Hospital

Lasalle General Hospital

Listed in its price file as “Hospital Service District #2 of Lasalle Parish”.

Lasalle General Hospital in Jena, LA publishes cash prices for 251 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Louisiana median for 121 of 248 procedures and above it for 121. By typical cash price it ranks #12 of 28 Louisiana hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

187 NINTH STREET, JENA, LA, 71342-2780 Collected Sep 27, 2026 Source price file (318) 992-9200

Acute care hospital No emergency department CMS star rating 1 of 5 CCN 190145 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ABI	$192.60	$321.00	$118.06–$205.22	at median	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI	$192.60	$321.00	$118.06–$205.22	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR SOFT TISSUE NECK 1V	$120.00	$200.00	$127.86–$155.64	49% below	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR SOFT TISSUE NECK W/ BARIUM	$153.60	$256.00	$155.64–$163.66	35% below	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR SOFT TISSUE NECK 1V	$120.00	$200.00	$127.86–$155.64	—	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR SOFT TISSUE NECK W/ BARIUM	$153.60	$256.00	$155.64–$163.66	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE SCAN-WHOLE BODY	$742.20	$1,237.00	$354.75–$790.81	22% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE SCAN-WHOLE BODY	$742.20	$1,237.00	$354.75–$790.81	—	40%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL	$208.80	$348.00	$77.22–$222.48	17% above	40%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL	$208.80	$348.00	$77.22–$222.48	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA AAA	$1,140.00	$1,900.00	$155.64–$1,214.67	20% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT PE PROTOCOL	$1,140.00	$1,900.00	$155.64–$1,214.67	20% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT PE PROTOCOL	$1,140.00	$1,900.00	$155.64–$1,214.67	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA AAA	$1,140.00	$1,900.00	$155.64–$1,214.67	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CALCIUM SCORE	$150.00	$250.00	$77.22–$159.82	89% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORE	$150.00	$250.00	$77.22–$159.82	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL STONE PROTOCOL	$378.00	$630.00	$211.73–$402.76	70% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL W/ ORAL ONLY	$378.00	$630.00	$211.73–$402.76	70% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PEL W/O	$378.00	$630.00	$211.73–$402.76	70% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN STONE PROTOCOL	$378.00	$630.00	$211.73–$402.76	70% below	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL W/ ORAL ONLY	$378.00	$630.00	$211.73–$402.76	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL STONE PROTOCOL	$378.00	$630.00	$211.73–$402.76	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PEL W/O	$378.00	$630.00	$211.73–$402.76	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN STONE PROTOCOL	$378.00	$630.00	$211.73–$402.76	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W/ ORAL/IV	$597.00	$995.00	$309.58–$636.10	63% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PEL W/ IV ONLY	$597.00	$995.00	$309.58–$636.10	63% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W/ IV ONLY	$597.00	$995.00	$309.58–$636.10	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PEL W/ ORAL/IV	$597.00	$995.00	$309.58–$636.10	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL W/WO IV ONLY	$661.20	$1,102.00	$309.58–$704.51	61% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT HEMATURIA PROTOCOL	$661.20	$1,102.00	$309.58–$704.51	61% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT RENAL MASS PROTOCOL	$661.20	$1,102.00	$309.58–$704.51	61% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PEL W/WO ORAL/IV	$661.20	$1,102.00	$309.58–$704.51	61% below	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL W/WO ORAL/IV	$661.20	$1,102.00	$309.58–$704.51	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT RENAL MASS PROTOCOL	$661.20	$1,102.00	$309.58–$704.51	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PEL W/WO IV ONLY	$661.20	$1,102.00	$309.58–$704.51	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT HEMATURIA PROTOCOL	$661.20	$1,102.00	$309.58–$704.51	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ IV ONLY	$597.00	$995.00	$155.64–$636.10	34% below	40%
CT scan of the abdomen with contrast CPT 74160 CT PANCREATIC PROTOCOL	$597.00	$995.00	$155.64–$636.10	34% below	40%
CT scan of the abdomen with contrast CPT 74160 CT HEMANGIOMA PROTOCOL	$597.00	$995.00	$155.64–$636.10	34% below	40%
CT scan of the abdomen with contrast CPT 74160 CT ADRENAL MASS PROTOCOL	$597.00	$995.00	$155.64–$636.10	34% below	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ ORAL/IV	$597.00	$995.00	$155.64–$636.10	34% below	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/WO IV ONLY	$597.00	$995.00	$155.64–$636.10	34% below	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT HEMANGIOMA PROTOCOL	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ADRENAL MASS PROTOCOL	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/WO IV ONLY	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ ORAL/IV	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT PANCREATIC PROTOCOL	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ IV ONLY	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/ ORAL ONLY	$378.00	$630.00	$92.78–$402.76	56% below	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O	$378.00	$630.00	$92.78–$402.76	56% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/ ORAL ONLY	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O	$378.00	$630.00	$92.78–$402.76	43% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O	$378.00	$630.00	$92.78–$402.76	43% below	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT MASTOIDS W/O	$378.00	$630.00	$92.78–$402.76	42% below	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O	$378.00	$630.00	$92.78–$402.76	42% below	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT MASTOIDS W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD W/ IV CONTRAST ONLY	$597.00	$995.00	$155.64–$636.10	25% below	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/ IV CONTRAST ONLY	$597.00	$995.00	$155.64–$636.10	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO	$661.20	$1,102.00	$155.64–$704.51	30% below	40%
CT scan of the head without and with contrast CPT 70470 CT TEMPORAL BONES W/O	$661.20	$1,102.00	$155.64–$704.51	30% below	40%
CT scan of the head without and with contrast CPT 70470 CT TEMPORAL BONES W/WO	$661.20	$1,102.00	$155.64–$704.51	30% below	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT TEMPORAL BONES W/O	$661.20	$1,102.00	$155.64–$704.51	—	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO	$661.20	$1,102.00	$155.64–$704.51	—	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT TEMPORAL BONES W/WO	$661.20	$1,102.00	$155.64–$704.51	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O	$378.00	$630.00	$92.78–$402.76	52% below	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SACRUM COCCYX W/O	$661.20	$1,102.00	$92.78–$704.51	17% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SACRUM COCCYX W/O	$661.20	$1,102.00	$92.78–$704.51	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O	$378.00	$630.00	$92.78–$402.76	52% below	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE W/O	$378.00	$630.00	$92.78–$402.76	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/	$597.00	$995.00	$155.64–$636.10	28% below	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/	$597.00	$995.00	$155.64–$636.10	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID	$361.20	$602.00	$211.73–$384.86	23% below	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID JWL	$361.20	$602.00	$211.73–$384.86	23% below	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID JWL	$361.20	$602.00	$211.73–$384.86	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID	$361.20	$602.00	$211.73–$384.86	—	40%
Chest X-ray, 2 views CPT 71046 XR CHEST PA & LAT	$107.40	$179.00	$77.22–$114.43	22% below	40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA & LAT	$107.40	$179.00	$77.22–$114.43	—	40%
Chest X-ray, single view CPT 71045 XR BABYGRAM	$56.40	$94.00	$60.09–$77.22	50% below	40%
Chest X-ray, single view CPT 71045 XR CHEST AP OR PA ONLY	$56.40	$94.00	$60.09–$77.22	50% below	40%
Chest X-ray, single view CPT 71045 XR CHEST AP PORTABLE	$56.40	$94.00	$60.09–$77.22	50% below	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST AP OR PA ONLY	$56.40	$94.00	$60.09–$77.22	—	40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST AP PORTABLE	$56.40	$94.00	$60.09–$77.22	—	40%
Chest X-ray, single view inpatient CPT 71045 XR BABYGRAM	$56.40	$94.00	$60.09–$77.22	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL	$298.20	$497.00	$92.78–$317.73	at median	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL	$298.20	$497.00	$92.78–$317.73	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR BONE DENSITY	$195.60	$326.00	$92.78–$208.41	17% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR BONE DENSITY	$195.60	$326.00	$92.78–$208.41	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB 2ND/3RD TRIMESTER COMPLETE	$274.80	$458.00	$211.73–$292.80	4% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB 2ND/3RD TRIMESTER COMPLETE	$274.80	$458.00	$211.73–$292.80	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O	$378.00	$630.00	$92.78–$402.76	51% below	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST/ABD/PELVIS W/O	$378.00	$630.00	$92.78–$402.76	51% below	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O	$378.00	$630.00	$92.78–$402.76	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST/ABD/PELVIS W/O	$378.00	$630.00	$92.78–$402.76	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/	$597.00	$995.00	$155.64–$636.10	37% below	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/ABD/PELVIS W/	$597.00	$995.00	$155.64–$636.10	37% below	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST/ABD/PELVIS W/	$597.00	$995.00	$155.64–$636.10	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/	$597.00	$995.00	$155.64–$636.10	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LOWER EXTREMITY BILATERAL	$477.00	$795.00	$211.73–$508.24	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US ARTERIAL LOWER EXTREMITY BILATERAL	$477.00	$795.00	$211.73–$508.24	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS LOWER EXTREMITY BILATERAL	$374.40	$624.00	$211.73–$398.92	—	40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS UPPER EXTREMITY BILATERAL	$374.40	$624.00	$211.73–$398.92	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS LOWER EXTREMITY BILATERAL	$374.40	$624.00	$211.73–$398.92	—	40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS UPPER EXTREMITY BILATERAL	$374.40	$624.00	$211.73–$398.92	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM	$345.00	$575.00	$367.60–$484.88	52% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAM	$345.00	$575.00	$367.60–$484.88	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE LOWER BACK	$232.20	$387.00	$92.78–$247.41	22% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$232.20	$387.00	$92.78–$247.41	22% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$232.20	$387.00	$92.78–$247.41	22% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$232.20	$387.00	$92.78–$247.41	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SOFT TISSUE LOWER BACK	$232.20	$387.00	$92.78–$247.41	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$232.20	$387.00	$92.78–$247.41	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LUNG SCREENING	$150.00	$250.00	$92.78–$159.82	41% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LUNG SCREENING	$150.00	$250.00	$92.78–$159.82	—	40%
MRI of the abdomen without contrast CPT 74181 MRI MRCP	$727.80	$1,213.00	$211.73–$775.47	33% below	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO	$859.80	$1,433.00	$309.58–$916.12	37% below	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the brain, no contrast dye CPT 70551 MRI IAC W/O	$727.80	$1,213.00	$211.73–$775.47	36% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$727.80	$1,213.00	$211.73–$775.47	36% below	40%
MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY W/O	$727.80	$1,213.00	$211.73–$775.47	36% below	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI PITUITARY W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITARY W/WO	$859.80	$1,433.00	$309.58–$916.12	41% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO	$859.80	$1,433.00	$309.58–$916.12	41% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC W/WO	$859.80	$1,433.00	$309.58–$916.12	41% below	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITARY W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR W/O	$727.80	$1,213.00	$211.73–$775.47	42% below	40%
