Hospital Ruston, LA

Northern Louisiana Medical Center

Northern Louisiana Medical Center in Ruston, LA publishes cash prices for 237 common procedures listed here, from its own machine-readable price file updated Jun 19, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Louisiana median for 229 of 235 procedures and below it for 5. By typical cash price it ranks #27 of 28 Louisiana hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

401 E VAUGHN AVE,RUSTON,LA,71270-0000 Collected Sep 27, 2026 Source price file (318) 254-2100

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 190086 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 5 actions for a hospital named Northern Louisiana Medical Center in Ruston, LA:

Apr 7, 2023 Warning notice
Sep 28, 2023 Case closed
Apr 11, 2025 Met requirements
May 19, 2026 Warning notice
Jul 10, 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. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

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 Louisiana	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE MIN 3 VW BILAT	$620.67	$1,128.50	$42.07–$2,347.50	—	45%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$620.67	$1,128.50	$42.07–$2,347.50	419% above	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MIN 3 VIEWS LT	$335.22	$609.50	$42.07–$2,347.50	180% above	45%
Ankle X-ray, complete, 3 or more views one side CPT 73610 ANKLE MIN 3 VIEWS RT	$335.22	$609.50	$42.07–$2,347.50	180% above	45%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE MIN 3 VW BILAT	$620.67	$1,128.50	$42.07–$2,347.50	—	45%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY EXAM OF ANKLE	$620.67	$1,128.50	$42.07–$2,347.50	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MIN 3 VIEWS RT	$335.22	$609.50	$42.07–$2,347.50	—	45%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 ANKLE MIN 3 VIEWS LT	$335.22	$609.50	$42.07–$2,347.50	—	45%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$675.40	$1,228.00	$91.85–$1,228.00	185% above	45%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM	$675.40	$1,228.00	$91.85–$1,228.00	185% above	45%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$675.40	$1,228.00	$91.85–$1,228.00	—	45%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGRAM	$675.40	$1,228.00	$91.85–$1,228.00	—	45%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,574.92	$2,863.50	$214.18–$2,863.50	159% above	45%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE/JOINT WHOLE BODY	$1,574.92	$2,863.50	$214.18–$2,863.50	159% above	45%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE/JOINT WHOLE BODY	$1,574.92	$2,863.50	$214.18–$2,863.50	—	45%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$1,574.92	$2,863.50	$214.18–$2,863.50	—	45%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$452.65	$823.00	$114.25–$3,292.50	162% above	45%
Breast ultrasound, complete, one breast CPT 76641 US BREAST COMP BIL	$905.57	$1,646.50	$114.25–$3,292.50	424% above	45%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMP LT	$452.65	$823.00	$114.25–$3,292.50	162% above	45%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST COMP RT	$452.65	$823.00	$114.25–$3,292.50	162% above	45%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE	$452.65	$823.00	$114.25–$3,292.50	—	45%
Breast ultrasound, complete, one breast inpatient CPT 76641 US BREAST COMP BIL	$905.57	$1,646.50	$114.25–$3,292.50	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMP LT	$452.65	$823.00	$114.25–$3,292.50	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST COMP RT	$452.65	$823.00	$114.25–$3,292.50	—	45%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED BILATERAL	$905.57	$1,646.50	$86.76–$3,292.50	—	45%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$452.65	$823.00	$86.76–$3,292.50	154% above	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD LT	$452.65	$823.00	$86.76–$3,292.50	154% above	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LTD RT	$452.65	$823.00	$86.76–$3,292.50	154% above	45%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST LIMITED BILATERAL	$905.57	$1,646.50	$86.76–$3,292.50	—	45%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED	$452.65	$823.00	$86.76–$3,292.50	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LTD RT	$452.65	$823.00	$86.76–$3,292.50	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LTD LT	$452.65	$823.00	$86.76–$3,292.50	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$3,216.95	$5,849.00	$336.00–$5,849.00	239% above	45%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WC	$3,216.95	$5,849.00	$336.00–$5,849.00	239% above	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WC	$3,216.95	$5,849.00	$336.00–$5,849.00	—	45%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$3,216.95	$5,849.00	$336.00–$5,849.00	—	45%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$110.00	$200.00	$14.96–$336.00	39% above	45%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO QUAL	$110.00	$200.00	$14.96–$336.00	39% above	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART WO QUAL	$110.00	$200.00	$14.96–$336.00	—	45%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$110.00	$200.00	$14.96–$336.00	—	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT RENAL STONE STUDY	$4,095.85	$7,447.00	$336.00–$14,894.00	228% above	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$4,095.85	$7,447.00	$336.00–$14,894.00	228% above	45%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD&PEL WO CONTRAST	$4,095.85	$7,447.00	$336.00–$14,894.00	228% above	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT RENAL STONE STUDY	$4,095.85	$7,447.00	$336.00–$14,894.00	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD&PEL WO CONTRAST	$4,095.85	$7,447.00	$336.00–$14,894.00	—	45%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$4,095.85	$7,447.00	$336.00–$14,894.00	—	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$5,409.52	$9,835.50	$336.00–$9,835.50	231% above	45%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD&PEL W CONTRAST	$5,409.52	$9,835.50	$336.00–$9,835.50	231% above	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD&PEL W CONTRAST	$5,409.52	$9,835.50	$336.00–$9,835.50	—	45%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST	$5,409.52	$9,835.50	$336.00–$9,835.50	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$6,413.82	$11,661.50	$336.00–$11,661.50	277% above	45%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PEL WO/W CONTRAST	$6,413.82	$11,661.50	$336.00–$11,661.50	277% above	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$6,413.82	$11,661.50	$336.00–$11,661.50	—	45%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PEL WO/W CONTRAST	$6,413.82	$11,661.50	$336.00–$11,661.50	—	45%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONT	$2,704.90	$4,918.00	$336.00–$4,918.00	200% above	45%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$2,704.90	$4,918.00	$336.00–$4,918.00	200% above	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH CONT	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	140% above	45%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$2,047.65	$3,723.00	$225.61–$3,723.00	140% above	45%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONT	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILO/SINUS W/O CONT	$2,047.65	$3,723.00	$225.61–$3,723.00	208% above	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	208% above	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILO/SINUS W/O CONT	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	212% above	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONT	$2,047.65	$3,723.00	$225.61–$3,723.00	212% above	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONT	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$2,704.90	$4,918.00	$336.00–$4,918.00	239% above	45%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN WITH CONT	$2,704.90	$4,918.00	$336.00–$4,918.00	239% above	45%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/DYE	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN WITH CONT	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$3,207.05	$5,831.00	$336.00–$5,831.00	238% above	45%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/W/O CONT	$3,207.05	$5,831.00	$336.00–$5,831.00	238% above	45%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/W/O CONT	$3,207.05	$5,831.00	$336.00–$5,831.00	—	45%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$3,207.05	$5,831.00	$336.00–$5,831.00	—	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	158% above	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	158% above	45%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	160% above	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	160% above	45%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST	$2,704.90	$4,918.00	$336.00–$4,918.00	226% above	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$2,704.90	$4,918.00	$336.00–$4,918.00	226% above	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUP BILAT	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DUP BILAT	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Chest X-ray, 2 views both sides CPT 71046 XR CHEST 2 LAT DECUBITUS BILAT	$335.22	$609.50	$35.20–$1,219.00	—	45%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$335.22	$609.50	$35.20–$1,219.00	145% above	45%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$335.22	$609.50	$35.20–$1,219.00	145% above	45%
Chest X-ray, 2 views inpatient both sides CPT 71046 XR CHEST 2 LAT DECUBITUS BILAT	$335.22	$609.50	$35.20–$1,219.00	—	45%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$335.22	$609.50	$35.20–$1,219.00	—	45%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$335.22	$609.50	$35.20–$1,219.00	—	45%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$251.35	$457.00	$26.60–$457.00	125% above	45%
Chest X-ray, single view CPT 71045 XR CHEST SGL VIEW	$251.35	$457.00	$26.60–$457.00	125% above	45%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$251.35	$457.00	$26.60–$457.00	—	45%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SGL VIEW	$251.35	$457.00	$26.60–$457.00	—	45%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$807.95	$1,469.00	$109.88–$1,469.00	172% above	45%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL/BLADDER COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	172% above	45%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL/BLADDER COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY	$555.50	$1,010.00	$47.80–$1,010.00	231% above	45%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$555.50	$1,010.00	$47.80–$1,010.00	231% above	45%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$555.50	$1,010.00	$47.80–$1,010.00	—	45%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY	$555.50	$1,010.00	$47.80–$1,010.00	—	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$2,047.65	$3,723.00	$225.61–$3,723.00	164% above	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	164% above	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$2,047.65	$3,723.00	$225.61–$3,723.00	—	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST	$2,704.90	$4,918.00	$336.00–$4,918.00	185% above	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$2,704.90	$4,918.00	$336.00–$4,918.00	185% above	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH CONTRAST	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX C+	$2,704.90	$4,918.00	$336.00–$4,918.00	—	45%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMMO W CAD BILAT	$425.70	$774.00	$57.89–$774.00	—	45%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$425.70	$774.00	$57.89–$774.00	—	45%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$425.70	$774.00	$57.89–$774.00	—	45%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMMO W CAD BILAT	$425.70	$774.00	$57.89–$774.00	—	45%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$402.60	$732.00	$61.34–$1,464.00	231% above	45%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMO W CAD LT LT	$402.60	$732.00	$61.34–$1,464.00	231% above	45%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMO W CAD RT RT	$402.60	$732.00	$61.34–$1,464.00	231% above	45%
Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI	$402.60	$732.00	$61.34–$1,464.00	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMO W CAD RT RT	$402.60	$732.00	$61.34–$1,464.00	—	45%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMO W CAD LT LT	$402.60	$732.00	$61.34–$1,464.00	—	45%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERY LOWER EXTREMITY BI	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$1,273.80	$2,316.00	$173.23–$2,316.00	181% above	45%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERY LOWER EXTREMITY BI	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 LOWER EXTREMITY STUDY	$1,273.80	$2,316.00	$173.23–$2,316.00	—	45%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEIN UPPER EXTREMITY BILAT	$1,273.80	$2,316.00	$280.75–$4,632.00	—	45%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VEIN LOWER EXTREMITY BILAT	$1,273.80	$2,316.00	$280.75–$4,632.00	—	45%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$1,273.80	$2,316.00	$280.75–$4,632.00	205% above	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEIN UPPER EXTREMITY BILAT	$1,273.80	$2,316.00	$280.75–$4,632.00	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VEIN LOWER EXTREMITY BILAT	$1,273.80	$2,316.00	$280.75–$4,632.00	—	45%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$1,273.80	$2,316.00	$280.75–$4,632.00	—	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$3,073.12	$5,587.50	$220.84–$5,587.50	328% above	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO W/SPEC/COLOR FLOW	$3,073.12	$5,587.50	$220.84–$5,587.50	328% above	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$3,073.12	$5,587.50	$220.84–$5,587.50	—	45%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO W/SPEC/COLOR FLOW	$3,073.12	$5,587.50	$220.84–$5,587.50	—	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,760.00	$3,200.00	$239.36–$3,200.00	248% above	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY IMAG	$1,760.00	$3,200.00	$239.36–$3,200.00	248% above	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,760.00	$3,200.00	$239.36–$3,200.00	—	45%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY IMAG	$1,760.00	$3,200.00	$239.36–$3,200.00	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$5,221.70	$9,494.00	$710.15–$9,494.00	350% above	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRM CPAP SPLIT	$5,221.70	$9,494.00	$710.15–$9,494.00	350% above	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$5,221.70	$9,494.00	$710.15–$9,494.00	—	45%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRM CPAP SPLIT	$5,221.70	$9,494.00	$710.15–$9,494.00	—	45%
Knee X-ray, 3 views both sides CPT 73562 KNEE 3VW BILAT	$620.67	$1,128.50	$47.80–$2,347.50	—	45%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$335.22	$609.50	$47.80–$2,347.50	137% above	45%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS RT	$335.22	$609.50	$47.80–$2,347.50	137% above	45%
Knee X-ray, 3 views one side CPT 73562 KNEE 3 VIEWS LT	$335.22	$609.50	$47.80–$2,347.50	137% above	45%
Knee X-ray, 3 views inpatient both sides CPT 73562 KNEE 3VW BILAT	$620.67	$1,128.50	$47.80–$2,347.50	—	45%
Knee X-ray, 3 views inpatient CPT 73562 X-RAY EXAM OF KNEE 3	$335.22	$609.50	$47.80–$2,347.50	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS LT	$335.22	$609.50	$47.80–$2,347.50	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 KNEE 3 VIEWS RT	$335.22	$609.50	$47.80–$2,347.50	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$807.95	$1,469.00	$99.93–$1,469.00	170% above	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$807.95	$1,469.00	$99.93–$1,469.00	170% above	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$807.95	$1,469.00	$99.93–$1,469.00	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$807.95	$1,469.00	$99.93–$1,469.00	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$341.27	$620.50	$46.41–$620.50	220% above	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT-LUNG SCREENING	$341.27	$620.50	$46.41–$620.50	220% above	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C-	$341.27	$620.50	$46.41–$620.50	—	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT-LUNG SCREENING	$341.27	$620.50	$46.41–$620.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR KNEE BILAT WO	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR HIP BILAT WO	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR ANKLE BILAT WO	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$5,409.52	$9,835.50	$469.09–$49,972.50	399% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE WITHOUT CONT RT	$2,814.07	$5,116.50	$469.09–$49,972.50	160% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE WO CONTRST LT	$2,814.07	$5,116.50	$469.09–$49,972.50	160% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EX JNT WO CST LT	$2,814.07	$5,116.50	$469.09–$49,972.50	160% above	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOW EX JOINT WO RT	$2,814.07	$5,116.50	$469.09–$49,972.50	160% above	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR ANKLE BILAT WO	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR HIP BILAT WO	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR KNEE BILAT WO	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$5,409.52	$9,835.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE WITHOUT CONT RT	$2,814.07	$5,116.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOW EX JOINT WO RT	$2,814.07	$5,116.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOW EX JNT WO CST LT	$2,814.07	$5,116.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE WO CONTRST LT	$2,814.07	$5,116.50	$469.09–$49,972.50	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MR ANKLE BILAT WW	$5,409.52	$9,835.50	$616.00–$34,307.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MR HIP BILAT WW	$5,409.52	$9,835.50	$616.00–$34,307.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$5,409.52	$9,835.50	$616.00–$34,307.00	299% above	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EX JNT W/WO RT	$4,024.90	$7,318.00	$616.00–$34,307.00	197% above	45%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LOW EX JNT W/WO LT	$4,024.90	$7,318.00	$616.00–$34,307.00	197% above	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MR HIP BILAT WW	$5,409.52	$9,835.50	$616.00–$34,307.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MR ANKLE BILAT WW	$5,409.52	$9,835.50	$616.00–$34,307.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$5,409.52	$9,835.50	$616.00–$34,307.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOW EX JNT W/WO LT	$4,024.90	$7,318.00	$616.00–$34,307.00	—	45%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LOW EX JNT W/WO RT	$4,024.90	$7,318.00	$616.00–$34,307.00	—	45%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	161% above	45%
MRI of the abdomen without contrast CPT 74181 MR ABDOMEN WO	$2,814.07	$5,116.50	$382.71–$5,116.50	161% above	45%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABDOMEN WO	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN WO/W	$4,024.90	$7,318.00	$547.38–$7,318.00	197% above	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$4,024.90	$7,318.00	$547.38–$7,318.00	197% above	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN WO/W	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	149% above	45%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	149% above	45%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/W/O CONTRAST	$4,024.90	$7,318.00	$547.38–$7,318.00	178% above	45%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$4,024.90	$7,318.00	$547.38–$7,318.00	178% above	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/W/O CONTRAST	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	123% above	45%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O CON	$2,814.07	$5,116.50	$382.71–$5,116.50	123% above	45%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CON	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE WWO CON	$4,024.90	$7,318.00	$547.38–$7,318.00	189% above	45%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$4,024.90	$7,318.00	$547.38–$7,318.00	189% above	45%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE WWO CON	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	135% above	45%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	135% above	45%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE WWO CONTRST	$4,024.90	$7,318.00	$547.38–$7,318.00	143% above	45%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$4,024.90	$7,318.00	$547.38–$7,318.00	143% above	45%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI NECK SPINE W/O & W/DYE	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE WWO CONTRST	$4,024.90	$7,318.00	$547.38–$7,318.00	—	45%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	129% above	45%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	129% above	45%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/W/O CONTRST	$4,024.90	$7,318.00	$502.37–$7,318.00	215% above	45%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$4,024.90	$7,318.00	$502.37–$7,318.00	215% above	45%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/W/O CONTRST	$4,024.90	$7,318.00	$502.37–$7,318.00	—	45%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE	$4,024.90	$7,318.00	$502.37–$7,318.00	—	45%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	149% above	45%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	149% above	45%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST	$2,814.07	$5,116.50	$382.71–$5,116.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MR SHOULDER BILAT WO	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MR ELBOW BILAT WO	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye both sides CPT 73221 MR WRIST BILAT WO	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$5,409.52	$9,835.50	$469.09–$39,739.50	401% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EX JOINT WO RT	$2,814.07	$5,116.50	$469.09–$39,739.50	161% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UP EX JOINT W/O LT	$2,814.07	$5,116.50	$469.09–$39,739.50	161% above	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MR WRIST BILAT WO	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MR ELBOW BILAT WO	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient both sides CPT 73221 MR SHOULDER BILAT WO	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$5,409.52	$9,835.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EX JOINT WO RT	$2,814.07	$5,116.50	$469.09–$39,739.50	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UP EX JOINT W/O LT	$2,814.07	$5,116.50	$469.09–$39,739.50	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM CARDIAC SPECT MULTIPLE	$1,760.55	$3,201.00	$478.86–$6,402.00	41% above	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$1,760.55	$3,201.00	$478.86–$6,402.00	41% above	45%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUS IMAGE SPECT MULTI	$1,760.55	$3,201.00	$478.86–$6,402.00	41% above	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUS IMAGE SPECT MULTI	$1,760.55	$3,201.00	$478.86–$6,402.00	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM CARDIAC SPECT MULTIPLE	$1,760.55	$3,201.00	$478.86–$6,402.00	—	45%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$1,760.55	$3,201.00	$478.86–$6,402.00	—	45%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH	$6,558.75	$11,925.00	$891.99–$11,925.00	222% above	45%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET W/CT SKULL-THIGH	$6,558.75	$11,925.00	$891.99–$11,925.00	222% above	45%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET IMAGE W/CT SKULL-THIGH	$6,558.75	$11,925.00	$891.99–$11,925.00	—	45%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 NM PET W/CT SKULL-THIGH	$6,558.75	$11,925.00	$891.99–$11,925.00	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$513.70	$934.00	$38.63–$934.00	189% above	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 ULTRASOUND PELVIS LMTD	$513.70	$934.00	$38.63–$934.00	189% above	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 ULTRASOUND PELVIS LMTD	$513.70	$934.00	$38.63–$934.00	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$513.70	$934.00	$38.63–$934.00	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 ULTRASOUND PELVIS COMP	$807.95	$1,469.00	$109.88–$1,469.00	181% above	45%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	181% above	45%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 ULTRASOUND PELVIS COMP	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$807.95	$1,469.00	$109.88–$1,469.00	192% above	45%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U S OB >14 WKS 1ST GEST	$807.95	$1,469.00	$109.88–$1,469.00	192% above	45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 U S OB >14 WKS 1ST GEST	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US UTER PRIOR 14 WKS	$807.95	$1,469.00	$84.21–$1,469.00	203% above	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$807.95	$1,469.00	$84.21–$1,469.00	203% above	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$807.95	$1,469.00	$84.21–$1,469.00	—	45%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US UTER PRIOR 14 WKS	$807.95	$1,469.00	$84.21–$1,469.00	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED	$513.70	$934.00	$69.86–$934.00	279% above	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$513.70	$934.00	$69.86–$934.00	279% above	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$513.70	$934.00	$69.86–$934.00	—	45%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB LIMITED	$513.70	$934.00	$69.86–$934.00	—	45%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$372.35	$677.00	$64.90–$2,031.00	—	45%
Screening mammogram, both breasts CPT 77067 SCRN MAMMO CAD BIL	$372.35	$677.00	$64.90–$2,031.00	209% above	45%
Screening mammogram, both breasts one side CPT 77067 MA MAMMOGRAM SCREENING RT	$372.35	$677.00	$64.90–$2,031.00	209% above	45%
Screening mammogram, both breasts one side CPT 77067 MA MAMMOGRAM SCREENING LT	$372.35	$677.00	$64.90–$2,031.00	209% above	45%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD	$372.35	$677.00	$64.90–$2,031.00	—	45%
Screening mammogram, both breasts inpatient CPT 77067 SCRN MAMMO CAD BIL	$372.35	$677.00	$64.90–$2,031.00	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MA MAMMOGRAM SCREENING RT	$372.35	$677.00	$64.90–$2,031.00	—	45%
