$783.84	$627.07–$783.84	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$263.35	$329.19	$263.35–$329.19	80% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$263.35	$329.19	$263.35–$329.19	—	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$357.88	$447.35	$357.88–$447.35	76% below	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$357.88	$447.35	$357.88–$447.35	—	20%
Nail removal (partial or complete), one nail CPT 11730 HC PRO AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE	$187.91	$234.89	$187.91–$234.89	58% below	20%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$187.91	$234.89	$187.91–$234.89	58% below	20%
Nail removal (partial or complete), one nail CPT 11730 HC REMOVAL OF NAIL PLATE	$330.01	$412.51	$330.01–$412.51	27% below	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC PRO AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE	$187.91	$234.89	$187.91–$234.89	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$187.91	$234.89	$187.91–$234.89	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVAL OF NAIL PLATE	$330.01	$412.51	$330.01–$412.51	—	20%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$193.98	$242.48	$193.98–$242.48	77% below	20%
Occipital nerve block (injection for headaches) CPT 64405 HC PRO INJECT NERV BLCK,GREAT OCCIPTL	$193.98	$242.48	$193.98–$242.48	77% below	20%
Occipital nerve block (injection for headaches) CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL	$634.80	$793.50	$634.80–$793.50	23% below	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION AA&/STRD GREATER OCCIPITAL NERVE	$193.98	$242.48	$193.98–$242.48	—	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC PRO INJECT NERV BLCK,GREAT OCCIPTL	$193.98	$242.48	$193.98–$242.48	—	20%
Occipital nerve block (injection for headaches) inpatient CPT 64405 HC INJECT NERV BLCK,GREAT OCCIPTL	$634.80	$793.50	$634.80–$793.50	—	20%
Paracentesis with imaging guidance CPT 49083 HC PRO ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE	$300.34	$375.42	$300.34–$375.42	83% below	20%
Paracentesis with imaging guidance CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$300.34	$375.42	$300.34–$375.42	83% below	20%
Paracentesis with imaging guidance CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE	$1,688.85	$2,111.06	$1,688.85–$2,111.06	5% below	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC PRO ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE	$300.34	$375.42	$300.34–$375.42	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE	$300.34	$375.42	$300.34–$375.42	—	20%
Paracentesis with imaging guidance inpatient CPT 49083 HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE	$1,688.85	$2,111.06	$1,688.85–$2,111.06	—	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$399.74	$499.68	$399.74–$499.68	68% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC PRO EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL	$478.68	$598.35	$478.68–$598.35	61% below	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED	$682.00	$852.50	$682.00–$852.50	45% below	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL	$399.74	$499.68	$399.74–$499.68	—	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC PRO EXCISION NAIL MATRIX PRT/CMPL PERMANENT REMOVAL	$478.68	$598.35	$478.68–$598.35	—	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED	$682.00	$852.50	$682.00–$852.50	—	20%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$366.34	$457.93	$366.34–$457.93	51% below	20%
Removal of a foreign object under the skin, simple CPT 10120 HC PRO REMOVE FOREIGN BODY SIMPLE	$386.68	$483.35	$386.68–$483.35	49% below	20%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY SIMPLE	$507.38	$634.23	$507.38–$634.23	33% below	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$366.34	$457.93	$366.34–$457.93	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC PRO REMOVE FOREIGN BODY SIMPLE	$386.68	$483.35	$386.68–$483.35	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY SIMPLE	$507.38	$634.23	$507.38–$634.23	—	20%
Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM	$246.66	$308.32	$246.66–$308.32	51% below	20%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST ELBOW FINGER SHORT ARM	$246.66	$308.32	$246.66–$308.32	—	20%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$173.70	$217.12	$173.70–$217.12	57% below	20%
Short arm splint (forearm and hand) CPT 29125 HC PRO APPLY FOREARM SPLINT,STATIC	$173.70	$217.12	$173.70–$217.12	57% below	20%
Short arm splint (forearm and hand) CPT 29125 HC APPLY FOREARM SPLINT,STATIC	$390.22	$487.77	$390.22–$487.77	4% below	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HC PRO APPLY FOREARM SPLINT,STATIC	$173.70	$217.12	$173.70–$217.12	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$173.70	$217.12	$173.70–$217.12	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY FOREARM SPLINT,STATIC	$390.22	$487.77	$390.22–$487.77	—	20%
Short leg cast (below the knee) CPT 29405 HC PRO APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$225.13	$281.41	$225.13–$281.41	55% below	20%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$225.13	$281.41	$225.13–$281.41	55% below	20%
