Hospital

Midwest Medical Center

Midwest Medical Center in Galena, IL publishes cash prices for 203 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 above the Illinois median for 107 of 203 procedures and below it for 94. By typical cash price it ranks #45 of 90 Illinois hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1 Medical Center Dr., Galena, IL 61036 Collected Sep 27, 2026 Source price file (815) 777-1340

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 141302 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Midwest Medical Center in Galena, IL:

Jul 1, 2026 Warning notice

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Extremity Artery Study, Single Charge	$315.22	$346.40	$24.05–$329.08	21% below	9%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 Extremity Artery Study, Single Charge	$315.22	$346.40	—	—	9%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$620.44	$681.80	$312.23–$647.71	15% above	9%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus	$620.44	$681.80	$436.35–$647.71	—	9%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Rt.	$514.88	$565.80	$301.01–$537.51	39% above	9%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Lt.	$514.88	$565.80	$301.01–$537.51	39% above	9%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Rt.	$514.88	$565.80	$321.94–$537.51	—	9%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Lt.	$514.88	$565.80	$321.94–$537.51	—	9%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$3,183.91	$3,498.80	$1,786.16–$3,323.86	37% above	9%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE w/ Cont	$3,183.91	$3,498.80	$1,786.16–$3,323.86	37% above	9%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest PE w/ Cont	$3,183.91	$3,498.80	$2,239.23–$3,323.86	—	9%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest	$3,183.91	$3,498.80	$2,239.23–$3,323.86	—	9%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen +Pelvis w/o Cont	$3,404.13	$3,740.80	$1,990.11–$3,553.76	13% above	9%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Radiology Request	$3,404.13	$3,740.80	$1,990.11–$3,553.76	13% above	9%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Chest +Abdomen +Pelvis w/o Cont	$4,942.67	$5,431.50	$3,476.16–$5,159.93	64% above	9%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 Radiology Request	$3,404.13	$3,740.80	$2,394.11–$3,553.76	—	9%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen +Pelvis w/o Cont	$3,404.13	$3,740.80	$2,394.11–$3,553.76	—	9%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Chest +Abdomen +Pelvis w/o Cont	$4,942.67	$5,431.50	$3,476.16–$5,159.93	—	9%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen +Pelvis w/ Cont	$4,270.08	$4,692.40	$2,496.36–$4,457.78	25% above	9%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 Radiology Request	$4,270.08	$4,692.40	$2,496.36–$4,457.78	25% above	9%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Chest +Abdomen +Pelvis w/ Cont	$6,499.04	$7,141.80	$4,570.75–$6,784.71	90% above	9%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen +Pelvis w/ Cont	$4,270.08	$4,692.40	$3,003.14–$4,457.78	—	9%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Radiology Request	$4,270.08	$4,692.40	$3,003.14–$4,457.78	—	9%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Chest +Abdomen +Pelvis w/ Cont	$6,499.04	$7,141.80	$4,570.75–$6,784.71	—	9%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen +Pelvis w/ + w/o Cont	$5,200.20	$5,714.50	$3,040.11–$5,428.78	20% above	9%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Radiology Request	$5,200.20	$5,714.50	$3,040.11–$5,428.78	20% above	9%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen +Pelvis w/ + w/o Cont	$5,200.20	$5,714.50	$3,657.28–$5,428.78	—	9%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 Radiology Request	$5,200.20	$5,714.50	$3,657.28–$5,428.78	—	9%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Cont	$2,229.32	$2,449.80	$1,385.21–$2,327.31	12% above	9%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Cont	$2,229.32	$2,449.80	$1,567.87–$2,327.31	—	9%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Cont	$1,702.34	$1,870.70	$1,105.84–$1,777.17	5% above	9%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Cont	$1,702.34	$1,870.70	$1,197.25–$1,777.17	—	9%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Cont	