MRI of the lower back, no contrast dye CPT 72148 MRI SACRUM W/O	$727.80	$1,213.00	$211.73–$775.47	42% below	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SACRUM W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W/WO	$859.80	$1,433.00	$309.58–$916.12	38% below	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SACRUM W/WO	$859.80	$1,433.00	$309.58–$916.12	38% below	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SACRUM W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE W/O	$727.80	$1,213.00	$211.73–$775.47	39% below	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W/WO	$859.80	$1,433.00	$309.58–$916.12	48% below	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O	$727.80	$1,213.00	$211.73–$775.47	41% below	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO	$859.80	$1,433.00	$309.58–$916.12	33% below	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO	$859.80	$1,433.00	$309.58–$916.12	—	40%
MRI of the pelvis, no contrast dye both sides CPT 72195 MRI HIP BILATERAL	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$727.80	$1,213.00	$211.73–$775.47	36% below	40%
MRI of the pelvis, no contrast dye inpatient both sides CPT 72195 MRI HIP BILATERAL	$727.80	$1,213.00	$211.73–$775.47	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$727.80	$1,213.00	$211.73–$775.47	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL STRESS/REST	$1,895.40	$3,159.00	$1,148.85–$2,019.55	52% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL LEXI SCAN	$1,895.40	$3,159.00	$1,148.85–$2,019.55	52% above	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL LEXI SCAN	$1,895.40	$3,159.00	$1,148.85–$2,019.55	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL STRESS/REST	$1,895.40	$3,159.00	$1,148.85–$2,019.55	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER	$232.20	$387.00	$92.78–$247.41	31% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED W/ TRANSVAGINAL	$232.20	$387.00	$92.78–$247.41	31% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$232.20	$387.00	$92.78–$247.41	31% above	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER	$232.20	$387.00	$92.78–$247.41	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$232.20	$387.00	$92.78–$247.41	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED W/ TRANSVAGINAL	$232.20	$387.00	$92.78–$247.41	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$274.80	$458.00	$92.78–$292.80	5% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMP W/ TRANSVAGINAL	$274.80	$458.00	$92.78–$292.80	5% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMP W/ TRANSVAGINAL	$274.80	$458.00	$92.78–$292.80	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$274.80	$458.00	$92.78–$292.80	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB 2ND/3RD TRIMESTER LIMITED	$294.60	$491.00	$92.78–$313.90	7% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB 2ND/3RD TRIMESTER LIMITED	$294.60	$491.00	$92.78–$313.90	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMESTER W/ TRANSVAGINAL	$271.80	$453.00	$92.78–$289.60	2% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1ST TRIMESTER COMPLETE	$271.80	$453.00	$92.78–$289.60	2% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMESTER COMPLETE	$271.80	$453.00	$92.78–$289.60	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB 1ST TRIMESTER W/ TRANSVAGINAL	$271.80	$453.00	$92.78–$289.60	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIM	$203.40	$339.00	$92.78–$216.72	50% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIM	$203.40	$339.00	$92.78–$216.72	—	40%
Screening mammogram, both breasts both sides CPT 77067 MM MG MAMMO BILAT SCREENING W/CAD	$240.00	$400.00	$79.11–$255.72	—	40%
Screening mammogram, both breasts both sides CPT 77067 MM 3D BILATERAL SCREENING	$240.00	$400.00	$79.11–$255.72	—	40%
Screening mammogram, both breasts both sides CPT 77067 MM 2D BILATERAL SCREENING	$240.00	$400.00	$79.11–$255.72	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM 3D BILATERAL SCREENING	$240.00	$400.00	$79.11–$255.72	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM MG MAMMO BILAT SCREENING W/CAD	$240.00	$400.00	$79.11–$255.72	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM 2D BILATERAL SCREENING	$240.00	$400.00	$79.11–$255.72	—	40%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 US STRESS TTE COMPLETE	$648.60	$1,081.00	$484.88–$691.08	7% above	40%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 US STRESS TTE COMPLETE	$648.60	$1,081.00	$484.88–$691.08	—	40%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL NON-OB	$286.80	$478.00	$92.78–$305.59	41% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL NON-OB	$286.80	$478.00	$92.78–$305.59	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 US TRANSVAGINAL OBSTETRIC	$198.60	$331.00	$92.78–$211.61	16% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US TRANSVAGINAL OBSTETRIC	$198.60	$331.00	$92.78–$211.61	—	40%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$298.20	$497.00	$92.78–$317.73	11% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$298.20	$497.00	$92.78–$317.73	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR	$180.00	$300.00	$92.78–$191.79	21% below	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR	$180.00	$300.00	$92.78–$191.79	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID	$278.40	$464.00	$92.78–$296.64	3% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$278.40	$464.00	$92.78–$296.64	3% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$278.40	$464.00	$92.78–$296.64	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID	$278.40	$464.00	$92.78–$296.64	—	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN KUB	$103.20	$172.00	$77.22–$109.96	9% below	40%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1V/AP	$130.80	$218.00	$77.22–$139.37	16% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN KUB	$103.20	$172.00	$77.22–$109.96	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1V/AP	$130.80	$218.00	$77.22–$139.37	—	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER RT	$107.40	$179.00	$77.22–$114.43	10% above	40%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LT	$107.40	$179.00	$77.22–$114.43	10% above	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER RT	$107.40	$179.00	$77.22–$114.43	—	40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LT	$107.40	$179.00	$77.22–$114.43	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2-3 VIEWS	$136.20	$227.00	$92.78–$145.12	10% below	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2-3 VIEWS	$136.20	$227.00	$92.78–$145.12	—	40%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBAR SPINE W/ OBLIQUES	$145.20	$242.00	$92.78–$154.71	37% below	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE W/ OBLIQUES	$145.20	$242.00	$92.78–$154.71	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES	$123.00	$205.00	$77.22–$131.06	2% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES	$123.00	$205.00	$77.22–$131.06	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL FLEXION & EXTENSION	$109.80	$183.00	$77.22–$116.99	24% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL SPINE 2/3 VIEWS	$109.80	$183.00	$77.22–$116.99	24% below	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL FLEXION & EXTENSION	$109.80	$183.00	$77.22–$116.99	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL SPINE 2/3 VIEWS	$109.80	$183.00	$77.22–$116.99	—	40%
X-ray of the pelvis, 1 or 2 views both sides CPT 72170 XR HIPS BILATERAL	$107.40	$179.00	$92.78–$114.43	—	40%
X-ray of the pelvis, 1 or 2 views both sides CPT 72170 XR BILATERAL HIP	$107.40	$179.00	$92.78–$114.43	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS	$107.40	$179.00	$92.78–$114.43	26% below	40%
X-ray of the pelvis, 1 or 2 views inpatient both sides CPT 72170 XR HIPS BILATERAL	$107.40	$179.00	$92.78–$114.43	—	40%
X-ray of the pelvis, 1 or 2 views inpatient both sides CPT 72170 XR BILATERAL HIP	$107.40	$179.00	$92.78–$114.43	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS	$107.40	$179.00	$92.78–$114.43	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2V	$136.20	$227.00	$77.22–$145.12	4% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX	$136.20	$227.00	$77.22–$145.12	4% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX	$136.20	$227.00	$77.22–$145.12	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2V	$136.20	$227.00	$77.22–$145.12	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT)	$36.00	$60.00	$5.19–$5.30	16% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT)	$36.00	$60.00	$5.19–$5.30	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT)	$34.20	$57.00	$5.08–$5.18	4% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT)	$34.20	$57.00	$5.08–$5.18	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$212.40	$354.00	$46.68–$47.63	83% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL	$212.40	$354.00	$46.68–$47.63	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, AMERICAN DUST MITE D. MICROCERAS	$30.00	$50.00	$5.12–$5.22	198% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SUNFLOWER SEED	$30.00	$50.00	$5.12–$5.22	198% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CANDIDA	$30.00	$50.00	$5.12–$5.22	198% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ACREMONIUM KILIENSE	$36.00	$60.00	$5.12–$5.22	258% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, GLUTEN	$36.00	$60.00	$5.12–$5.22	258% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MUSSEL, BLUE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE XTRC E	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, RAGWEED, SHORT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PECAN, HICKORY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SHRIMP	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PENCILLIUM NOTATUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SILVER BIRCH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PENICILLIUM CHRYSOGENUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SOYBEAN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PINE NUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, LOBSTER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PIGWEED	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PECAN NUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PEANUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PEACH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, OYSTER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ORANGE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ONION	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, OAT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, OAK (WHITE)	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, STEMPHYLIUM HERBARUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PINEAPPLE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, OAK (LIVE)	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, STRAWBERRY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SHEEP SORREL	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BAHIA GRASS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, NETTLE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MUGWORT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MUCOR RECEMOSUS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MOUSE URIN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MILK	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MELON	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MARSHELDER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MAPLE/BOX	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MAPLE LEAF SYCAMORE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SESAME SEED	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ASPERGILLIS FUMIGATUS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MANGO	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MACKEREL	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, MACADAMIA NUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, LETTUCE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, LEMON	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, LAMB'S QUARTERS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, LAMB	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, JOHNSON GRASS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HORNET YELLOW	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SCALLOP	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ASCARIS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HORNET WHITE FACE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HORMODENDRUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HONEYBEE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HICKORY (WHITE)	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HERRING	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HELMINTHISPORIUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HAZELNUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HALIBUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, HADDOCK	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PRIVET, COMMON	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COTTON LINT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, AUREOBASIDI PULLULANS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BIPOLARIS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BARLEY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COCKLEBUR	