Short leg cast (below the knee) inpatient CPT 29405 HC PRO APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$225.13	$281.41	$225.13–$281.41	—	20%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$225.13	$281.41	$225.13–$281.41	—	20%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$167.44	$209.30	$167.44–$209.30	66% below	20%
Short leg splint (calf to foot) CPT 29515 HC PRO APPLY LOWER LEG SPLINT	$168.78	$210.97	$168.78–$210.97	66% below	20%
Short leg splint (calf to foot) CPT 29515 HC APPLY LOWER LEG SPLINT	$390.22	$487.77	$390.22–$487.77	21% below	20%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT CALF FOOT	$167.44	$209.30	$167.44–$209.30	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 HC PRO APPLY LOWER LEG SPLINT	$168.78	$210.97	$168.78–$210.97	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY LOWER LEG SPLINT	$390.22	$487.77	$390.22–$487.77	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC PRO REPAIR SUPERFICAL WND BODY <2.5CM	$415.29	$519.11	$415.29–$519.11	6% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$415.29	$519.11	$415.29–$519.11	6% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC RESUPERF WND BODY <2.5CM	$883.20	$1,104.00	$883.20–$1,104.00	100% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$415.29	$519.11	$415.29–$519.11	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC PRO REPAIR SUPERFICAL WND BODY <2.5CM	$415.29	$519.11	$415.29–$519.11	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC RESUPERF WND BODY <2.5CM	$883.20	$1,104.00	$883.20–$1,104.00	—	20%
Skin biopsy, punch, one lesion CPT 11104 HC PRO PUNCH BIOPSY SKIN SINGLE LESION	$137.45	$171.81	$137.45–$171.81	81% below	20%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$337.69	$422.11	$337.69–$422.11	53% below	20%
Skin biopsy, punch, one lesion CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$469.75	$587.19	$469.75–$587.19	35% below	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PRO PUNCH BIOPSY SKIN SINGLE LESION	$137.45	$171.81	$137.45–$171.81	—	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$337.69	$422.11	$337.69–$422.11	—	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 HC PUNCH BIOPSY SKIN SINGLE LESION	$469.75	$587.19	$469.75–$587.19	—	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$470.58	$588.23	$470.58–$588.23	76% below	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$470.58	$588.23	$470.58–$588.23	—	20%
Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$170.02	$212.52	$170.02–$212.52	56% below	20%
Skin tag removal, up to 15 tags CPT 11200 HC PRO REMOVAL OF SKIN TAGS, UP TO 15	$209.26	$261.57	$209.26–$261.57	46% below	20%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15	$328.81	$411.01	$328.81–$411.01	16% below	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$170.02	$212.52	$170.02–$212.52	—	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC PRO REMOVAL OF SKIN TAGS, UP TO 15	$209.26	$261.57	$209.26–$261.57	—	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS, UP TO 15	$328.81	$411.01	$328.81–$411.01	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$800.63	$1,000.79	$800.63–$1,000.79	35% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC PRO SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$800.63	$1,000.79	$800.63–$1,000.79	35% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$1,317.35	$1,646.69	$1,317.35–$1,646.69	8% above	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC PRO SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$800.63	$1,000.79	$800.63–$1,000.79	—	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$800.63	$1,000.79	$800.63–$1,000.79	—	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 HC SPINAL PUNCTURE,LUMBAR,DIAGNOSTIC	$1,317.35	$1,646.69	$1,317.35–$1,646.69	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC PRO REPAIR SUPERFICAL WND BODY 2.6-7.5 CM	$501.50	$626.87	$501.50–$626.87	26% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$501.50	$626.87	$501.50–$626.87	26% below	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM	$978.98	$1,223.72	$978.98–$1,223.72	44% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC PRO REPAIR SUPERFICAL WND BODY 2.6-7.5 CM	$501.50	$626.87	$501.50–$626.87	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$501.50	$626.87	$501.50–$626.87	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC RESUP NPTERF WND BODY 2.6-7.5 CM	$978.98	$1,223.72	$978.98–$1,223.72	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$416.49	$520.61	$416.49–$520.61	37% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC PRO REPAIR SUPERFICIAL WND FACE <2.5CM	$501.50	$626.87	$501.50–$626.87	24% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC RESUPERF WND FACE <2.5 CM	$631.95	$789.94	$631.95–$789.94	4% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$416.49	$520.61	$416.49–$520.61	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC PRO REPAIR SUPERFICIAL WND FACE <2.5CM	$501.50	$626.87	$501.50–$626.87	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC RESUPERF WND FACE <2.5 CM	$631.95	$789.94	$631.95–$789.94	—	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC PRO TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$109.76	$137.20	$109.76–$137.20	80% below	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$268.41	$335.51	$268.41–$335.51	51% below	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$469.75	$587.19	$469.75–$587.19	15% below	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC PRO TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$109.76	$137.20	$109.76–$137.20	—	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$268.41	$335.51	$268.41–$335.51	—	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BIOPSY OF SKIN (EG, SHAVE, SCOOP, SAUCERIZE, CURETTE); SINGLE LESION	$469.75	$587.19	$469.75–$587.19	—	20%
