Salem Regional Medical Center
Salem Regional Medical Center in Salem, OH publishes cash prices for 282 common procedures listed here, from its own machine-readable price file updated Apr 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Ohio median for 160 of 281 procedures and below it for 121. By typical cash price it ranks #85 of 116 Ohio hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
1995 East State Street, Salem, OH 44460 Collected Sep 27, 2026 Source price file (330) 332-7214
Acute care hospital Emergency department CMS star rating 3 of 5 CCN 360185 · CMS hospital register
The price file shows no self-pay discount
For 1730 of the 1730 prices listed here, the cash price in Salem Regional Medical Center's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing.
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Salem Regional Medical Center in Salem, OH:
- Mar 9, 2026 Warning notice
- Jun 16, 2026 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 BILATERAL ANKLE 3 VIEW | $298.75 | $298.75 | — | — | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE RIGHT MIN 3 VIEWS | $206.50 | $206.50 | — | 35% below | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE LEFT MIN 3 VIEWS | $206.50 | $206.50 | — | 35% below | — |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 BILATERAL ANKLE 3 VIEW | $298.75 | $298.75 | — | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE RIGHT MIN 3 VIEWS | $206.50 | $206.50 | — | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE LEFT MIN 3 VIEWS | $206.50 | $206.50 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 VASCULAR STUDIES | $192.00 | $192.00 | — | 60% below | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 TCOM/SPP-LIMITED 1-2 LEVELS | $194.75 | $194.75 | — | 60% below | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOPPLER STUDIES | $246.25 | $246.25 | — | 49% below | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US PHYSIO ARTERIO SINGLE LEVEL | $552.25 | $552.25 | — | 15% above | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 VASCULAR STUDIES | $192.00 | $192.00 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 TCOM/SPP-LIMITED 1-2 LEVELS | $194.75 | $194.75 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOPPLER STUDIES | $246.25 | $246.25 | — | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US PHYSIO ARTERIO SINGLE LEVEL | $552.25 | $552.25 | — | — | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM | $556.25 | $556.25 | — | 29% above | — |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM | $556.25 | $556.25 | — | — | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN NM WITH MEDRONATE | $1,030.00 | $1,030.00 | — | 33% below | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN NM WITH MEDRONATE | $1,030.00 | $1,030.00 | — | — | — |
| Breast ultrasound, complete, one breast both sides CPT 76641 BILATERAL BREAST COMPLETE | $963.25 | $963.25 | — | — | — |
| Breast ultrasound, complete, one breast both sides CPT 76641 US BILATERAL BREAST COMPLETE | $963.25 | $963.25 | — | — | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US RT BREAST COMPLETE | $661.50 | $661.50 | — | 108% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US LT BREAST COMPLETE | $661.50 | $661.50 | — | 108% above | — |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BILATERAL BREAST COMPLETE | $963.25 | $963.25 | — | — | — |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 BILATERAL BREAST COMPLETE | $963.25 | $963.25 | — | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US LT BREAST COMPLETE | $661.50 | $661.50 | — | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US RT BREAST COMPLETE | $661.50 | $661.50 | — | — | — |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 BILATERAL BREAST LIMITED | $569.75 | $569.75 | — | — | — |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BILATERAL BREAST LIMITED | $569.75 | $569.75 | — | — | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US LT BREAST LIMITED | $405.00 | $405.00 | — | 2% below | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US RT BREAST LIMITED | $405.00 | $405.00 | — | 2% below | — |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 BILATERAL BREAST LIMITED | $569.75 | $569.75 | — | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BILATERAL BREAST LIMITED | $569.75 | $569.75 | — | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US RT BREAST LIMITED | $405.00 | $405.00 | — | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US LT BREAST LIMITED | $405.00 | $405.00 | — | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W/CONTRAST | $2,776.00 | $2,776.00 | — | 96% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W/CONTRAST | $2,776.00 | $2,776.00 | — | — | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CARDIAC CT ANGIOGRAPHY | $2,334.75 | $2,334.75 | — | 46% above | — |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CARDIAC CT ANGIOGRAPHY | $2,334.75 | $2,334.75 | — | — | — |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CARDIAC CT CALCIUM SCORING | $42.00 | $42.00 | — | 86% below | — |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CARDIAC CT CALCIUM SCORING | $42.00 | $42.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 STONE PROTOCOL ABD/PELVIS ST | $2,797.50 | $2,797.50 | — | 78% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 STONE PROTOCOL ABD/PELVIS CT | $2,840.00 | $2,840.00 | — | 81% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS NO CONTRAST | $2,840.00 | $2,840.00 | — | 81% above | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 STONE PROTOCOL ABD/PELVIS ST | $2,797.50 | $2,797.50 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 STONE PROTOCOL ABD/PELVIS CT | $2,840.00 | $2,840.00 | — | — | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS NO CONTRAST | $2,840.00 | $2,840.00 | — | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS WITH CONTRAST | $3,550.00 | $3,550.00 | — | 84% above | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS WITH CONTRAST | $3,550.00 | $3,550.00 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT UROGRAM | $3,904.75 | $3,904.75 | — | 86% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W AND W/O CONTRA | $3,904.75 | $3,904.75 | — | 86% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W AND W/O CONTRA | $3,904.75 | $3,904.75 | — | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT UROGRAM | $3,904.75 | $3,904.75 | — | — | — |
| CT scan of the abdomen with contrast CPT 74160 KIDNEY CT W CONTRAST | $1,703.25 | $1,703.25 | — | 53% above | — |
| CT scan of the abdomen with contrast CPT 74160 ABDOMEN CT W/CONTRAST | $1,703.25 | $1,703.25 | — | 53% above | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 ABDOMEN CT W/CONTRAST | $1,703.25 | $1,703.25 | — | — | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 KIDNEY CT W CONTRAST | $1,703.25 | $1,703.25 | — | — | — |
| CT scan of the abdomen without contrast CPT 74150 KIDNEY CT NO CONTRAST | $1,619.50 | $1,619.50 | — | 55% above | — |
| CT scan of the abdomen without contrast CPT 74150 ABDOMEN CT NO CONTRAST | $1,619.50 | $1,619.50 | — | 55% above | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 KIDNEY CT NO CONTRAST | $1,619.50 | $1,619.50 | — | — | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 ABDOMEN CT NO CONTRAST | $1,619.50 | $1,619.50 | — | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 SINUS CT | $1,357.50 | $1,357.50 | — | 55% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 FACIAL BONE CT | $1,357.50 | $1,357.50 | — | 55% above | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 FACIAL BONE CT | $1,357.50 | $1,357.50 | — | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 SINUS CT | $1,357.50 | $1,357.50 | — | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 HEAD CT NO CONTRAST | $1,154.75 | $1,154.75 | — | 39% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN NO CONTRAST | $1,154.75 | $1,154.75 | — | 39% above | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN NO CONTRAST | $1,154.75 | $1,154.75 | — | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD CT NO CONTRAST | $1,154.75 | $1,154.75 | — | — | — |
| CT scan of the head with contrast CPT 70460 HEAD CT W/ CONTRAST | $1,354.50 | $1,354.50 | — | 35% above | — |
| CT scan of the head with contrast inpatient CPT 70460 HEAD CT W/ CONTRAST | $1,354.50 | $1,354.50 | — | — | — |
| CT scan of the head without and with contrast CPT 70470 HEAD CT W/WO CONTRAST | $1,658.50 | $1,658.50 | — | 53% above | — |
| CT scan of the head without and with contrast inpatient CPT 70470 HEAD CT W/WO CONTRAST | $1,658.50 | $1,658.50 | — | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 LUMBAR CT NO CONTRAST | $1,620.75 | $1,620.75 | — | 54% above | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 LUMBAR CT NO CONTRAST | $1,620.75 | $1,620.75 | — | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CERVICAL SPINE CT | $1,409.25 | $1,409.25 | — | 36% above | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CERVICAL SPINE CT | $1,409.25 | $1,409.25 | — | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 PELVIS CT W/CONTRAST | $1,622.25 | $1,622.25 | — | 45% above | — |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS CT W/CONTRAST | $1,622.25 | $1,622.25 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID VASCULAR STUDY | $1,249.50 | $1,249.50 | — | 72% above | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID VASCULAR US-COL | $1,249.50 | $1,249.50 | — | 72% above | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID VASCULAR STUDY | $1,249.50 | $1,249.50 | — | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID VASCULAR US-COL | $1,249.50 | $1,249.50 | — | — | — |
| Chest X-ray, 2 views CPT 71046 CHEST, 2 VIEWS | $263.75 | $263.75 | — | 1% above | — |
| Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS | $277.00 | $277.00 | — | 6% above | — |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST, 2 VIEWS | $263.75 | $263.75 | — | — | — |
| Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS | $277.00 | $277.00 | — | — | — |
| Chest X-ray, single view CPT 71045 CHEST, 1 VIEW | $233.00 | $233.00 | — | 8% above | — |
| Chest X-ray, single view CPT 71045 CHEST, 1 VIEW PORTABLE | $233.00 | $233.00 | — | 8% above | — |
| Chest X-ray, single view inpatient CPT 71045 CHEST, 1 VIEW | $233.00 | $233.00 | — | — | — |
| Chest X-ray, single view inpatient CPT 71045 CHEST, 1 VIEW PORTABLE | $233.00 | $233.00 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RETROPERITONEAL COMPLETE | $670.75 | $670.75 | — | at median | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 ABD/RETROPERITONEAL COMPLETE | $670.75 | $670.75 | — | at median | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RETROPERITONEAL COMPLETE | $670.75 | $670.75 | — | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 ABD/RETROPERITONEAL COMPLETE | $670.75 | $670.75 | — | — | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA SKELETON-SPINE | $331.75 | $331.75 | — | 27% below | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA SPINE - COL | $331.75 | $331.75 | — | 27% below | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA SKELETON-SPINE | $331.75 | $331.75 | — | — | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA SPINE - COL | $331.75 | $331.75 | — | — | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA SKELETON-APPENDICULAR | $273.00 | $273.00 | — | 7% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA APPENDICULAR-COL | $273.00 | $273.00 | — | 7% above | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA APPENDICULAR-COL | $273.00 | $273.00 | — | — | — |
| DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA SKELETON-APPENDICULAR | $273.00 | $273.00 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST CT NO CONTRAST | $1,409.25 | $1,409.25 | — | 56% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST W/O CONT PLUS HIGH RESOL | $1,409.25 | $1,409.25 | — | 56% above | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST CT NO CONTRAST | $1,409.25 | $1,409.25 | — | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST W/O CONT PLUS HIGH RESOL | $1,409.25 | $1,409.25 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST CT/CONTRAST | $1,653.25 | $1,653.25 | — | 48% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST W CONT PLUS HIGH RESOLUT | $1,653.25 | $1,653.25 | — | 48% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST W CONT FOR PUL EMBOLI | $1,653.25 | $1,653.25 | — | 48% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST W CONT PLUS PUL EMBOLI | $1,653.25 | $1,653.25 | — | 48% above | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST W CONT PLUS PUL EMBOLI | $1,653.25 | $1,653.25 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST CT/CONTRAST | $1,653.25 | $1,653.25 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST W CONT FOR PUL EMBOLI | $1,653.25 | $1,653.25 | — | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST W CONT PLUS HIGH RESOLUT | $1,653.25 | $1,653.25 | — | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIGITAL DIAGNOSTIC MAMMO BILAT | $281.00 | $281.00 | — | — | — |
| Diagnostic mammogram, both breasts CPT 77066 TOMOSYNTHESIS DIAGNOSTIC BIL | $69.25 | $69.25 | — | 71% below | — |
| Diagnostic mammogram, both breasts CPT 77066 DIGITAL MAMMO BIL ADDL INC CAD | $281.00 | $281.00 | — | 17% above | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIGITAL DIAGNOSTIC MAMMO BILAT | $281.00 | $281.00 | — | — | — |
| Diagnostic mammogram, both breasts inpatient CPT 77066 TOMOSYNTHESIS DIAGNOSTIC BIL | $69.25 | $69.25 | — | — | — |
| Diagnostic mammogram, both breasts inpatient CPT 77066 DIGITAL MAMMO BIL ADDL INC CAD | $281.00 | $281.00 | — | — | — |
| Diagnostic mammogram, one breast CPT 77065 DIGITAL MAMMO UNI ADDL INC CAD | $227.75 | $227.75 | — | 31% below | — |
| Diagnostic mammogram, one breast one side CPT 77065 TOMOSYNTHESIS DIAGNOSTIC RT | $41.25 | $41.25 | — | 88% below | — |
| Diagnostic mammogram, one breast one side CPT 77065 TOMOSYNTHESIS DIAGNOSTIC LT | $41.25 | $41.25 | — | 88% below | — |
| Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAG MAMMO LT INC CAD | $227.75 | $227.75 | — | 31% below | — |
| Diagnostic mammogram, one breast one side CPT 77065 DIGITAL DIAG MAMMO RT INC CAD | $227.75 | $227.75 | — | 31% below | — |
| Diagnostic mammogram, one breast inpatient CPT 77065 DIGITAL MAMMO UNI ADDL INC CAD | $227.75 | $227.75 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 TOMOSYNTHESIS DIAGNOSTIC RT | $41.25 | $41.25 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 TOMOSYNTHESIS DIAGNOSTIC LT | $41.25 | $41.25 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIGITAL DIAG MAMMO LT INC CAD | $227.75 | $227.75 | — | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DIGITAL DIAG MAMMO RT INC CAD | $227.75 | $227.75 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX SCAN LOWER ARTERIES BIL | $1,680.00 | $1,680.00 | — | 84% above | — |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 DUPLEX SCAN LOWER EXT ART BIL | $1,680.00 | $1,680.00 | — | 84% above | — |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN LOWER ARTERIES BIL | $1,680.00 | $1,680.00 | — | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 DUPLEX SCAN LOWER EXT ART BIL | $1,680.00 | $1,680.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUP SCAN EXT VEINS BILAT | $1,151.75 | $1,151.75 | — | — | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS COMPETENCY SCAN | $714.00 | $714.00 | — | 15% below | — |
| Duplex ultrasound of the leg veins, both legs CPT 93970 DUPLEX SCAN EXTREM VEINS BIL | $1,009.50 | $1,009.50 | — | 20% above | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUP SCAN EXT VEINS BILAT | $1,151.75 | $1,151.75 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US VENOUS COMPETENCY SCAN | $714.00 | $714.00 | — | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 DUPLEX SCAN EXTREM VEINS BIL | $1,009.50 | $1,009.50 | — | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM WITH DOPPLER | $1,075.00 | $1,075.00 | — | 36% below | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM WITH DOPPLER | $1,075.00 | $1,075.00 | — | — | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HIDA SCAN | $546.00 | $546.00 | — | 63% below | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HIDA SCAN | $546.00 | $546.00 | — | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP TEST | $949.00 | $949.00 | — | 39% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP TEST | $949.00 | $949.00 | — | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PARTIAL PSGT/CPAP | $3,566.75 | $3,566.75 | — | 1% below | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY W CPAP | $4,755.75 | $4,755.75 | — | 32% above | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PARTIAL PSGT/CPAP | $3,566.75 | $3,566.75 | — | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY W CPAP | $4,755.75 | $4,755.75 | — | — | — |
| Knee X-ray, 3 views both sides CPT 73562 BILATERAL KNEE 3 VIEW | $325.75 | $325.75 | — | — | — |
| Knee X-ray, 3 views one side CPT 73562 KNEE RIGHT 3 VIEWS | $225.00 | $225.00 | — | 34% below | — |
| Knee X-ray, 3 views one side CPT 73562 KNEE LEFT 3 VIEWS | $225.00 | $225.00 | — | 34% below | — |