Screening mammogram, both breasts inpatient one side CPT 77067 MA MAMMOGRAM SCREENING LT	$372.35	$677.00	$64.90–$2,031.00	—	45%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 SHOULDER 2+VWS BILAT	$620.67	$1,128.50	$38.05–$2,347.50	—	45%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$335.22	$609.50	$38.05–$2,347.50	155% above	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2+ VIEWS RT	$335.22	$609.50	$38.05–$2,347.50	155% above	45%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER 2+ VIEWS LT	$335.22	$609.50	$38.05–$2,347.50	155% above	45%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 SHOULDER 2+VWS BILAT	$620.67	$1,128.50	$38.05–$2,347.50	—	45%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY EXAM OF SHOULDER	$335.22	$609.50	$38.05–$2,347.50	—	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2+ VIEWS LT	$335.22	$609.50	$38.05–$2,347.50	—	45%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER 2+ VIEWS RT	$335.22	$609.50	$38.05–$2,347.50	—	45%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY	$5,221.70	$9,494.00	$683.26–$9,494.00	290% above	45%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$5,221.70	$9,494.00	$683.26–$9,494.00	290% above	45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY	$5,221.70	$9,494.00	$683.26–$9,494.00	—	45%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$5,221.70	$9,494.00	$683.26–$9,494.00	—	45%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 NI TTE STRESS CON WO	$2,996.67	$5,448.50	$246.15–$5,448.50	396% above	45%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE	$2,996.67	$5,448.50	$246.15–$5,448.50	396% above	45%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE COMPLETE	$2,996.67	$5,448.50	$246.15–$5,448.50	—	45%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 NI TTE STRESS CON WO	$2,996.67	$5,448.50	$246.15–$5,448.50	—	45%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MODIFIED BARIUM SWALLOW	$675.40	$1,228.00	$91.85–$1,228.00	178% above	45%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$675.40	$1,228.00	$91.85–$1,228.00	178% above	45%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$675.40	$1,228.00	$91.85–$1,228.00	—	45%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MODIFIED BARIUM SWALLOW	$675.40	$1,228.00	$91.85–$1,228.00	—	45%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$807.95	$1,469.00	$109.88–$1,469.00	298% above	45%
Transvaginal pelvic ultrasound CPT 76830 ULTRASOUND TRANSVAGINAL	$807.95	$1,469.00	$109.88–$1,469.00	298% above	45%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Transvaginal pelvic ultrasound inpatient CPT 76830 ULTRASOUND TRANSVAGINAL	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$513.70	$934.00	$69.86–$934.00	199% above	45%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAG	$513.70	$934.00	$69.86–$934.00	199% above	45%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAG	$513.70	$934.00	$69.86–$934.00	—	45%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$513.70	$934.00	$69.86–$934.00	—	45%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	141% above	45%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	141% above	45%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$807.95	$1,469.00	$109.88–$1,469.00	256% above	45%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/TESTICLES	$807.95	$1,469.00	$109.88–$1,469.00	256% above	45%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM/TESTICLES	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRSND SOFT TISSUE NECK	$807.95	$1,469.00	$109.88–$1,469.00	181% above	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$807.95	$1,469.00	$109.88–$1,469.00	181% above	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRSND SOFT TISSUE NECK	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$807.95	$1,469.00	$109.88–$1,469.00	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI WO/KUB	$683.92	$1,243.50	$93.01–$1,243.50	152% above	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$683.92	$1,243.50	$93.01–$1,243.50	152% above	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$683.92	$1,243.50	$93.01–$1,243.50	—	45%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI WO/KUB	$683.92	$1,243.50	$93.01–$1,243.50	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$807.95	$1,469.00	$174.09–$5,876.00	140% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN UPPER EXTREMITY LT	$807.95	$1,469.00	$174.09–$5,876.00	140% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN UPPER EXTREMITY RT	$807.95	$1,469.00	$174.09–$5,876.00	140% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN LOWER EXTREMITY RT	$807.95	$1,469.00	$174.09–$5,876.00	140% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEIN LOWER EXTREMITY LT	$807.95	$1,469.00	$174.09–$5,876.00	140% above	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$807.95	$1,469.00	$174.09–$5,876.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN UPPER EXTREMITY LT	$807.95	$1,469.00	$174.09–$5,876.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN LOWER EXTREMITY LT	$807.95	$1,469.00	$174.09–$5,876.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN LOWER EXTREMITY RT	$807.95	$1,469.00	$174.09–$5,876.00	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEIN UPPER EXTREMITY RT	$807.95	$1,469.00	$174.09–$5,876.00	—	45%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 WRIST 3VW BILATERAL	$620.67	$1,128.50	$48.37–$2,347.50	—	45%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$335.22	$609.50	$48.37–$2,347.50	197% above	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS LT	$335.22	$609.50	$48.37–$2,347.50	197% above	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST 3 VIEWS RT	$335.22	$609.50	$48.37–$2,347.50	197% above	45%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 WRIST 3VW BILATERAL	$620.67	$1,128.50	$48.37–$2,347.50	—	45%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY EXAM OF WRIST	$335.22	$609.50	$48.37–$2,347.50	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS RT	$335.22	$609.50	$48.37–$2,347.50	—	45%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST 3 VIEWS LT	$335.22	$609.50	$48.37–$2,347.50	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$335.22	$609.50	$54.67–$1,219.00	136% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY HIP 2/3 VW RT	$335.22	$609.50	$54.67–$1,219.00	136% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XRAY HIP 2/3 VW LT	$335.22	$609.50	$54.67–$1,219.00	136% above	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$335.22	$609.50	$54.67–$1,219.00	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY HIP 2/3 VW RT	$335.22	$609.50	$54.67–$1,219.00	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XRAY HIP 2/3 VW LT	$335.22	$609.50	$54.67–$1,219.00	—	45%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$335.22	$609.50	$32.33–$609.50	196% above	45%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$335.22	$609.50	$32.33–$609.50	196% above	45%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$335.22	$609.50	$32.33–$609.50	—	45%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADEX ABDOMEN 1 VIEW	$335.22	$609.50	$32.33–$609.50	—	45%
X-ray of the ankle, 2 views both sides CPT 73600 ANKLE 2 VW BILATERAL	$620.67	$1,128.50	$37.48–$2,347.50	—	45%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$335.22	$609.50	$37.48–$2,347.50	211% above	45%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT	$335.22	$609.50	$37.48–$2,347.50	211% above	45%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT	$335.22	$609.50	$37.48–$2,347.50	211% above	45%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 ANKLE 2 VW BILATERAL	$620.67	$1,128.50	$37.48–$2,347.50	—	45%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY EXAM OF ANKLE	$335.22	$609.50	$37.48–$2,347.50	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT	$335.22	$609.50	$37.48–$2,347.50	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT	$335.22	$609.50	$37.48–$2,347.50	—	45%
X-ray of the finger(s), 2 or more views both sides CPT 73140 FINGER 2+VW BILAT	$620.67	$1,128.50	$46.07–$2,347.50	—	45%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$335.22	$609.50	$46.07–$2,347.50	242% above	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER(S) MIN 2 VIEWS RT	$335.22	$609.50	$46.07–$2,347.50	242% above	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LT	$335.22	$609.50	$46.07–$2,347.50	242% above	45%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 FINGER 2+VW BILAT	$620.67	$1,128.50	$46.07–$2,347.50	—	45%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S)	$335.22	$609.50	$46.07–$2,347.50	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LT	$335.22	$609.50	$46.07–$2,347.50	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER(S) MIN 2 VIEWS RT	$335.22	$609.50	$46.07–$2,347.50	—	45%
X-ray of the foot, 2 views both sides CPT 73620 FOOT 2VW BILATERAL	$620.67	$1,128.50	$32.33–$2,347.50	—	45%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$620.67	$1,128.50	$32.33–$2,347.50	476% above	45%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT	$335.22	$609.50	$32.33–$2,347.50	211% above	45%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT	$335.22	$609.50	$32.33–$2,347.50	211% above	45%
X-ray of the foot, 2 views inpatient both sides CPT 73620 FOOT 2VW BILATERAL	$620.67	$1,128.50	$32.33–$2,347.50	—	45%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY EXAM OF FOOT	$620.67	$1,128.50	$32.33–$2,347.50	—	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT	$335.22	$609.50	$32.33–$2,347.50	—	45%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT	$335.22	$609.50	$32.33–$2,347.50	—	45%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 FOOT MIN 3VW BILAT	$620.67	$1,128.50	$39.20–$2,347.50	—	45%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$620.67	$1,128.50	$39.20–$2,347.50	407% above	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3 VIEWS RT	$335.22	$609.50	$39.20–$2,347.50	174% above	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 FOOT MIN 3 VIEWS LT	$335.22	$609.50	$39.20–$2,347.50	174% above	45%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 FOOT MIN 3VW BILAT	$620.67	$1,128.50	$39.20–$2,347.50	—	45%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY EXAM OF FOOT	$620.67	$1,128.50	$39.20–$2,347.50	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MIN 3 VIEWS LT	$335.22	$609.50	$39.20–$2,347.50	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 FOOT MIN 3 VIEWS RT	$335.22	$609.50	$39.20–$2,347.50	—	45%
X-ray of the hand, 3 or more views both sides CPT 73130 HAND 3VW BILATERAL	$620.67	$1,128.50	$42.07–$2,347.50	—	45%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$335.22	$609.50	$42.07–$2,347.50	164% above	45%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VIEWS RT	$335.22	$609.50	$42.07–$2,347.50	164% above	45%
X-ray of the hand, 3 or more views one side CPT 73130 HAND MIN 3 VIEWS LT	$335.22	$609.50	$42.07–$2,347.50	164% above	45%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND 3VW BILATERAL	$620.67	$1,128.50	$42.07–$2,347.50	—	45%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY EXAM OF HAND	$335.22	$609.50	$42.07–$2,347.50	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VIEWS LT	$335.22	$609.50	$42.07–$2,347.50	—	45%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND MIN 3 VIEWS RT	$335.22	$609.50	$42.07–$2,347.50	—	45%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR KNEE 1-2 VIEWS BILAT	$670.45	$1,219.00	$40.35–$2,438.00	—	45%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$335.22	$609.50	$40.35–$2,438.00	204% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEWS LT	$335.22	$609.50	$40.35–$2,438.00	204% above	45%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE 1-2 VIEWS RT	$335.22	$609.50	$40.35–$2,438.00	204% above	45%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR KNEE 1-2 VIEWS BILAT	$670.45	$1,219.00	$40.35–$2,438.00	—	45%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$335.22	$609.50	$40.35–$2,438.00	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEWS RT	$335.22	$609.50	$40.35–$2,438.00	—	45%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE 1-2 VIEWS LT	$335.22	$609.50	$40.35–$2,438.00	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$335.22	$609.50	$43.22–$609.50	121% above	45%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACRAL 2-3 VIEWS	$335.22	$609.50	$43.22–$609.50	121% above	45%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$335.22	$609.50	$43.22–$609.50	—	45%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBOSACRAL 2-3 VIEWS	$335.22	$609.50	$43.22–$609.50	—	45%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$577.50	$1,050.00	$56.97–$1,050.00	151% above	45%