Thoracentesis with imaging guidance CPT 32555 HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$308.89	$386.11	$308.89–$386.11	85% below	20%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$308.89	$386.11	$308.89–$386.11	85% below	20%
Thoracentesis with imaging guidance CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,304.70	$1,630.87	$1,304.70–$1,630.87	36% below	20%
Thoracentesis with imaging guidance inpatient CPT 32555 HC PRO THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$308.89	$386.11	$308.89–$386.11	—	20%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$308.89	$386.11	$308.89–$386.11	—	20%
Thoracentesis with imaging guidance inpatient CPT 32555 HC THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING	$1,304.70	$1,630.87	$1,304.70–$1,630.87	—	20%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$266.98	$333.73	$266.98–$333.73	57% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC PRO INJECT TRIGGER POINT, 1 OR 2	$266.98	$333.73	$266.98–$333.73	57% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2	$670.18	$837.72	$670.18–$837.72	7% above	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC PRO INJECT TRIGGER POINT, 1 OR 2	$266.98	$333.73	$266.98–$333.73	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$266.98	$333.73	$266.98–$333.73	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJECT TRIGGER POINT, 1 OR 2	$670.18	$837.72	$670.18–$837.72	—	20%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$155.76	$194.70	$155.76–$194.70	57% below	20%
Wart removal, up to 14 warts CPT 17110 HC PRO DESTRUCTION BENIGN LESIONS UP TO 14	$315.10	$393.88	$315.10–$393.88	12% below	20%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14	$428.17	$535.21	$428.17–$535.21	19% above	20%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS UP TO 14	$155.76	$194.70	$155.76–$194.70	—	20%
Wart removal, up to 14 warts inpatient CPT 17110 HC PRO DESTRUCTION BENIGN LESIONS UP TO 14	$315.10	$393.88	$315.10–$393.88	—	20%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCTION BENIGN LESIONS UP TO 14	$428.17	$535.21	$428.17–$535.21	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<	$107.74	$134.67	$107.74–$134.67	84% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC PRO DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM	$222.78	$278.47	$222.78–$278.47	67% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM	$810.15	$1,012.69	$810.15–$1,012.69	19% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<	$107.74	$134.67	$107.74–$134.67	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC PRO DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM	$222.78	$278.47	$222.78–$278.47	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM	$810.15	$1,012.69	$810.15–$1,012.69	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs California	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD TRANSFUSION SERVICE	$2,162.18	$2,702.73	$2,162.18–$2,702.73	148% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC BLOOD TRANSFUSION SERVICE	$2,162.18	$2,702.73	$2,162.18–$2,702.73	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT SUBSEQUENT (EA)	$58.74	$73.43	$58.74–$73.43	81% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$238.33	$297.91	$238.33–$297.91	23% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC INHALATION TREATMENT	$348.36	$435.45	$348.36–$435.45	13% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT INHALATION TREATMENT	$238.32	$297.90	$238.32–$297.90	23% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT SUBSEQUENT (EA)	$58.74	$73.43	$58.74–$73.43	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$238.33	$297.91	$238.33–$297.91	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC INHALATION TREATMENT	$348.36	$435.45	$348.36–$435.45	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient one side CPT 94640 HC RT INHALATION TREATMENT	$238.32	$297.90	$238.32–$297.90	—	20%
Critical care, first 30 to 74 minutes CPT 99291 HC PRO CRITICAL CARE, E/M 30-74 MINUTES	$744.38	$930.47	$744.38–$930.47	85% below	20%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$744.38	$930.47	$744.38–$930.47	85% below	20%