| Knee X-ray, 3 views inpatient both sides CPT 73562 BILATERAL KNEE 3 VIEW | $325.75 | $325.75 | — | — | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE RIGHT 3 VIEWS | $225.00 | $225.00 | — | — | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 KNEE LEFT 3 VIEWS | $225.00 | $225.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN US LIMITED - COL | $529.50 | $529.50 | — | 4% below | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER | $532.75 | $532.75 | — | 3% below | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 PANCREAS ULTRASOUND | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN US LIMITED STUDY | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIVER ULTRASOUND | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER W/ELASTROGRAPHY | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 GALLBLADDER ULTRASOUND | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SPLEEN ULTRASOUND | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN FOR ASCITES | $609.00 | $609.00 | — | 10% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN US LIMITED - COL | $529.50 | $529.50 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER | $532.75 | $532.75 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER W/ELASTROGRAPHY | $609.00 | $609.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN FOR ASCITES | $609.00 | $609.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 LIVER ULTRASOUND | $609.00 | $609.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 PANCREAS ULTRASOUND | $609.00 | $609.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SPLEEN ULTRASOUND | $609.00 | $609.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 GALLBLADDER ULTRASOUND | $609.00 | $609.00 | — | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN US LIMITED STUDY | $609.00 | $609.00 | — | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LUNG SCREENING | $590.00 | $590.00 | — | 123% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG SCREENING | $590.00 | $590.00 | — | — | — |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST W OR W/O CONT BILAT | $1,341.25 | $1,341.25 | — | — | — |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST W OR W/O CONT BILAT | $1,341.25 | $1,341.25 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI KNEE LIMITED | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 KNEE LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 KNEE RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HIP LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HIP RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 ANKLE LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 ANKLE RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 30% above | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI KNEE LIMITED | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HIP RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 ANKLE LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 HIP LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 ANKLE RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 KNEE RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 KNEE LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 ANKLE LEFT MRI W AND W/O CONTR | $3,950.25 | $3,950.25 | — | 72% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP LEFT W AND W/O CONTRAS | $3,950.25 | $3,950.25 | — | 72% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP RT W AND W/O CONTRAST | $3,950.25 | $3,950.25 | — | 72% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 ANKLE RT MRI W AND W/O CONTRAS | $3,950.25 | $3,950.25 | — | 72% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 KNEE LEFT MRI W AND W/O CONTRA | $3,950.25 | $3,950.25 | — | 72% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 KNEE RIGHT MRI W AND W/O CONTR | $3,950.25 | $3,950.25 | — | 72% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP LEFT W AND W/O CONTRAS | $3,950.25 | $3,950.25 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 ANKLE LEFT MRI W AND W/O CONTR | $3,950.25 | $3,950.25 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 ANKLE RT MRI W AND W/O CONTRAS | $3,950.25 | $3,950.25 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP RT W AND W/O CONTRAST | $3,950.25 | $3,950.25 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 KNEE LEFT MRI W AND W/O CONTRA | $3,950.25 | $3,950.25 | — | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 KNEE RIGHT MRI W AND W/O CONTR | $3,950.25 | $3,950.25 | — | — | — |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP | $1,884.00 | $1,884.00 | — | 16% above | — |
| MRI of the abdomen without contrast CPT 74181 ABDOMEN MRI NO CONTRAST | $1,884.00 | $1,884.00 | — | 16% above | — |
| MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN MRI NO CONTRAST | $1,884.00 | $1,884.00 | — | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP | $1,884.00 | $1,884.00 | — | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN MRI W AND W/O CONTRAST | $4,582.00 | $4,582.00 | — | 123% above | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN MRI W AND W/O CONTRAST | $4,582.00 | $4,582.00 | — | — | — |
| MRI of the brain, no contrast dye CPT 70551 BRAIN INCL IACS NO CONTRAST | $1,907.75 | $1,907.75 | — | 36% above | — |
| MRI of the brain, no contrast dye CPT 70551 BRAIN MRI NO CONTRAST | $1,907.75 | $1,907.75 | — | 36% above | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN MRI NO CONTRAST | $1,907.75 | $1,907.75 | — | — | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN INCL IACS NO CONTRAST | $1,907.75 | $1,907.75 | — | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN INCL ORBITS W/O +W/CONT | $4,157.75 | $4,157.75 | — | 106% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN INCL PIT W/O + W/CONT | $4,157.75 | $4,157.75 | — | 106% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN MRI W AND W/O CONTRAST | $4,157.75 | $4,157.75 | — | 106% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI I AC W AND W/O CONTRAST | $4,157.75 | $4,157.75 | — | 106% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN ICL IACS W/O +W/CONT | $4,157.75 | $4,157.75 | — | 106% above | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN ICL IACS W/O +W/CONT | $4,157.75 | $4,157.75 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI I AC W AND W/O CONTRAST | $4,157.75 | $4,157.75 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN INCL PIT W/O + W/CONT | $4,157.75 | $4,157.75 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN INCL ORBITS W/O +W/CONT | $4,157.75 | $4,157.75 | — | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN MRI W AND W/O CONTRAST | $4,157.75 | $4,157.75 | — | — | — |
| MRI of the lower back, no contrast dye CPT 72148 LUMBAR MRI NO CONTRAST | $2,085.75 | $2,085.75 | — | 59% above | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR MRI NO CONTRAST | $2,085.75 | $2,085.75 | — | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR SPINE LIMITED, MRI | $2,715.25 | $2,715.25 | — | 28% above | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR W/WO CONTRAST, MRI | $4,056.25 | $4,056.25 | — | 92% above | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR SPINE LIMITED, MRI | $2,715.25 | $2,715.25 | — | — | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR W/WO CONTRAST, MRI | $4,056.25 | $4,056.25 | — | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE NO CONTRAST | $2,139.00 | $2,139.00 | — | 50% above | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE NO CONTRAST | $2,139.00 | $2,139.00 | — | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL LIMITED, MRI | $2,792.50 | $2,792.50 | — | 28% above | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL MRI W AND W/O CONTRAS | $4,158.00 | $4,158.00 | — | 91% above | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL LIMITED, MRI | $2,792.50 | $2,792.50 | — | — | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL MRI W AND W/O CONTRAS | $4,158.00 | $4,158.00 | — | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 CERVICAL MRI NO CONTRAST | $1,960.25 | $1,960.25 | — | 44% above | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERVICAL MRI NO CONTRAST | $1,960.25 | $1,960.25 | — | — | — |
| MRI of the pelvis without and with contrast CPT 72197 PELVIS MRI W AND W/O CONTRAST | $3,984.25 | $3,984.25 | — | 111% above | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI PROSTATE PELVIS W AND W/O | $3,984.25 | $3,984.25 | — | 111% above | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS MRI W AND W/O CONTRAST | $3,984.25 | $3,984.25 | — | — | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PROSTATE PELVIS W AND W/O | $3,984.25 | $3,984.25 | — | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 PELVIS MRI NO CONTRAST | $1,885.00 | $1,885.00 | — | 36% above | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS MRI NO CONTRAST | $1,885.00 | $1,885.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 SHOULDER LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 49% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 ELBOW RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 49% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 ELBOW LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 49% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 WRIST RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 49% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 WRIST LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 49% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 SHOULDER RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | 49% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 SHOULDER RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 WRIST RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 ELBOW LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 WRIST LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 SHOULDER LEFT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 ELBOW RIGHT MRI NO CONTRAST | $1,883.00 | $1,883.00 | — | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 SPECT MYOCARDIAL PERF MULTI,PH | $3,221.00 | $3,221.00 | — | 12% below | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 SPECT MYOCARDIAL PERF MULTI,TR | $3,221.00 | $3,221.00 | — | 12% below | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 SPECT MYOCARDIAL PERF MULTI,TR | $3,221.00 | $3,221.00 | — | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 SPECT MYOCARDIAL PERF MULTI,PH | $3,221.00 | $3,221.00 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET/CT SKULL TO THIGH | $4,501.25 | $4,501.25 | — | 7% below | — |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PSMA PET SKULL TO MID-THIGH | $4,501.25 | $4,501.25 | — | 7% below | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PSMA PET SKULL TO MID-THIGH | $4,501.25 | $4,501.25 | — | — | — |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET/CT SKULL TO THIGH | $4,501.25 | $4,501.25 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIS LIMITED, ULTRASOUND | $498.75 | $498.75 | — | 20% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIS LIMITED | $498.75 | $498.75 | — | 20% above | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIS LIMITED | $498.75 | $498.75 | — | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIS LIMITED, ULTRASOUND | $498.75 | $498.75 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIS COMPLETE | $559.50 | $559.50 | — | 17% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC ULTRASOUND | $559.50 | $559.50 | — | 17% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC ULTRASOUND | $559.50 | $559.50 | — | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIS COMPLETE | $559.50 | $559.50 | — | — | — |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB ULTRASOUND 2ND-3RD TRIMESTE | $782.00 | $782.00 | — | 51% above | — |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB ULTRASOUND 2ND-3RD TRIMESTE | $782.00 | $782.00 | — | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTERUS 1ST TRIMESTER | $782.00 | $782.00 | — | 56% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTERUS 1ST TRIMESTER | $782.00 | $782.00 | — | — | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 LIMITED OB ULTRASOUND | $525.50 | $525.50 | — | 10% above | — |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 LIMITED OB ULTRASOUND | $525.50 | $525.50 | — | — | — |
| Screening mammogram, both breasts CPT 77067 DIGITAL SCREENING MAMMO BIL | $245.25 | $245.25 | — | 41% above | — |
| Screening mammogram, both breasts CPT 77067 DIGITAL SCREEN MAMM BIL INC CA | $281.00 | $281.00 | — | 61% above | — |
| Screening mammogram, both breasts one side CPT 77067 DIGITAL SCREEN MAMM LT INC CAD | $227.75 | $227.75 | — | 31% above | — |
| Screening mammogram, both breasts one side CPT 77067 DIGITAL SCREEN MAMM RT INC CAD | $227.75 | $227.75 | — | 31% above | — |
| Screening mammogram, both breasts inpatient CPT 77067 DIGITAL SCREENING MAMMO BIL | $245.25 | $245.25 | — | — | — |
| Screening mammogram, both breasts inpatient CPT 77067 DIGITAL SCREEN MAMM BIL INC CA | $281.00 | $281.00 | — | — | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 DIGITAL SCREEN MAMM LT INC CAD | $227.75 | $227.75 | — | — | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 DIGITAL SCREEN MAMM RT INC CAD | $227.75 | $227.75 | — | — | — |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 BILATERAL SHOULDER 2 VIEW | $305.00 | $305.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT | $210.25 | $210.25 | — | 38% below | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER, LEFT | $210.25 | $210.25 | — | 38% below | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER, RIGHT | $210.25 | $210.25 | — | 38% below | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT | $210.25 | $210.25 | — | 38% below | — |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 BILATERAL SHOULDER 2 VIEW | $305.00 | $305.00 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT | $210.25 | $210.25 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER, RIGHT | $210.25 | $210.25 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER, LEFT | $210.25 | $210.25 | — | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT | $210.25 | $210.25 | — | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 PARTIAL PSGT | $3,271.25 | $3,271.25 | — | 4% below | — |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY | $4,361.50 | $4,361.50 | — | 27% above | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 PARTIAL PSGT | $3,271.25 | $3,271.25 | — | — | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY | $4,361.50 | $4,361.50 | — | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 VIDEO-FLUORO BARIUM SWALLOW | $548.00 | $548.00 | — | 8% above | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 VIDEO-FLUORO BARIUM SWALLOW | $548.00 | $548.00 | — | — | — |
| Transvaginal pelvic ultrasound CPT 76830 PELVIS W/TRANS VAGINAL | $696.50 | $696.50 | — | 30% above | — |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL SCAN ULTRASOUND | $801.00 | $801.00 | — | 49% above | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 PELVIS W/TRANS VAGINAL | $696.50 | $696.50 | — | — | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL SCAN ULTRASOUND | $801.00 | $801.00 | — | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL SCAN OBSTRETICAL | $696.50 | $696.50 | — | 46% above | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL SCAN OBSTRETICAL | $696.50 | $696.50 | — | — | — |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMPLETE | $696.50 | $696.50 | — | 23% above | — |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE | $801.00 | $801.00 | — | 41% above | — |
| Ultrasound of the abdomen, complete CPT 76700 PEDIATRIC ABDOMINAL SURVEY US | $801.00 | $801.00 | — | 41% above | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMPLETE | $696.50 | $696.50 | — | — | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 PEDIATRIC ABDOMINAL SURVEY US | $801.00 | $801.00 | — | — | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE | $801.00 | $801.00 | — | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 SCROTUM ULTRASOUND | $745.25 | $745.25 | — | 48% above | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM ULTRASOUND | $745.25 | $745.25 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID/SOFT TISSUE NECK | $498.75 | $498.75 | — | 10% below | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SOFT TISSUE NECK ULT | $571.00 | $571.00 | — | 4% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 THYROID ULTRASOUND | $571.00 | $571.00 | — | 4% above | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 THYROID/SOFT TISSUE NECK | $498.75 | $498.75 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SOFT TISSUE NECK ULT | $571.00 | $571.00 | — | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 THYROID ULTRASOUND | $571.00 | $571.00 | — | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UPPER GI ONE CONTRAST | $964.25 | $964.25 | — | 68% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI SERIES | $964.25 | $964.25 | — | 68% above | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UPPER GI ONE CONTRAST | $964.25 | $964.25 | — | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI SERIES | $964.25 | $964.25 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX SCAN EXTREM VEINS UNIL | $721.00 | $721.00 | — | 1% below | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUP SCAN EXT VEINS UNILAT | $721.00 | $721.00 | — | 1% below | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DUPLEX SCAN EXTREM VEINS UNIL | $721.00 | $721.00 | — | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP SCAN EXT VEINS UNILAT | $721.00 | $721.00 | — | — | — |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 BILATERAL WRIST 3 VIEW | $284.50 | $284.50 | — | — | — |
| Wrist X-ray, complete, 3 or more views CPT 73110 WRIST INCLUDING NAVICULAR RIGH | $196.75 | $196.75 | — | 41% below | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT MIN 3 VIEWS | $196.75 | $196.75 | — | 41% below | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST MINIMUM 3 VIEWS LEFT | $196.75 | $196.75 | — | 41% below | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT MIN 3 VIEWS | $196.75 | $196.75 | — | 41% below | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST INCLUDING NAVICULAR LEFT | $196.75 | $196.75 | — | 41% below | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST MINIMUM 3 VIEWS RIGHT | $196.75 | $196.75 | — | 41% below | — |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 BILATERAL WRIST 3 VIEW | $284.50 | $284.50 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 WRIST INCLUDING NAVICULAR RIGH | $196.75 | $196.75 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST MINIMUM 3 VIEWS RIGHT | $196.75 | $196.75 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT MIN 3 VIEWS | $196.75 | $196.75 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT MIN 3 VIEWS | $196.75 | $196.75 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST MINIMUM 3 VIEWS LEFT | $196.75 | $196.75 | — | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST INCLUDING NAVICULAR LEFT | $196.75 | $196.75 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT 2/3 VIEWS + AP PELVIS | $221.50 | $221.50 | — | 30% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT 2/3 VIEWS | $221.50 | $221.50 | — | 30% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT + AP PELVIS 2/3 VIEW | $221.50 | $221.50 | — | 30% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT 2/3 VIEWS | $221.50 | $221.50 | — | 30% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP RIGHT 2/3 VIEW + AP PELVIS | $221.50 | $221.50 | — | 30% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP LEFT + AP PELVIS 2/3 VIEWS | $222.50 | $222.50 | — | 30% below | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT + AP PELVIS 2/3 VIEW | $221.50 | $221.50 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT 2/3 VIEWS | $221.50 | $221.50 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT 2/3 VIEWS + AP PELVIS | $221.50 | $221.50 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT 2/3 VIEWS | $221.50 | $221.50 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP RIGHT 2/3 VIEW + AP PELVIS | $221.50 | $221.50 | — | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP LEFT + AP PELVIS 2/3 VIEWS | $222.50 | $222.50 | — | — | — |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW | $341.75 | $341.75 | — | 39% above | — |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW PORTABLE | $341.75 | $341.75 | — | 39% above | — |
| X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1V TUBE PLACEMNT | $341.75 | $341.75 | — | 39% above | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW | $341.75 | $341.75 | — | — | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW PORTABLE | $341.75 | $341.75 | — | — | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1V TUBE PLACEMNT | $341.75 | $341.75 | — | — | — |
| X-ray of the ankle, 2 views both sides CPT 73600 BILATERAL ANKLE 2 VIEW | $258.75 | $258.75 | — | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEWS | $179.25 | $179.25 | — | 30% below | — |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 1 VIEW,RIGHT | $179.25 | $179.25 | — | 30% below | — |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE 1 VIEW,LEFT | $179.25 | $179.25 | — | 30% below | — |