X-ray of the lower back, 4 or more views CPT 72110 LUMBOSACRAL MIN 4 VIEW	$577.50	$1,050.00	$56.97–$1,050.00	151% above	45%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBOSACRAL MIN 4 VIEW	$577.50	$1,050.00	$56.97–$1,050.00	—	45%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$577.50	$1,050.00	$56.97–$1,050.00	—	45%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS	$335.22	$609.50	$34.62–$609.50	90% above	45%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$335.22	$609.50	$34.62–$609.50	90% above	45%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$335.22	$609.50	$34.62–$609.50	—	45%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2 VIEWS	$335.22	$609.50	$34.62–$609.50	—	45%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$335.22	$609.50	$44.35–$609.50	177% above	45%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONE MIN 3 VIEWS	$335.22	$609.50	$44.35–$609.50	177% above	45%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONE MIN 3 VIEWS	$335.22	$609.50	$44.35–$609.50	—	45%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES	$335.22	$609.50	$44.35–$609.50	—	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$335.22	$609.50	$43.22–$609.50	133% above	45%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2-3 VIEWS	$335.22	$609.50	$43.22–$609.50	133% above	45%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2-3 VIEWS	$335.22	$609.50	$43.22–$609.50	—	45%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$335.22	$609.50	$43.22–$609.50	—	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS	$335.22	$609.50	$31.75–$609.50	132% above	45%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$335.22	$609.50	$31.75–$609.50	132% above	45%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS	$335.22	$609.50	$31.75–$609.50	—	45%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS	$335.22	$609.50	$31.75–$609.50	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM &COCCYX MIN 2 VW	$335.22	$609.50	$36.34–$609.50	137% above	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$335.22	$609.50	$36.34–$609.50	137% above	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE	$335.22	$609.50	$36.34–$609.50	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM &COCCYX MIN 2 VW	$335.22	$609.50	$36.34–$609.50	—	45%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$133.65	$243.00	$4.24–$243.00	331% above	45%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$133.65	$243.00	$4.24–$243.00	331% above	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$133.65	$243.00	$4.24–$243.00	—	45%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$133.65	$243.00	$4.24–$243.00	—	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$130.35	$237.00	$4.14–$237.00	295% above	45%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$130.35	$237.00	$4.14–$237.00	295% above	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$130.35	$237.00	$4.14–$237.00	—	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$130.35	$237.00	$4.14–$237.00	—	45%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$1,201.75	$2,185.00	$38.10–$2,185.00	938% above	45%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$1,201.75	$2,185.00	$38.10–$2,185.00	—	45%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE EACH	$54.17	$98.50	$4.18–$98.50	438% above	45%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$54.17	$98.50	$4.18–$98.50	438% above	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE EACH	$54.17	$98.50	$4.18–$98.50	—	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$54.17	$98.50	$4.18–$98.50	—	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$130.35	$237.00	$10.36–$237.00	174% above	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB	$130.35	$237.00	$10.36–$237.00	174% above	45%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$130.35	$237.00	$10.36–$237.00	—	45%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB	$130.35	$237.00	$10.36–$237.00	—	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA NON-REFLEX TO TITER	$304.97	$554.50	$9.67–$554.50	482% above	45%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$304.97	$554.50	$9.67–$554.50	482% above	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$304.97	$554.50	$9.67–$554.50	—	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA NON-REFLEX TO TITER	$304.97	$554.50	$9.67–$554.50	—	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$856.35	$1,557.00	$28.46–$1,557.00	990% above	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$856.35	$1,557.00	$28.46–$1,557.00	990% above	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$856.35	$1,557.00	$28.46–$1,557.00	—	45%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$856.35	$1,557.00	$28.46–$1,557.00	—	45%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL TOTAL CA	$213.67	$388.50	$6.77–$388.50	249% above	45%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$213.67	$388.50	$6.77–$388.50	249% above	45%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$213.67	$388.50	$6.77–$388.50	—	45%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL TOTAL CA	$213.67	$388.50	$6.77–$388.50	—	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$191.95	$349.00	$19.65–$349.00	163% above	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURG PATH GROSS & MICRO	$191.95	$349.00	$19.65–$349.00	163% above	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURG PATH GROSS & MICRO	$191.95	$349.00	$19.65–$349.00	—	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$191.95	$349.00	$19.65–$349.00	—	45%
Blood culture for bacteria CPT 87040 CULTURE BLOOD	$305.25	$555.00	$8.26–$555.00	319% above	45%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$305.25	$555.00	$8.26–$555.00	319% above	45%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$305.25	$555.00	$8.26–$555.00	—	45%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD	$305.25	$555.00	$8.26–$555.00	—	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$16.77	$30.50	$1.80–$30.50	96% above	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$16.77	$30.50	$1.80–$30.50	96% above	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$16.77	$30.50	$1.80–$30.50	—	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$16.77	$30.50	$1.80–$30.50	—	45%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLD QN	$59.12	$107.50	$3.14–$107.50	241% above	45%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$59.12	$107.50	$3.14–$107.50	241% above	45%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$59.12	$107.50	$3.14–$107.50	—	45%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLD QN	$59.12	$107.50	$3.14–$107.50	—	45%
Blood lead test CPT 83655 LEAD BLOOD	$305.52	$555.50	$9.69–$555.50	882% above	45%
Blood lead test CPT 83655 ASSAY OF LEAD	$305.52	$555.50	$9.69–$555.50	882% above	45%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$305.52	$555.50	$9.69–$555.50	—	45%
Blood lead test inpatient CPT 83655 LEAD BLOOD	$305.52	$555.50	$9.69–$555.50	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SERUM	$189.47	$344.50	$6.02–$344.50	243% above	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$189.47	$344.50	$6.02–$344.50	243% above	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SERUM	$189.47	$344.50	$6.02–$344.50	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$189.47	$344.50	$6.02–$344.50	—	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE	$120.45	$219.00	$2.39–$219.00	155% above	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$120.45	$219.00	$2.39–$219.00	155% above	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE	$120.45	$219.00	$2.39–$219.00	—	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$120.45	$219.00	$2.39–$219.00	—	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$130.35	$237.00	$4.14–$237.00	285% above	45%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$130.35	$237.00	$4.14–$237.00	—	45%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$144.65	$263.00	$19.67–$263.00	110% above	45%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMP PROB	$144.65	$263.00	$19.67–$263.00	110% above	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMP PROB	$144.65	$263.00	$19.67–$263.00	—	45%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$144.65	$263.00	$19.67–$263.00	—	45%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$91.56	$166.48	$12.45–$166.48	88% above	45%
CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN 19-9	$91.56	$166.48	$12.45–$166.48	88% above	45%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN 19-9	$91.56	$166.48	$12.45–$166.48	—	45%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$91.56	$166.48	$12.45–$166.48	—	45%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$524.97	$954.50	$16.65–$954.50	684% above	45%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$524.97	$954.50	$16.65–$954.50	684% above	45%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125	$524.97	$954.50	$16.65–$954.50	—	45%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$524.97	$954.50	$16.65–$954.50	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$169.40	$308.00	$23.03–$308.00	200% above	45%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 PRB	$169.40	$308.00	$23.03–$308.00	200% above	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$169.40	$308.00	$23.03–$308.00	—	45%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 PRB	$169.40	$308.00	$23.03–$308.00	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE	$426.80	$776.00	$28.07–$776.00	662% above	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMP PROBE	$426.80	$776.00	$28.07–$776.00	662% above	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T AMP PROBE	$426.80	$776.00	$28.07–$776.00	—	45%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP PROBE	$426.80	$776.00	$28.07–$776.00	—	45%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$301.12	$547.50	$10.71–$547.50	325% above	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$301.12	$547.50	$10.71–$547.50	—	45%
Complete blood count (CBC) with differential CPT 85025 CBC AUTO DIFF	$196.35	$357.00	$6.22–$357.00	416% above	45%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$196.35	$357.00	$6.22–$357.00	416% above	45%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO DIFF	$196.35	$357.00	$6.22–$357.00	—	45%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$196.35	$357.00	$6.22–$357.00	—	45%
Complete blood count (CBC), no differential CPT 85027 CBC HEMOGRAM	$194.70	$354.00	$5.18–$354.00	343% above	45%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$194.70	$354.00	$5.18–$354.00	343% above	45%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$194.70	$354.00	$5.18–$354.00	—	45%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC HEMOGRAM	$194.70	$354.00	$5.18–$354.00	—	45%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$266.75	$485.00	$8.45–$485.00	136% above	45%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$266.75	$485.00	$8.45–$485.00	136% above	45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$266.75	$485.00	$8.45–$485.00	—	45%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$266.75	$485.00	$8.45–$485.00	—	45%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$45.92	$83.50	$6.24–$83.50	36% below	45%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$45.92	$83.50	$6.24–$83.50	36% below	45%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT	$45.92	$83.50	$6.24–$83.50	—	45%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$45.92	$83.50	$6.24–$83.50	—	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$560.72	$1,019.50	$17.78–$1,019.50	805% above	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$560.72	$1,019.50	$17.78–$1,019.50	805% above	45%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$560.72	$1,019.50	$17.78–$1,019.50	—	45%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE	$560.72	$1,019.50	$17.78–$1,019.50	—	45%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$705.10	$1,282.00	$22.35–$1,282.00	796% above	45%
Estradiol blood test CPT 82670 ESTRADIOL	$705.10	$1,282.00	$22.35–$1,282.00	796% above	45%
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$705.10	$1,282.00	$22.35–$1,282.00	—	45%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$705.10	$1,282.00	$22.35–$1,282.00	—	45%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$181.77	$330.50	$14.86–$330.50	188% above	45%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$181.77	$330.50	$14.86–$330.50	188% above	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$181.77	$330.50	$14.86–$330.50	—	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$181.77	$330.50	$14.86–$330.50	—	45%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$61.87	$112.50	$8.41–$112.50	53% below	45%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$61.87	$112.50	$8.41–$112.50	53% below	45%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$61.87	$112.50	$8.41–$112.50	—	45%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$61.87	$112.50	$8.41–$112.50	—	45%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$78.37	$142.50	$10.65–$142.50	42% above	45%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$78.37	$142.50	$10.65–$142.50	42% above	45%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$78.37	$142.50	$10.65–$142.50	—	45%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$78.37	$142.50	$10.65–$142.50	—	45%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$468.60	$852.00	$11.76–$852.00	899% above	45%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$468.60	$852.00	$11.76–$852.00	899% above	45%