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COTTONWOOD	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SALMON	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, APRICOT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, GREEN PEA	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, GREEN BEAN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, GRAPEFRUIT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, GIANT RAGWEED	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, FOXTAIL (MEADOW)	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, FLOUNDER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, FIRE ANT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, FILBERT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, FESCUE, MEADOW	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, RYE GRASS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, KIWI	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CUCUMBER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PISTACHIO	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, STRING BEAN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PLANTAIN, ENGLISH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SWEET GUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PLUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, SWEET POTATO	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, APPLE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, PORK	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, TILAPIA	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE, IGE W/ REFLEX	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, RED DYE (CARMINE)	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BANANA	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, TIMOTHY GRASS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BEEF	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, TOMATO	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ELM, AMERICAN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, EGG YOLK	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, EGG WHITE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, EUROPEAN DUST MITE-D. PTERONYSSINUS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, DUST MITE (D PTERONYSSINU	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, DUST MITE (D FARINAE)	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, DOG DANDER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CRAWFISH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CRAB	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, RYE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ALTERNARIA ALTERNATA	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CORN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COFFEE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CODFISH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COCONUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COCKROACH, GERMAN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BERMUDA GRASS	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, TROUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, COCKROACH, AMERICAN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CLAM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CLADOSPORIUM HERBARUM	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CINNAMON	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE,CURVULARIA LUNATA	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ROUGH MARSH ELDER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, ALMOND	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CHOCOLATE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK, IGE W/REFLEX	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BLUEBERRY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CHICKEN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE,WHITE MULBERRY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CHESTNUT, SWEET	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, YELLOW JACKET	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CHEDDAR CHEESE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, YEAST	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CELERY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WHOLE EGG	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CEDAR, MOUNTAIN	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WHITE POTATO	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CATFISH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WHITE PINE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CAT DANDER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WHITE ASH	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CASHEW NUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, RICE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE-ALPHA 1,3	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, TUNA	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BLUEGRASS, KENTUCKY	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WALNUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WHEAT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CARROT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WESTERN RAGWEED	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, CARMINE	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WATERMELON	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BROCCOLI	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, WASP, PAPER	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE, BRAZIL NUT	$37.20	$62.00	$5.12–$5.22	270% above	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SUNFLOWER SEED	$30.00	$50.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CANDIDA	$30.00	$50.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, AMERICAN DUST MITE D. MICROCERAS	$30.00	$50.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ACREMONIUM KILIENSE	$36.00	$60.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, GLUTEN	$36.00	$60.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HERRING	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HELMINTHISPORIUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COCKROACH, GERMAN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HAZELNUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HALIBUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, TOMATO	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HADDOCK	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CAT DANDER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PRIVET, COMMON	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BERMUDA GRASS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COTTON LINT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CARROT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, AUREOBASIDI PULLULANS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COCKROACH, AMERICAN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BIPOLARIS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WHITE ASH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BARLEY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CLAM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COCKLEBUR	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WALNUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COTTONWOOD	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CLADOSPORIUM HERBARUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SALMON	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CASHEW NUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, APRICOT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CINNAMON	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, GREEN PEA	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WESTERN RAGWEED	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, GREEN BEAN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE,CURVULARIA LUNATA	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, GRAPEFRUIT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, RICE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, GIANT RAGWEED	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ROUGH MARSH ELDER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, FOXTAIL (MEADOW)	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WASP, PAPER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, FLOUNDER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ALMOND	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, FIRE ANT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE-ALPHA 1,3	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, FILBERT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CHOCOLATE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, FESCUE, MEADOW	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CARMINE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HORMODENDRUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK, IGE W/REFLEX	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, STRAWBERRY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, KIWI	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, TROUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CUCUMBER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PISTACHIO	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CHICKEN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, STRING BEAN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, RYE GRASS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CODFISH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HONEYBEE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HICKORY (WHITE)	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COCONUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ONION	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BANANA	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, OAT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, OAK (WHITE)	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, TIMOTHY GRASS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PIGWEED	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CELERY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, STEMPHYLIUM HERBARUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BEEF	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, OAK (LIVE)	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, TUNA	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PINEAPPLE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ELM, AMERICAN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SHEEP SORREL	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WHOLE EGG	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BAHIA GRASS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, EGG YOLK	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, NETTLE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WATERMELON	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MUGWORT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, EGG WHITE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MUCOR RECEMOSUS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CEDAR, MOUNTAIN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MOUSE URIN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, EUROPEAN DUST MITE-D. PTERONYSSINUS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MILK	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BLUEGRASS, KENTUCKY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MELON	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, DUST MITE (D PTERONYSSINU	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MARSHELDER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WHITE POTATO	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MAPLE/BOX	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, DUST MITE (D FARINAE)	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MAPLE LEAF SYCAMORE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BRAZIL NUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SESAME SEED	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, DOG DANDER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ASPERGILLIS FUMIGATUS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CATFISH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MANGO	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CRAWFISH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MACKEREL	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WHEAT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MACADAMIA NUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CRAB	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, LETTUCE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, WHITE PINE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, LEMON	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, RYE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, LAMB'S QUARTERS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BROCCOLI	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, LAMB	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ALTERNARIA ALTERNATA	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, JOHNSON