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$10,049.99	$12,562.49	$10,049.99–$12,562.49	103% above	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC PRO CRITICAL CARE, E/M 30-74 MINUTES	$744.38	$930.47	$744.38–$930.47	—	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$744.38	$930.47	$744.38–$930.47	—	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$10,049.99	$12,562.49	$10,049.99–$12,562.49	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ELECTROCARDIOGRAM, TRACING	$665.62	$832.03	$665.62–$832.03	97% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ELECTROCARDIOGRAM, TRACING	$665.62	$832.03	$665.62–$832.03	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$165.23	$206.54	$165.23–$206.54	57% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC PRO EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB	$165.23	$206.54	$165.23–$206.54	57% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB	$374.72	$468.40	$374.72–$468.40	3% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC PRO EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB	$165.23	$206.54	$165.23–$206.54	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$165.23	$206.54	$165.23–$206.54	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC EMERGENCY DEPARTMENT LEVEL 1 VISIT LIMITED/MINOR PROB	$374.72	$468.40	$374.72–$468.40	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$223.79	$279.74	$223.79–$279.74	70% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC PRO EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY	$223.79	$279.74	$223.79–$279.74	70% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY	$1,177.46	$1,471.83	$1,177.46–$1,471.83	58% above	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC PRO EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY	$223.79	$279.74	$223.79–$279.74	—	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$223.79	$279.74	$223.79–$279.74	—	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC EMERGENCY DEPARTMENT LEVEL 2 VISIT LOW/MODER SEVERITY	$1,177.46	$1,471.83	$1,177.46–$1,471.83	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$335.11	$418.89	$335.11–$418.89	72% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC PRO EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$335.11	$418.89	$335.11–$418.89	72% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$2,201.66	$2,752.07	$2,201.66–$2,752.07	82% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPARTMENT VISIT LOW MDM	$335.11	$418.89	$335.11–$418.89	—	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC PRO EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$335.11	$418.89	$335.11–$418.89	—	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC EMERGENCY DEPARTMENT LEVEL 3 VISIT MODERATE SEVERITY	$2,201.66	$2,752.07	$2,201.66–$2,752.07	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC PRO EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$501.50	$626.87	$501.50–$626.87	74% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$501.50	$626.87	$501.50–$626.87	74% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$3,204.46	$4,005.57	$3,204.46–$4,005.57	64% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC PRO EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$501.50	$626.87	$501.50–$626.87	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPARTMENT VISIT MODERATE MDM	$501.50	$626.87	$501.50–$626.87	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC EMERGENCY DEPARTMENT LEVEL 4 VISIT HIGH/URGENT SEVERITY	$3,204.46	$4,005.57	$3,204.46–$4,005.57	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$746.77	$933.46	$746.77–$933.46	77% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC PRO EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$746.77	$933.46	$746.77–$933.46	77% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$5,802.17	$7,252.71	$5,802.17–$7,252.71	77% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPARTMENT VISIT HIGH MDM	$746.77	$933.46	$746.77–$933.46	—	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC PRO EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$746.77	$933.46	$746.77–$933.46	—	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC EMERGENCY DEPARTMENT LEVEL 5 VISIT HIGH SEVERITY&THREAT FUNC	$5,802.17	$7,252.71	$5,802.17–$7,252.71	—	20%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$345.00	$431.25	$345.00–$431.25	1% above	20%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS	$345.00	$431.25	$345.00–$431.25	—	20%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$345.00	$431.25	$345.00–$431.25	1% above	20%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS	$345.00	$431.25	$345.00–$431.25	—	20%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY	$271.40	$339.25	$271.40–$339.25	at median	20%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY	$271.40	$339.25	$271.40–$339.25	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN	$1,349.82	$1,687.28	$1,349.82–$1,687.28	197% above	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC IV INFUSION, HYDRATION, 31-60 MIN	$1,349.82	$1,687.28	$1,349.82–$1,687.28	—	20%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR	$623.49	$779.36	$623.49–$779.36	30% above	20%