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$468.60	$852.00	$11.76–$852.00	—	45%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$468.60	$852.00	$11.76–$852.00	—	45%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$248.87	$452.50	$12.02–$452.50	351% above	45%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$248.87	$452.50	$12.02–$452.50	351% above	45%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$248.87	$452.50	$12.02–$452.50	—	45%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$248.87	$452.50	$12.02–$452.50	—	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$227.42	$413.50	$7.22–$413.50	294% above	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$227.42	$413.50	$7.22–$413.50	294% above	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$227.42	$413.50	$7.22–$413.50	—	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$227.42	$413.50	$7.22–$413.50	—	45%
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$642.12	$1,167.50	$20.38–$1,167.50	779% above	45%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$642.12	$1,167.50	$20.38–$1,167.50	779% above	45%
Free testosterone test inpatient CPT 84402 ASSAY OF FREE TESTOSTERONE	$642.12	$1,167.50	$20.38–$1,167.50	—	45%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$642.12	$1,167.50	$20.38–$1,167.50	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POSTRANDIAL	$119.90	$218.00	$3.80–$218.00	646% above	45%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$119.90	$218.00	$3.80–$218.00	646% above	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST	$119.90	$218.00	$3.80–$218.00	—	45%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR POSTRANDIAL	$119.90	$218.00	$3.80–$218.00	—	45%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$293.42	$533.50	$10.30–$533.50	534% above	45%
Glucose tolerance test, 3 samples CPT 82951 GTT 1ST 3 SPECIMENS	$293.42	$533.50	$10.30–$533.50	534% above	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$293.42	$533.50	$10.30–$533.50	—	45%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 1ST 3 SPECIMENS	$293.42	$533.50	$10.30–$533.50	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC AMP PROBE	$293.70	$534.00	$28.07–$534.00	456% above	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB	$293.70	$534.00	$28.07–$534.00	456% above	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC AMP PROBE	$293.70	$534.00	$28.07–$534.00	—	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE DNA AMP PROB	$293.70	$534.00	$28.07–$534.00	—	45%
H. pylori antibody blood test CPT 86677 H PYLORI AB QUAL	$317.62	$577.50	$12.17–$577.50	310% above	45%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$317.62	$577.50	$12.17–$577.50	310% above	45%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODY	$317.62	$577.50	$12.17–$577.50	—	45%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB QUAL	$317.62	$577.50	$12.17–$577.50	—	45%
H. pylori stool antigen test CPT 87338 H. PYLORI STOOL ANTIGEN	$117.15	$213.00	$6.46–$213.00	78% above	45%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$117.15	$213.00	$6.46–$213.00	78% above	45%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI STOOL ANTIGEN	$117.15	$213.00	$6.46–$213.00	—	45%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL AG IA	$117.15	$213.00	$6.46–$213.00	—	45%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD	$330.00	$600.00	$44.88–$600.00	72% above	45%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$330.00	$600.00	$44.88–$600.00	72% above	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV VIRAL LOAD	$330.00	$600.00	$44.88–$600.00	—	45%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$330.00	$600.00	$44.88–$600.00	—	45%
HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$279.12	$507.50	$10.97–$507.50	447% above	45%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 AB QUAL	$279.12	$507.50	$10.97–$507.50	447% above	45%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY	$279.12	$507.50	$10.97–$507.50	—	45%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1&2 AB QUAL	$279.12	$507.50	$10.97–$507.50	—	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 4TH GEN, RFLX CONF	$93.50	$170.00	$12.71–$170.00	89% above	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA	$93.50	$170.00	$12.71–$170.00	89% above	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 4TH GEN, RFLX CONF	$93.50	$170.00	$12.71–$170.00	—	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/HIV-1&-2 AB AG IA	$93.50	$170.00	$12.71–$170.00	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$28.05	$51.00	$3.81–$51.00	43% below	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$28.05	$51.00	$3.81–$51.00	43% below	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$28.05	$51.00	$3.81–$51.00	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$28.05	$51.00	$3.81–$51.00	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$47.25	$85.92	$6.42–$85.92	17% above	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$47.25	$85.92	$6.42–$85.92	17% above	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$47.25	$85.92	$6.42–$85.92	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$47.25	$85.92	$6.42–$85.92	—	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$45.45	$82.64	$6.18–$82.64	5% above	45%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG	$45.45	$82.64	$6.18–$82.64	5% above	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$45.45	$82.64	$6.18–$82.64	—	45%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF AG	$45.45	$82.64	$6.18–$82.64	—	45%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$359.97	$654.50	$11.42–$654.50	603% above	45%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$359.97	$654.50	$11.42–$654.50	603% above	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST	$359.97	$654.50	$11.42–$654.50	—	45%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$359.97	$654.50	$11.42–$654.50	—	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$166.10	$302.00	$22.58–$302.00	at median	45%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C RNA QUANT	$166.10	$302.00	$22.58–$302.00	at median	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C RNA QUANT	$166.10	$302.00	$22.58–$302.00	—	45%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$166.10	$302.00	$22.58–$302.00	—	45%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMP1 AB QUAL	$249.97	$454.50	$10.55–$454.50	589% above	45%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$249.97	$454.50	$10.55–$454.50	589% above	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$249.97	$454.50	$10.55–$454.50	—	45%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMP1 AB QUAL	$249.97	$454.50	$10.55–$454.50	—	45%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$97.90	$178.00	$13.31–$178.00	118% above	45%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 AB IGG	$97.90	$178.00	$13.31–$178.00	118% above	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$97.90	$178.00	$13.31–$178.00	—	45%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 AB IGG	$97.90	$178.00	$13.31–$178.00	—	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$326.70	$594.00	$10.36–$594.00	634% above	45%
High-sensitivity CRP (hs-CRP) test CPT 86141 HS CRP	$326.70	$594.00	$10.36–$594.00	634% above	45%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HS CRP	$326.70	$594.00	$10.36–$594.00	—	45%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$326.70	$594.00	$10.36–$594.00	—	45%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$425.42	$773.50	$14.14–$773.50	646% above	45%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$425.42	$773.50	$14.14–$773.50	646% above	45%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTEINE	$425.42	$773.50	$14.14–$773.50	—	45%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$425.42	$773.50	$14.14–$773.50	—	45%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$288.75	$525.00	$9.14–$525.00	586% above	45%
Insulin blood test CPT 83525 INSULIN TOTAL	$288.75	$525.00	$9.14–$525.00	586% above	45%
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN	$288.75	$525.00	$9.14–$525.00	—	45%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL	$288.75	$525.00	$9.14–$525.00	—	45%
Iron blood test (serum iron) CPT 83540 IRON	$135.30	$246.00	$5.18–$246.00	292% above	45%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$135.30	$246.00	$5.18–$246.00	292% above	45%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$135.30	$246.00	$5.18–$246.00	—	45%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$135.30	$246.00	$5.18–$246.00	—	45%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$220.55	$401.00	$6.99–$401.00	398% above	45%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING (TIBC)	$220.55	$401.00	$6.99–$401.00	398% above	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING TEST	$220.55	$401.00	$6.99–$401.00	—	45%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING (TIBC)	$220.55	$401.00	$6.99–$401.00	—	45%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$219.17	$398.50	$6.94–$398.50	168% above	45%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$219.17	$398.50	$6.94–$398.50	—	45%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$467.50	$850.00	$14.82–$850.00	668% above	45%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE	$467.50	$850.00	$14.82–$850.00	668% above	45%
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH)	$467.50	$850.00	$14.82–$850.00	—	45%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE	$467.50	$850.00	$14.82–$850.00	—	45%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$173.80	$316.00	$5.51–$316.00	314% above	45%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$173.80	$316.00	$5.51–$316.00	314% above	45%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$173.80	$316.00	$5.51–$316.00	—	45%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$173.80	$316.00	$5.51–$316.00	—	45%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$583.27	$1,060.50	$6.54–$1,060.50	591% above	45%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$583.27	$1,060.50	$6.54–$1,060.50	—	45%
Lyme disease antibody test CPT 86618 LYME DISEASE AB QL	$69.85	$127.00	$9.49–$127.00	38% above	45%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$69.85	$127.00	$9.49–$127.00	38% above	45%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$69.85	$127.00	$9.49–$127.00	—	45%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB QL	$69.85	$127.00	$9.49–$127.00	—	45%
Magnesium blood test CPT 83735 MAGNESIUM BLD	$169.12	$307.50	$5.36–$307.50	518% above	45%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$169.12	$307.50	$5.36–$307.50	518% above	45%
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$169.12	$307.50	$5.36–$307.50	—	45%
Magnesium blood test inpatient CPT 83735 MAGNESIUM BLD	$169.12	$307.50	$5.36–$307.50	—	45%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$325.05	$591.00	$10.30–$591.00	772% above	45%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB QUAL	$325.05	$591.00	$10.30–$591.00	772% above	45%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$325.05	$591.00	$10.30–$591.00	—	45%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB QUAL	$325.05	$591.00	$10.30–$591.00	—	45%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO SCR (HETEROPHILE)	$130.35	$237.00	$4.14–$237.00	256% above	45%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$130.35	$237.00	$4.14–$237.00	256% above	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN	$130.35	$237.00	$4.14–$237.00	—	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO SCR (HETEROPHILE)	$130.35	$237.00	$4.14–$237.00	—	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROS SPEC AG FREE	$70.67	$128.50	$9.61–$128.50	22% above	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$70.67	$128.50	$9.61–$128.50	22% above	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROS SPEC AG FREE	$70.67	$128.50	$9.61–$128.50	—	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE	$70.67	$128.50	$9.61–$128.50	—	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$464.20	$844.00	$14.71–$844.00	719% above	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROS SPEC AG (PSA)	$464.20	$844.00	$14.71–$844.00	719% above	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROS SPEC AG (PSA)	$464.20	$844.00	$14.71–$844.00	—	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$464.20	$844.00	$14.71–$844.00	—	45%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$1,041.15	$1,893.00	$33.02–$1,893.00	855% above	45%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$1,041.15	$1,893.00	$33.02–$1,893.00	855% above	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$1,041.15	$1,893.00	$33.02–$1,893.00	—	45%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$1,041.15	$1,893.00	$33.02–$1,893.00	—	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$151.25	$275.00	$4.81–$275.00	358% above	45%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$151.25	$275.00	$4.81–$275.00	358% above	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$151.25	$275.00	$4.81–$275.00	—	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$151.25	$275.00	$4.81–$275.00	—	45%
Progesterone blood test CPT 84144 PROGESTERONE	$526.35	$957.00	$16.69–$957.00	632% above	45%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$526.35	$957.00	$16.69–$957.00	632% above	45%
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$526.35	$957.00	$16.69–$957.00	—	45%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$526.35	$957.00	$16.69–$957.00	—	45%