GRASS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HORNET YELLOW	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CORN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SCALLOP	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ASCARIS	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, COFFEE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, HORNET WHITE FACE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PLANTAIN, ENGLISH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE,WHITE MULBERRY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SWEET GUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE CRUDE XTRC E	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, RAGWEED, SHORT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PLUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PECAN, HICKORY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CHESTNUT, SWEET	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SHRIMP	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, APPLE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PENCILLIUM NOTATUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, BLUEBERRY	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SILVER BIRCH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SWEET POTATO	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PENICILLIUM CHRYSOGENUM	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, YELLOW JACKET	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, SOYBEAN	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PORK	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PINE NUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, MUSSEL, BLUE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, LOBSTER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, TILAPIA	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PECAN NUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, CHEDDAR CHEESE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PEANUT	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE, IGE W/ REFLEX	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, PEACH	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, OYSTER	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, RED DYE (CARMINE)	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, ORANGE	$37.20	$62.00	$5.12–$5.22	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE, YEAST	$37.20	$62.00	$5.12–$5.22	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ABS IGG/IGA	$72.60	$121.00	$12.69–$12.95	53% above	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ACCP AB	$72.60	$121.00	$12.69–$12.95	53% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ACCP AB	$72.60	$121.00	$12.69–$12.95	—	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ABS IGG/IGA	$72.60	$121.00	$12.69–$12.95	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/REFLEX	$50.40	$84.00	$11.85–$12.09	4% below	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/REFLEX	$50.40	$84.00	$11.85–$12.09	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-TYPE NATRIURETIC PEPTIDE (PBNP)	$57.00	$95.00	$38.47–$39.26	27% below	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PLAIN B-TYPE NATRIURETIC PEPTIDE	$57.00	$95.00	$38.47–$39.26	27% below	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 PLAIN B-TYPE NATRIURETIC PEPTIDE	$57.00	$95.00	$38.47–$39.26	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-TYPE NATRIURETIC PEPTIDE (PBNP)	$57.00	$95.00	$38.47–$39.26	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$60.60	$101.00	$8.29–$8.46	1% below	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL FREQUENCY	$60.60	$101.00	$8.29–$8.46	1% below	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$60.60	$101.00	$8.29–$8.46	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL FREQUENCY	$60.60	$101.00	$8.29–$8.46	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 DELTA PATHOLOGY TISSUE SINGLE	$78.00	$130.00	$60.71	7% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 DELTA PATHOLOGY TISSUE SINGLE	$78.00	$130.00	$60.71	—	40%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$81.60	$136.00	$10.11–$10.32	12% above	40%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$81.60	$136.00	$10.11–$10.32	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$6.61	$11.01	$3.00–$9.15	23% below	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$6.61	$11.01	$3.00–$9.15	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$30.60	$51.00	$3.85–$3.93	77% above	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$30.60	$51.00	$3.85–$3.93	—	40%
Blood lead test CPT 83655 LEAD, BLOOD, PEDI<16	$100.20	$167.00	$11.87–$12.11	222% above	40%
Blood lead test CPT 83655 LEAD, BLOOD (ADULT)	$100.20	$167.00	$11.87–$12.11	222% above	40%
Blood lead test inpatient CPT 83655 LEAD, BLOOD, PEDI<16	$100.20	$167.00	$11.87–$12.11	—	40%
Blood lead test inpatient CPT 83655 LEAD, BLOOD (ADULT)	$100.20	$167.00	$11.87–$12.11	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 SERUM PREGNANCY	$65.40	$109.00	$7.37–$7.52	18% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 URINE PREGNANCY	$65.40	$109.00	$7.37–$7.52	18% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 URINE PREGNANCY	$65.40	$109.00	$7.37–$7.52	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 SERUM PREGNANCY	$65.40	$109.00	$7.37–$7.52	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE	$48.00	$80.00	$2.93–$2.99	2% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPE	$48.00	$80.00	$2.93–$2.99	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$40.80	$68.00	$5.08–$5.18	20% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$40.80	$68.00	$5.08–$5.18	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C. DIFFICILE, NAA	$54.00	$90.00	$36.52–$37.27	22% below	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. DIFFICILE, NAA	$54.00	$90.00	$36.52–$37.27	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19, SARS-COV-2, NAA	$84.00	$140.00	$38.48–$50.28	49% above	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19, SARS-COV-2, NAA	$84.00	$140.00	$38.48–$50.28	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHYLMD TRACH DNA AMP PROBE	$57.60	$96.00	$34.39–$35.09	3% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHYLMD TRACH DNA AMP PROBE	$57.60	$96.00	$34.39–$35.09	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$94.80	$158.00	$13.12–$13.39	34% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$94.80	$158.00	$13.12–$13.39	—	40%
Complete blood count (CBC) with differential CPT 85025 .CBC W AUTO DIFFERENTIAL (CHARGE)	$44.40	$74.00	$7.61–$7.77	17% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 .CBC W AUTO DIFFERENTIAL (CHARGE)	$44.40	$74.00	$7.61–$7.77	—	40%
Complete blood count (CBC), no differential CPT 85027 .CBC HEMOGRAM	$39.00	$65.00	$6.34–$6.47	11% below	40%
Complete blood count (CBC), no differential inpatient CPT 85027 .CBC HEMOGRAM	$39.00	$65.00	$6.34–$6.47	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL FREQUENCY	$76.80	$128.00	$10.35–$10.56	32% below	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$76.80	$128.00	$10.35–$10.56	32% below	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL FREQUENCY	$76.80	$128.00	$10.35–$10.56	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$76.80	$128.00	$10.35–$10.56	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANTITATIVE	$73.80	$123.00	$9.98–$10.18	2% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANTITATIVE	$73.80	$123.00	$9.98–$10.18	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA	$157.20	$262.00	$21.79–$22.23	154% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE SULFATE (DHEA-S)	$157.20	$262.00	$21.79–$22.23	154% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA	$157.20	$262.00	$21.79–$22.23	—	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE (DHEA-S)	$157.20	$262.00	$21.79–$22.23	—	40%
Estradiol blood test CPT 82670 ESTRADIOL	$208.80	$348.00	$27.38–$27.94	165% above	40%
Estradiol blood test CPT 82670 ESTRADIOL, SENSITIVE	$208.80	$348.00	$27.38–$27.94	165% above	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL, SENSITIVE	$208.80	$348.00	$27.38–$27.94	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$208.80	$348.00	$27.38–$27.94	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$131.40	$219.00	$18.21–$18.58	108% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$131.40	$219.00	$18.21–$18.58	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, STOOL	$104.40	$174.00	$19.24–$19.63	21% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, STOOL	$104.40	$174.00	$19.24–$19.63	—	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN, SERUM	$67.20	$112.00	$13.36–$13.63	22% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN, SERUM	$67.20	$112.00	$13.36–$13.63	—	40%
Folate (folic acid) blood test CPT 82746 FOLATE	$103.20	$172.00	$14.41–$14.70	120% above	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$103.20	$172.00	$14.41–$14.70	—	40%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE (T3) FREE, SERUM	$83.40	$139.00	$13.43–$16.60	51% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE (T3) FREE, SERUM	$83.40	$139.00	$13.43–$16.60	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$78.60	$131.00	$8.84–$9.02	36% above	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, FREE,DIRECT	$78.60	$131.00	$8.84–$9.02	36% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$78.60	$131.00	$8.84–$9.02	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4, FREE,DIRECT	$78.60	$131.00	$8.84–$9.02	—	40%
Free testosterone test CPT 84402 TESTOSTERONE, FREE, DIRECT	$85.80	$143.00	$24.96–$25.47	17% above	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE, DIRECT	$85.80	$143.00	$24.96–$25.47	—	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE FIRST 3 SPECS	$71.40	$119.00	$12.61–$12.87	54% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE FIRST 3 SPECS	$71.40	$119.00	$12.61–$12.87	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE, NAA	$57.60	$96.00	$34.39–$35.09	9% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE, NAA	$57.60	$96.00	$34.39–$35.09	—	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ABS IGG	$115.20	$192.00	$15.82–$16.51	49% above	40%
H. pylori antibody blood test CPT 86677 H PYLORI	$115.20	$192.00	$15.82–$16.51	49% above	40%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI	$115.20	$192.00	$15.82–$16.51	—	40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ABS IGG	$115.20	$192.00	$15.82–$16.51	—	40%
H. pylori stool antigen test CPT 87338 H. PYLORI AG, STOOL, EIA	$100.20	$167.00	$6.31–$14.09	52% above	40%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI AG, STOOL, EIA	$100.20	$167.00	$6.31–$14.09	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA	$202.80	$338.00	$83.40–$85.10	6% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA QUANTITATIVE	$539.40	$899.00	$83.40–$85.10	181% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT PCR WITH REFLEX GENOSURE	$539.40	$899.00	$83.40–$85.10	181% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA	$202.80	$338.00	$83.40–$85.10	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA QUANTITATIVE	$539.40	$899.00	$83.40–$85.10	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT PCR WITH REFLEX GENOSURE	$539.40	$899.00	$83.40–$85.10	—	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1 AND 2 SCREEN	$90.00	$150.00	$23.60–$24.08	82% above	40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1 AND 2 SCREEN	$90.00	$150.00	$23.60–$24.08	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$52.85	$88.09	$9.52–$9.71	7% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$52.85	$88.09	$9.52–$9.71	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB	$76.80	$128.00	$10.53–$10.74	91% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB	$76.80	$128.00	$10.53–$10.74	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE ANTIGEN	$72.60	$121.00	$10.12–$10.33	67% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE ANTIGEN	$72.60	$121.00	$10.12–$10.33	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB W REFLEX QUANT PCR	$92.40	$154.00	$13.98–$14.27	81% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$92.40	$154.00	$13.98–$14.27	81% above	40%
Hepatitis C antibody blood test (screening) CPT 86803 HCV WITH HCV REFLEX QUANT PCR	$92.40	$154.00	$13.98–$14.27	81% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV WITH HCV REFLEX QUANT PCR	$92.40	$154.00	$13.98–$14.27	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$92.40	$154.00	$13.98–$14.27	—	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB W REFLEX QUANT PCR	$92.40	$154.00	$13.98–$14.27	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS,QUANTITATIVE,RNA	$92.40	$154.00	$41.98–$42.84	44% below	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA BY PCR, QN RFX GENO	$335.40	$559.00	$41.98–$42.84	102% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS,QUANTITATIVE,RNA	$92.40	$154.00	$41.98–$42.84	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA BY PCR, QN RFX GENO	$335.40	$559.00	$41.98–$42.84	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$54.00	$90.00	$12.93–$13.19	49% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$54.00	$90.00	$12.93–$13.19	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$54.00	$90.00	$18.96–$19.35	20% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$54.00	$90.00	$18.96–$19.35	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HIGH SENSITIVITY	$81.60	$136.00	$12.69–$12.95	83% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HIGH SENSITIVITY	$81.60	$136.00	$12.69–$12.95	—	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE-PLASMA	$57.00	$95.00	$17.56–$17.92	at median	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE-PLASMA	$57.00	$95.00	$17.56–$17.92	—	40%