| X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEWS | $179.25 | $179.25 | — | 30% below | — |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 BILATERAL ANKLE 2 VIEW | $258.75 | $258.75 | — | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 1 VIEW,LEFT | $179.25 | $179.25 | — | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEWS | $179.25 | $179.25 | — | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEWS | $179.25 | $179.25 | — | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE 1 VIEW,RIGHT | $179.25 | $179.25 | — | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS RIGHT MIN 2 VIEWS | $155.75 | $155.75 | — | 33% below | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S), LEFT | $155.75 | $155.75 | — | 33% below | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGERS LEFT MIN 2 VIEWS | $155.75 | $155.75 | — | 33% below | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S), RIGHT | $155.75 | $155.75 | — | 33% below | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S), LEFT | $155.75 | $155.75 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S), RIGHT | $155.75 | $155.75 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS RIGHT MIN 2 VIEWS | $155.75 | $155.75 | — | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGERS LEFT MIN 2 VIEWS | $155.75 | $155.75 | — | — | — |
| X-ray of the foot, 2 views both sides CPT 73620 BILATERAL FOOT 2 VIEW | $258.75 | $258.75 | — | — | — |
| X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEWS | $179.25 | $179.25 | — | 21% below | — |
| X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 1 VIEW | $179.25 | $179.25 | — | 21% below | — |
| X-ray of the foot, 2 views one side CPT 73620 FOOT CMA LEFT 2 VIEWS | $179.25 | $179.25 | — | 21% below | — |
| X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEWS | $179.25 | $179.25 | — | 21% below | — |
| X-ray of the foot, 2 views one side CPT 73620 FOOT CMA RIGHT 2 VIEWS | $179.25 | $179.25 | — | 21% below | — |
| X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 1 VIEW | $179.25 | $179.25 | — | 21% below | — |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 BILATERAL FOOT 2 VIEW | $258.75 | $258.75 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 1 VIEW | $179.25 | $179.25 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT CMA RIGHT 2 VIEWS | $179.25 | $179.25 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEWS | $179.25 | $179.25 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT CMA LEFT 2 VIEWS | $179.25 | $179.25 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 1 VIEW | $179.25 | $179.25 | — | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEWS | $179.25 | $179.25 | — | — | — |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 BILATERAL FOOT 3 VIEW | $298.75 | $298.75 | — | — | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT RIGHT MIN 3 VIEWS | $206.50 | $206.50 | — | 34% below | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT LEFT MIN 3 VIEWS | $206.50 | $206.50 | — | 34% below | — |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 BILATERAL FOOT 3 VIEW | $298.75 | $298.75 | — | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT RIGHT MIN 3 VIEWS | $206.50 | $206.50 | — | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT LEFT MIN 3 VIEWS | $206.50 | $206.50 | — | — | — |
| X-ray of the hand, 3 or more views both sides CPT 73130 BILATERAL HAND 3 VIEW | $298.75 | $298.75 | — | — | — |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND RIGHT MIN 3 VIEWS | $196.75 | $196.75 | — | 40% below | — |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND CMA LEFT MIN 3 VIEWS | $196.75 | $196.75 | — | 40% below | — |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND MINIMUM 3 VIEWS RIGHT | $206.50 | $206.50 | — | 37% below | — |
| X-ray of the hand, 3 or more views one side CPT 73130 HAND MINIMUM 3 VIEWS LEFT | $206.50 | $206.50 | — | 37% below | — |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 BILATERAL HAND 3 VIEW | $298.75 | $298.75 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND RIGHT MIN 3 VIEWS | $196.75 | $196.75 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND CMA LEFT MIN 3 VIEWS | $196.75 | $196.75 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS RIGHT | $206.50 | $206.50 | — | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MINIMUM 3 VIEWS LEFT | $206.50 | $206.50 | — | — | — |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 BILATERAL KNEE 2 VIEW | $275.25 | $275.25 | — | — | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS | $190.75 | $190.75 | — | 29% below | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 OR 2 VIEWS | $190.75 | $190.75 | — | 29% below | — |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 BILATERAL KNEE 2 VIEW | $275.25 | $275.25 | — | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1 OR 2 VIEWS | $190.75 | $190.75 | — | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1 OR 2 VIEWS | $190.75 | $190.75 | — | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 OR 3 VIEWS | $245.25 | $245.25 | — | 17% below | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACRAL SPINE 2 OR 3 VIEWS | $257.50 | $257.50 | — | 13% below | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 OR 3 VIEWS | $245.25 | $245.25 | — | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL SPINE 2 OR 3 VIEWS | $257.50 | $257.50 | — | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE W/ FLEX AND EXT | $428.50 | $428.50 | — | at median | — |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE MIN 4 VIEWS | $428.50 | $428.50 | — | at median | — |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE W FLEX AND EXT | $428.50 | $428.50 | — | at median | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE MIN 4 VIEWS | $428.50 | $428.50 | — | — | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE W/ FLEX AND EXT | $428.50 | $428.50 | — | — | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE W FLEX AND EXT | $428.50 | $428.50 | — | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS | $242.25 | $242.25 | — | 16% below | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS | $242.25 | $242.25 | — | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 NOSE | $149.50 | $149.50 | — | 47% below | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES, MIN 3 VIEWS | $149.50 | $149.50 | — | 47% below | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NOSE | $149.50 | $149.50 | — | — | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES, MIN 3 VIEWS | $149.50 | $149.50 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS | $336.00 | $336.00 | — | 14% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 VIEWS | $352.75 | $352.75 | — | 19% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE LATERAL VIEW | $352.75 | $352.75 | — | 19% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE LATERAL PORTABL | $352.75 | $352.75 | — | 19% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE TRAUMA SERIES | $352.75 | $352.75 | — | 19% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS | $336.00 | $336.00 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE LATERAL VIEW | $352.75 | $352.75 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2 VIEWS | $352.75 | $352.75 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE LATERAL PORTABL | $352.75 | $352.75 | — | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE TRAUMA SERIES | $352.75 | $352.75 | — | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS | $190.75 | $190.75 | — | 23% below | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS | $190.75 | $190.75 | — | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX | $288.50 | $288.50 | — | 1% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM / COCCYX | $288.50 | $288.50 | — | 1% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX | $288.50 | $288.50 | — | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM / COCCYX | $288.50 | $288.50 | — | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT | $30.00 | $30.00 | — | 9% above | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) | $41.25 | $41.25 | — | 49% above | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT | $30.00 | $30.00 | — | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) | $41.25 | $41.25 | — | — | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $47.50 | $47.50 | — | 88% above | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST | $47.50 | $47.50 | — | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $411.00 | $411.00 | — | 92% above | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL | $411.00 | $411.00 | — | — | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM,AMERICAN IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 YEAST, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 WILLOW, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORNET, YELLOW, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PARSLEY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITEFISH, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASH, WHITE IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG, (YOLK), IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN, HICKORY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG,WHOLE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORNET,WHITE FACE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM CHRYSOGEN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEPPER TREE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA BETAE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 DUCK FEATHERS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED,COMMON IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEYBEE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALLEYE PIKE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 D. PTERONYSSINUS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BANANA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO NUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE HAZELNUT COMPONENT | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET VERNAL, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TROUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TRICHODERMA VIRIDAE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PLANTAIN,ENGLISH IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAHIA GRASS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 D FARINAE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 POTATO,WHITE IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PRIVET,COMMON IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CYPRESS,ITALIAN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY, WHITE IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT EPITHELIUM, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CURVULARIA IUNATA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED,FALSE IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITHELIUM,IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED,GIANT IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED,SHORT IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT (FILBERT), IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RASBERRY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RED TOP,BENTGRASS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACKEREL, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RHIZOPUS NIGRICANS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RICE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HALIBUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH MARSHELDER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TILLETIA TRITICI, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 TILAPIA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 THISTLE,RUSSIAN IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE LEAF SYCAMORE,IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET POTATO, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER SEED, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM HERBARUM,IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MESQUITE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE GRASS,PERENNIAL IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 STACHYBOTRYS ATRA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SETOMELANOMMA ROSTRAT,IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 HADDOCK, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH,GERMAN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH,AMERICAN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN BEAN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 LETTUCE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CINNAMON, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE/CACAO IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MELON, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 AUREOBASIDI PULLULANS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 LENSCALE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET CHESTNUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOLDENROD, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHAETOMIUM GLOBOSUM, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CELERY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CEDAR,MOUNTAIN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMON, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GINGER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE/BOX ELDER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGULLUS NIGER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 COMMON SILVER BIRCH, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRY IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUEGRASS,KENTUCKY, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOTRYTIS CINEREA, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROME, SMOOTH IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BUMBLEBEE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALBICANS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB'S QUARTERS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MULBERRY WHITE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM PROLIFERATUM IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUSHROOM, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEEF, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUSTARD, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 FESCUE,MEADOW IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK,WHITE IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 KIWI FRUIT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK,LIVE/VIRGINIA IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 FENNEL,DOG IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEECH, AMERICAN, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 EUCALYPTUS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ONION, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM PURPUR, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER, IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 BAYBERRY/SWEET GALE IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 PALM,QUEEN IgE | $41.50 | $41.50 | — | 77% above | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE LEAF SYCAMORE,IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITHELIUM,IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MESQUITE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELON, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE/BOX ELDER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACKEREL, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LETTUCE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LENSCALE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB'S QUARTERS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI FRUIT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORNET, YELLOW, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORNET,WHITE FACE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEYBEE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HICKORY, WHITE IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT (FILBERT), IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HALIBUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HADDOCK, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN BEAN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOLDENROD, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GINGER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GARLIC, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM PROLIFERATUM IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FESCUE,MEADOW IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FENNEL,DOG IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUCALYPTUS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM PURPUR, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM,AMERICAN IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG, (YOLK), IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG,WHOLE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK FEATHERS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. PTERONYSSINUS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D FARINAE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CYPRESS,ITALIAN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CURVULARIA IUNATA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH,GERMAN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH,AMERICAN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CINNAMON, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHOCOLATE/CACAO IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET CHESTNUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHAETOMIUM GLOBOSUM, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CEDAR,MOUNTAIN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MULBERRY WHITE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSHROOM, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUSTARD, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK,WHITE IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK,LIVE/VIRGINIA IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PALM,QUEEN IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARSLEY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN, HICKORY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM CHRYSOGEN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEPPER TREE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHOMA BETAE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PIGWEED,COMMON IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALLEYE PIKE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO NUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PLANTAIN,ENGLISH IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO,WHITE IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PRIVET,COMMON IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT EPITHELIUM, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED,FALSE IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED,GIANT IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED,SHORT IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RASBERRY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED TOP,BENTGRASS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RHIZOPUS NIGRICANS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ROUGH MARSHELDER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE GRASS,PERENNIAL IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SETOMELANOMMA ROSTRAT,IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STACHYBOTRYS ATRA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STEMPHYLIUM HERBARUM,IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER SEED, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET POTATO, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 THISTLE,RUSSIAN IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TILAPIA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TILLETIA TRITICI, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TRICHODERMA VIRIDAE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TROUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET VERNAL, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE HAZELNUT COMPONENT | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASH, WHITE IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITEFISH, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WILLOW, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANDIDA ALBICANS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BUMBLEBEE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BROME, SMOOTH IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOTRYTIS CINEREA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEGRASS,KENTUCKY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEBERRY IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON SILVER BIRCH, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT TREE, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGULLUS NIGER, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AUREOBASIDI PULLULANS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAHIA GRASS, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BAYBERRY/SWEET GALE IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEECH, AMERICAN, IgE | $41.50 | $41.50 | — | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF, IgE | $41.50 | $41.50 | — | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IGG ANTIBODIES | $103.00 | $103.00 | — | 78% above | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP IGG ANTIBODIES | $103.00 | $103.00 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA IN SCLERODERMA PROFILE | $29.50 | $29.50 | — | 45% below | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA | $51.50 | $51.50 | — | 5% below | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH AUTO REFLEX | $107.75 | $107.75 | — | 100% above | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA IN SCLERODERMA PROFILE | $29.50 | $29.50 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA | $51.50 | $51.50 | — | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH AUTO REFLEX | $107.75 | $107.75 | — | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP | $125.25 | $125.25 | — | 12% below | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO BNP | $206.00 | $206.00 | — | 45% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP | $125.25 | $125.25 | — | — | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PRO BNP | $206.00 | $206.00 | — | — | — |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $116.50 | $116.50 | — | 96% above | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $116.50 | $116.50 | — | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV | $256.50 | $256.50 | — | 41% above | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV | $256.50 | $256.50 | — | — | — |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE, 1 SET | $122.25 | $122.25 | — | 31% above | — |
| Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE, 1 SET | $122.25 | $122.25 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $28.00 | $28.00 | — | 89% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD CULTURE VENIPUNCTURE | $28.00 | $28.00 | — | 89% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PATERNITY DRAW | $49.00 | $49.00 | — | 231% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE SERVICE | $50.50 | $50.50 | — | 241% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD CULTURE VENIPUNCTURE | $28.00 | $28.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $28.00 | $28.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PATERNITY DRAW | $49.00 | $49.00 | — | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE SERVICE | $50.50 | $50.50 | — | — | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE VERIFICATION | $28.00 | $28.00 | — | 33% above | — |
| Blood glucose (sugar) test CPT 82947 GLUCOSE | $28.00 | $28.00 | — | 33% above | — |
| Blood glucose (sugar) test CPT 82947 2 HR GTT SPECIMEN | $32.50 | $32.50 | — | 55% above | — |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE VERIFICATION | $28.00 | $28.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE | $28.00 | $28.00 | — | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 2 HR GTT SPECIMEN | $32.50 | $32.50 | — | — | — |
| Blood lead test CPT 83655 LEAD,URINE | $77.00 | $77.00 | — | 92% above | — |
| Blood lead test CPT 83655 ADULT LEAD IN EXPOSURE PANEL | $79.50 | $79.50 | — | 99% above | — |
| Blood lead test CPT 83655 LEAD, BLOOD | $79.50 | $79.50 | — | 99% above | — |
| Blood lead test inpatient CPT 83655 LEAD,URINE | $77.00 | $77.00 | — | — | — |
| Blood lead test inpatient CPT 83655 LEAD, BLOOD | $79.50 | $79.50 | — | — | — |
| Blood lead test inpatient CPT 83655 ADULT LEAD IN EXPOSURE PANEL | $79.50 | $79.50 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 URINE PREGNANCY SCREEN | $94.25 | $94.25 | — | 92% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG BETA SCREEN | $94.25 | $94.25 | — | 92% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG BETA SCREEN | $94.25 | $94.25 | — | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 URINE PREGNANCY SCREEN | $94.25 | $94.25 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC ABO TYPE | $45.00 | $45.00 | — | 8% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO RECHECK | $46.00 | $46.00 | — | 6% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE TRANSFUSION REACTION | $46.00 | $46.00 | — | 6% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE CORD BLOOD | $46.00 | $46.00 | — | 6% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE | $46.00 | $46.00 | — | 6% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ARC ABO TYPE | $45.00 | $45.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE CORD BLOOD | $46.00 | $46.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE | $46.00 | $46.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO RECHECK | $46.00 | $46.00 | — | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE TRANSFUSION REACTION | $46.00 | $46.00 | — | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 PROMETHEUS C REACTIVE PROTEIN | $41.25 | $41.25 | — | 5% below | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP | $82.00 | $82.00 | — | 89% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 PROMETHEUS C REACTIVE PROTEIN | $41.25 | $41.25 | — | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP | $82.00 | $82.00 | — | — | — |
| CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 | $164.50 | $164.50 | — | 143% above | — |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $164.50 | $164.50 | — | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $164.50 | $164.50 | — | 76% above | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $164.50 | $164.50 | — | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID,SARS ASSAY | $164.50 | $164.50 | — | 17% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID,SARS ASSAY | $164.50 | $164.50 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY NAA | $51.50 | $51.50 | — | 44% below | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS | $138.75 | $138.75 | — | 50% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS(VAGINAL) | $138.75 | $138.75 | — | 50% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS,NAA | $138.75 | $138.75 | — | 50% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY NAA | $51.50 | $51.50 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS | $138.75 | $138.75 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS,NAA | $138.75 | $138.75 | — | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS(VAGINAL) | $138.75 | $138.75 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 NMR LIPID PANEL | $100.00 | $100.00 | — | 93% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID B PROFILE | $108.25 | $108.25 | — | 108% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 NMR LIPID PANEL | $100.00 | $100.00 | — | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID B PROFILE | $108.25 | $108.25 | — | — | — |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH DIFF | $93.75 | $93.75 | — | 167% above | — |
| Complete blood count (CBC) with differential CPT 85025 CBC PTH REVIEW ONCOLOGY | $93.75 | $93.75 | — | 167% above | — |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH CITRATED PLT | $93.75 | $93.75 | — | 167% above | — |
| Complete blood count (CBC) with differential CPT 85025 CBC WITH AUTO DIFF | $93.75 | $93.75 | — | 167% above | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC PTH REVIEW ONCOLOGY | $93.75 | $93.75 | — | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH DIFF | $93.75 | $93.75 | — | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTO DIFF | $93.75 | $93.75 | — | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH CITRATED PLT | $93.75 | $93.75 | — | — | — |
| Complete blood count (CBC), no differential CPT 85027 CBC WITHOUT DIFF | $59.25 | $59.25 | — | 83% above | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC WITHOUT DIFF | $59.25 | $59.25 | — | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $183.50 | $183.50 | — | 204% above | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $183.50 | $183.50 | — | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER | $117.25 | $117.25 | — | 69% above | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER | $117.25 | $117.25 | — | — | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE, SERUM | $229.25 | $229.25 | — | 134% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE, SERUM | $229.25 | $229.25 | — | — | — |
| Estradiol blood test CPT 82670 ESTRADIOL, SERUM | $85.00 | $85.00 | — | 18% below | — |
| Estradiol blood test CPT 82670 ESTRADIOL | $177.75 | $177.75 | — | 71% above | — |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL, SERUM | $85.00 | $85.00 | — | — | — |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $177.75 | $177.75 | — | — | — |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH, SERUM | $170.25 | $170.25 | — | 101% above | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, SERUM | $170.25 | $170.25 | — | — | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL | $310.75 | $310.75 | — | 108% above | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL | $310.75 | $310.75 | — | — | — |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $79.50 | $79.50 | — | 5% above | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $79.50 | $79.50 | — | — | — |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID | $67.00 | $67.00 | — | 2% above | — |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $67.00 | $67.00 | — | — | — |
| Free T3 thyroid hormone test CPT 84481 FREE T3 | $161.75 | $161.75 | — | 137% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 | $161.75 | $161.75 | — | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 | $66.50 | $66.50 | — | 65% above | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $66.50 | $66.50 | — | — | — |
| Free testosterone test CPT 84402 FREE TESTOSTERONE, DIRECT | $114.50 | $114.50 | — | 22% above | — |
| Free testosterone test CPT 84402 FREE TESTOSTERONE | $149.00 | $149.00 | — | 59% above | — |
| Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE, DIRECT | $114.50 | $114.50 | — | — | — |
| Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE | $149.00 | $149.00 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE,POST GLUCOSE DOSE | $67.50 | $67.50 | — | 131% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE DRAWN POST GLUCOSE DOS | $67.50 | $67.50 | — | 131% above | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE DRAWN POST GLUCOSE DOS | $67.50 | $67.50 | — | — | — |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE,POST GLUCOSE DOSE | $67.50 | $67.50 | — | — | — |
| Glucose tolerance test, 3 samples CPT 82951 3 TOLERANCE SPECIMENS | $100.00 | $100.00 | — | 73% above | — |
| Glucose tolerance test, 3 samples CPT 82951 OB 2 HR GLUCOSE TOLERANCE | $100.00 | $100.00 | — | 73% above | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 OB 2 HR GLUCOSE TOLERANCE | $100.00 | $100.00 | — | — | — |
| Glucose tolerance test, 3 samples inpatient CPT 82951 3 TOLERANCE SPECIMENS | $100.00 | $100.00 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA BY NAA | $51.50 | $51.50 | — | 45% below | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE | $138.75 | $138.75 | — | 49% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORR (VAGINAL) | $138.75 | $138.75 | — | 49% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE,NNA | $138.75 | $138.75 | — | 49% above | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA BY NAA | $51.50 | $51.50 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORR (VAGINAL) | $138.75 | $138.75 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE,NNA | $138.75 | $138.75 | — | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE | $138.75 | $138.75 | — | — | — |
| H. pylori stool antigen test CPT 87338 H PYLORI STOOL ANTIGEN | $143.75 | $143.75 | — | 116% above | — |
| H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL ANTIGEN | $143.75 | $143.75 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV BY PCR | $273.00 | $273.00 | — | 18% below | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD | $669.50 | $669.50 | — | 100% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV BY PCR | $273.00 | $273.00 | — | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD | $669.50 | $669.50 | — | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 SCREEN | $88.75 | $88.75 | — | 35% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 SCREEN | $88.75 | $88.75 | — | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C | $92.25 | $92.25 | — | 111% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C | $92.25 | $92.25 | — | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE Ab | $48.00 | $48.00 | — | at median | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE Ab | $48.00 | $48.00 | — | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE Ag, QUAL | $48.00 | $48.00 | — | 4% above | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE Ag, QUAL | $48.00 | $48.00 | — | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY | $127.75 | $127.75 | — | 101% above | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY | $127.75 | $127.75 | — | — | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANT REFLEX | $175.75 | $175.75 | — | 9% below | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV, QUANT RNA PCR | $400.00 | $400.00 | — | 108% above | — |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR QUANT | $206.00 | $206.00 | — | 7% above | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANT REFLEX | $175.75 | $175.75 | — | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV, QUANT RNA PCR | $400.00 | $400.00 | — | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR QUANT | $206.00 | $206.00 | — | — | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGG, TYPE SPEC | $67.00 | $67.00 | — | 13% above | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGG, TYPE SPEC | $67.00 | $67.00 | — | — | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV2 IGG, TYPE SPEC | $67.00 | $67.00 | — | 1% above | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV2 IGG, TYPE SPEC | $67.00 | $67.00 | — | — | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C REACTIVE PROTEIN, ULTRA SENS | $82.00 | $82.00 | — | 37% above | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C REACTIVE PROTEIN, ULTRA SENS | $82.00 | $82.00 | — | — | — |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE | $128.75 | $128.75 | — | 65% above | — |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $128.75 | $128.75 | — | — | — |
| Insulin blood test CPT 83525 INSULIN | $95.50 | $95.50 | — | 86% above | — |
| Insulin blood test CPT 83525 TOTAL INSULIN | $105.75 | $105.75 | — | 106% above | — |
| Insulin blood test inpatient CPT 83525 INSULIN | $95.50 | $95.50 | — | — | — |
| Insulin blood test inpatient CPT 83525 TOTAL INSULIN | $105.75 | $105.75 | — | — | — |
| Iron blood test (serum iron) CPT 83540 IRON | $64.50 | $64.50 | — | 90% above | — |
| Iron blood test (serum iron) CPT 83540 IRON,LIVER | $235.00 | $235.00 | — | 591% above | — |
| Iron blood test (serum iron) inpatient CPT 83540 IRON | $64.50 | $64.50 | — | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 IRON,LIVER | $235.00 | $235.00 | — | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BINDING CAPACITY | $73.25 | $73.25 | — | 88% above | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY | $73.25 | $73.25 | — | — | — |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $171.50 | $171.50 | — | 175% above | — |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $171.50 | $171.50 | — | — | — |
| LH (luteinizing hormone) test CPT 83002 LH SERUM | $226.25 | $226.25 | — | 137% above | — |
| LH (luteinizing hormone) test inpatient CPT 83002 LH SERUM | $226.25 | $226.25 | — | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $68.75 | $68.75 | — | 34% above | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $68.75 | $68.75 | — | — | — |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $107.25 | $107.25 | — | 91% above | — |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $107.25 | $107.25 | — | — | — |
| Lyme disease antibody test CPT 86618 LYME DISEASE SEROLOGY W/RFX | $183.25 | $183.25 | — | 140% above | — |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SEROLOGY W/RFX | $183.25 | $183.25 | — | — | — |
| Magnesium blood test CPT 83735 URINE MAGNESIUM | $28.50 | $28.50 | — | 10% below | — |
| Magnesium blood test CPT 83735 MAGNESIUM | $59.75 | $59.75 | — | 88% above | — |
| Magnesium blood test CPT 83735 MAGNESIUM, RBC | $59.75 | $59.75 | — | 88% above | — |