Prolactin blood test CPT 84146 PROLACTIN	$489.22	$889.50	$15.50–$889.50	538% above	45%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$489.22	$889.50	$15.50–$889.50	538% above	45%
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN	$489.22	$889.50	$15.50–$889.50	—	45%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$489.22	$889.50	$15.50–$889.50	—	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME	$99.27	$180.50	$3.29–$180.50	380% above	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$99.27	$180.50	$3.29–$180.50	380% above	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME	$99.27	$180.50	$3.29–$180.50	—	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$99.27	$180.50	$3.29–$180.50	—	45%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$141.35	$257.00	$10.06–$257.00	295% above	45%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA VIRUS A AG OIA	$141.35	$257.00	$10.06–$257.00	295% above	45%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA VIRUS A AG OIA	$141.35	$257.00	$10.06–$257.00	—	45%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$141.35	$257.00	$10.06–$257.00	—	45%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, QUANT	$143.27	$260.50	$4.54–$260.50	425% above	45%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$143.27	$260.50	$4.54–$260.50	425% above	45%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, QUANT	$143.27	$260.50	$4.54–$260.50	—	45%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$143.27	$260.50	$4.54–$260.50	—	45%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$363.00	$660.00	$11.51–$660.00	854% above	45%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM ANTIBODY	$363.00	$660.00	$11.51–$660.00	854% above	45%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM ANTIBODY	$363.00	$660.00	$11.51–$660.00	—	45%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$363.00	$660.00	$11.51–$660.00	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE AUTO	$11.88	$21.60	$1.61–$21.60	62% below	45%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$11.88	$21.60	$1.61–$21.60	62% below	45%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$11.88	$21.60	$1.61–$21.60	—	45%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE AUTO	$11.88	$21.60	$1.61–$21.60	—	45%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$220.82	$401.50	$7.12–$401.50	500% above	45%
Stool ova and parasites exam CPT 87177 O&P SMEAR CONC ID	$220.82	$401.50	$7.12–$401.50	500% above	45%
Stool ova and parasites exam inpatient CPT 87177 O&P SMEAR CONC ID	$220.82	$401.50	$7.12–$401.50	—	45%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$220.82	$401.50	$7.12–$401.50	—	45%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD STL 1-3 SIM	$81.95	$149.00	$2.72–$149.00	310% above	45%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$81.95	$149.00	$2.72–$149.00	310% above	45%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$81.95	$149.00	$2.72–$149.00	—	45%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD STL 1-3 SIM	$81.95	$149.00	$2.72–$149.00	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$107.52	$195.50	$3.42–$195.50	440% above	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$107.52	$195.50	$3.42–$195.50	440% above	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$107.52	$195.50	$3.42–$195.50	—	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL	$107.52	$195.50	$3.42–$195.50	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$304.70	$554.00	$41.43–$554.00	164% above	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$304.70	$554.00	$41.43–$554.00	164% above	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$304.70	$554.00	$41.43–$554.00	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$304.70	$554.00	$41.43–$554.00	—	45%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$651.75	$1,185.00	$20.65–$1,185.00	844% above	45%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$651.75	$1,185.00	$20.65–$1,185.00	844% above	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$651.75	$1,185.00	$20.65–$1,185.00	—	45%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$651.75	$1,185.00	$20.65–$1,185.00	—	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$367.12	$667.50	$11.64–$1,335.00	726% above	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL AB	$367.12	$667.50	$11.64–$1,335.00	726% above	45%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$367.12	$667.50	$11.64–$1,335.00	726% above	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI MICROSOMAL AB	$367.12	$667.50	$11.64–$1,335.00	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$367.12	$667.50	$11.64–$1,335.00	—	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$367.12	$667.50	$11.64–$1,335.00	—	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$423.77	$770.50	$13.44–$770.50	784% above	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$423.77	$770.50	$13.44–$770.50	784% above	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$423.77	$770.50	$13.44–$770.50	—	45%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$423.77	$770.50	$13.44–$770.50	—	45%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$135.85	$247.00	$18.47–$247.00	131% above	45%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS, VAG SWAB, AMP	$135.85	$247.00	$18.47–$247.00	131% above	45%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$135.85	$247.00	$18.47–$247.00	—	45%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS, VAG SWAB, AMP	$135.85	$247.00	$18.47–$247.00	—	45%
Uric acid blood test CPT 84550 URIC ACID BLD	$113.85	$207.00	$3.62–$207.00	330% above	45%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$113.85	$207.00	$3.62–$207.00	330% above	45%
Uric acid blood test inpatient CPT 84550 URIC ACID BLD	$113.85	$207.00	$3.62–$207.00	—	45%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$113.85	$207.00	$3.62–$207.00	—	45%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$80.02	$145.50	$2.54–$145.50	65% above	45%
Urinalysis with microscope exam, automated CPT 81001 UA W MICROSCOPIC AUTO	$80.02	$145.50	$2.54–$145.50	65% above	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA W MICROSCOPIC AUTO	$80.02	$145.50	$2.54–$145.50	—	45%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$80.02	$145.50	$2.54–$145.50	—	45%
Urinalysis without microscope exam, automated CPT 81003 UA W O MICRO AUTO	$56.65	$103.00	$1.80–$103.00	472% above	45%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$56.65	$103.00	$1.80–$103.00	472% above	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$56.65	$103.00	$1.80–$103.00	—	45%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA W O MICRO AUTO	$56.65	$103.00	$1.80–$103.00	—	45%
Urine culture for bacteria, with colony count CPT 87086 CULT COLONY COUNT UR	$212.02	$385.50	$6.46–$385.50	297% above	45%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT	$212.02	$385.50	$6.46–$385.50	297% above	45%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE/COLONY COUNT	$212.02	$385.50	$6.46–$385.50	—	45%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT COLONY COUNT UR	$212.02	$385.50	$6.46–$385.50	—	45%
Urine pregnancy test, read by color change CPT 81025 PREG URINE QUAL	$159.50	$290.00	$5.30–$290.00	639% above	45%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$159.50	$290.00	$5.30–$290.00	639% above	45%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$159.50	$290.00	$5.30–$290.00	—	45%
Urine pregnancy test, read by color change inpatient CPT 81025 PREG URINE QUAL	$159.50	$290.00	$5.30–$290.00	—	45%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$380.32	$691.50	$12.06–$691.50	596% above	45%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$380.32	$691.50	$12.06–$691.50	596% above	45%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$380.32	$691.50	$12.06–$691.50	—	45%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$380.32	$691.50	$12.06–$691.50	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$746.62	$1,357.50	$23.68–$1,357.50	625% above	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D3 25-OH	$746.62	$1,357.50	$23.68–$1,357.50	625% above	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D3 25-OH	$746.62	$1,357.50	$23.68–$1,357.50	—	45%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$746.62	$1,357.50	$23.68–$1,357.50	—	45%
Zinc blood test CPT 84630 ASSAY OF ZINC	$287.10	$522.00	$9.11–$522.00	597% above	45%
Zinc blood test CPT 84630 ZINC BLOOD	$287.10	$522.00	$9.11–$522.00	597% above	45%
Zinc blood test inpatient CPT 84630 ZINC BLOOD	$287.10	$522.00	$9.11–$522.00	—	45%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$287.10	$522.00	$9.11–$522.00	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG BETA QUANTITATIVE	$206.52	$375.50	$12.04–$375.50	202% above	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$206.52	$375.50	$12.04–$375.50	202% above	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$206.52	$375.50	$12.04–$375.50	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG BETA QUANTITATIVE	$206.52	$375.50	$12.04–$375.50	—	45%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Cardiac catheterization with coronary angiogram CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$10,440.92	$18,983.50	$1,019.91–$18,983.50	122% above	45%
Cardiac catheterization with coronary angiogram CPT 93458 CC-L HRT ARTERY-VENT	$10,440.92	$18,983.50	$1,019.91–$18,983.50	122% above	45%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 CC-L HRT ARTERY-VENT	$10,440.92	$18,983.50	$1,019.91–$18,983.50	—	45%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 L HRT ARTERY/VENTRICLE ANGIO	$10,440.92	$18,983.50	$1,019.91–$18,983.50	—	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 DEFIBRILLATION	$605.00	$1,100.00	$160.91–$5,729.50	12% above	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$2,546.22	$4,629.50	$160.91–$5,729.50	372% above	45%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$2,546.22	$4,629.50	$160.91–$5,729.50	372% above	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 DEFIBRILLATION	$605.00	$1,100.00	$160.91–$5,729.50	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$2,546.22	$4,629.50	$160.91–$5,729.50	—	45%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$2,546.22	$4,629.50	$160.91–$5,729.50	—	45%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,112.65	$2,023.00	$278.55–$2,648.00	22% above	45%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$1,112.65	$2,023.00	$278.55–$2,648.00	—	45%
Coronary stent placement, one artery CPT 92928 NON-DES, INITIAL	$18,202.52	$33,095.50	$973.62–$33,095.50	231% above	45%
Coronary stent placement, one artery CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$18,202.52	$33,095.50	$973.62–$33,095.50	231% above	45%
Coronary stent placement, one artery inpatient CPT 92928 NON-DES, INITIAL	$18,202.52	$33,095.50	$973.62–$33,095.50	—	45%
Coronary stent placement, one artery inpatient CPT 92928 PRQ TCAT PLMT NTRAC ST 1 LES	$18,202.52	$33,095.50	$973.62–$33,095.50	—	45%
Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED WAX FAC	$231.55	$421.00	$31.49–$1,300.00	283% above	45%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$231.55	$421.00	$31.49–$1,300.00	283% above	45%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$231.55	$421.00	$31.49–$1,300.00	—	45%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVAL OF IMPACTED WAX FAC	$231.55	$421.00	$31.49–$1,300.00	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ CATH HYSTERO	$1,120.95	$2,038.10	$66.48–$2,038.10	698% above	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$1,120.95	$2,038.10	$66.48–$2,038.10	698% above	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETER FOR HYSTEROGRAPHY	$1,120.95	$2,038.10	$66.48–$2,038.10	—	45%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ CATH HYSTERO	$1,120.95	$2,038.10	$66.48–$2,038.10	—	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS,CYST SIMPLE-FAC	$473.00	$860.00	$64.32–$1,300.00	157% above	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$473.00	$860.00	$64.32–$1,300.00	157% above	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS,CYST SIMPLE-FAC	$473.00	$860.00	$64.32–$1,300.00	—	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$473.00	$860.00	$64.32–$1,300.00	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 INJ/ASP LG JOINT SHLDR/KNEE	$473.00	$860.00	$64.32–$1,300.00	83% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$473.00	$860.00	$64.32–$1,300.00	83% above	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$473.00	$860.00	$64.32–$1,300.00	—	45%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 INJ/ASP LG JOINT SHLDR/KNEE	$473.00	$860.00	$64.32–$1,300.00	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$473.00	$860.00	$56.51–$1,300.00	86% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJ/ASP INTERMEDIATE JOINT	$473.00	$860.00	$56.51–$1,300.00	86% above	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ JOINT/BURSA W/O US	$473.00	$860.00	$56.51–$1,300.00	—	45%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJ/ASP INTERMEDIATE JOINT	$473.00	$860.00	$56.51–$1,300.00	—	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJ/ASP SMALL JOINT OR BURSA	$473.00	$860.00	$54.52–$1,300.00	106% above	45%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$473.00	$860.00	$54.52–$1,300.00	106% above	45%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJ/ASP SMALL JOINT OR BURSA	$473.00	$860.00	$54.52–$1,300.00	—	45%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJ JOINT/BURSA W/O US	$473.00	$860.00	$54.52–$1,300.00	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC/LAYER2.5ORLESS/SCALP,TRUNK	$669.90	$1,218.00	$91.10–$1,300.00	123% above	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$669.90	$1,218.00	$91.10–$1,300.00	123% above	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC/LAYER2.5ORLESS/SCALP,TRUNK	$669.90	$1,218.00	$91.10–$1,300.00	—	45%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$669.90	$1,218.00	$91.10–$1,300.00	—	45%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$217.80	$396.00	$29.62–$1,300.00	45% above	45%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE/FAC	$217.80	$396.00	$29.62–$1,300.00	45% above	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$217.80	$396.00	$29.62–$1,300.00	—	45%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE/FAC	$217.80	$396.00	$29.62–$1,300.00	—	45%