Insulin blood test CPT 83525 INSULIN-SERUM	$80.40	$134.00	$11.20–$11.43	91% above	40%
Insulin blood test inpatient CPT 83525 INSULIN-SERUM	$80.40	$134.00	$11.20–$11.43	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$45.60	$76.00	$6.34–$6.47	32% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$45.60	$76.00	$6.34–$6.47	—	40%
Iron-binding capacity (TIBC) test CPT 83550 .TOTAL IRON BINDING CAPACITY	$68.40	$114.00	$8.57–$8.74	54% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 .TOTAL IRON BINDING CAPACITY	$68.40	$114.00	$8.57–$8.74	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$59.40	$99.00	$8.51–$8.68	27% below	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$59.40	$99.00	$8.51–$8.68	—	40%
LH (luteinizing hormone) test CPT 83002 LUTENIZING HORMONE	$131.40	$219.00	$18.15–$18.52	116% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 LUTENIZING HORMONE	$131.40	$219.00	$18.15–$18.52	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$67.80	$113.00	$6.75–$6.89	62% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$67.80	$113.00	$6.75–$6.89	—	40%
Liver function blood test panel CPT 80076 LIVER PANEL (HEPATIC FUNCTION) FREQUENCY	$93.60	$156.00	$8.01–$8.17	11% above	40%
Liver function blood test panel CPT 80076 LIVER PANEL (HEPATIC FUNCTION PANEL)	$93.60	$156.00	$8.01–$8.17	11% above	40%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL (HEPATIC FUNCTION) FREQUENCY	$93.60	$156.00	$8.01–$8.17	—	40%
Liver function blood test panel inpatient CPT 80076 LIVER PANEL (HEPATIC FUNCTION PANEL)	$93.60	$156.00	$8.01–$8.17	—	40%
Lyme disease antibody test CPT 86618 LYME TOTAL ANTIBODY W/REFLEX TO IMMUNOAS	$150.00	$250.00	$16.69–$17.03	196% above	40%
Lyme disease antibody test inpatient CPT 86618 LYME TOTAL ANTIBODY W/REFLEX TO IMMUNOAS	$150.00	$250.00	$16.69–$17.03	—	40%
Magnesium blood test CPT 83735 MAGNESIUM, RBC	$55.20	$92.00	$6.57–$6.70	102% above	40%
Magnesium blood test CPT 83735 MAGNESIUM FREQUENCY	$55.20	$92.00	$6.57–$6.70	102% above	40%
Magnesium blood test CPT 83735 MAGNESIUM	$55.20	$92.00	$6.57–$6.70	102% above	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, RBC	$55.20	$92.00	$6.57–$6.70	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$55.20	$92.00	$6.57–$6.70	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM FREQUENCY	$55.20	$92.00	$6.57–$6.70	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ABS (MEASLES), IGG	$80.40	$134.00	$12.62–$12.88	116% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ABS (MEASLES), IGM	$80.40	$134.00	$12.62–$12.88	116% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ABS (MEASLES), IGM	$80.40	$134.00	$12.62–$12.88	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ABS (MEASLES), IGG	$80.40	$134.00	$12.62–$12.88	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$38.40	$64.00	$5.08–$5.18	5% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO W/RF TITER	$38.40	$64.00	$5.08–$5.18	5% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$38.40	$64.00	$5.08–$5.18	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO W/RF TITER	$38.40	$64.00	$5.08–$5.18	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$94.20	$157.00	$18.02–$18.39	63% above	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$94.20	$157.00	$18.02–$18.39	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA 3RD GEN	$80.40	$134.00	$18.02–$18.39	42% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (SERIAL MONITOR)	$80.40	$134.00	$18.02–$18.39	42% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$80.40	$134.00	$18.02–$18.39	42% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA 3RD GEN	$80.40	$134.00	$18.02–$18.39	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$80.40	$134.00	$18.02–$18.39	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (SERIAL MONITOR)	$80.40	$134.00	$18.02–$18.39	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE, INTACT	$142.80	$238.00	$40.45–$41.28	31% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE, INTACT	$142.80	$238.00	$40.45–$41.28	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME (PTT)	$48.00	$80.00	$5.89–$6.01	45% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME FREQUENCY	$48.00	$80.00	$5.89–$6.01	45% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PT SENDOUT	$48.00	$80.00	$5.89–$6.01	45% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME (PTT)	$48.00	$80.00	$5.89–$6.01	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME FREQUENCY	$48.00	$80.00	$5.89–$6.01	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PT SENDOUT	$48.00	$80.00	$5.89–$6.01	—	40%
Progesterone blood test CPT 84144 PROGESTERONE	$120.60	$201.00	$20.44–$20.86	68% above	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$120.60	$201.00	$20.44–$20.86	—	40%
Prolactin blood test CPT 84146 PROLACTIN	$126.60	$211.00	$18.99–$19.38	65% above	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$126.60	$211.00	$18.99–$19.38	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME WITH INR (PT/INR)	$31.80	$53.00	$4.20–$4.29	54% above	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME WITH INR (PT/INR) FREQUENCY	$31.80	$53.00	$4.20–$4.29	54% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME WITH INR (PT/INR)	$31.80	$53.00	$4.20–$4.29	—	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME WITH INR (PT/INR) FREQUENCY	$31.80	$53.00	$4.20–$4.29	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN COLLECTION	$22.80	$38.00	$12.35–$12.60	at median	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 WALMART DRUG SCREEN COLLECTION	$63.00	$105.00	$12.35–$12.60	177% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN-COC	$63.00	$105.00	$12.35–$12.60	177% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCREEN COLL-OP DR	$63.00	$105.00	$12.35–$12.60	177% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN COLLECTION	$22.80	$38.00	$12.35–$12.60	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN COLL-OP DR	$63.00	$105.00	$12.35–$12.60	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN-COC	$63.00	$105.00	$12.35–$12.60	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 WALMART DRUG SCREEN COLLECTION	$63.00	$105.00	$12.35–$12.60	—	40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP SCREEN	$33.04	$55.06	$16.20–$16.32	20% above	40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP SCREEN	$33.04	$55.06	$16.20–$16.32	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, QUANTITATIVE	$52.85	$88.09	$5.56–$5.67	94% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, QUANTITATIVE	$52.85	$88.09	$5.56–$5.67	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODIES, IGG	$100.20	$167.00	$14.10–$14.39	163% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODIES, IGG	$100.20	$167.00	$14.10–$14.39	—	40%
Stool ova and parasites exam CPT 87177 OVA & PARASITES, URINE	$60.60	$101.00	$8.72–$8.90	65% above	40%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES, URINE	$60.60	$101.00	$8.72–$8.90	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGIN,QUANT	$60.60	$101.00	$4.18–$4.27	204% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN,QUANT	$60.60	$101.00	$4.18–$4.27	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GOLD, CLIENT INCUBATED	$75.00	$125.00	$60.74–$61.98	35% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD, CLIENT INCUBATED	$75.00	$125.00	$60.74–$61.98	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$42.60	$71.00	$25.29–$25.81	38% below	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$42.60	$71.00	$25.29–$25.81	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER, KIDNEY MICROSOMAL ANTIBODY	$104.40	$174.00	$14.26–$14.55	135% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROPEROXIDASE (TPO) AB	$104.40	$174.00	$14.26–$14.55	135% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$104.40	$174.00	$14.26–$14.55	135% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER, KIDNEY MICROSOMAL ANTIBODY	$104.40	$174.00	$14.26–$14.55	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOMAL AB	$104.40	$174.00	$14.26–$14.55	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROPEROXIDASE (TPO) AB	$104.40	$174.00	$14.26–$14.55	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$118.80	$198.00	$16.46–$16.80	148% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$118.80	$198.00	$16.46–$16.80	—	40%
Trichomonas test (NAAT) CPT 87661 THRICHOMONAS VAGINALIS AMPLIF	$117.00	$195.00	$34.39–$35.09	99% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 THRICHOMONAS VAGINALIS AMPLIF	$117.00	$195.00	$34.39–$35.09	—	40%
Uric acid blood test CPT 84550 URIC ACID	$34.20	$57.00	$4.43–$4.52	29% above	40%
Uric acid blood test inpatient CPT 84550 URIC ACID	$34.20	$57.00	$4.43–$4.52	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC	$34.20	$57.00	$3.11–$3.17	29% below	40%
Urinalysis with microscope exam, automated CPT 81001 .MICROSCOPIC EXAM, URINE	$34.20	$57.00	$3.11–$3.17	29% below	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC	$34.20	$57.00	$3.11–$3.17	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 .MICROSCOPIC EXAM, URINE	$34.20	$57.00	$3.11–$3.17	—	40%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$52.85	$88.09	$7.91–$8.07	1% below	40%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$52.85	$88.09	$7.91–$8.07	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VIT B12 CASCADE	$118.20	$197.00	$14.78–$15.08	116% above	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$118.20	$197.00	$14.78–$15.08	116% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VIT B12 CASCADE	$118.20	$197.00	$14.78–$15.08	—	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$118.20	$197.00	$14.78–$15.08	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, 25-HYDROXY	$105.00	$175.00	$29.01–$29.60	2% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 ANTI JO ANTIBODY	$105.00	$175.00	$29.01–$29.60	2% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D, D2, D3	$144.60	$241.00	$29.01–$29.60	40% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 ANTI JO ANTIBODY	$105.00	$175.00	$29.01–$29.60	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, 25-HYDROXY	$105.00	$175.00	$29.01–$29.60	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D, D2, D3	$144.60	$241.00	$29.01–$29.60	—	40%
Zinc blood test CPT 84630 ZINC, RBC	$90.60	$151.00	$11.16–$11.39	120% above	40%
Zinc blood test CPT 84630 ZINC-PLASMA/SERUM	$90.60	$151.00	$11.16–$11.39	120% above	40%
Zinc blood test inpatient CPT 84630 ZINC-PLASMA/SERUM	$90.60	$151.00	$11.16–$11.39	—	40%
Zinc blood test inpatient CPT 84630 ZINC, RBC	$90.60	$151.00	$11.16–$11.39	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 PREGNANCY, BETA-HCG, QUANTITATIVE	$100.20	$167.00	$14.75–$15.05	46% above	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 PREGNANCY, BETA-HCG, QUANTITATIVE	$100.20	$167.00	$14.75–$15.05	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$2,533.80	$4,223.00	$1,405.95–$5,744.78	61% above	40%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$2,533.80	$4,223.00	$1,405.95–$5,744.78	—	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION-EXTERNAL	$479.40	$799.00	$510.80–$586.51	11% below	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION-EXTERNAL	$479.40	$799.00	$510.80–$586.51	—	40%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL RELEASE O/R	$1,747.20	$2,912.00	$468.30–$1,732.83	1% below	40%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE O/R	$1,747.20	$2,912.00	$468.30–$1,732.83	—	40%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION(OVER 3Y	$2,673.04	$4,455.06	$468.30–$1,854.98	113% above	40%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION(OVER 3Y	$2,673.04	$4,455.06	$468.30–$1,854.98	—	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$342.00	$570.00	$364.40–$1,854.98	66% below	40%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$342.00	$570.00	$364.40–$1,854.98	—	40%
Circumcision, surgical, older than a newborn CPT 54160 CIRCUMCISION NEONATE	$342.00	$570.00	$364.40–$618.77	51% below	40%
Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION NEONATE	$342.00	$570.00	$364.40–$618.77	—	40%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY-BIOPSY BY SNA	$867.00	$1,445.00	$468.30–$1,061.88	10% below	40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY-BIOPSY BY SNA	$867.00	$1,445.00	$468.30–$1,061.88	—	40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/ BIOPSY	$867.00	$1,445.00	$468.30–$1,061.88	4% below	40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/ BIOPSY	$867.00	$1,445.00	$468.30–$1,061.88	—	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$747.60	$1,246.00	$468.30–$825.23	18% below	40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY SCREENING	$747.60	$1,246.00	$468.30–$825.23	18% below	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY SCREENING	$747.60	$1,246.00	$468.30–$825.23	—	40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$747.60	$1,246.00	$468.30–$825.23	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION OF 1ST LESION	$45.00	$75.00	$47.95–$178.04	54% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 IM DECONSTRUCT PREMAL UNSPEC 1700	$45.00	$75.00	$47.95–$178.04	54% below	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION OF 1ST LESION	$45.00	$75.00	$47.95–$178.04	—	40%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 IM DECONSTRUCT PREMAL UNSPEC 1700	$45.00	$75.00	$47.95–$178.04	—	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE EAR WAX USING WASH	$45.00	$75.00	$47.95–$52.35	19% below	40%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$75.00	$125.00	$52.35	36% above	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE EAR WAX USING WASH	$45.00	$75.00	$47.95–$52.35	—	40%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$75.00	$125.00	$52.35	—	40%
Earwax removal with instruments, one ear CPT 69210 EAR IRRIGATION IN ER	$42.00	$70.00	$44.75–$52.35	30% below	40%
Earwax removal with instruments, one ear CPT 69210 CERUMEN-REMOVAL	$42.00	$70.00	$44.75–$52.35	30% below	40%
Earwax removal with instruments, one ear CPT 69210 IM REMOVE IMPACTED EAR WAX UNI 69210	$42.00	$70.00	$44.75–$52.35	30% below	40%
Earwax removal with instruments, one ear CPT 69210 EAR IRR IN TX ROOM	$42.00	$70.00	$44.75–$52.35	30% below	40%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR IRRIGATION IN ER	$42.00	$70.00	$44.75–$52.35	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR IRR IN TX ROOM	$42.00	$70.00	$44.75–$52.35	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 IM REMOVE IMPACTED EAR WAX UNI 69210	$42.00	$70.00	$44.75–$52.35	—	40%
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN-REMOVAL	$42.00	$70.00	$44.75–$52.35	—	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY WO BIOPSY	$802.80	$1,338.00	$349.65–$825.23	86% above	40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY WO BIOPSY	$802.80	$1,338.00	$349.65–$825.23	—	40%
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLE	$1,982.40	$3,304.00	$535.50–$5,364.73	11% above	40%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLE	$1,982.40	$3,304.00	$535.50–$5,364.73	—	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE W/CHOLANGIOGRAM	$4,173.00	$6,955.00	$535.50–$5,364.73	145% above	40%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE W/CHOLANGIOGRAM	$4,173.00	$6,955.00	$535.50–$5,364.73	—	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPH	$100.20	$167.00	$468.30	29% below	40%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETER FOR HYSTEROGRAPH	$100.20	$167.00	$468.30	—	40%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTERSCOPY; BIOPSEY	$2,011.80	$3,353.00	$535.50–$2,872.59	67% above	40%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTERSCOPY; BIOPSEY	$2,011.80	$3,353.00	$535.50–$2,872.59	—	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS-SIMPLE	$79.20	$132.00	$84.39–$178.04	57% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 IM I&D SIMPLE/SINGLE 10060	$79.20	$132.00	$84.39–$178.04	57% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D SKIN ABSESS	$129.60	$216.00	$178.04–$349.65	30% below	40%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$219.60	$366.00	$178.04–$233.98	19% above	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 IM I&D SIMPLE/SINGLE 10060	$79.20	$132.00	$84.39–$178.04	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS-SIMPLE	$79.20	$132.00	$84.39–$178.04	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D SKIN ABSESS	$129.60	$216.00	$178.04–$349.65	—	40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE	$219.60	$366.00	$178.04–$233.98	—	40%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5	$3,049.20	$5,082.00	$661.50–$3,177.20	59% above	40%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP I/HERN INIT REDUC >5	$3,049.20	$5,082.00	$661.50–$3,177.20	—	40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ SINGLE TENDON SHEATH	$50.40	$84.00	$53.70–$272.38	65% below	40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ SINGLE TENDON SHEATH	$50.40	$84.00	$53.70–$272.38	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHO MAJOR	$150.00	$250.00	$272.38	42% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT JOINT/BURSA	$245.40	$409.00	$261.47–$272.38	5% below	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHO MAJOR	$150.00	$250.00	$272.38	—	40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT JOINT/BURSA	$245.40	$409.00	$261.47–$272.38	—	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHO INTERMEDIATE	$150.00	$250.00	$272.38	41% below	40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHO INTERMEDIATE	$150.00	$250.00	$272.38	—	40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHO SIMPLE	$59.46	$99.10	$63.35–$272.38	74% below	40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHO SIMPLE	$59.46	$99.10	$63.35–$272.38	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 IM INT NECK/AXILLA/TRUNK/EXT <2.5 CM	$180.00	$300.00	$191.79–$360.74	40% below	40%
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/<	$180.00	$300.00	$191.79–$360.74	40% below	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER 2.5CM OR LESS	$360.00	$600.00	$349.65–$360.74	20% above	40%
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/<	$180.00	$300.00	$191.79–$360.74	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 IM INT NECK/AXILLA/TRUNK/EXT <2.5 CM	$180.00	$300.00	$191.79–$360.74	—	40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER 2.5CM OR LESS	$360.00	$600.00	$349.65–$360.74	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EX BE LES TK AR LG 0.5CM OR LESS	$67.20	$112.00	$71.60–$628.39	68% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 IM B9 TRUNK/ARMS/LEGS <0.5 CM 11400	$67.20	$112.00	$71.60–$628.39	68% below	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 IM B9 TRUNK/ARMS/LEGS <0.5 CM 11400	$67.20	$112.00	$71.60–$628.39	—	40%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EX BE LES TK AR LG 0.5CM OR LESS	$67.20	$112.00	$71.60–$628.39	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 IM B9 FACE/EAR/EYE/NOSE/LIP <0.5 CM	$288.00	$480.00	$306.86–$628.39	6% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$288.00	$480.00	$306.86–$628.39	6% below	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 IM B9 FACE/EAR/EYE/NOSE/LIP <0.5 CM	$288.00	$480.00	$306.86–$628.39	—	40%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/<	$288.00	$480.00	$306.86–$628.39	—	40%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE	$103.20	$172.00	$178.04	31% below	40%
Nail removal (partial or complete), one nail CPT 11730 IM REMOVAL OF NAIL PLATE 11730	$103.20	$172.00	$109.96–$178.04	31% below	40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE	$153.00	$255.00	$178.04	2% above	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 IM REMOVAL OF NAIL PLATE 11730	$103.20	$172.00	$109.96–$178.04	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE	$103.20	$172.00	$178.04	—	40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE	$153.00	$255.00	$178.04	—	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGIN	$510.00	$850.00	$804.84	13% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGIN	$510.00	$850.00	$804.84	—	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 IM REMOVAL OF NAIL BED 11750	$200.40	$334.00	$213.53–$360.74	22% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$200.40	$334.00	$213.53–$360.74	22% below	40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED 11750	$456.00	$760.00	$349.65–$360.74	77% above	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$200.40	$334.00	$213.53–$360.74	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 IM REMOVAL OF NAIL BED 11750	$200.40	$334.00	$213.53–$360.74	—	40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED 11750	$456.00	$760.00	$349.65–$360.74	—	40%
Removal of a foreign object under the skin, simple CPT 10120 IM FOREIGN BODY REMOVAL - SIMPLE 10120	$74.40	$124.00	$79.27–$360.74	70% below	40%
Removal of a foreign object under the skin, simple CPT 10120 I&D SUBCUTANEOUS SIMPLE	$74.40	$124.00	$79.27–$360.74	70% below	40%
Removal of a foreign object under the skin, simple CPT 10120 FB REM; SUBQ TISSUE SIMPL	$239.40	$399.00	$255.08–$360.74	3% below	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&D SUBCUTANEOUS SIMPLE	$74.40	$124.00	$79.27–$360.74	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 IM FOREIGN BODY REMOVAL - SIMPLE 10120	$74.40	$124.00	$79.27–$360.74	—	40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REM; SUBQ TISSUE SIMPL	$239.40	$399.00	$255.08–$360.74	—	40%
Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CA	$144.00	$240.00	$153.43–$248.19	15% below	40%
Short arm cast (elbow to hand) CPT 29075 APPL; CAST-SHORT ARM	$213.00	$355.00	$226.95–$248.19	26% above	40%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION OF FOREARM CA	$144.00	$240.00	$153.43–$248.19	—	40%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL; CAST-SHORT ARM	$213.00	$355.00	$226.95–$248.19	—	40%
Short arm splint (forearm and hand) CPT 29125 APPL SPLINT SHORT ARM STA	$50.40	$84.00	$53.70–$118.06	56% below	40%
Short arm splint (forearm and hand) CPT 29125 APPL; SPLT SHORT ARM-STAT	$95.40	$159.00	$101.65–$118.06	16% below	40%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL SPLINT SHORT ARM STA	$50.40	$84.00	$53.70–$118.06	—	40%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL; SPLT SHORT ARM-STAT	$95.40	$159.00	$101.65–$118.06	—	40%
Short leg cast (below the knee) CPT 29405 APPL; CAST-SHORT LEG	$213.00	$355.00	$226.95–$248.19	at median	40%
Short leg cast (below the knee) inpatient CPT 29405 APPL; CAST-SHORT LEG	$213.00	$355.00	$226.95–$248.19	—	40%
Short leg splint (calf to foot) CPT 29515 APPL; SPLINT SHORT LEG	$95.40	$159.00	$101.65–$144.20	29% below	40%
Short leg splint (calf to foot) inpatient CPT 29515 APPL; SPLINT SHORT LEG	$95.40	$159.00	$101.65–$144.20	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REPAIR 2.5 OR LESS	$84.00	$140.00	$89.50–$178.04	54% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 IM SMP NECK/AXILLA/GEN/EX 2.5 CM OR L<	$84.00	$140.00	$89.50–$178.04	54% below	40%
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	$111.00	$185.00	$118.27–$178.04	39% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE 2.5 CM OR LESS	$151.20	$252.00	$161.10–$178.04	17% below	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REPAIR 2.5 OR LESS	$84.00	$140.00	$89.50–$178.04	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 IM SMP NECK/AXILLA/GEN/EX 2.5 CM OR L<	$84.00	$140.00	$89.50–$178.04	—	40%
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	$111.00	$185.00	$118.27–$178.04	—	40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE 2.5 CM OR LESS	$151.20	$252.00	$161.10–$178.04	—	40%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$78.00	$130.00	$83.11–$360.74	58% below	40%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SINGLE LESION	$78.00	$130.00	$83.11–$360.74	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM	$93.00	$155.00	$99.09–$628.39	80% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 IM TRUNK/ARMS/LEGS <0.5 CM 11600	$171.00	$285.00	$182.20–$628.39	63% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 TRUNK/ARMS/LEGS <0.5 CM 11600	$345.00	$575.00	$628.39	25% below	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC TR-EXT MAL+MARG 0.5 CM	$93.00	$155.00	$99.09–$628.39	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 IM TRUNK/ARMS/LEGS <0.5 CM 11600	$171.00	$285.00	$182.20–$628.39	—	40%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 TRUNK/ARMS/LEGS <0.5 CM 11600	$345.00	$575.00	$628.39	—	40%
Skin tag removal, up to 15 tags CPT 11200 IM REMOVAL OF SKIN TAGS 1-15 11200	$133.20	$222.00	$141.92–$178.04	at median	40%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAGS UPTO 15	$133.20	$222.00	$141.92–$178.04	at median	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 IM REMOVAL OF SKIN TAGS 1-15 11200	$133.20	$222.00	$141.92–$178.04	—	40%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL OF SKIN TAGS UPTO 15	$133.20	$222.00	$141.92–$178.04	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ADHESIVE SKIN	$70.80	$118.00	$75.44–$178.04	61% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 IM SMP NECK/AXILLA/GEN/EX 2.6-7.5 CM	$94.20	$157.00	$100.37–$178.04	48% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REPAIR 2.6 TO 7.5CM	$94.20	$157.00	$100.37–$178.04	48% below	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMPLE 2.6 - 7.5CM	$205.20	$342.00	$178.04–$349.65	12% above	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ADHESIVE SKIN	$70.80	$118.00	$75.44–$178.04	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REPAIR 2.6 TO 7.5CM	$94.20	$157.00	$100.37–$178.04	—	40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 IM SMP NECK/AXILLA/GEN/EX 2.6-7.5 CM	$94.20	$157.00	$100.37–$178.04	—	40%