| Magnesium blood test inpatient CPT 83735 URINE MAGNESIUM | $28.50 | $28.50 | — | — | — |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $59.75 | $59.75 | — | — | — |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC | $59.75 | $59.75 | — | — | — |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IN IMMUNITY PANEL | $31.00 | $31.00 | — | 41% below | — |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IN IMMUNITY PANEL | $31.00 | $31.00 | — | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 MONO SPOT | $67.00 | $67.00 | — | 30% above | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SPOT | $67.00 | $67.00 | — | — | — |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $453.75 | $453.75 | — | 128% above | — |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $453.75 | $453.75 | — | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA | $109.75 | $109.75 | — | 36% above | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA | $109.75 | $109.75 | — | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL PSA | $92.25 | $92.25 | — | 20% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, DIAGNOSTIC | $93.75 | $93.75 | — | 22% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING FOR MEN 50 & OVE | $93.75 | $93.75 | — | 22% above | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL PSA | $92.25 | $92.25 | — | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING FOR MEN 50 & OVE | $93.75 | $93.75 | — | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, DIAGNOSTIC | $93.75 | $93.75 | — | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT INTRA OP 15 MIN | $159.25 | $159.25 | — | 16% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT INTRA OP BASELINE | $159.25 | $159.25 | — | 16% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT | $159.25 | $159.25 | — | 16% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT INTRA OP 5 MIN | $159.25 | $159.25 | — | 16% above | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT INTRA OP 10 MIN | $159.25 | $159.25 | — | 16% above | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT INTRA OP BASELINE | $159.25 | $159.25 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT INTRA OP 15 MIN | $159.25 | $159.25 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT INTRA OP 10 MIN | $159.25 | $159.25 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT INTRA OP 5 MIN | $159.25 | $159.25 | — | — | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT | $159.25 | $159.25 | — | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT HEPARIN | $66.00 | $66.00 | — | 90% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT | $72.25 | $72.25 | — | 108% above | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT HEPARIN | $66.00 | $66.00 | — | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT | $72.25 | $72.25 | — | — | — |
| Progesterone blood test CPT 84144 PROGESTERONE | $72.25 | $72.25 | — | 2% above | — |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $72.25 | $72.25 | — | — | — |
| Prolactin blood test CPT 84146 PROLACTIN | $193.25 | $193.25 | — | 138% above | — |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $193.25 | $193.25 | — | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME COUMADIN | $64.50 | $64.50 | — | 176% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME | $64.50 | $64.50 | — | 176% above | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME COUMADIN | $64.50 | $64.50 | — | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME | $64.50 | $64.50 | — | — | — |
| Rapid flu test (influenza antigen) CPT 87804 RAPID FLU A | $42.75 | $42.75 | — | 35% below | — |
| Rapid flu test (influenza antigen) CPT 87804 RADID FLU B | $42.75 | $42.75 | — | 35% below | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 RADID FLU B | $42.75 | $42.75 | — | — | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 RAPID FLU A | $42.75 | $42.75 | — | — | — |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR | $91.50 | $91.50 | — | 193% above | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR | $91.50 | $91.50 | — | — | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IN IMMUNITY PANEL | $33.00 | $33.00 | — | 4% below | — |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM | $61.00 | $61.00 | — | 78% above | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IN IMMUNITY PANEL | $33.00 | $33.00 | — | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM | $61.00 | $61.00 | — | — | — |
| Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES | $70.75 | $70.75 | — | 78% above | — |
| Stool ova and parasites exam inpatient CPT 87177 SMEAR FOR PARASITES | $70.75 | $70.75 | — | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL, OCCULT BLOOD | $27.00 | $27.00 | — | 7% above | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL, OCCULT BLOOD | $27.00 | $27.00 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF VDRL | $25.75 | $25.75 | — | 37% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $49.00 | $49.00 | — | 160% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CSF VDRL | $25.75 | $25.75 | — | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR | $49.00 | $49.00 | — | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD | $259.50 | $259.50 | — | 133% above | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD | $259.50 | $259.50 | — | — | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, SERUM | $169.00 | $169.00 | — | 95% above | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 TOTAL TESTOSTERONE | $169.00 | $169.00 | — | 95% above | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TOTAL TESTOSTERONE | $169.00 | $169.00 | — | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, SERUM | $169.00 | $169.00 | — | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER/KIDNEY AUTOSOMAL ANTIBOD | $100.50 | $100.50 | — | 71% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES | $131.50 | $131.50 | — | 124% above | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER/KIDNEY AUTOSOMAL ANTIBOD | $100.50 | $100.50 | — | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES | $131.50 | $131.50 | — | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $143.00 | $143.00 | — | 108% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH | $143.00 | $143.00 | — | — | — |
| Trichomonas test (NAAT) CPT 87661 TRIC VAG BY NAA | $72.25 | $72.25 | — | 16% below | — |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS | $100.00 | $100.00 | — | 17% above | — |
| Trichomonas test (NAAT) inpatient CPT 87661 TRIC VAG BY NAA | $72.25 | $72.25 | — | — | — |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS | $100.00 | $100.00 | — | — | — |
| Uric acid blood test CPT 84550 URIC ACID IN RHEUMATOID PROFIL | $41.25 | $41.25 | — | 21% above | — |
| Uric acid blood test CPT 84550 URIC ACID | $41.25 | $41.25 | — | 21% above | — |
| Uric acid blood test inpatient CPT 84550 URIC ACID IN RHEUMATOID PROFIL | $41.25 | $41.25 | — | — | — |
| Uric acid blood test inpatient CPT 84550 URIC ACID | $41.25 | $41.25 | — | — | — |
| Urinalysis without microscope exam, automated CPT 81003 URINE CHEMSCREEN | $27.00 | $27.00 | — | 19% above | — |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS, NO CULTURE | $44.00 | $44.00 | — | 93% above | — |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/MICR, NO CULTURE | $44.00 | $44.00 | — | 93% above | — |
| Urinalysis without microscope exam, automated CPT 81003 URINE URINALYSIS | $44.00 | $44.00 | — | 93% above | — |
| Urinalysis without microscope exam, automated CPT 81003 PREGNANCY URINALYSIS | $44.00 | $44.00 | — | 93% above | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE CHEMSCREEN | $27.00 | $27.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/MICR, NO CULTURE | $44.00 | $44.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE URINALYSIS | $44.00 | $44.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS, NO CULTURE | $44.00 | $44.00 | — | — | — |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PREGNANCY URINALYSIS | $44.00 | $44.00 | — | — | — |
| Urinalysis without microscope exam, manual CPT 81002 PREGNANCY CHEM SCREEN | $27.00 | $27.00 | — | 73% above | — |
| Urinalysis without microscope exam, manual inpatient CPT 81002 PREGNANCY CHEM SCREEN | $27.00 | $27.00 | — | — | — |
| Urine culture for bacteria, with colony count CPT 87086 REFLEX URINE CULTURE + SENSI | $100.00 | $100.00 | — | 82% above | — |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE +NEEDED SENSI | $100.00 | $100.00 | — | 82% above | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 REFLEX URINE CULTURE + SENSI | $100.00 | $100.00 | — | — | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE +NEEDED SENSI | $100.00 | $100.00 | — | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 | $65.00 | $65.00 | — | 10% below | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $65.00 | $65.00 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D2 & D3 | $190.75 | $190.75 | — | 142% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 3 | $205.50 | $205.50 | — | 161% above | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D2 & D3 | $190.75 | $190.75 | — | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 3 | $205.50 | $205.50 | — | — | — |
| Zinc blood test CPT 84630 ZINC,SERUM | $94.25 | $94.25 | — | 123% above | — |
| Zinc blood test inpatient CPT 84630 ZINC,SERUM | $94.25 | $94.25 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE | $159.25 | $159.25 | — | 136% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT, LABCORP | $159.25 | $159.25 | — | 136% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT, LABCORP | $159.25 | $159.25 | — | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE | $159.25 | $159.25 | — | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Botox injections for chronic migraine CPT 64615 CHEMODENERVATION MIGRAINE BILA | $382.25 | $382.25 | — | 30% below | — |
| Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERVATION MIGRAINE BILA | $382.25 | $382.25 | — | — | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BREAST BIOPSY RT MAM 1ST LESIO | $3,533.25 | $3,533.25 | — | 11% below | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 BREAST BIOPSY LEFT MAM 1ST LES | $3,533.25 | $3,533.25 | — | 11% below | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BREAST BIOPSY LEFT MAM 1ST LES | $3,533.25 | $3,533.25 | — | — | — |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 BREAST BIOPSY RT MAM 1ST LESIO | $3,533.25 | $3,533.25 | — | — | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 C RM TREAT ANKLE FRACTR W/O MA | $545.00 | $545.00 | — | 45% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 TREATMENT OF ANKLE FRACTURE LT | $545.00 | $545.00 | — | 45% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 TREATMENT OF ANKLE FRACTURE RT | $545.00 | $545.00 | — | 45% above | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 C RM TREAT ANKLE FRACTR W/O MA | $545.00 | $545.00 | — | — | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 TREATMENT OF ANKLE FRACTURE RT | $545.00 | $545.00 | — | — | — |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 TREATMENT OF ANKLE FRACTURE LT | $545.00 | $545.00 | — | — | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TX METATARSAL FRACTURE W/O MAN | $497.50 | $497.50 | — | 37% above | — |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 C RM TREAT METATARSAL FRACTR | $497.50 | $497.50 | — | 37% above | — |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TX METATARSAL FRACTURE W/O MAN | $497.50 | $497.50 | — | — | — |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 C RM TREAT METATARSAL FRACTR | $497.50 | $497.50 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE | $958.00 | $958.00 | — | 54% below | — |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION | $983.75 | $983.75 | — | 52% below | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE | $958.00 | $958.00 | — | — | — |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION | $983.75 | $983.75 | — | — | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMSION NEWBORN CLAMP OR OT | $2,136.25 | $2,136.25 | — | 2% above | — |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMSION NEWBORN CLAMP OR OT | $2,136.25 | $2,136.25 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT FRACTURE RADIUS/ULNA | $545.00 | $545.00 | — | 33% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TX FX RADIUS/ULNA RT | $545.00 | $545.00 | — | 33% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLOSED TX FX RADIUS/ULNA LT | $545.00 | $545.00 | — | 33% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 C RM CLOSD FRACTR RADIUS/UL LT | $662.50 | $662.50 | — | 62% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 C RM CLOSD FRACTR RADIUS/UL RT | $662.50 | $662.50 | — | 62% above | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT FRACTURE RADIUS/ULNA | $545.00 | $545.00 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 CLOSED TX FX RADIUS/ULNA LT | $545.00 | $545.00 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 CLOSED TX FX RADIUS/ULNA RT | $545.00 | $545.00 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 C RM CLOSD FRACTR RADIUS/UL RT | $662.50 | $662.50 | — | — | — |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 C RM CLOSD FRACTR RADIUS/UL LT | $662.50 | $662.50 | — | — | — |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 US D&C DIAGNOSTIC/THER NON-OB | $6,144.00 | $6,144.00 | — | 15% below | — |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 US D&C DIAGNOSTIC/THER NON-OB | $6,144.00 | $6,144.00 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE BIL IMPACT CERUMEN IRR | $388.50 | $388.50 | — | 151% above | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE RT IMPACT CERUMEN IRR | $193.75 | $193.75 | — | 25% above | — |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE LT IMPACT CERUMEN IRR | $193.75 | $193.75 | — | 25% above | — |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE BIL IMPACT CERUMEN IRR | $388.50 | $388.50 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE LT IMPACT CERUMEN IRR | $193.75 | $193.75 | — | — | — |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE RT IMPACT CERUMEN IRR | $193.75 | $193.75 | — | — | — |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CEREMUN INST | $388.50 | $388.50 | — | 151% above | — |
| Earwax removal with instruments, one ear one side CPT 69210 REMOVE RT IMPACT CERUMEN INSTR | $193.75 | $193.75 | — | 25% above | — |
| Earwax removal with instruments, one ear one side CPT 69210 REMOV IMPACT CERUMEN INSTR LT | $193.75 | $193.75 | — | 25% above | — |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL IMPACTED CEREMUN INST | $388.50 | $388.50 | — | — | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE RT IMPACT CERUMEN INSTR | $193.75 | $193.75 | — | — | — |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOV IMPACT CERUMEN INSTR LT | $193.75 | $193.75 | — | — | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 US GUIDED ENDOMETRIAL BIOPSY | $467.75 | $467.75 | — | 23% above | — |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 US GUIDED ENDOMETRIAL BIOPSY | $467.75 | $467.75 | — | — | — |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ DX/THER INTERLAM CRV/THRC | $2,896.50 | $2,896.50 | — | 30% above | — |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ DX/THER INTERLAM CRV/THRC | $2,896.50 | $2,896.50 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 SACRAL FACET SINGLE LEVEL | $1,195.00 | $1,195.00 | — | 43% below | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LUMBAR FACET SINGLE LEVEL | $1,195.00 | $1,195.00 | — | 43% below | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 SACRAL FACET SINGLE LEV BIL | $2,387.75 | $2,387.75 | — | 13% above | — |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 LUMBAR FACET SINGLE LEVEL BIL | $2,387.75 | $2,387.75 | — | 13% above | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 SACRAL FACET SINGLE LEVEL | $1,195.00 | $1,195.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 LUMBAR FACET SINGLE LEVEL | $1,195.00 | $1,195.00 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 SACRAL FACET SINGLE LEV BIL | $2,387.75 | $2,387.75 | — | — | — |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 LUMBAR FACET SINGLE LEVEL BIL | $2,387.75 | $2,387.75 | — | — | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 US SALINE INFUS/SONOHYSTEROGRA | $600.50 | $600.50 | — | 57% above | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INTRO SALINE/CONTRAST HYSTEROS | $998.25 | $998.25 | — | 162% above | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 US SALINE INFUS/SONOHYSTEROGRA | $600.50 | $600.50 | — | — | — |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INTRO SALINE/CONTRAST HYSTEROS | $998.25 | $998.25 | — | — | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION/DRAIN ABSCESS SIMPLE | $436.75 | $436.75 | — | 15% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 C RM INCISION/DRAINAGE SIMPLE | $436.75 | $436.75 | — | 15% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE SIMPLE | $437.75 | $437.75 | — | 16% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION DRAINAGE SIMPLE | $437.75 | $437.75 | — | 16% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABCESS SIMPLE | $437.75 | $437.75 | — | 16% above | — |
| Incision and drainage of a simple or single skin abscess CPT 10060 I AND D ABCESS SIMPLE | $437.75 | $437.75 | — | 16% above | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION/DRAIN ABSCESS SIMPLE | $436.75 | $436.75 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 C RM INCISION/DRAINAGE SIMPLE | $436.75 | $436.75 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION DRAINAGE SIMPLE | $437.75 | $437.75 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABCESS SIMPLE | $437.75 | $437.75 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I AND D ABCESS SIMPLE | $437.75 | $437.75 | — | — | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE SIMPLE | $437.75 | $437.75 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) both sides CPT 20550 INJECT TENDON SHEATH/LIG BILAT | $260.75 | $260.75 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON SHEATH/LIGAMENT | $174.25 | $174.25 | — | 49% below | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECT TENDON,LIGAMENT,SINGLE | $522.25 | $522.25 | — | 54% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TENDON SHEATH INJECTION | $578.00 | $578.00 | — | 70% above | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient both sides CPT 20550 INJECT TENDON SHEATH/LIG BILAT | $260.75 | $260.75 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON SHEATH/LIGAMENT | $174.25 | $174.25 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECT TENDON,LIGAMENT,SINGLE | $522.25 | $522.25 | — | — | — |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TENDON SHEATH INJECTION | $578.00 | $578.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound both sides CPT 20610 ASPIR/INJECT BILAT MAJOR JOINT | $514.00 | $514.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJECT MAJOR JOINT | $343.00 | $343.00 | — | 51% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJECT MAJOR JOINT | $513.00 | $513.00 | — | 26% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 C RM ASPIR/INJ MAJOR JOINT | $513.00 | $513.00 | — | 26% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INTRA AURICULAR KNEE INJ | $515.00 | $515.00 | — | 26% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION/INJ LARGE JOINT | $515.00 | $515.00 | — | 26% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 MAJ JOINT INJ SHOULDER HIP KNE | $515.00 | $515.00 | — | 26% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIR/INJCT MAJOR JOINT W/O US | $515.00 | $515.00 | — | 26% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS, ASPIR INJ MAJO | $569.75 | $569.75 | — | 18% below | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 C RM ASPIR/INJ MAJOR JOINT BIL | $765.50 | $765.50 | — | 10% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJECT MAJ JOINT BIL W/O U | $1,030.00 | $1,030.00 | — | 48% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 ASPIR/INJECT BILAT MAJOR JOINT | $514.00 | $514.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJECT MAJOR JOINT | $343.00 | $343.