IV infusion of a medicine, first hour inpatient CPT 96365 HC IV INFUSION, THERAP/PROPH/DIAGNOST,INITIAL,1ST HOUR	$623.49	$779.36	$623.49–$779.36	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$65.87	$82.34	$65.87–$82.34	58% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$233.40	$291.75	$233.40–$291.75	49% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$65.87	$82.34	$65.87–$82.34	—	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$233.40	$291.75	$233.40–$291.75	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION	$409.40	$511.75	$409.40–$511.75	29% above	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$409.40	$511.75	$409.40–$511.75	29% above	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 HC PSYCHIATRIC DIAGNOSTIC EVALUATION	$409.40	$511.75	$409.40–$511.75	—	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION	$409.40	$511.75	$409.40–$511.75	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN	$99.41	$124.26	$99.41–$124.26	22% below	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC PT NEUROMUSC REEDUCAT,1+ AREAS, EA 15 MIN	$99.41	$124.26	$99.41–$124.26	—	20%
New patient office visit, about 30 minutes CPT 99203 HC PRO OFFICE OUTPATIENT NEW 30-44 MINUTES	$255.30	$319.13	$255.30–$319.13	42% above	20%
New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$268.09	$335.11	$268.09–$335.11	49% above	20%
New patient office visit, about 30 minutes inpatient CPT 99203 HC PRO OFFICE OUTPATIENT NEW 30-44 MINUTES	$255.30	$319.13	$255.30–$319.13	—	20%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$268.09	$335.11	$268.09–$335.11	—	20%
New patient office visit, about 45 minutes CPT 99204 HC PRO OFFICE OUTPATIENT NEW 45-59 MINUTES	$364.74	$455.92	$364.74–$455.92	54% above	20%
New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$383.00	$478.75	$383.00–$478.75	62% above	20%
New patient office visit, about 45 minutes inpatient CPT 99204 HC PRO OFFICE OUTPATIENT NEW 45-59 MINUTES	$364.74	$455.92	$364.74–$455.92	—	20%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$383.00	$478.75	$383.00–$478.75	—	20%
New patient office visit, about 60 minutes CPT 99205 HC PRO OFFICE OUTPATIENT NEW 60-74 MINUTES	$492.38	$615.48	$492.38–$615.48	73% above	20%
New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$517.04	$646.30	$517.04–$646.30	81% above	20%
New patient office visit, about 60 minutes inpatient CPT 99205 HC PRO OFFICE OUTPATIENT NEW 60-74 MINUTES	$492.38	$615.48	$492.38–$615.48	—	20%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$517.04	$646.30	$517.04–$646.30	—	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC PRO OFFICE OUTPATIENT NEW 15-29 MINUTES	$196.14	$245.18	$196.14–$245.18	48% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$205.99	$257.49	$205.99–$257.49	55% above	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC PRO OFFICE OUTPATIENT NEW 15-29 MINUTES	$196.14	$245.18	$196.14–$245.18	—	20%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$205.99	$257.49	$205.99–$257.49	—	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$75.44	$94.30	$75.44–$94.30	24% below	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$75.44	$94.30	$75.44–$94.30	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$440.00	$550.00	$440.00–$550.00	at median	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS	$440.00	$550.00	$440.00–$550.00	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$251.76	$314.70	$251.76–$314.70	3% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS	$251.76	$314.70	$251.76–$314.70	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$307.70	$384.62	$307.70–$384.62	14% below	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS	$307.70	$384.62	$307.70–$384.62	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN	$84.27	$105.34	$84.27–$105.34	30% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC PT MANUAL THER TECH,1+REGIONS,EA 15 MIN	$84.27	$105.34	$84.27–$105.34	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPEUTIC EXERCISES	$112.00	$140.00	$112.00–$140.00	13% below	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC PT THERAPEUTIC EXERCISES	$112.00	$140.00	$112.00–$140.00	—	20%
Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$386.68	$483.35	$386.68–$483.35	133% above	20%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$386.68	$483.35	$386.68–$483.35	—	20%
Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$438.10	$547.63	$438.10–$547.63	136% above	20%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$438.10	$547.63	$438.10–$547.63	—	20%
Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$427.25	$534.06	$427.25–$534.06	136% above	20%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$427.25	$534.06	$427.25–$534.06	—	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$320.71	$400.89	$320.71–$400.89	107% above	20%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$320.71	$400.89	$320.71–$400.89	—	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$363.86	$454.83	$363.86–$454.83	131% above	20%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$363.86	$454.83	$363.86–$454.83	—	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$398.68	$498.35	$398.68–$498.35	155% above	20%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$398.68	$498.35	$398.68–$498.35	—	20%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$460.00	$575.00	$460.00–$575.00	21% above	20%