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 SIMPLE 2.6 - 7.5CM	$205.20	$342.00	$178.04–$349.65	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REPAIR 2.5 OR LESS FACE	$87.00	$145.00	$92.70–$178.04	52% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 IM SMP FACE/EAR/EYE/NOSE/LIP 2.5 CM <	$87.00	$145.00	$92.70–$178.04	52% below	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMPLE 2.5CM OR LESS	$192.60	$321.00	$178.04–$205.22	6% above	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 IM SMP FACE/EAR/EYE/NOSE/LIP 2.5 CM <	$87.00	$145.00	$92.70–$178.04	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REPAIR 2.5 OR LESS FACE	$87.00	$145.00	$92.70–$178.04	—	40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMPLE 2.5CM OR LESS	$192.60	$321.00	$178.04–$205.22	—	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY SKIN LESION	$48.00	$80.00	$51.14–$360.74	63% below	40%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$63.00	$105.00	$67.13–$360.74	51% below	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY SKIN LESION	$48.00	$80.00	$51.14–$360.74	—	40%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION	$63.00	$105.00	$67.13–$360.74	—	40%
Tonsil and adenoid removal, age 12 or older CPT 42821 T&A OVER 12 YEAR OLD	$1,200.00	$2,000.00	$752.85–$2,942.10	31% below	40%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 T&A OVER 12 YEAR OLD	$1,200.00	$2,000.00	$752.85–$2,942.10	—	40%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SINGLE/MULTIPLE TRIGGER 1/2 MUSCLE(S	$150.00	$250.00	$272.38	13% above	40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SINGLE/MULTIPLE TRIGGER 1/2 MUSCLE(S	$150.00	$250.00	$272.38	—	40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/BIOPSY	$925.20	$1,542.00	$468.30–$804.84	15% above	40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/BIOPSY	$925.20	$1,542.00	$468.30–$804.84	—	40%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC	$781.80	$1,303.00	$349.65–$804.84	5% below	40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC	$781.80	$1,303.00	$349.65–$804.84	—	40%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$1,411.20	$2,352.00	$468.30–$1,854.98	68% above	40%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$1,411.20	$2,352.00	$468.30–$1,854.98	—	40%
Wart removal, up to 14 warts CPT 17110 IM DECONSTRUCT B9 LESION 14 OR MORE	$241.80	$403.00	$178.04–$257.64	77% above	40%
Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14	$241.80	$403.00	$178.04–$257.64	77% above	40%
Wart removal, up to 14 warts inpatient CPT 17110 IM DECONSTRUCT B9 LESION 14 OR MORE	$241.80	$403.00	$178.04–$257.64	—	40%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT B9 LESION 1-14	$241.80	$403.00	$178.04–$257.64	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE	$166.20	$277.00	$177.09–$360.74	55% below	40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDMENT SUBQ TISSUE 1ST 20CM OR LESS	$456.00	$760.00	$360.74–$468.30	23% above	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN/TISSUE	$166.20	$277.00	$177.09–$360.74	—	40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDMENT SUBQ TISSUE 1ST 20CM OR LESS	$456.00	$760.00	$360.74–$468.30	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Blood transfusion (giving blood or blood components) CPT 36430 .BLOOD COMPONENT ADMINISTRATION	$249.60	$416.00	$265.95–$391.49	47% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 .TRANSFUSION; BLOOD	$293.40	$489.00	$312.62–$391.49	38% below	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 .BLOOD COMPONENT ADMINISTRATION	$249.60	$416.00	$265.95–$391.49	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 .TRANSFUSION; BLOOD	$293.40	$489.00	$312.62–$391.49	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT	$102.00	$170.00	$108.68–$194.31	9% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION	$102.00	$170.00	$108.68–$194.31	9% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 IPPB TX-INITIAL	$135.00	$225.00	$143.84–$194.31	44% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI INITIAL	$135.00	$225.00	$143.84–$194.31	44% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MINI NEB TX-INITIAL	$135.00	$225.00	$143.84–$194.31	44% above	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT	$102.00	$170.00	$108.68–$194.31	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION	$102.00	$170.00	$108.68–$194.31	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI INITIAL	$135.00	$225.00	$143.84–$194.31	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MINI NEB TX-INITIAL	$135.00	$225.00	$143.84–$194.31	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 IPPB TX-INITIAL	$135.00	$225.00	$143.84–$194.31	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE-30 TO 74 MIN *	$561.00	$935.00	$597.75–$733.01	25% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE-30 TO 74 MIN *	$561.00	$935.00	$597.75–$733.01	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG	$96.60	$161.00	$52.35–$102.93	17% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG DAILY	$96.60	$161.00	$52.35–$102.93	17% above	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG DAILY	$96.60	$161.00	$52.35–$102.93	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG	$96.60	$161.00	$52.35–$102.93	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL 1 O/P ER *	$62.40	$104.00	$66.49–$74.82	7% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PROCEDURE LEVEL 1	$330.00	$550.00	$74.82–$351.62	464% above	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LEVEL 1 O/P ER *	$62.40	$104.00	$66.49–$74.82	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER PROCEDURE LEVEL 1	$330.00	$550.00	$74.82–$351.62	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL 2 O/P ER *	$100.80	$168.00	$107.40–$136.25	31% below	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER PROCEDURE LEVEL 2	$450.00	$750.00	$136.25–$479.48	206% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LEVEL 2 O/P ER *	$100.80	$168.00	$107.40–$136.25	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER PROCEDURE LEVEL 2	$450.00	$750.00	$136.25–$479.48	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL 3 O/P ER *	$158.40	$264.00	$168.78–$242.24	31% below	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER PROCEDURE LEVEL 3	$925.20	$1,542.00	$242.24–$985.80	301% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 LEVEL 3 O/P ER *	$158.40	$264.00	$168.78–$242.24	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER PROCEDURE LEVEL 3	$925.20	$1,542.00	$242.24–$985.80	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL 4 O/P ER *	$252.60	$421.00	$269.15–$370.27	33% below	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER PROCEDURE LEVEL 4	$1,651.80	$2,753.00	$370.27–$1,759.99	335% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 LEVEL 4 O/P ER *	$252.60	$421.00	$269.15–$370.27	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER PROCEDURE LEVEL 4	$1,651.80	$2,753.00	$370.27–$1,759.99	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVEL 5 O/P ER	$375.60	$626.00	$400.20–$528.46	28% below	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER PROCEDURE LEVEL 5	$2,114.40	$3,524.00	$528.46–$2,252.89	308% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 LEVEL 5 O/P ER	$375.60	$626.00	$400.20–$528.46	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER PROCEDURE LEVEL 5	$2,114.40	$3,524.00	$528.46–$2,252.89	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST;TRACING ONLY	$226.80	$378.00	$191.61–$241.66	35% below	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS EKG W/PHYS PRESENCE	$226.80	$378.00	$191.61–$241.66	35% below	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS EKG W/PHYS PRESENCE	$226.80	$378.00	$191.61–$241.66	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST;TRACING ONLY	$226.80	$378.00	$191.61–$241.66	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUS HYDRAT T/R 1ST HR	$140.40	$234.00	$149.60–$188.75	17% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUS HYDRAT ER 1ST HOUR	$140.40	$234.00	$149.60–$188.75	17% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUS HYDRAT T/R 1ST HR	$140.40	$234.00	$149.60–$188.75	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUS HYDRAT ER 1ST HOUR	$140.40	$234.00	$149.60–$188.75	—	40%
IV infusion of a medicine, first hour CPT 96365 INFUSION T/R 1ST HR MEDS	$140.40	$234.00	$149.60–$188.75	25% below	40%
IV infusion of a medicine, first hour CPT 96365 INFUSION ER 1ST HOUR	$141.00	$235.00	$150.24–$188.75	24% below	40%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION T/R 1ST HR MEDS	$140.40	$234.00	$149.60–$188.75	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION ER 1ST HOUR	$141.00	$235.00	$150.24–$188.75	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM/SQ-1ST	$17.40	$29.00	$18.54–$63.90	67% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT IM SQ -ER -FIRST	$33.00	$55.00	$35.16–$63.90	37% below	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECT IM SQ -T/R -FIRST	$36.00	$60.00	$38.36–$63.90	31% below	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM/SQ-1ST	$17.40	$29.00	$18.54–$63.90	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECT IM SQ -ER -FIRST	$33.00	$55.00	$35.16–$63.90	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECT IM SQ -T/R -FIRST	$36.00	$60.00	$38.36–$63.90	—	40%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric diagnostic Eval	$99.00	$165.00	$105.48–$157.51	5% below	40%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 Psychiatric diagnostic Eval	$99.00	$165.00	$105.48–$157.51	—	40%
New patient office visit, about 30 minutes CPT 99203 OFF VST-NEW-INTER(30MIN) 99203	$80.40	$134.00	$38.00	46% above	40%
New patient office visit, about 30 minutes CPT 99203 IM OFFICE VISIT - NEW LEVEL 3 99203	$80.40	$134.00	$38.00	46% above	40%
New patient office visit, about 30 minutes inpatient CPT 99203 OFF VST-NEW-INTER(30MIN) 99203	$80.40	$134.00	$38.00	—	40%
New patient office visit, about 30 minutes inpatient CPT 99203 IM OFFICE VISIT - NEW LEVEL 3 99203	$80.40	$134.00	$38.00	—	40%
New patient office visit, about 45 minutes CPT 99204 IM OFFICE VISIT - NEW LEVEL 4 99204	$121.80	$203.00	$57.00	35% above	40%
New patient office visit, about 45 minutes CPT 99204 OFF VST-NEW-EXTEND(45MIN) 99204	$121.80	$203.00	$57.00	35% above	40%
New patient office visit, about 45 minutes inpatient CPT 99204 IM OFFICE VISIT - NEW LEVEL 4 99204	$121.80	$203.00	$57.00	—	40%
New patient office visit, about 45 minutes inpatient CPT 99204 OFF VST-NEW-EXTEND(45MIN) 99204	$121.80	$203.00	$57.00	—	40%
New patient office visit, about 60 minutes CPT 99205 OFF VST-NEW-COMP(60MIN) 99205	$150.60	$251.00	$57.00	9% above	40%
New patient office visit, about 60 minutes CPT 99205 IM OFFICE VISIT - NEW LEVEL 5 99205	$150.60	$251.00	$57.00	9% above	40%
New patient office visit, about 60 minutes inpatient CPT 99205 OFF VST-NEW-COMP(60MIN) 99205	$150.60	$251.00	$57.00	—	40%
New patient office visit, about 60 minutes inpatient CPT 99205 IM OFFICE VISIT - NEW LEVEL 5 99205	$150.60	$251.00	$57.00	—	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 IM OFFICE VISIT - NEW LEVEL 2 99202	$59.46	$99.10	$33.00	49% above	40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFF VST-NEW-LTD(20MIN) 99202	$59.46	$99.10	$33.00	49% above	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFF VST-NEW-LTD(20MIN) 99202	$59.46	$99.10	$33.00	—	40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 IM OFFICE VISIT - NEW LEVEL 2 99202	$59.46	$99.10	$33.00	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1 REGION	$90.00	$150.00	—	104% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1 REGION	$90.00	$150.00	—	—	40%
Preventive checkup, new patient aged 18–39 CPT 99385 PREVENTIVE - NEW 18-39 YEARS	$87.00	$145.00	$92.70	40% below	40%
Preventive checkup, new patient aged 18–39 CPT 99385 PM-INIT/NEW (AGE 18-39) 99385	$87.00	$145.00	$92.70	40% below	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREVENTIVE - NEW 18-39 YEARS	$87.00	$145.00	$92.70	—	40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PM-INIT/NEW (AGE 18-39) 99385	$87.00	$145.00	$92.70	—	40%
Preventive checkup, new patient aged 40–64 CPT 99386 PREVENTIVE - NEW 40-64 YEARS	$106.80	$178.00	$113.80	19% below	40%
Preventive checkup, new patient aged 40–64 CPT 99386 PM INIT/NEW PT AGES 40 TO 64 YRS 99386	$106.80	$178.00	$113.80	19% below	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREVENTIVE - NEW 40-64 YEARS	$106.80	$178.00	$113.80	—	40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PM INIT/NEW PT AGES 40 TO 64 YRS 99386	$106.80	$178.00	$113.80	—	40%
Preventive checkup, new patient aged 65 or older CPT 99387 PM INIT/NEW PT AGES 65 AND OLDER 99387	$106.80	$178.00	$113.80	28% below	40%
Preventive checkup, new patient aged 65 or older CPT 99387 PREVENTIVE - NEW 65+ YEARS	$106.80	$178.00	$113.80	28% below	40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREVENTIVE - NEW 65+ YEARS	$106.80	$178.00	$113.80	—	40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PM INIT/NEW PT AGES 65 AND OLDER 99387	$106.80	$178.00	$113.80	—	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREVENTIVE - EST 18-39 YEARS	$70.20	$117.00	$74.80	14% below	40%