$1,496.13	$1,644.10	$897.23–$1,561.90	4% above	9%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus or Facial w/o Cont	$1,496.13	$1,644.10	$897.23–$1,561.90	4% above	9%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast Request	$1,600.69	$1,759.00	$897.23–$1,671.05	12% above	9%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus or Facial w/o Cont	$1,496.13	$1,644.10	$1,052.22–$1,561.90	—	9%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Cont	$1,496.13	$1,644.10	$1,052.22–$1,561.90	—	9%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast Request	$1,600.69	$1,759.00	$1,125.76–$1,671.05	—	9%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head or Brain w/o Cont	$1,702.34	$1,870.70	$912.70–$1,777.17	8% above	9%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head or Brain w/o Cont	$1,702.34	$1,870.70	$1,197.25–$1,777.17	—	9%
CT scan of the head with contrast CPT 70460 CT Head or Brain w/ Cont	$2,040.40	$2,242.20	$1,435.01–$2,130.09	27% above	9%
CT scan of the head with contrast inpatient CPT 70460 CT Head or Brain w/ Cont	$2,040.40	$2,242.20	$1,435.01–$2,130.09	—	9%
CT scan of the head without and with contrast CPT 70470 CT Head or Brain w/ + w/o Cont	$2,493.49	$2,740.10	$1,283.98–$2,603.10	16% above	9%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head or Brain w/ + w/o Cont	$2,493.49	$2,740.10	$1,753.66–$2,603.10	—	9%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Cont	$1,929.56	$2,120.40	$1,320.55–$2,014.38	1% below	9%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Cont	$1,929.56	$2,120.40	$1,357.06–$2,014.38	—	9%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Cont	$1,929.56	$2,120.40	$1,272.99–$2,014.38	2% below	9%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Cont	$1,929.56	$2,120.40	$1,357.06–$2,014.38	—	9%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Cont	$2,040.77	$2,242.60	$1,313.45–$2,130.47	11% above	9%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Cont	$2,040.77	$2,242.60	$1,435.26–$2,130.47	—	9%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US Carotid Duplex Bil	$1,349.53	$1,483.00	$843.83–$1,408.85	80% above	9%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US Carotid Duplex Bil	$1,349.53	$1,483.00	$843.83–$1,408.85	—	9%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$262.63	$288.60	$153.54–$274.17	7% below	9%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$262.63	$288.60	$184.70–$274.17	—	9%
Chest X-ray, single view CPT 71045 XR Chest 1 View	$205.66	$226.00	$120.23–$214.70	12% below	9%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View	$205.66	$226.00	$144.64–$214.70	—	9%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Aorta Comp	$853.58	$938.00	$431.68–$891.10	9% above	9%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal Comp	$853.58	$938.00	$431.68–$891.10	9% above	9%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Kidney +Bladder Comp	$853.58	$938.00	$431.68–$891.10	9% above	9%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Comp	$853.58	$938.00	$431.68–$891.10	9% above	9%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal Comp	$853.58	$938.00	$533.72–$891.10	—	9%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Aorta Comp	$853.58	$938.00	$533.72–$891.10	—	9%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Comp	$853.58	$938.00	$533.72–$891.10	—	9%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Kidney +Bladder Comp	$853.58	$938.00	$533.72–$891.10	—	9%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD DEXA Axial Skeleton	$344.34	$378.40	$201.31–$359.48	18% below	9%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD DEXA Axial Skeleton	$344.34	$378.40	$242.18–$359.48	—	9%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Cont	$1,884.70	$2,071.10	$1,148.39–$1,967.55	51% above	9%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest Thin Section ILD Request	$3,586.77	$3,941.50	$1,148.39–$3,744.43	187% above	9%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Cont	$1,884.70	$2,071.10	$1,325.50–$1,967.55	—	9%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest Thin Section ILD Request	$3,586.77	$3,941.50	$2,522.56–$3,744.43	—	9%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Cont	$2,229.32	$2,449.80	$1,377.84–$2,327.31	11% above	9%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest +Abdomen w/ Cont	$4,458.27	$4,899.20	$1,377.84–$4,654.24	122% above	9%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Radiology Request	$4,458.27	$4,899.20	$1,377.84–$4,654.24	122% above	9%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Cont	$2,229.32	$2,449.80	$1,567.87–$2,327.31	—	9%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 Radiology Request	$4,458.27	$4,899.20	$3,135.49–$4,654.24	—	9%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest +Abdomen w/ Cont	$4,458.27	$4,899.20	$3,135.49–$4,654.24	—	9%