Psychiatric evaluation with medical services CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$460.00	$575.00	$460.00–$575.00	21% above	20%
Psychiatric evaluation with medical services inpatient CPT 90792 HC PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$460.00	$575.00	$460.00–$575.00	—	20%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$460.00	$575.00	$460.00–$575.00	—	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$332.12	$415.15	$332.12–$415.15	3% below	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INIT 60 MINS	$332.12	$415.15	$332.12–$415.15	3% below	20%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$332.12	$415.15	$332.12–$415.15	—	20%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 HC PSYCHOTHERAPY FOR CRISIS INIT 60 MINS	$332.12	$415.15	$332.12–$415.15	—	20%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$179.40	$224.25	$179.40–$224.25	40% below	20%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES	$299.00	$373.75	$299.00–$373.75	at median	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES	$179.40	$224.25	$179.40–$224.25	—	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES	$299.00	$373.75	$299.00–$373.75	—	20%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$236.44	$295.55	$236.44–$295.55	26% below	20%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$322.00	$402.50	$322.00–$402.50	1% above	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES	$236.44	$295.55	$236.44–$295.55	—	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES	$322.00	$402.50	$322.00–$402.50	—	20%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES	$345.00	$431.25	$345.00–$431.25	1% above	20%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$346.84	$433.55	$346.84–$433.55	1% above	20%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W/PATIENT 60 MINUTES	$346.84	$433.55	$346.84–$433.55	1% above	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES	$345.00	$431.25	$345.00–$431.25	—	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W/PATIENT 60 MINUTES	$346.84	$433.55	$346.84–$433.55	—	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES	$346.84	$433.55	$346.84–$433.55	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$23.72	$29.65	$23.72–$29.65	57% below	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$23.72	$29.65	$23.72–$29.65	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC OFFICE OUTPATIENT VISIT EST 40-54 MINUTES	$319.15	$398.94	$319.15–$398.94	46% above	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$335.11	$418.89	$335.11–$418.89	53% above	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC OFFICE OUTPATIENT VISIT EST 40-54 MINUTES	$319.15	$398.94	$319.15–$398.94	—	20%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$335.11	$418.89	$335.11–$418.89	—	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC PRO OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$137.95	$172.44	$137.95–$172.44	4% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$144.86	$181.07	$144.86–$181.07	at median	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$246.29	$307.86	$246.29–$307.86	71% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC PRO OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$137.95	$172.44	$137.95–$172.44	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$144.86	$181.07	$144.86–$181.07	—	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC OFFICE OUTPATIENT VISIT EST 20-29 MINUTES	$246.29	$307.86	$246.29–$307.86	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC PRO OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$199.55	$249.44	$199.55–$249.44	14% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$209.53	$261.91	$209.53–$261.91	20% above	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$220.06	$275.08	$220.06–$275.08	26% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC PRO OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$199.55	$249.44	$199.55–$249.44	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$209.53	$261.91	$209.53–$261.91	—	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC OFFICE OUTPATIENT VISIT EST 30-39 MINUTES	$220.06	$275.08	$220.06–$275.08	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC PRO OFFICE OUTPATIENT VISIT EST 10-19 MINUTES	$107.18	$133.98	$107.18–$133.98	5% below	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$112.56	$140.70	$112.56–$140.70	at median	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC OFFICE OUTPATIENT VISIT EST 10-19 MINUTES	$257.65	$322.06	$257.65–$322.06	128% above	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC PRO OFFICE OUTPATIENT VISIT EST 10-19 MINUTES	$107.18	$133.98	$107.18–$133.98	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$112.56	$140.70	$112.56–$140.70	—	20%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC OFFICE OUTPATIENT VISIT EST 10-19 MINUTES	$257.65	$322.06	$257.65–$322.06	—	20%
Speech and language evaluation CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION	$586.41	$733.01	$586.41–$733.01	28% above	20%
Speech and language evaluation inpatient CPT 92523 HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION	$586.41	$733.01	$586.41–$733.01	—	20%