Pacemaker implant (dual chamber) CPT 33208 INSRT HEART PM ATRIAL & VENT	$32,011.37	$58,202.50	$781.46–$58,202.50	190% above	45%
Pacemaker implant (dual chamber) CPT 33208 PERM PACE INS DUAL	$32,011.37	$58,202.50	$781.46–$58,202.50	190% above	45%
Pacemaker implant (dual chamber) inpatient CPT 33208 PERM PACE INS DUAL	$32,011.37	$58,202.50	$781.46–$58,202.50	—	45%
Pacemaker implant (dual chamber) inpatient CPT 33208 INSRT HEART PM ATRIAL & VENT	$32,011.37	$58,202.50	$781.46–$58,202.50	—	45%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,342.00	$2,440.00	$161.44–$2,648.00	128% above	45%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTS W/IMAG	$1,342.00	$2,440.00	$161.44–$2,648.00	128% above	45%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTS W/IMAG	$1,342.00	$2,440.00	$161.44–$2,648.00	—	45%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,342.00	$2,440.00	$161.44–$2,648.00	—	45%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL&NAIL MATRIX	$669.90	$1,218.00	$91.10–$1,300.00	159% above	45%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL EXCISION PARTIAL OR COMPL	$669.90	$1,218.00	$91.10–$1,300.00	159% above	45%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL EXCISION PARTIAL OR COMPL	$669.90	$1,218.00	$91.10–$1,300.00	—	45%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL&NAIL MATRIX	$669.90	$1,218.00	$91.10–$1,300.00	—	45%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL F.B.W/INCISION-FAC	$473.00	$860.00	$64.32–$1,300.00	92% above	45%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$473.00	$860.00	$64.32–$1,300.00	92% above	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL F.B.W/INCISION-FAC	$473.00	$860.00	$64.32–$1,300.00	—	45%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$473.00	$860.00	$64.32–$1,300.00	—	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$7,650.50	$13,910.00	$384.56–$13,910.00	146% above	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$7,650.50	$13,910.00	$384.56–$13,910.00	146% above	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$7,650.50	$13,910.00	$384.56–$13,910.00	—	45%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE	$7,650.50	$13,910.00	$384.56–$13,910.00	—	45%
Short arm splint (forearm and hand) CPT 29125 OT APPLICATION FOREARM SPLING STATIC	$222.75	$405.00	$57.69–$1,623.00	96% above	45%
Short arm splint (forearm and hand) CPT 29125 APPL SHORT ARM SPLINT STATIC	$222.75	$405.00	$57.69–$1,623.00	96% above	45%
Short arm splint (forearm and hand) CPT 29125 APPL.SHORT ARM SPLINT FAC	$669.90	$1,218.00	$57.69–$1,623.00	491% above	45%
Short arm splint (forearm and hand) inpatient CPT 29125 OT APPLICATION FOREARM SPLING STATIC	$222.75	$405.00	$57.69–$1,623.00	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL SHORT ARM SPLINT STATIC	$222.75	$405.00	$57.69–$1,623.00	—	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL.SHORT ARM SPLINT FAC	$669.90	$1,218.00	$57.69–$1,623.00	—	45%
Short leg splint (calf to foot) CPT 29515 APPL OF SHORT LEG SPLINT FAC	$669.90	$1,218.00	$73.09–$1,218.00	398% above	45%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT	$669.90	$1,218.00	$73.09–$1,218.00	398% above	45%
Short leg splint (calf to foot) inpatient CPT 29515 APPL OF SHORT LEG SPLINT FAC	$669.90	$1,218.00	$73.09–$1,218.00	—	45%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT	$669.90	$1,218.00	$73.09–$1,218.00	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC-SIM/2.5ORLESS/SCP,TRNK,EXT	$473.00	$860.00	$62.42–$1,300.00	159% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$473.00	$860.00	$62.42–$1,300.00	159% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$473.00	$860.00	$62.42–$1,300.00	—	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC-SIM/2.5ORLESS/SCP,TRNK,EXT	$473.00	$860.00	$62.42–$1,300.00	—	45%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN	$1,827.40	$3,322.56	$65.50–$3,322.56	882% above	45%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$1,827.40	$3,322.56	$65.50–$3,322.56	882% above	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$1,827.40	$3,322.56	$65.50–$3,322.56	—	45%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN	$1,827.40	$3,322.56	$65.50–$3,322.56	—	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP FACILITY	$945.72	$1,719.50	$91.26–$2,489.00	91% above	45%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$945.72	$1,719.50	$91.26–$2,489.00	91% above	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP FACILITY	$945.72	$1,719.50	$91.26–$2,489.00	—	45%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$945.72	$1,719.50	$91.26–$2,489.00	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIM/2.6-7.5/SCALP/TRNK/FAC	$473.00	$860.00	$64.32–$860.00	159% above	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$473.00	$860.00	$64.32–$860.00	159% above	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIM/2.6-7.5/SCALP/TRNK/FAC	$473.00	$860.00	$64.32–$860.00	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$473.00	$860.00	$64.32–$860.00	—	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$473.00	$860.00	$64.32–$860.00	159% above	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIM/2.5ORLESS/EARS/NOSEFAC	$473.00	$860.00	$64.32–$860.00	159% above	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$473.00	$860.00	$64.32–$860.00	—	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIM/2.5ORLESS/EARS/NOSEFAC	$473.00	$860.00	$64.32–$860.00	—	45%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,341.72	$2,439.50	$182.47–$2,489.00	114% above	45%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLRA W/IMAG	$1,341.72	$2,439.50	$182.47–$2,489.00	114% above	45%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$1,341.72	$2,439.50	$182.47–$2,489.00	—	45%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLRA W/IMAG	$1,341.72	$2,439.50	$182.47–$2,489.00	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US-BRST BX PERC FIRST LESION	$2,458.77	$4,470.50	$216.14–$4,470.50	161% above	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG	$2,458.77	$4,470.50	$216.14–$4,470.50	161% above	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1ST LESION US IMAG	$2,458.77	$4,470.50	$216.14–$4,470.50	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US-BRST BX PERC FIRST LESION	$2,458.77	$4,470.50	$216.14–$4,470.50	—	45%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,112.65	$2,023.00	$206.96–$2,648.00	38% above	45%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,112.65	$2,023.00	$206.96–$2,648.00	—	45%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION	$1,265.55	$2,301.00	$45.61–$11,205.00	168% above	45%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSE BLOOD/BLD PROD EA UNIT	$2,206.87	$4,012.50	$45.61–$11,205.00	368% above	45%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$2,690.32	$4,891.50	$45.61–$11,205.00	470% above	45%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD INFUSION	$2,690.32	$4,891.50	$45.61–$11,205.00	470% above	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION	$1,265.55	$2,301.00	$45.61–$11,205.00	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSE BLOOD/BLD PROD EA UNIT	$2,206.87	$4,012.50	$45.61–$11,205.00	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPNT	$2,690.32	$4,891.50	$45.61–$11,205.00	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD INFUSION	$2,690.32	$4,891.50	$45.61–$11,205.00	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$209.00	$380.00	$24.95–$1,570.00	122% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEBULIZER-1ST TX	$217.80	$396.00	$24.95–$1,570.00	132% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$217.80	$396.00	$24.95–$1,570.00	132% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB SUBQ	$218.35	$397.00	$24.95–$1,570.00	132% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB INIT	$218.35	$397.00	$24.95–$1,570.00	132% above	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$209.00	$380.00	$24.95–$1,570.00	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEBULIZER-1ST TX	$217.80	$396.00	$24.95–$1,570.00	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$217.80	$396.00	$24.95–$1,570.00	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB SUBQ	$218.35	$397.00	$24.95–$1,570.00	—	45%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB INIT	$218.35	$397.00	$24.95–$1,570.00	—	45%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FAC	$1,694.00	$3,080.00	$221.80–$3,499.00	126% above	45%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,694.00	$3,080.00	$221.80–$3,499.00	126% above	45%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$1,694.00	$3,080.00	$221.80–$3,499.00	—	45%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FAC	$1,694.00	$3,080.00	$221.80–$3,499.00	—	45%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$1,091.20	$1,984.00	$148.40–$1,984.00	252% above	45%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$1,091.20	$1,984.00	$148.40–$1,984.00	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$150.97	$274.50	$14.24–$1,044.00	83% above	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG TRACING 12 LEAD	$150.97	$274.50	$14.24–$1,044.00	83% above	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$272.25	$495.00	$14.24–$1,044.00	231% above	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$150.97	$274.50	$14.24–$1,044.00	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG TRACING 12 LEAD	$150.97	$274.50	$14.24–$1,044.00	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$272.25	$495.00	$14.24–$1,044.00	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER TRIAGE ONLY	$82.50	$150.00	$22.82–$810.00	41% above	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1	$363.00	$660.00	$22.82–$810.00	521% above	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$363.00	$660.00	$22.82–$810.00	521% above	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER TRIAGE ONLY	$82.50	$150.00	$22.82–$810.00	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL 1	$363.00	$660.00	$22.82–$810.00	—	45%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$363.00	$660.00	$22.82–$810.00	—	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$393.25	$715.00	$43.81–$715.00	168% above	45%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2	$393.25	$715.00	$43.81–$715.00	168% above	45%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2	$393.25	$715.00	$43.81–$715.00	—	45%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$393.25	$715.00	$43.81–$715.00	—	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3	$574.75	$1,045.00	$65.60–$1,045.00	149% above	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$574.75	$1,045.00	$65.60–$1,045.00	149% above	45%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3	$574.75	$1,045.00	$65.60–$1,045.00	—	45%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$574.75	$1,045.00	$65.60–$1,045.00	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$937.75	$1,705.00	$120.88–$1,705.00	147% above	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4	$937.75	$1,705.00	$120.88–$1,705.00	147% above	45%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$937.75	$1,705.00	$120.88–$1,705.00	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4	$937.75	$1,705.00	$120.88–$1,705.00	—	45%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,300.75	$2,365.00	$175.80–$2,365.00	151% above	45%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5(TRANSFER)	$1,300.75	$2,365.00	$175.80–$2,365.00	151% above	45%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,300.75	$2,365.00	$175.80–$2,365.00	—	45%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5(TRANSFER)	$1,300.75	$2,365.00	$175.80–$2,365.00	—	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$280.50	$510.00	$55.63–$1,648.50	20% below	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$626.17	$1,138.50	$55.63–$1,648.50	78% above	45%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W/ PHARMACEUTICAL	$626.17	$1,138.50	$55.63–$1,648.50	78% above	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$280.50	$510.00	$55.63–$1,648.50	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W/ PHARMACEUTICAL	$626.17	$1,138.50	$55.63–$1,648.50	—	45%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$626.17	$1,138.50	$55.63–$1,648.50	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1 HR	$513.15	$933.00	$49.09–$3,733.50	203% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUSION HYDRATION,INITIAL	$513.42	$933.50	$49.09–$3,733.50	203% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1ST HOUR	$513.42	$933.50	$49.09–$3,733.50	203% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP IV HYDRATION INITIAL	$513.42	$933.50	$49.09–$3,733.50	203% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$513.42	$933.50	$49.09–$3,733.50	203% above	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1 HR	$513.15	$933.00	$49.09–$3,733.50	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUSION HYDRATION,INITIAL	$513.42	$933.50	$49.09–$3,733.50	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1ST HOUR	$513.42	$933.50	$49.09–$3,733.50	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OP IV HYDRATION INITIAL	$513.42	$933.50	$49.09–$3,733.50	—	45%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$513.42	$933.50	$49.09–$3,733.50	—	45%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY DX 1 HR	$513.42	$933.50	$101.46–$3,734.00	176% above	45%