Preventive checkup, returning patient aged 18–39 CPT 99395 PM-PERIOD/EST(18-39YR) 99395	$70.20	$117.00	$74.80	14% below	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREVENTIVE - EST 18-39 YEARS	$70.20	$117.00	$74.80	—	40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PM-PERIOD/EST(18-39YR) 99395	$70.20	$117.00	$74.80	—	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREVENTIVE - EST 40-64 YEARS	$87.00	$145.00	$92.70	29% below	40%
Preventive checkup, returning patient aged 40–64 CPT 99396 PM REEVAL OF EST PT AGES 40-64 YRS 99396	$87.00	$145.00	$92.70	29% below	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PM REEVAL OF EST PT AGES 40-64 YRS 99396	$87.00	$145.00	$92.70	—	40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREVENTIVE - EST 40-64 YEARS	$87.00	$145.00	$92.70	—	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 PM REEVAL OF EST PT AGES 65 &OLDER 99397	$87.00	$145.00	$92.70	21% below	40%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREVENTIVE - EST 65+ YEARS	$87.00	$145.00	$92.70	21% below	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREVENTIVE - EST 65+ YEARS	$87.00	$145.00	$92.70	—	40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PM REEVAL OF EST PT AGES 65 &OLDER 99397	$87.00	$145.00	$92.70	—	40%
Psychiatric evaluation with medical services CPT 90792 Psychiatric diagnostic E&M	$150.00	$250.00	$157.51–$159.82	50% above	40%
Psychiatric evaluation with medical services inpatient CPT 90792 Psychiatric diagnostic E&M	$150.00	$250.00	$157.51–$159.82	—	40%
Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINUTES	$90.00	$150.00	$95.90–$157.51	10% below	40%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY 30 MINUTES	$90.00	$150.00	$95.90–$157.51	—	40%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINUTES	$96.00	$160.00	$102.29–$157.51	26% below	40%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY 45 MINUTES	$96.00	$160.00	$102.29–$157.51	—	40%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINUTES	$105.00	$175.00	$111.88–$157.51	33% below	40%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MINUTES	$105.00	$175.00	$111.88–$157.51	—	40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION COUNSELING 3-10 MIN	$30.00	$50.00	$31.96–$33.25	3% above	40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION COUNSELING 3-10 MIN	$30.00	$50.00	$31.96–$33.25	—	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFF VST-EST-COMP(40MIN) 99215	$133.20	$222.00	$57.00	53% above	40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 IM OFFICE VISIT - EST LEVEL 5 99215	$133.20	$222.00	$57.00	53% above	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFF VST-EST-COMP(40MIN) 99215	$133.20	$222.00	$57.00	—	40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 IM OFFICE VISIT - EST LEVEL 5 99215	$133.20	$222.00	$57.00	—	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFF VST-EST-INTER(15MIN) 99213	$58.20	$97.00	$38.00	66% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IM OFFICE VISIT - EST LEVEL 3 99213	$58.20	$97.00	$38.00	66% above	40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 IM PHYSICAL ABILITIES EXAM 99213	$150.00	$250.00	$38.00	329% above	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 IM OFFICE VISIT - EST LEVEL 3 99213	$58.20	$97.00	$38.00	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFF VST-EST-INTER(15MIN) 99213	$58.20	$97.00	$38.00	—	40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 IM PHYSICAL ABILITIES EXAM 99213	$150.00	$250.00	$38.00	—	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 IM OFFICE VISIT - EST LEVEL 4 99214	$116.40	$194.00	$57.00	83% above	40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFF VST-EST-EXTEND(25MIN) 99214	$116.40	$194.00	$57.00	83% above	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFF VST-EST-EXTEND(25MIN) 99214	$116.40	$194.00	$57.00	—	40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 IM OFFICE VISIT - EST LEVEL 4 99214	$116.40	$194.00	$57.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFF VST-EST-LTD(10MIN) 99212	$42.00	$70.00	$33.00	45% above	40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 IM OFFICE VISIT - EST LEVEL 2 99212	$42.00	$70.00	$33.00	45% above	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 IM OFFICE VISIT - EST LEVEL 2 99212	$42.00	$70.00	$33.00	—	40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFF VST-EST-LTD(10MIN) 99212	$42.00	$70.00	$33.00	—	40%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULTATION DETAILED	$121.20	$202.00	$129.14	at median	40%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULTATION DETAILED	$121.20	$202.00	$129.14	—	40%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULTATION COMPREHENSIVE	$138.00	$230.00	$147.04	1% below	40%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULTATION COMPREHENSIVE	$138.00	$230.00	$147.04	—	40%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION	$129.60	$216.00	$138.09–$191.61	9% below	40%
Spirometry (breathing test) CPT 94010 PFT- SPIROMETRY SCREENING	$129.60	$216.00	$138.09–$191.61	9% below	40%
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION	$129.60	$216.00	$138.09–$191.61	—	40%
Spirometry (breathing test) inpatient CPT 94010 PFT- SPIROMETRY SCREENING	$129.60	$216.00	$138.09–$191.61	—	40%
Spirometry before and after a bronchodilator CPT 94060 PEAK FLOW RATE	$150.00	$250.00	$159.82–$331.13	52% below	40%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY PRE AND POST	$150.00	$250.00	$159.82–$331.13	52% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PEAK FLOW RATE	$150.00	$250.00	$159.82–$331.13	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY PRE AND POST	$150.00	$250.00	$159.82–$331.13	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$52.85	$88.09	$56.32–$118.06	49% below	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPUETIC PHLEBOTOMY	$72.60	$121.00	$77.36–$118.06	29% below	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$52.85	$88.09	$56.32–$118.06	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPUETIC PHLEBOTOMY	$72.60	$121.00	$77.36–$118.06	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Louisiana	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAC - VARICELLA VACCINE LIVE VACCINE	$126.00	$210.00	$134.25	6% below	40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VAC - VARICELLA VACCINE LIVE VACCINE	$126.00	$210.00	$134.25	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 VAC - INFLUENZA PF 2024-2025 TRIVALENT	$36.00	$60.00	$38.36	56% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 VAC - INFLUENZA PF 2025-2026 TRIVALENT	$36.00	$60.00	$38.36	56% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 VAC - INFLUENZA PF 2025-2026 TRIVALENT	$36.00	$60.00	$38.36	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 VAC - INFLUENZA PF 2024-2025 TRIVALENT	$36.00	$60.00	$38.36	—	40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 VAC - HUMAN PAPILLOMAVIRUS 9-VAL VACCINE	$198.00	$330.00	$210.97	61% above	40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 VAC - HUMAN PAPILLOMAVIRUS 9-VAL VACCINE	$198.00	$330.00	$210.97	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 VAC - HEP-A/HEP-B VACCINE SUS INJ	$82.20	$137.00	$87.58	94% above	40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM	$116.40	$194.00	$124.02	174% above	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 VAC - HEP-A/HEP-B VACCINE SUS INJ	$82.20	$137.00	$87.58	—	40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HEP A/HEP B VACC ADULT IM	$116.40	$194.00	$124.02	—	40%
Hepatitis A vaccine, adult dose CPT 90632 VAC - HEPATITIS A VACCINE 1440 EL.U.	$62.40	$104.00	$66.49	30% above	40%
Hepatitis A vaccine, adult dose CPT 90632 VACCINE-HEPATITIS A	$63.00	$105.00	$67.13	31% above	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 VAC - HEPATITIS A VACCINE 1440 EL.U.	$62.40	$104.00	$66.49	—	40%
Hepatitis A vaccine, adult dose inpatient CPT 90632 VACCINE-HEPATITIS A	$63.00	$105.00	$67.13	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 VAC - HEPATITS B VACCINE ADULT [20MCG]	$52.20	$87.00	$55.62	20% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B ADULT	$160.20	$267.00	$170.69	269% above	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 VAC - HEPATITS B VACCINE ADULT [20MCG]	$52.20	$87.00	$55.62	—	40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B ADULT	$160.20	$267.00	$170.69	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 VAC - MEASLES-MUMPS-RUBELLA	$73.20	$122.00	$77.99	at median	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 VAC - MEASLES-MUMPS-RUBELLA	$73.20	$122.00	$77.99	—	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 VAC - MENINGOCOCCAL A C Y & W-135 OLIG	$103.20	$172.00	$109.96	19% above	40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 VAC - MENINGOCOCCAL DIPTHERIA TOXOID	$224.40	$374.00	$239.10	158% above	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 VAC - MENINGOCOCCAL A C Y & W-135 OLIG	$103.20	$172.00	$109.96	—	40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 VAC - MENINGOCOCCAL DIPTHERIA TOXOID	$224.40	$374.00	$239.10	—	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 VAC - PNEUMOCOCCAL 20-VALENT CON	$180.00	$300.00	$191.79	18% above	40%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 VAC - PNEUMOCOCCAL 20-VALENT CON	$180.00	$300.00	$191.79	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMONIA 2 YRS AND OLDER	$57.00	$95.00	$60.73	6% below	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 VAC - PNEUMOCOCCAL VACCINE PNEUMOVAX23	$195.00	$325.00	$207.77	221% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMONIA 2 YRS AND OLDER	$57.00	$95.00	$60.73	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 VAC - PNEUMOCOCCAL VACCINE PNEUMOVAX23	$195.00	$325.00	$207.77	—	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 VAC - NIRSEVIMAB-ALIP 50MG/0.5ML RSV VAC	$360.00	$600.00	$383.58	13% below	40%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 VAC - NIRSEVIMAB-ALIP 50MG/0.5ML RSV VAC	$360.00	$600.00	$383.58	—	40%
Rabies vaccine, one dose CPT 90675 VAC - RABIES VACCINNE ABSORB [2.5IU]	$212.40	$354.00	$226.31–$313.36	76% below	40%
Rabies vaccine, one dose inpatient CPT 90675 VAC - RABIES VACCINNE ABSORB [2.5IU]	$212.40	$354.00	$226.31–$313.36	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD ABSORBED 7OR OLDER	$22.20	$37.00	$23.65	29% below	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 VAC - Td TET TOX/DIPHT TOX ADULT INJ	$60.60	$101.00	$64.57	94% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD ABSORBED 7OR OLDER	$22.20	$37.00	$23.65	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 VAC - Td TET TOX/DIPHT TOX ADULT INJ	$60.60	$101.00	$64.57	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 VAC - TDAP ADULT TET TOX/PERTUSSIS/DIP**	$67.20	$112.00	$71.60	44% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 VAC - TDAP ADULT TET TOX/PERTUSSIS/DIP**	$67.20	$112.00	$71.60	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM	$60.00	$100.00	$63.93	86% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 VAC - TYPHOID VI POLYSACCH VACCINE	$90.00	$150.00	$95.90	80% below	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE IM	$60.00	$100.00	$63.93	—	40%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 VAC - TYPHOID VI POLYSACCH VACCINE	$90.00	$150.00	$95.90	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN-SINGLE INJECT	$35.10	$58.50	$37.40–$63.90	13% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF VACCINE - ONE	$35.10	$58.50	$37.40–$63.90	13% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU VACCINE ADMIN	$35.10	$58.50	$37.40–$63.90	13% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF VACCINE-ONE	$35.10	$58.50	$37.40–$63.90	13% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INJECT/IMMUNIZ IN TX RM	$36.00	$60.00	$38.36–$63.90	11% below	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF VACCINE-ONE	$35.10	$58.50	$37.40–$63.90	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FLU VACCINE ADMIN	$35.10	$58.50	$37.40–$63.90	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF VACCINE - ONE	$35.10	$58.50	$37.40–$63.90	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN-SINGLE INJECT	$35.10	$58.50	$37.40–$63.90	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECT/IMMUNIZ IN TX RM	$36.00	$60.00	$38.36–$63.90	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN OF VACCINE - EA ADD'L	$35.10	$58.50	$37.40	31% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN OF VACCINE-EA ADD'L	$35.10	$58.50	$37.40	31% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN-EACH ADDL INJ	$35.10	$58.50	$37.40	31% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN OF VACCINE - EA ADD'L	$35.10	$58.50	$37.40	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN-EACH ADDL INJ	$35.10	$58.50	$37.40	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN OF VACCINE-EA ADD'L	$35.10	$58.50	$37.40	—	40%

Source file: https://www.lasallegeneralhospital.com/wp-content/uploads/2026/03/720690217_hospital-services-district-2-of-lasalle-parish_standardcharges.csv