Diagnostic mammogram, both breasts CPT 77066 MA Diag Bil.	$366.28	$402.50	$214.13–$382.38	28% above	9%
Diagnostic mammogram, both breasts inpatient CPT 77066 MA Diag Bil.	$366.28	$402.50	$229.02–$382.38	—	9%
Diagnostic mammogram, one breast one side CPT 77065 MA Addl Views Lt.	$243.88	$268.00	$142.58–$254.60	14% below	9%
Diagnostic mammogram, one breast one side CPT 77065 MA Addl Views Rt.	$243.88	$268.00	$142.58–$254.60	14% below	9%
Diagnostic mammogram, one breast one side CPT 77065 MA Diag Lt.	$305.49	$335.70	$178.59–$318.92	8% above	9%
Diagnostic mammogram, one breast one side CPT 77065 MA Diag Rt.	$305.49	$335.70	$178.59–$318.92	8% above	9%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Addl Views Lt.	$243.88	$268.00	$152.49–$254.60	—	9%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Addl Views Rt.	$243.88	$268.00	$152.49–$254.60	—	9%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Diag Rt.	$305.49	$335.70	$191.01–$318.92	—	9%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MA Diag Lt.	$305.49	$335.70	$191.01–$318.92	—	9%
Duplex ultrasound of the leg veins, both legs CPT 93970 US LE Veins Duplex Bil	$1,501.59	$1,650.10	$938.91–$1,567.60	2% below	9%
Duplex ultrasound of the leg veins, both legs CPT 93970 US UE Veins Duplex Bil	$1,501.59	$1,650.10	$938.91–$1,567.60	2% below	9%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US UE Veins Duplex Bil	$1,501.59	$1,650.10	$938.91–$1,567.60	—	9%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US LE Veins Duplex Bil	$1,501.59	$1,650.10	$938.91–$1,567.60	—	9%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Comp w/ Color Flow Doppler	$2,663.21	$2,926.60	$1,665.24–$2,780.27	48% above	9%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Comp w/ Color Flow Doppler	$2,663.21	$2,926.60	$1,665.24–$2,780.27	—	9%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study W/CPAP	$3,271.63	$3,595.20	$2,045.67–$3,415.44	at median	9%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnog; W/4/> Add Param W/	$4,284.46	$4,708.20	$234.65–$4,472.79	31% above	9%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Study W/CPAP	$3,271.63	$3,595.20	$2,045.67–$3,415.44	—	9%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Polysomnog; W/4/> Add Param W/	$4,284.46	$4,708.20	—	—	9%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder	$637.27	$700.30	$398.47–$665.29	10% above	9%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Ltd	$637.27	$700.30	$398.47–$665.29	10% above	9%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Ltd	$637.27	$700.30	$398.47–$665.29	—	9%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder	$637.27	$700.30	$398.47–$665.29	—	9%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Toes w/o Cont Lt	$2,097.28	$2,304.70	$1,475.01–$2,189.47	13% below	9%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Toes w/o Cont Rt	$2,097.28	$2,304.70	$1,475.01–$2,189.47	13% below	9%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Toes w/o Cont Rt	$2,097.28	$2,304.70	$1,475.01–$2,189.47	—	9%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Toes w/o Cont Lt	$2,097.28	$2,304.70	$1,475.01–$2,189.47	—	9%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Toes w/ + w/o Cont Lt	$2,945.22	$3,236.50	$2,071.36–$3,074.68	9% below	9%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Fingers w/o Cont Lt	$2,945.22	$3,236.50	$2,071.36–$3,074.68	9% below	9%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Toes w/ + w/o Cont Rt	$2,945.22	$3,236.50	$2,071.36–$3,074.68	9% below	9%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Fingers w/o Cont Lt	$2,945.22	$3,236.50	$2,071.36–$3,074.68	—	9%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Toes w/ + w/o Cont Lt	$2,945.22	$3,236.50	$2,071.36–$3,074.68	—	