Speech therapy session, individual CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL	$239.34	$299.17	$239.34–$299.17	14% below	20%
Speech therapy session, individual inpatient CPT 92507 HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL	$239.34	$299.17	$239.34–$299.17	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$124.00	$155.00	$124.00–$155.00	10% below	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC PT THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN	$124.00	$155.00	$124.00–$155.00	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$92.18	$115.23	$92.18–$115.23	69% below	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE	$92.18	$115.23	$92.18–$115.23	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs California	Off list
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$230.40	$288.00	$230.40–$288.00	1% below	20%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$230.40	$288.00	$230.40–$288.00	—	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$242.88	$303.60	$242.88–$303.60	22% below	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$242.88	$303.60	$242.88–$303.60	—	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$82.80	$103.50	$82.80–$103.50	146% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$82.80	$103.50	$82.80–$103.50	—	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACC 2/3 DOSE SCHED IM USE	$424.00	$530.00	$424.00–$530.00	10% above	20%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9VHPV VACC 2/3 DOSE SCHED IM USE	$424.00	$530.00	$424.00–$530.00	—	20%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$163.20	$204.00	$163.20–$204.00	17% above	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$163.20	$204.00	$163.20–$204.00	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$190.96	$238.70	$190.96–$238.70	126% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$190.96	$238.70	$190.96–$238.70	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$49.44	$61.80	$49.44–$61.80	61% below	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$49.44	$61.80	$49.44–$61.80	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS RUBELLA VIRUS (MMR II/PRIORIX) VACCINE LIVE SUBQ	$188.60	$235.75	$188.60–$235.75	61% above	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MUMPS RUBELLA VIRUS (MMR II/PRIORIX) VACCINE LIVE SUBQ	$188.60	$235.75	$188.60–$235.75	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$224.00	$280.00	$224.00–$280.00	14% below	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$224.00	$280.00	$224.00–$280.00	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$314.40	$393.00	$314.40–$393.00	10% above	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM	$314.40	$393.00	$314.40–$393.00	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$387.20	$484.00	$387.20–$484.00	23% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$387.20	$484.00	$387.20–$484.00	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$234.40	$293.00	$234.40–$293.00	45% above	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$234.40	$293.00	$234.40–$293.00	—	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$434.40	$543.00	$434.40–$543.00	41% above	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$434.40	$543.00	$434.40–$543.00	—	20%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE INTRAMUSCULAR	$583.20	$729.00	$583.20–$729.00	17% below	20%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE INTRAMUSCULAR	$583.20	$729.00	$583.20–$729.00	—	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE	$274.40	$343.00	$274.40–$343.00	26% above	20%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM USE	$274.40	$343.00	$274.40–$343.00	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$111.20	$139.00	$111.20–$139.00	40% above	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$111.20	$139.00	$111.20–$139.00	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$141.60	$177.00	$141.60–$177.00	68% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$141.60	$177.00	$141.60–$177.00	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID CHILDREN	$26.41	$33.01	$26.41–$33.01	74% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$95.78	$119.72	$95.78–$119.72	5% below	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$112.93	$141.16	$112.93–$141.16	12% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID CHILDREN	$26.41	$33.01	$26.41–$33.01	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID	$95.78	$119.72	$95.78–$119.72	—	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$112.93	$141.16	$112.93–$141.16	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL	$36.62	$45.77	$36.62–$45.77	46% below	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$40.02	$50.03	$40.02–$50.03	41% below	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 HC IMMUNIZ,ADMIN,EACH ADDL	$36.62	$45.77	$36.62–$45.77	—	20%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$40.02	$50.03	$40.02–$50.03	—	20%

Source file: https://sohumhealth.org/app/uploads/2026/08/942664285_jerold-phelps-community-hospital_standardcharges.csv