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJECT MAJOR JOINT | $513.00 | $513.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 C RM ASPIR/INJ MAJOR JOINT | $513.00 | $513.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIRATION/INJ LARGE JOINT | $515.00 | $515.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INTRA AURICULAR KNEE INJ | $515.00 | $515.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 MAJ JOINT INJ SHOULDER HIP KNE | $515.00 | $515.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASPIR/INJCT MAJOR JOINT W/O US | $515.00 | $515.00 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS, ASPIR INJ MAJO | $569.75 | $569.75 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 C RM ASPIR/INJ MAJOR JOINT BIL | $765.50 | $765.50 | — | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJECT MAJ JOINT BIL W/O U | $1,030.00 | $1,030.00 | — | — | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVRY IMPLANT | $451.25 | $451.25 | — | 3% above | — |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVRY IMPLANT | $451.25 | $451.25 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) both sides CPT 20605 ASPIR/INJECT BILAT INTRM JOINT | $387.50 | $387.50 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIR/INJECT INTERMED JOINT | $357.50 | $357.50 | — | 43% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 C RM ASPIR/INJ INTERMED JOINT | $357.50 | $357.50 | — | 43% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATE/INJECT MED JOINT | $358.50 | $358.50 | — | 43% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIR/INJECT MED JOINT W/O US | $358.50 | $358.50 | — | 43% below | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASPIRATE/INJECT INTERMED JOINT | $651.00 | $651.00 | — | 4% above | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 ASPIR/INJECT BILAT INTRM JOINT | $387.50 | $387.50 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 C RM ASPIR/INJ INTERMED JOINT | $357.50 | $357.50 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIR/INJECT INTERMED JOINT | $357.50 | $357.50 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATE/INJECT MED JOINT | $358.50 | $358.50 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIR/INJECT MED JOINT W/O US | $358.50 | $358.50 | — | — | — |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASPIRATE/INJECT INTERMED JOINT | $651.00 | $651.00 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) both sides CPT 20600 ASPIR/INJECT BILAT SMALL JOINT | $314.25 | $314.25 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION/INJECT SMALL JOINT | $210.25 | $210.25 | — | 57% below | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATION/INJ SMALL JOINT | $324.50 | $324.50 | — | 34% below | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIR/INJECT SMALL JOINT | $332.75 | $332.75 | — | 33% below | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 C RM ASPIR/INJECT SM JOINT | $332.75 | $332.75 | — | 33% below | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIR/INJECT SM JOINT W/O US | $333.75 | $333.75 | — | 32% below | — |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASPIRATE/INJECT SMALL JOINT | $573.75 | $573.75 | — | 16% above | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 ASPIR/INJECT BILAT SMALL JOINT | $314.25 | $314.25 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION/INJECT SMALL JOINT | $210.25 | $210.25 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATION/INJ SMALL JOINT | $324.50 | $324.50 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 C RM ASPIR/INJECT SM JOINT | $332.75 | $332.75 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIR/INJECT SMALL JOINT | $332.75 | $332.75 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIR/INJECT SM JOINT W/O US | $333.75 | $333.75 | — | — | — |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASPIRATE/INJECT SMALL JOINT | $573.75 | $573.75 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 CLOSE WOUND SCALP ETC 2.5 OR < | $252.50 | $252.50 | — | 53% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 WOUND CLOS LAY<2.5CM SC/AX/TR/ | $252.50 | $252.50 | — | 53% below | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 CLOSE WOUND SCALP ETC 2.5 OR < | $252.50 | $252.50 | — | — | — |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 WOUND CLOS LAY<2.5CM SC/AX/TR/ | $252.50 | $252.50 | — | — | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR INJ THERAPEUTIC | $1,284.50 | $1,284.50 | — | 37% below | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 LUMBAR INJECTION THERAPEUTIC | $1,284.50 | $1,284.50 | — | 37% below | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR INJECTION THERAPEUTIC | $1,284.50 | $1,284.50 | — | — | — |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 LUMBAR INJ THERAPEUTIC | $1,284.50 | $1,284.50 | — | — | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 CAUDAL EPIDURAL | $1,004.25 | $1,004.25 | — | 38% below | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 EPIDURAL BLOCK (NERVE) | $1,004.25 | $1,004.25 | — | 38% below | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 LUMBAR EPIDURAL | $1,004.25 | $1,004.25 | — | 38% below | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 LUMBAR EPIDURAL | $1,004.25 | $1,004.25 | — | — | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 EPIDURAL BLOCK (NERVE) | $1,004.25 | $1,004.25 | — | — | — |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 CAUDAL EPIDURAL | $1,004.25 | $1,004.25 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORM EPID LUMB/SACRAL SIN | $1,004.25 | $1,004.25 | — | 46% below | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORM EPID LUMB/SACRAL BIL | $2,008.50 | $2,008.50 | — | 7% above | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORM EPID LUMB/SACRAL SIN | $1,004.25 | $1,004.25 | — | — | — |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORM EPID LUMB/SACRAL BIL | $2,008.50 | $2,008.50 | — | — | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC B LESION.5CM< ARM LEG TRUN | $934.25 | $934.25 | — | 32% below | — |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC B LESION.5CM< ARM LEG TRUN | $934.25 | $934.25 | — | — | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC B LESION FACE ER EYE .5CM< | $1,047.75 | $1,047.75 | — | 24% below | — |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC B LESION FACE ER EYE .5CM< | $1,047.75 | $1,047.75 | — | — | — |
| Nail removal (partial or complete), one nail CPT 11730 C RM AVULSION NAIL PLATE | $183.50 | $183.50 | — | 42% below | — |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE | $183.50 | $183.50 | — | 42% below | — |
| Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PART/COMP SIM | $184.50 | $184.50 | — | 42% below | — |
| Nail removal (partial or complete), one nail CPT 11730 FINGER/TOE NAIL REMOVAL | $184.50 | $184.50 | — | 42% below | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE | $183.50 | $183.50 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 C RM AVULSION NAIL PLATE | $183.50 | $183.50 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PART/COMP SIM | $184.50 | $184.50 | — | — | — |
| Nail removal (partial or complete), one nail inpatient CPT 11730 FINGER/TOE NAIL REMOVAL | $184.50 | $184.50 | — | — | — |
| Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK | $434.75 | $434.75 | — | 57% below | — |
| Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK GR> BIL | $869.50 | $869.50 | — | 13% below | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK | $434.75 | $434.75 | — | — | — |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK GR> BIL | $869.50 | $869.50 | — | — | — |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/ULTRASOUND | $1,511.25 | $1,511.25 | — | 12% below | — |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $1,514.25 | $1,514.25 | — | 12% below | — |
| Paracentesis with imaging guidance CPT 49083 US ABDOMINAL PARACENTESIS | $1,676.00 | $1,676.00 | — | 3% below | — |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/ULTRASOUND | $1,511.25 | $1,511.25 | — | — | — |
| Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING | $1,514.25 | $1,514.25 | — | — | — |
| Paracentesis with imaging guidance inpatient CPT 49083 US ABDOMINAL PARACENTESIS | $1,676.00 | $1,676.00 | — | — | — |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $650.00 | $650.00 | — | 17% below | — |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED | $650.00 | $650.00 | — | — | — |
| Prostate biopsy CPT 55700 PROSTATE BIOPSY | $1,822.25 | $1,822.25 | — | 25% above | — |
| Prostate biopsy CPT 55700 BIOPSY PROSTATE | $2,572.00 | $2,572.00 | — | 76% above | — |
| Prostate biopsy inpatient CPT 55700 PROSTATE BIOPSY | $1,822.25 | $1,822.25 | — | — | — |
| Prostate biopsy inpatient CPT 55700 BIOPSY PROSTATE | $2,572.00 | $2,572.00 | — | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RADIO FREQ FACET LUMB,SACRAL S | $1,930.25 | $1,930.25 | — | 39% below | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RADIO FREQ FACET LUMB/SAC BIL | $3,860.50 | $3,860.50 | — | 22% above | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 RADIO FREQ FACET LUMB,SACRAL S | $1,930.25 | $1,930.25 | — | — | — |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 RADIO FREQ FACET LUMB/SAC BIL | $3,860.50 | $3,860.50 | — | — | — |
| Removal of a breast lump, open surgery one side CPT 19120 EXC BREAST BIOPSY LT | $4,639.25 | $4,639.25 | — | 18% above | — |
| Removal of a breast lump, open surgery one side CPT 19120 EXC BREAST BIOPSY RT | $4,639.25 | $4,639.25 | — | 18% above | — |
| Removal of a breast lump, open surgery inpatient one side CPT 19120 EXC BREAST BIOPSY LT | $4,639.25 | $4,639.25 | — | — | — |
| Removal of a breast lump, open surgery inpatient one side CPT 19120 EXC BREAST BIOPSY RT | $4,639.25 | $4,639.25 | — | — | — |
| Removal of a foreign object under the skin, simple CPT 10120 C RM FOREIGN BODY REMOVAL SUBQ | $528.50 | $528.50 | — | 19% below | — |
| Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY REMOVAL SIMPLE | $528.50 | $528.50 | — | 19% below | — |
| Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMOVAL FB SQ SIMPL | $529.50 | $529.50 | — | 18% below | — |
| Removal of a foreign object under the skin, simple CPT 10120 FOREIGN BODY REMOVAL SUBQ SMPL | $529.50 | $529.50 | — | 18% below | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 C RM FOREIGN BODY REMOVAL SUBQ | $528.50 | $528.50 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 FOREIGN BODY REMOVAL SIMPLE | $528.50 | $528.50 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMOVAL FB SQ SIMPL | $529.50 | $529.50 | — | — | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 FOREIGN BODY REMOVAL SUBQ SMPL | $529.50 | $529.50 | — | — | — |
| Short arm cast (elbow to hand) CPT 29075 CAST SHORT ARM LFT | $150.50 | $150.50 | — | 48% below | — |
| Short arm cast (elbow to hand) one side CPT 29075 CAST SHORT ARM RT | $150.50 | $150.50 | — | 48% below | — |
| Short arm cast (elbow to hand) one side CPT 29075 C RM CAST SHORT ARM LT | $245.25 | $245.25 | — | 15% below | — |
| Short arm cast (elbow to hand) one side CPT 29075 C RM CAST SHORT ARM RT | $245.25 | $245.25 | — | 15% below | — |
| Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT ARM LFT | $150.50 | $150.50 | — | — | — |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 CAST SHORT ARM RT | $150.50 | $150.50 | — | — | — |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 C RM CAST SHORT ARM LT | $245.25 | $245.25 | — | — | — |
| Short arm cast (elbow to hand) inpatient one side CPT 29075 C RM CAST SHORT ARM RT | $245.25 | $245.25 | — | — | — |
| Short arm splint (forearm and hand) both sides CPT 29125 APPLIC SHORT ARM SPLINT BILAT | $285.50 | $285.50 | — | — | — |
| Short arm splint (forearm and hand) both sides CPT 29125 APPLIC SHORT LEG SPLINT BILAT | $378.25 | $378.25 | — | — | — |
| Short arm splint (forearm and hand) CPT 29125 SHORT ARM SPLINT-STATIC | $253.50 | $253.50 | — | 12% below | — |
| Short arm splint (forearm and hand) CPT 29125 APPL BOTH SHORT ARM SPLINT | $517.25 | $517.25 | — | 79% above | — |
| Short arm splint (forearm and hand) CPT 29125 C RM APPL BTH SHORT ARM SPLINT | $517.25 | $517.25 | — | 79% above | — |
| Short arm splint (forearm and hand) one side CPT 29125 APPLIC SHORT ARM SPLINT LT | $190.75 | $190.75 | — | 34% below | — |
| Short arm splint (forearm and hand) one side CPT 29125 APPLIC SHORT ARM SPLINT RT | $190.75 | $190.75 | — | 34% below | — |
| Short arm splint (forearm and hand) one side CPT 29125 APPL RT SHORT ARM SPLINT | $260.75 | $260.75 | — | 10% below | — |
| Short arm splint (forearm and hand) one side CPT 29125 APPL LT SHORT ARM SPLINT | $260.75 | $260.75 | — | 10% below | — |
| Short arm splint (forearm and hand) one side CPT 29125 C RM APPL LT SHORT ARM SPLINT | $260.75 | $260.75 | — | 10% below | — |
| Short arm splint (forearm and hand) one side CPT 29125 C RM APPL RT SHORT ARM SPLINT | $260.75 | $260.75 | — | 10% below | — |
| Short arm splint (forearm and hand) inpatient both sides CPT 29125 APPLIC SHORT ARM SPLINT BILAT | $285.50 | $285.50 | — | — | — |
| Short arm splint (forearm and hand) inpatient both sides CPT 29125 APPLIC SHORT LEG SPLINT BILAT | $378.25 | $378.25 | — | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 SHORT ARM SPLINT-STATIC | $253.50 | $253.50 | — | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPL BOTH SHORT ARM SPLINT | $517.25 | $517.25 | — | — | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 C RM APPL BTH SHORT ARM SPLINT | $517.25 | $517.25 | — | — | — |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLIC SHORT ARM SPLINT RT | $190.75 | $190.75 | — | — | — |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLIC SHORT ARM SPLINT LT | $190.75 | $190.75 | — | — | — |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 C RM APPL RT SHORT ARM SPLINT | $260.75 | $260.75 | — | — | — |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 C RM APPL LT SHORT ARM SPLINT | $260.75 | $260.75 | — | — | — |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 APPL RT SHORT ARM SPLINT | $260.75 | $260.75 | — | — | — |
| Short arm splint (forearm and hand) inpatient one side CPT 29125 APPL LT SHORT ARM SPLINT | $260.75 | $260.75 | — | — | — |
| Short leg cast (below the knee) CPT 29405 CAST SHORT LEG LFT | $182.50 | $182.50 | — | 49% below | — |
| Short leg cast (below the knee) one side CPT 29405 CAST SHORT LEG RT | $182.50 | $182.50 | — | 49% below | — |
| Short leg cast (below the knee) one side CPT 29405 C RM CAST SHORT LEG LT | $434.75 | $434.75 | — | 21% above | — |
| Short leg cast (below the knee) one side CPT 29405 C RM CAST SHORT LEG RT | $434.75 | $434.75 | — | 21% above | — |
| Short leg cast (below the knee) inpatient CPT 29405 CAST SHORT LEG LFT | $182.50 | $182.50 | — | — | — |
| Short leg cast (below the knee) inpatient one side CPT 29405 CAST SHORT LEG RT | $182.50 | $182.50 | — | — | — |
| Short leg cast (below the knee) inpatient one side CPT 29405 C RM CAST SHORT LEG RT | $434.75 | $434.75 | — | — | — |
| Short leg cast (below the knee) inpatient one side CPT 29405 C RM CAST SHORT LEG LT | $434.75 | $434.75 | — | — | — |
| Short leg splint (calf to foot) CPT 29515 SHORT LEG SPLINT | $253.50 | $253.50 | — | 17% below | — |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT L | $261.75 | $261.75 | — | 14% below | — |
| Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT R | $261.75 | $261.75 | — | 14% below | — |
| Short leg splint (calf to foot) CPT 29515 C RM APP BOTH SHORT LEG SPLINT | $517.25 | $517.25 | — | 70% above | — |
| Short leg splint (calf to foot) CPT 29515 APPLIC BOTH SHORT LEG SPLINT | $517.25 | $517.25 | — | 70% above | — |
| Short leg splint (calf to foot) one side CPT 29515 C RM APP LT SHORT LEG SPLINT | $260.75 | $260.75 | — | 14% below | — |
| Short leg splint (calf to foot) one side CPT 29515 C RM APP RT SHORT LEG SPLINT | $260.75 | $260.75 | — | 14% below | — |
| Short leg splint (calf to foot) one side CPT 29515 APPL RT SHORT LEG SPLINT | $260.75 | $260.75 | — | 14% below | — |
| Short leg splint (calf to foot) one side CPT 29515 APPL LT SHORT LEG SPLINT | $260.75 | $260.75 | — | 14% below | — |
| Short leg splint (calf to foot) inpatient CPT 29515 SHORT LEG SPLINT | $253.50 | $253.50 | — | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT L | $261.75 | $261.75 | — | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT R | $261.75 | $261.75 | — | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLIC BOTH SHORT LEG SPLINT | $517.25 | $517.25 | — | — | — |
| Short leg splint (calf to foot) inpatient CPT 29515 C RM APP BOTH SHORT LEG SPLINT | $517.25 | $517.25 | — | — | — |
| Short leg splint (calf to foot) inpatient one side CPT 29515 APPL LT SHORT LEG SPLINT | $260.75 | $260.75 | — | — | — |
| Short leg splint (calf to foot) inpatient one side CPT 29515 APPL RT SHORT LEG SPLINT | $260.75 | $260.75 | — | — | — |
| Short leg splint (calf to foot) inpatient one side CPT 29515 C RM APP LT SHORT LEG SPLINT | $260.75 | $260.75 | — | — | — |
| Short leg splint (calf to foot) inpatient one side CPT 29515 C RM APP RT SHORT LEG SPLINT | $260.75 | $260.75 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE WOUND REP SCALP ETC 2.5 | $252.50 | $252.50 | — | 23% below | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE WOUND REPAIR 2.5 OR < | $252.50 | $252.50 | — | 23% below | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE WOUND REP SCALP ETC 2.5 | $252.50 | $252.50 | — | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE WOUND REPAIR 2.5 OR < | $252.50 | $252.50 | — | — | — |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN 1 LEASON | $343.00 | $343.00 | — | 24% below | — |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGL LESION | $343.00 | $343.00 | — | 24% below | — |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SUBQ SGLE LE | $343.00 | $343.00 | — | 24% below | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN 1 LEASON | $343.00 | $343.00 | — | — | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SUBQ SGLE LE | $343.00 | $343.00 | — | — | — |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGL LESION | $343.00 | $343.00 | — | — | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MAL LESION .5CM<ARM LEG TR | $1,304.00 | $1,304.00 | — | 5% below | — |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MAL LESION .5CM<ARM LEG TR | $1,304.00 | $1,304.00 | — | — | — |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS UP TO 15 LES | $380.25 | $380.25 | — | 29% above | — |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS UP TO 15 LES | $380.25 | $380.25 | — | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE W/O IMAGING | $908.50 | $908.50 | — | 13% below | — |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE W/O IMAGING | $908.50 | $908.50 | — | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE WOUND REP SCALP ETC 2.6 | $252.50 | $252.50 | — | 28% below | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPLE WOUND REP SCALP ETC 2.6 | $252.50 | $252.50 | — | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE WOUND REP FACE 2.5 or < | $374.00 | $374.00 | — | 18% above | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE WOUND REP FACE 2.5 or < | $374.00 | $374.00 | — | — | — |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING | $596.50 | $596.50 | — | 67% below | — |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS WITH IMAGING | $596.50 | $596.50 | — | 67% below | — |
| Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/USGUIDANCE | $660.25 | $660.25 | — | 64% below | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS WITH IMAGING | $596.50 | $596.50 | — | — | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING | $596.50 | $596.50 | — | — | — |
| Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/USGUIDANCE | $660.25 | $660.25 | — | — | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECT, 1-2 SITE | $268.00 | $268.00 | — | 64% below | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECT 1-2 SITES | $420.25 | $420.25 | — | 43% below | — |
| Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJECT 1-2 MUSCL | $421.50 | $421.50 | — | 43% below | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECT, 1-2 SITE | $268.00 | $268.00 | — | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECT 1-2 SITES | $420.25 | $420.25 | — | — | — |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJECT 1-2 MUSCL | $421.50 | $421.50 | — | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BREAST BIOPSY RT ULTRASOUND | $2,807.75 | $2,807.75 | — | 12% below | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 BREAST BIOPSY LT ULTRASOUND | $2,807.75 | $2,807.75 | — | 12% below | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BREAST BIOPSY LT ULTRASOUND | $2,807.75 | $2,807.75 | — | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 BREAST BIOPSY RT ULTRASOUND | $2,807.75 | $2,807.75 | — | — | — |
| Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION 1-14 | $297.75 | $297.75 | — | 10% above | — |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESION 1-14 | $297.75 | $297.75 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 C RM DEBRIDE SUBQ TISS 20CM < | $670.75 | $670.75 | — | 14% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN AND SUBCUTANE | $670.75 | $670.75 | — | 14% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN &SUBQ TISSUE<=20S | $673.75 | $673.75 | — | 14% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN&SUBQ TISSUE<=20S | $673.75 | $673.75 | — | 14% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMNT EXCIS SUBQ TIS 20SQ | $673.75 | $673.75 | — | 14% below | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN AND SUBCUTANE | $670.75 | $670.75 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 C RM DEBRIDE SUBQ TISS 20CM < | $670.75 | $670.75 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN&SUBQ TISSUE<=20S | $673.75 | $673.75 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN &SUBQ TISSUE<=20S | $673.75 | $673.75 | — | — | — |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMNT EXCIS SUBQ TIS 20SQ | $673.75 | $673.75 | — | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION EMER ROOM | $514.00 | $514.00 | — | 56% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 C RM BLOOD TRANSFUSION | $514.00 | $514.00 | — | 56% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION | $516.25 | $516.25 | — | 56% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION (6-10 HOURS) | $516.25 | $516.25 | — | 56% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION | $516.25 | $516.25 | — | 56% below | — |
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION (1-5 HOURS) | $516.25 | $516.25 | — | 56% below | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION EMER ROOM | $514.00 | $514.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 C RM BLOOD TRANSFUSION | $514.00 | $514.00 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION | $516.25 | $516.25 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION | $516.25 | $516.25 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION (6-10 HOURS) | $516.25 | $516.25 | — | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION (1-5 HOURS) | $516.25 | $516.25 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EzPAP | $76.25 | $76.25 | — | 57% below | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 EMER DEPT MININEB | $76.25 | $76.25 | — | 57% below | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MININEB | $76.25 | $76.25 | — | 57% below | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EzPAP | $76.25 | $76.25 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 EMER DEPT MININEB | $76.25 | $76.25 | — | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MININEB | $76.25 | $76.25 | — | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION, 1HR INITIAL | $851.75 | $851.75 | — | 14% above | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION, 1HR INITIAL | $851.75 | $851.75 | — | — | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE WITH PROCEDURE | $1,600.00 | $1,600.00 | — | 46% below | — |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE WITHOUT PROCEDUR | $1,600.00 | $1,600.00 | — | 46% below | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE WITHOUT PROCEDUR | $1,600.00 | $1,600.00 | — | — | — |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE WITH PROCEDURE | $1,600.00 | $1,600.00 | — | — | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY | $733.50 | $733.50 | — | 31% below | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY | $733.50 | $733.50 | — | — | — |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM,COMPLETE ECG | $54.75 | $54.75 | — | 78% below | — |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM,COMPLETE ECG | $54.75 | $54.75 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EMER DEPT EKG | $139.25 | $139.25 | — | 25% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $139.25 | $139.25 | — | 25% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EMER DEPT EKG | $139.25 | $139.25 | — | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG | $139.25 | $139.25 | — | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1 WITH PROCEDURE | $113.50 | $113.50 | — | 61% below | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1 WITHOUT PROCEDURE | $113.50 | $113.50 | — | 61% below | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL 1 WITHOUT PROCEDURE | $113.50 | $113.50 | — | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED LEVEL 1 WITH PROCEDURE | $113.50 | $113.50 | — | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2 WITH PROCEDURE | $275.00 | $275.00 | — | 46% below | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2 WITHOUT PROCEDURE | $275.00 | $275.00 | — | 46% below | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL 2 WITHOUT PROCEDURE | $275.00 | $275.00 | — | — | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED LEVEL 2 WITH PROCEDURE | $275.00 | $275.00 | — | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3 WITH PROCEDURE | $460.00 | $460.00 | — | 46% below | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3 WITHOUT PROCEDURE | $460.00 | $460.00 | — | 46% below | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL 3 WITH PROCEDURE | $460.00 | $460.00 | — | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED LEVEL 3 WITHOUT PROCEDURE | $460.00 | $460.00 | — | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL 4 WITH PROCEDURE | $780.00 | $780.00 | — | 42% below | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL 4 WITHOUT PROCEDURE | $780.00 | $780.00 | — | 42% below | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL 4 WITH PROCEDURE | $780.00 | $780.00 | — | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED LEVEL 4 WITHOUT PROCEDURE | $780.00 | $780.00 | — | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5 WITH PROCEDURE | $930.00 | $930.00 | — | 41% below | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5 WITHOUT PROCEDURE | $930.00 | $930.00 | — | 41% below | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL 5 WITHOUT PROCEDURE | $930.00 | $930.00 | — | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED LEVEL 5 WITH PROCEDURE | $930.00 | $930.00 | — | — | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS-PHARM | $620.75 | $620.75 | — | 30% below | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL | $620.75 | $620.75 | — | 30% below | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EMER DEPT TREADMILL | $620.75 | $620.75 | — | 30% below | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 EMER DEPT TREADMILL | $620.75 | $620.75 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL | $620.75 | $620.75 | — | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIOVASCULAR STRESS-PHARM | $620.75 | $620.75 | — | — | — |
| Family therapy with the patient, 50 minutes CPT 90847 TBS FAMILY THERAPY W/PT | $205.00 | $205.00 | — | 28% below | — |
| Family therapy with the patient, 50 minutes CPT 90847 MEDI FAMILY THERAPY W/ PATIENT | $205.00 | $205.00 | — | 28% below | — |
| Family therapy with the patient, 50 minutes CPT 90847 MEDI PHP FAMILY THERAPY W PT | $205.00 | $205.00 | — | 28% below | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 MEDI FAMILY THERAPY W/ PATIENT | $205.00 | $205.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 TBS FAMILY THERAPY W/PT | $205.00 | $205.00 | — | — | — |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 MEDI PHP FAMILY THERAPY W PT | $205.00 | $205.00 | — | — | — |
| Family therapy without the patient, 50 minutes CPT 90846 TBS FAMILY THERAPY W/O PT | $205.00 | $205.00 | — | 33% below | — |
| Family therapy without the patient, 50 minutes CPT 90846 MEDI FAMILY THERAPY WO PATIENT | $205.00 | $205.00 | — | 33% below | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 MEDI FAMILY THERAPY WO PATIENT | $205.00 | $205.00 | — | — | — |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 TBS FAMILY THERAPY W/O PT | $205.00 | $205.00 | — | — | — |
| Group psychotherapy session CPT 90853 TBS ONE GROUP | $175.25 | $175.25 | — | 6% above | — |
| Group psychotherapy session CPT 90853 MEDI GROUP THERAPY | $175.25 | $175.25 | — | 6% above | — |
| Group psychotherapy session CPT 90853 COM AFTERCARE | $523.25 | $523.25 | — | 217% above | — |
| Group psychotherapy session CPT 90853 MEDI AFTERCARE | $523.25 | $523.25 | — | 217% above | — |
| Group psychotherapy session inpatient CPT 90853 MEDI GROUP THERAPY | $175.25 | $175.25 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 TBS ONE GROUP | $175.25 | $175.25 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 COM AFTERCARE | $523.25 | $523.25 | — | — | — |
| Group psychotherapy session inpatient CPT 90853 MEDI AFTERCARE | $523.25 | $523.25 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION INITIAL | $402.75 | $402.75 | — | 4% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION XU HYDRATION INT H | $402.75 | $402.75 | — | 4% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION,HYDRATION,INITIAL | $404.00 | $404.00 | — | 3% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION,HYDRATION,INIT XU | $404.00 | $404.00 | — | 3% below | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION XU HYDRATION INT H | $402.75 | $402.75 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION INITIAL | $402.75 | $402.75 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION,HYDRATION,INITIAL | $404.00 | $404.00 | — | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION,HYDRATION,INIT XU | $404.00 | $404.00 | — | — | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPEUTIC/DX INI | $391.50 | $391.50 | — | 10% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THER/DX INITIAL XU | $391.50 | $391.50 | — | 10% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION,THERAPEUTIC/DX INI | $402.75 | $402.75 | — | 7% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION XU MEDS INIT HOUR | $402.75 | $402.75 | — | 7% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPUTIC/DX INIT | $402.75 | $402.75 | — | 7% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THER/DX INIT XU | $404.00 | $404.00 | — | 7% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THER/DX INT UP TO | $404.00 | $404.00 | — | 7% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPUETIC/DX INI | $404.00 | $404.00 | — | 7% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPEUTIC/DX,INI | $418.25 | $418.25 | — | 3% below | — |
| IV infusion of a medicine, first hour CPT 96365 IV INFUSION, THERAPUETIC/DX IN | $418.25 | $418.25 | — | 3% below | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER/DX INITIAL XU | $391.50 | $391.50 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPEUTIC/DX INI | $391.50 | $391.50 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION,THERAPEUTIC/DX INI | $402.75 | $402.75 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPUTIC/DX INIT | $402.75 | $402.75 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION XU MEDS INIT HOUR | $402.75 | $402.75 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER/DX INT UP TO | $404.00 | $404.00 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPUETIC/DX INI | $404.00 | $404.00 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THER/DX INIT XU | $404.00 | $404.00 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION, THERAPUETIC/DX IN | $418.25 | $418.25 | — | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPEUTIC/DX,INI | $418.25 | $418.25 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM ANTIBIOTIC | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 RHOGAM INJECTION | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THER/DX SC/IM | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THER/DX SC/IM XU | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ ANTI-BIOTIC IM/SC | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION XU THER/DX SC/IM | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THER/DX/SC/IM | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION,ADMINISTRATION | $91.75 | $91.75 | — | 36% below | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RHOGAM INJECTION | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION,ADMINISTRATION | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THER/DX/SC/IM | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM ANTIBIOTIC | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION XU THER/DX SC/IM | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ ANTI-BIOTIC IM/SC | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THER/DX SC/IM XU | $91.75 | $91.75 | — | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION THER/DX SC/IM | $91.75 | $91.75 | — | — | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE COND STUDIES 7-8 STUDIES | $263.75 | $263.75 | — | 81% below | — |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 NCS 7-8 STUDIES | $263.75 | $263.75 | — | 81% below | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE COND STUDIES 7-8 STUDIES | $263.75 | $263.75 | — | — | — |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NCS 7-8 STUDIES | $263.75 | $263.75 | — | — | — |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR EDUCATION | $117.50 | $117.50 | — | 10% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION | $117.50 | $117.50 | — | 10% above | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR EDUCATION | $117.50 | $117.50 | — | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION | $117.50 | $117.50 | — | — | — |
| New patient office visit, about 30 minutes CPT 99203 RAD ONC NEW PATIENT LEVEL 3 | $263.75 | $263.75 | — | 164% above | — |
| New patient office visit, about 30 minutes CPT 99203 ORTH NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | 172% above | — |
| New patient office visit, about 30 minutes CPT 99203 ONC NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | 172% above | — |
| New patient office visit, about 30 minutes CPT 99203 ONC NEW VISIT LEVEL 3 MOD 25 | $272.00 | $272.00 | — | 172% above | — |
| New patient office visit, about 30 minutes CPT 99203 NEUROLOGY NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | 172% above | — |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | 172% above | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 RAD ONC NEW PATIENT LEVEL 3 | $263.75 | $263.75 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 ONC NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEUROLOGY NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 ORTH NEW PATIENT LEVEL 3 | $272.00 | $272.00 | — | — | — |
| New patient office visit, about 30 minutes inpatient CPT 99203 ONC NEW VISIT LEVEL 3 MOD 25 | $272.00 | $272.00 | — | — | — |
| New patient office visit, about 45 minutes CPT 99204 RAD ONC NEW PATIENT LEVEL 4 | $341.00 | $341.00 | — | 155% above | — |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | 163% above | — |
| New patient office visit, about 45 minutes CPT 99204 ONC NEW VISIT LEVEL 4 MOD 25 | $351.25 | $351.25 | — | 163% above | — |
| New patient office visit, about 45 minutes CPT 99204 NEUROLOGY NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | 163% above | — |
| New patient office visit, about 45 minutes CPT 99204 ONC NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | 163% above | — |
| New patient office visit, about 45 minutes CPT 99204 ORTH NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | 163% above | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 RAD ONC NEW PATIENT LEVEL 4 | $341.00 | $341.00 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 ONC NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 ONC NEW VISIT LEVEL 4 MOD 25 | $351.25 | $351.25 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 ORTH NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | — | — |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEUROLOGY NEW PATIENT LEVEL 4 | $351.25 | $351.25 | — | — | — |
| New patient office visit, about 60 minutes CPT 99205 RAD ONC NEW PATIENT LEVEL 5 | $445.00 | $445.00 | — | 150% above | — |
| New patient office visit, about 60 minutes CPT 99205 ONC NEW VISIT LEVEL 5 MOD 25 | $458.50 | $458.50 | — | 157% above | — |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | 157% above | — |
| New patient office visit, about 60 minutes CPT 99205 ONC NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | 157% above | — |
| New patient office visit, about 60 minutes CPT 99205 NEUROLOGY NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | 157% above | — |
| New patient office visit, about 60 minutes CPT 99205 ORTH NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | 157% above | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 RAD ONC NEW PATIENT LEVEL 5 | $445.00 | $445.00 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEUROLOGY NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 ONC NEW VISIT LEVEL 5 MOD 25 | $458.50 | $458.50 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 ONC NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | — | — |
| New patient office visit, about 60 minutes inpatient CPT 99205 ORTH NEW PATIENT LEVEL 5 | $458.50 | $458.50 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 RAD ONC NEW PATIENT LEVEL 2 | $200.00 | $200.00 | — | 121% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEUROLOGY NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | 128% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 ONC NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | 128% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 ORTH NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | 128% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | 128% above | — |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 ONC NEW VISIT LEVEL 2 MOD 25 | $206.00 | $206.00 | — | 128% above | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 RAD ONC NEW PATIENT LEVEL 2 | $200.00 | $200.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ONC NEW VISIT LEVEL 2 MOD 25 | $206.00 | $206.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ONC NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEUROLOGY NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 ORTH NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | — | — |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 NEW PATIENT LEVEL 2 | $206.00 | $206.00 | — | — | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITION COUNSELING 15MIN | $34.00 | $34.00 | — | 48% below | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 DSMI INDIVIDUAL ASSESS 30 MIN | $90.75 | $90.75 | — | 39% above | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITION COUNSELING 15MIN | $34.00 | $34.00 | — | — | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 DSMI INDIVIDUAL ASSESS 30 MIN | $90.75 | $90.75 | — | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30MIN | $225.75 | $225.75 | — | 14% below | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30MIN | $225.75 | $225.75 | — | — | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45MIN | $446.00 | $446.00 | — | 50% above | — |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45MIN | $446.00 | $446.00 | — | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20MIN | $201.00 | $201.00 | — | 24% below | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20MIN | $201.00 | $201.00 | — | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30MIN | $301.00 | $301.00 | — | 9% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30MIN | $301.00 | $301.00 | — | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY | $103.00 | $103.00 | — | 4% below | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY | $103.00 | $103.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT EXERCISE | $20.00 | $20.00 | — | 82% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE | $109.25 | $109.25 | — | 2% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE WITH MODALITY | $109.25 | $109.25 | — | 2% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE W MODALIT | $109.25 | $109.25 | — | 2% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE 15 MIN | $109.25 | $109.25 | — | 2% below | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT EXERCISE | $20.00 | $20.00 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE | $109.25 | $109.25 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISE 15 MIN | $109.25 | $109.25 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISE WITH MODALITY | $109.25 | $109.25 | — | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE W MODALIT | $109.25 | $109.25 | — | — | — |
| Psychotherapy for crisis, first 60 minutes CPT 90839 TBS CRISIS PSYCHOTHERAPY 60MIN | $259.75 | $259.75 | — | 17% below | — |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 TBS CRISIS PSYCHOTHERAPY 60MIN | $259.75 | $259.75 | — | — | — |
| Psychotherapy session, 30 minutes CPT 90832 TBS 30 MIN BRIEF INDIVIDUAL | $146.50 | $146.50 | — | 19% below | — |
| Psychotherapy session, 30 minutes CPT 90832 30 MIN BRIEF INDIVIDUAL THERAP | $146.50 | $146.50 | — | 19% below | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 30 MIN BRIEF INDIVIDUAL THERAP | $146.50 | $146.50 | — | — | — |
| Psychotherapy session, 30 minutes inpatient CPT 90832 TBS 30 MIN BRIEF INDIVIDUAL | $146.50 | $146.50 | — | — | — |
| Psychotherapy session, 45 minutes CPT 90834 TBS 45 MIN EXTEND INDIVIDUAL | $205.00 | $205.00 | — | 23% below | — |
| Psychotherapy session, 45 minutes CPT 90834 45 MIN EXTEND INDIVIDUAL THERA | $205.00 | $205.00 | — | 23% below | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 45 MIN EXTEND INDIVIDUAL THERA | $205.00 | $205.00 | — | — | — |
| Psychotherapy session, 45 minutes inpatient CPT 90834 TBS 45 MIN EXTEND INDIVIDUAL | $205.00 | $205.00 | — | — | — |
| Psychotherapy session, 60 minutes CPT 90837 60 MIN INDIVIDUAL THERAPY | $267.00 | $267.00 | — | 15% below | — |
| Psychotherapy session, 60 minutes CPT 90837 TBS 60 MIN INDIVIDUAL THERAPY | $267.00 | $267.00 | — | 15% below | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 TBS 60 MIN INDIVIDUAL THERAPY | $267.00 | $267.00 | — | — | — |
| Psychotherapy session, 60 minutes inpatient CPT 90837 60 MIN INDIVIDUAL THERAPY | $267.00 | $267.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 NEUROLOGY EST VISIT LEVEL 5 | $330.75 | $330.75 | — | 96% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ORTH EST VISIT LEVEL 5 | $330.75 | $330.75 | — | 96% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 RAD ONC EST VISIT LEVEL 5 | $341.00 | $341.00 | — | 102% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ONCOLOGY EST VISIT LEVEL 5 | $351.25 | $351.25 | — | 108% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ONC EST VISIT LEVEL 5 MOD 25 | $351.25 | $351.25 | — | 108% above | — |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST PATIENT LEVEL 5 | $351.25 | $351.25 | — | 108% above | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 NEUROLOGY EST VISIT LEVEL 5 | $330.75 | $330.75 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ORTH EST VISIT LEVEL 5 | $330.75 | $330.75 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RAD ONC EST VISIT LEVEL 5 | $341.00 | $341.00 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST PATIENT LEVEL 5 | $351.25 | $351.25 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ONC EST VISIT LEVEL 5 MOD 25 | $351.25 | $351.25 | — | — | — |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 ONCOLOGY EST VISIT LEVEL 5 | $351.25 | $351.25 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PRE SURGERY | $116.50 | $116.50 | — | 8% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 POST MONITORING | $116.50 | $116.50 | — | 8% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PRE MONITORING | $116.50 | $116.50 | — | 8% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 POST SURGERY | $116.50 | $116.50 | — | 8% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 C RM REMOVL OF FIXATION DEVICE | $164.00 | $164.00 | — | 52% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 DRESSING APPLICATION MAJOR PLU | $204.00 | $204.00 | — | 89% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OSTOMY CARE LEVEL 3 | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 NEUROLOGY EST VISIT LEVEL 3 | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 JOINT INJECTION | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 REMOVAL/FIXATION DEVICE | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 WOUND CARE 50>SQCM | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ORTH EST VISIT LEVEL 3 | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP VISIT LEVEL 3 | $236.00 | $236.00 | — | 118% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ENDO VISIT LEVEL 3 | $245.25 | $245.25 | — | 127% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PEG REMOVAL - NO EGD | $245.25 | $245.25 | — | 127% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 RAD ONC EST VISIT LEVEL 3 | $246.25 | $246.25 | — | 128% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST PATIENT LEVEL 3 | $254.50 | $254.50 | — | 135% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONCOLOGY EST VISIT LEVEL 3 | $254.50 | $254.50 | — | 135% above | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONC EST VISIT LEVEL 3 MOD 25 | $254.50 | $254.50 | — | 135% above | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PRE MONITORING | $116.50 | $116.50 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 POST MONITORING | $116.50 | $116.50 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PRE SURGERY | $116.50 | $116.50 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 POST SURGERY | $116.50 | $116.50 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 C RM REMOVL OF FIXATION DEVICE | $164.00 | $164.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 DRESSING APPLICATION MAJOR PLU | $204.00 | $204.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 NEUROLOGY EST VISIT LEVEL 3 | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OSTOMY CARE LEVEL 3 | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 JOINT INJECTION | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP VISIT LEVEL 3 | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ORTH EST VISIT LEVEL 3 | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 REMOVAL/FIXATION DEVICE | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WOUND CARE 50>SQCM | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ENDO VISIT LEVEL 3 | $245.25 | $245.25 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PEG REMOVAL - NO EGD | $245.25 | $245.25 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RAD ONC EST VISIT LEVEL 3 | $246.25 | $246.25 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONC EST VISIT LEVEL 3 MOD 25 | $254.50 | $254.50 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONCOLOGY EST VISIT LEVEL 3 | $254.50 | $254.50 | — | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 EST PATIENT LEVEL 3 | $254.50 | $254.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP RECOVERY CHARGE | $74.50 | $74.50 | — | 48% below | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RAD ONC EST VISIT LEVEL 4 | $278.25 | $278.25 | — | 96% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ORTH EST VISIT LEVEL 4 | $287.50 | $287.50 | — | 102% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONC EST VISIT LEVEL 4 MOD 25 | $287.50 | $287.50 | — | 102% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONCOLOGY EST VISIT LEVEL 4 | $287.50 | $287.50 | — | 102% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP VISIT LEVEL 4 | $287.50 | $287.50 | — | 102% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST PATIENT LEVEL 4 | $287.50 | $287.50 | — | 102% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 NEUROLOGY EST VISIT LEVEL 4 | $287.50 | $287.50 | — | 102% above | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP RECOVERY CHARGE | $74.50 | $74.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RAD ONC EST VISIT LEVEL 4 | $278.25 | $278.25 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST PATIENT LEVEL 4 | $287.50 | $287.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP VISIT LEVEL 4 | $287.50 | $287.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONC EST VISIT LEVEL 4 MOD 25 | $287.50 | $287.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ORTH EST VISIT LEVEL 4 | $287.50 | $287.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 NEUROLOGY EST VISIT LEVEL 4 | $287.50 | $287.50 | — | — | — |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONCOLOGY EST VISIT LEVEL 4 | $287.50 | $287.50 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 NEUROLOGY EST VISIT LEVEL 2 | $130.00 | $130.00 | — | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT LEVEL 2 | $130.00 | $130.00 | — | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WOUND CARE 25-50 SQCM | $130.00 | $130.00 | — | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OSTOMY CARE LEVEL 2 | $130.00 | $130.00 | — | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ORTH EST VISIT LEVEL 2 | $130.00 | $130.00 | — | 33% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ENDOSCOPY VISIT LEVEL 2 | $135.00 | $135.00 | — | 38% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DRESSING APPLICATION MAJOR | $167.00 | $167.00 | — | 71% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RAD ONC EST VISIT LEVEL 2 | $228.75 | $228.75 | — | 135% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONC EST VISIT LEVEL 2 MOD 25 | $236.00 | $236.00 | — | 142% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ONCOLOGY EST VISIT LEVEL 2 | $236.00 | $236.00 | — | 142% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST PATIENT LEVEL 2 | $236.00 | $236.00 | — | 142% above | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 NEUROLOGY EST VISIT LEVEL 2 | $130.00 | $130.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OSTOMY CARE LEVEL 2 | $130.00 | $130.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WOUND CARE 25-50 SQCM | $130.00 | $130.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT LEVEL 2 | $130.00 | $130.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ORTH EST VISIT LEVEL 2 | $130.00 | $130.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ENDOSCOPY VISIT LEVEL 2 | $135.00 | $135.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 DRESSING APPLICATION MAJOR | $167.00 | $167.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RAD ONC EST VISIT LEVEL 2 | $228.75 | $228.75 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONC EST VISIT LEVEL 2 MOD 25 | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ONCOLOGY EST VISIT LEVEL 2 | $236.00 | $236.00 | — | — | — |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EST PATIENT LEVEL 2 | $236.00 | $236.00 | — | — | — |
| Speech and language evaluation CPT 92523 EVAL OF SPEECH PROC C LANG COM | $255.50 | $255.50 | — | 19% below | — |
| Speech and language evaluation inpatient CPT 92523 EVAL OF SPEECH PROC C LANG COM | $255.50 | $255.50 | — | — | — |
| Speech therapy session, individual CPT 92507 SLP TREATMENT | $136.00 | $136.00 | — | 41% below | — |
| Speech therapy session, individual CPT 92507 TRAINING FOR VOICE PROSTHETIC | $136.00 | $136.00 | — | 41% below | — |
| Speech therapy session, individual inpatient CPT 92507 TRAINING FOR VOICE PROSTHETIC | $136.00 | $136.00 | — | — | — |
| Speech therapy session, individual inpatient CPT 92507 SLP TREATMENT | $136.00 | $136.00 | — | — | — |
| Spirometry (breathing test) CPT 94010 SIMPLE SPIROMETRY | $196.75 | $196.75 | — | 32% below | — |
| Spirometry (breathing test) inpatient CPT 94010 SIMPLE SPIROMETRY | $196.75 | $196.75 | — | — | — |
| Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE AND POST | $453.75 | $453.75 | — | 20% below | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE AND POST | $453.75 | $453.75 | — | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL TRAINING | $117.50 | $117.50 | — | 5% below | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL TRAINING | $117.50 | $117.50 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY 200 | $113.00 | $113.00 | — | 55% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY 150 | $113.00 | $113.00 | — | 55% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $113.00 | $113.00 | — | 55% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY 300CC | $113.00 | $113.00 | — | 55% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY 500CC | $113.00 | $113.00 | — | 55% below | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY 250CC | $113.00 | $113.00 | — | 55% below | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY 500CC | $113.00 | $113.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY | $113.00 | $113.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY 200 | $113.00 | $113.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY 150 | $113.00 | $113.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY 250CC | $113.00 | $113.00 | — | — | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY 300CC | $113.00 | $113.00 | — | — | — |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Ohio | Off list |
|---|---|---|---|---|---|
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARIVAX VACCINE VIAL | $316.60 | $316.60 | — | 12% below | — |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARIVAX VACCINE VIAL | $316.60 | $316.60 | — | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL 9 | $511.00 | $511.00 | — | 2% below | — |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL 9 | $511.00 | $511.00 | — | — | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS-B VACCINE ADULT | $282.00 | $282.00 | — | 82% above | — |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS-B VACCINE ADULT | $282.00 | $282.00 | — | — | — |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACCINE VIAL | $420.00 | $420.00 | — | 32% above | — |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE VIAL | $420.00 | $420.00 | — | — | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL CONJ VACCINE 20 V | $628.00 | $628.00 | — | 5% below | — |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL CONJ VACCINE 20 V | $628.00 | $628.00 | — | — | — |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE VIAL | $1,301.43 | $1,301.43 | — | 36% above | — |
| Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE VIAL | $1,301.43 | $1,301.43 | — | — | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTH TOX. 0.5ML | $169.00 | $169.00 | — | 89% above | — |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTH TOX. 0.5ML | $169.00 | $169.00 | — | — | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL 0.5ML | $139.50 | $139.50 | — | 26% above | — |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL 0.5ML | $139.50 | $139.50 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ PNEUMONOCOCCAL VACCINE | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS VACCINE ADM NON MED | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL VACCINE ADMIN NON | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINST 1 VACCINE | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IM INJ RABIES VACCINE | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ FLU VACINE | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION DPT/TETANUS | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ DPT/TETANUS | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION INJECTION | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ HEPATITIS VACCINE | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ FLU VACCINE | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJ IMMUNIZATION ADMINISTR | $65.00 | $65.00 | — | 62% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECTION TD/DPT/TETANUS | $67.00 | $67.00 | — | 67% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ FLU VACINE | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ DPT/TETANUS | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINST 1 VACCINE | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS VACCINE ADM NON MED | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IM INJ RABIES VACCINE | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION DPT/TETANUS | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL VACCINE ADMIN NON | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ FLU VACCINE | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ IMMUNIZATION ADMINISTR | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ PNEUMONOCOCCAL VACCINE | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJ HEPATITIS VACCINE | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION INJECTION | $65.00 | $65.00 | — | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION TD/DPT/TETANUS | $67.00 | $67.00 | — | — | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADD VACC | $65.00 | $65.00 | — | 87% above | — |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADD VACC | $65.00 | $65.00 | — | — | — |
Source file: https://srmcmrf.blob.core.windows.net/srmcmrf/341041385_salem-regional-medical-center_standardcharges.json