9%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Toes w/ + w/o Cont Rt	$2,945.22	$3,236.50	$2,071.36–$3,074.68	—	9%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Cont	$2,161.89	$2,375.70	$1,468.98–$2,256.92	4% above	9%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Cont	$2,161.89	$2,375.70	$1,520.45–$2,256.92	—	9%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Cont	$3,036.49	$3,336.80	$1,954.38–$3,169.96	1% below	9%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Cont	$3,036.49	$3,336.80	$2,135.55–$3,169.96	—	9%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Cont	$2,159.89	$2,373.50	$1,370.11–$2,254.83	1% below	9%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Cont	$2,159.89	$2,373.50	$1,519.04–$2,254.83	—	9%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Cont	$3,166.16	$3,479.30	$2,117.24–$3,305.34	2% below	9%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Cont	$3,166.16	$3,479.30	$2,226.75–$3,305.34	—	9%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Cont	$2,244.97	$2,467.00	$1,535.77–$2,343.65	12% below	9%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Cont	$2,244.97	$2,467.00	$1,578.88–$2,343.65	—	9%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Cont	$3,225.86	$3,544.90	$2,238.65–$3,367.66	1% below	9%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Cont	$3,225.86	$3,544.90	$2,268.74–$3,367.66	—	9%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Cont	$2,233.96	$2,454.90	$1,552.48–$2,332.16	12% below	9%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Cont	$2,233.96	$2,454.90	$1,571.14–$2,332.16	—	9%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Cont	$3,221.31	$3,539.90	$2,084.17–$3,362.91	at median	9%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Cont	$3,221.31	$3,539.90	$2,265.54–$3,362.91	—	9%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Cont	$2,230.23	$2,450.80	$1,488.26–$2,328.26	3% below	9%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Cont	$2,230.23	$2,450.80	$1,568.51–$2,328.26	—	9%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Cont	$2,999.72	$3,296.40	$1,667.76–$3,131.58	7% above	9%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Cont	$2,999.72	$3,296.40	$2,109.70–$3,131.58	—	9%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Cont	$2,149.06	$2,361.60	$1,408.56–$2,243.52	at median	9%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Cont	$2,149.06	$2,361.60	$1,511.42–$2,243.52	—	9%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Cont Lt	$2,101.10	$2,308.90	$1,469.57–$2,193.46	19% below	9%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Fingers w/o Cont Rt	$2,101.10	$2,308.90	$1,469.57–$2,193.46	19% below	9%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Cont Lt	$2,101.10	$2,308.90	$1,477.70–$2,193.46	—	9%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Fingers w/o Cont Rt	$2,101.10	$2,308.90	$1,477.70–$2,193.46	—	9%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Non-OB Ltd	$260.35	$286.10	$162.79–$271.80	39% below	9%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Non-OB Ltd	$260.35	$286.10	$162.79–$271.80	—	9%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 MMC US Pelvic Non-OB Ltd	$260.35	$286.10	$162.79–$461.64	59% below	9%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non-OB Comp	$436.53	$479.70	$272.95–$461.64	31% below	9%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvis Non-OB Comp	$436.53	$479.70	$272.95–$461.64	31% below	9%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 MMC US Pelvic Non-OB Ltd	$260.35	$286.10	$162.79–$271.80	—	9%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvis Non-OB Comp	$436.53	$479.70	$272.95–$455.72	—	9%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Non-OB Comp	$436.53	$479.70	$272.95–$455.72	—	9%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US Pregnant > 14 Weeks 1st Gest	$991.90	$1,090.00	$417.57–$1,035.50	63% above	9%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US Pregnant > 14 Weeks 1st Gest	$991.90	$1,090.00	$620.21–$1,035.50	—	9%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US Pregnant < 14 Weeks 1st Gest	$688.87	$757.00	$354.86–$719.15	24% above	9%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US Pregnant < 14 Weeks 1st Gest	$688.87	$757.00	$430.73–$719.15	—	9%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Pregnant Ltd	$665.12	$730.90	$269.73–$694.36	63% above	9%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Pregnant Ltd	$665.12	$730.90	$415.88–$694.36	—	9%