IV infusion of a medicine, first hour CPT 96365 INFUSION THER/DIAG	$513.42	$933.50	$101.46–$3,734.00	176% above	45%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$513.42	$933.50	$101.46–$3,734.00	176% above	45%
IV infusion of a medicine, first hour CPT 96365 OP IV THERAPY INITIAL	$513.42	$933.50	$101.46–$3,734.00	176% above	45%
IV infusion of a medicine, first hour CPT 96365 IVPB THER INITIAL HOUR	$513.42	$933.50	$101.46–$3,734.00	176% above	45%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THER/DIAG	$513.42	$933.50	$101.46–$3,734.00	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 OP IV THERAPY INITIAL	$513.42	$933.50	$101.46–$3,734.00	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$513.42	$933.50	$101.46–$3,734.00	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IVPB THER INITIAL HOUR	$513.42	$933.50	$101.46–$3,734.00	—	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DX 1 HR	$513.42	$933.50	$101.46–$3,734.00	—	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP INJECTION DX SQ IM	$240.35	$437.00	$21.16–$1,311.00	360% above	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION	$240.35	$437.00	$21.16–$1,311.00	360% above	45%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$240.35	$437.00	$21.16–$1,311.00	360% above	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$240.35	$437.00	$21.16–$1,311.00	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP INJECTION DX SQ IM	$240.35	$437.00	$21.16–$1,311.00	—	45%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION	$240.35	$437.00	$21.16–$1,311.00	—	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUC	$146.57	$266.50	$24.86–$1,332.50	295% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$146.57	$266.50	$24.86–$1,332.50	295% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA	$146.57	$266.50	$24.86–$1,332.50	295% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA	$146.57	$266.50	$24.86–$1,332.50	295% above	45%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PT	$146.57	$266.50	$24.86–$1,332.50	295% above	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULR RE-EDUCATION EA 15 MIN COTA	$146.57	$266.50	$24.86–$1,332.50	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$146.57	$266.50	$24.86–$1,332.50	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PT	$146.57	$266.50	$24.86–$1,332.50	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUCATION EA 15 MIN PTA	$146.57	$266.50	$24.86–$1,332.50	—	45%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR RE-EDUC	$146.57	$266.50	$24.86–$1,332.50	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MED NUTRITON THERAPY EACH 15 MIN INITIAL	$230.17	$418.50	$20.43–$418.50	699% above	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MEDICAL NUTRITION INDIV IN	$230.17	$418.50	$20.43–$418.50	699% above	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MED NUTRITON THERAPY EACH 15 MIN INITIAL	$230.17	$418.50	$20.43–$418.50	—	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MEDICAL NUTRITION INDIV IN	$230.17	$418.50	$20.43–$418.50	—	45%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$372.62	$677.50	$50.67–$677.50	242% above	45%
Occupational therapy evaluation, low complexity CPT 97165 OT EVALUATION INITIAL - LOW	$372.62	$677.50	$50.67–$677.50	242% above	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$372.62	$677.50	$50.67–$677.50	—	45%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVALUATION INITIAL - LOW	$372.62	$677.50	$50.67–$677.50	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVALUATION INITIAL - HIGH	$348.70	$634.00	$47.42–$634.00	223% above	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$348.70	$634.00	$47.42–$634.00	223% above	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVALUATION INITIAL - HIGH	$348.70	$634.00	$47.42–$634.00	—	45%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$348.70	$634.00	$47.42–$634.00	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION INITIAL - LOW	$393.25	$715.00	$53.48–$715.00	316% above	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$393.25	$715.00	$53.48–$715.00	316% above	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$393.25	$715.00	$53.48–$715.00	—	45%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION INITIAL - LOW	$393.25	$715.00	$53.48–$715.00	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION INITIAL - MOD	$293.15	$533.00	$39.86–$533.00	205% above	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$293.15	$533.00	$39.86–$533.00	205% above	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$293.15	$533.00	$39.86–$533.00	—	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION INITIAL - MOD	$293.15	$533.00	$39.86–$533.00	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA	$133.37	$242.50	$21.07–$1,212.50	202% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$133.37	$242.50	$21.07–$1,212.50	202% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA	$133.37	$242.50	$21.07–$1,212.50	202% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15 MIN	$133.37	$242.50	$21.07–$1,212.50	202% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15MIN PT	$133.37	$242.50	$21.07–$1,212.50	202% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$133.37	$242.50	$21.07–$1,212.50	202% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15MIN PT	$133.37	$242.50	$21.07–$1,212.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15 MIN	$133.37	$242.50	$21.07–$1,212.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES COTA	$133.37	$242.50	$21.07–$1,212.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1/> REGIONS	$133.37	$242.50	$21.07–$1,212.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY	$133.37	$242.50	$21.07–$1,212.50	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY EA 15 MINUTES PTA	$133.37	$242.50	$21.07–$1,212.50	—	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA	$141.62	$257.50	$10.96–$1,030.00	273% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE	$141.62	$257.50	$10.96–$1,030.00	273% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$141.62	$257.50	$10.96–$1,030.00	273% above	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA	$141.62	$257.50	$10.96–$1,030.00	273% above	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE	$141.62	$257.50	$10.96–$1,030.00	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES	$141.62	$257.50	$10.96–$1,030.00	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN PTA	$141.62	$257.50	$10.96–$1,030.00	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES EA 15 MIN COTA	$141.62	$257.50	$10.96–$1,030.00	—	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION	$75.62	$137.50	$10.28–$137.50	160% above	45%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$75.62	$137.50	$10.28–$137.50	160% above	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION	$75.62	$137.50	$10.28–$137.50	—	45%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$75.62	$137.50	$10.28–$137.50	—	45%
Speech and language evaluation CPT 92523 ST EVAL SPEECH/LANGUAGE	$962.50	$1,750.00	$130.90–$1,750.00	532% above	45%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$962.50	$1,750.00	$130.90–$1,750.00	532% above	45%
Speech and language evaluation inpatient CPT 92523 ST EVAL SPEECH/LANGUAGE	$962.50	$1,750.00	$130.90–$1,750.00	—	45%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$962.50	$1,750.00	$130.90–$1,750.00	—	45%
Speech therapy session, individual CPT 92507 ST SPEECH TREATMENT	$311.85	$567.00	$32.79–$567.00	284% above	45%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$311.85	$567.00	$32.79–$567.00	284% above	45%
Speech therapy session, individual inpatient CPT 92507 TX SP LANG VOICE COMM INDIV	$311.85	$567.00	$32.79–$567.00	—	45%
Speech therapy session, individual inpatient CPT 92507 ST SPEECH TREATMENT	$311.85	$567.00	$32.79–$567.00	—	45%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$585.20	$1,064.00	$37.82–$1,064.00	312% above	45%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION TEST	$585.20	$1,064.00	$37.82–$1,064.00	312% above	45%
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION TEST	$585.20	$1,064.00	$37.82–$1,064.00	—	45%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$585.20	$1,064.00	$37.82–$1,064.00	—	45%
Spirometry before and after a bronchodilator CPT 94060 COMPLETE PFT	$786.50	$1,430.00	$64.75–$1,430.00	150% above	45%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$786.50	$1,430.00	$64.75–$1,430.00	150% above	45%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$786.50	$1,430.00	$64.75–$1,430.00	—	45%
Spirometry before and after a bronchodilator inpatient CPT 94060 COMPLETE PFT	$786.50	$1,430.00	$64.75–$1,430.00	—	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA	$150.15	$273.00	$8.76–$1,092.00	299% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$150.15	$273.00	$8.76–$1,092.00	299% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA	$150.15	$273.00	$8.76–$1,092.00	299% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PT	$150.15	$273.00	$8.76–$1,092.00	299% above	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PT	$150.15	$273.00	$8.76–$1,092.00	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15 MIN PTA	$150.15	$273.00	$8.76–$1,092.00	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES DIR EA 15MIN COTA	$150.15	$273.00	$8.76–$1,092.00	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES	$150.15	$273.00	$8.76–$1,092.00	—	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEB	$267.85	$487.00	$36.42–$487.00	161% above	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$267.85	$487.00	$36.42–$487.00	161% above	45%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$267.85	$487.00	$36.42–$487.00	—	45%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEB	$267.85	$487.00	$36.42–$487.00	—	45%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$275.00	$500.00	$37.40–$500.00	276% above	45%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR INJ	$275.00	$500.00	$37.40–$500.00	276% above	45%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR INJ	$275.00	$500.00	$37.40–$500.00	—	45%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE SC	$275.00	$500.00	$37.40–$500.00	—	45%
Rabies vaccine, one dose CPT 90675 RABIES VAC 2.5UNITS UD J	$1,191.57	$2,166.50	$162.05–$2,166.50	37% above	45%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$1,191.57	$2,166.50	$162.05–$2,166.50	37% above	45%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$1,191.57	$2,166.50	$162.05–$2,166.50	—	45%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC 2.5UNITS UD J	$1,191.57	$2,166.50	$162.05–$2,166.50	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$153.72	$279.50	$20.90–$279.50	393% above	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET\DIPHTOXOID PF J	$153.72	$279.50	$20.90–$279.50	393% above	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$153.72	$279.50	$20.90–$279.50	—	45%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET\DIPHTOXOID PF J	$153.72	$279.50	$20.90–$279.50	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACC 7YRS>IM	$160.60	$292.00	$21.84–$292.00	245% above	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$160.60	$292.00	$21.84–$292.00	245% above	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACC 7YRS>IM	$160.60	$292.00	$21.84–$292.00	—	45%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$160.60	$292.00	$21.84–$292.00	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION	$110.82	$201.50	$7.00–$405.00	175% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$111.92	$203.50	$7.00–$405.00	178% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMISTRATION	$111.92	$203.50	$7.00–$405.00	178% above	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION	$110.82	$201.50	$7.00–$405.00	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMISTRATION	$111.92	$203.50	$7.00–$405.00	—	45%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$111.92	$203.50	$7.00–$405.00	—	45%

Source file: https://northernlouisianamedicalcenter.com/844422249_NORTHERN-LOUISIANA-MEDICAL-CENTER_standardcharges.csv