Screening mammogram, both breasts CPT 77067 MA Routine Screen Bil.	$320.50	$352.20	$187.37–$334.59	21% above	9%
Screening mammogram, both breasts CPT 77067 MA Routine Screen Implant Bil.	$552.92	$607.60	$323.24–$577.22	108% above	9%
Screening mammogram, both breasts inpatient CPT 77067 MA Routine Screen Bil.	$320.50	$352.20	$200.40–$334.59	—	9%
Screening mammogram, both breasts inpatient CPT 77067 MA Routine Screen Implant Bil.	$552.92	$607.60	$345.72–$577.22	—	9%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study / 4+ Request	$2,658.84	$2,921.80	$1,662.50–$2,775.71	10% below	9%
Sleep study in a lab (polysomnography) CPT 95810 Polysomnography; W/4-more Add	$4,074.43	$4,477.40	$226.20–$4,253.53	38% above	9%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study / 4+ Request	$2,658.84	$2,921.80	$1,662.50–$2,775.71	—	9%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysomnography; W/4-more Add	$4,074.43	$4,477.40	—	—	9%
Transvaginal pelvic ultrasound CPT 76830 US Pelvis Non-OB Comp Transvaginal	$436.53	$479.70	$272.95–$455.72	21% below	9%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal	$436.53	$479.70	$272.95–$455.72	21% below	9%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal	$436.53	$479.70	$272.95–$455.72	—	9%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Pelvis Non-OB Comp Transvaginal	$436.53	$479.70	$272.95–$455.72	—	9%
Transvaginal ultrasound during pregnancy CPT 76817 US Pregnant Transvaginal	$688.87	$757.00	$305.93–$719.15	46% above	9%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Pregnant Transvaginal	$688.87	$757.00	$430.73–$719.15	—	9%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Comp	$880.88	$968.00	$502.89–$919.60	9% below	9%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Comp	$880.88	$968.00	$550.79–$919.60	—	9%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum +Contents	$686.41	$754.30	$399.91–$716.59	5% above	9%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum +Contents	$686.41	$754.30	$429.20–$716.59	—	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head +Neck Soft Tissue - Report	$183.27	$201.40	$20.09–$191.33	70% below	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$626.99	$689.00	$392.04–$654.55	2% above	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Radiology Request	$626.99	$689.00	$392.04–$654.55	2% above	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head +Neck Soft Tissue	$626.99	$689.00	$392.04–$654.55	2% above	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head +Neck Soft Tissue - Report	$183.27	$201.40	$20.09–$191.33	—	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head +Neck Soft Tissue	$626.99	$689.00	$392.04–$654.55	—	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 Radiology Request	$626.99	$689.00	$392.04–$654.55	—	9%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$626.99	$689.00	$392.04–$654.55	—	9%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI w/o KUB	$787.97	$865.90	$432.49–$822.61	46% above	9%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI w/o KUB	$787.97	$865.90	$554.18–$822.61	—	9%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Veins Duplex Rt	$995.54	$1,094.00	$622.49–$1,039.30	57% above	9%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LE Veins Duplex Rt	$995.54	$1,094.00	$622.49–$1,039.30	57% above	9%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US UE Veins Duplex Lt	$995.54	$1,094.00	$622.49–$1,039.30	57% above	9%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LE Veins Duplex Rt	$995.54	$1,094.00	$622.49–$1,039.30	—	9%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Veins Duplex Rt	$995.54	$1,094.00	$622.49–$1,039.30	—	9%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US UE Veins Duplex Lt	$995.54	$1,094.00	$622.49–$1,039.30	—	9%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis	$272.64	$299.60	$159.39–$284.62	at median	9%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis	$272.64	$299.60	$159.39–$284.62	at median	9%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 1 View Rt w/ Pelvis	$272.64	$299.60	$159.39–$284.62	at median	9%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Lt w/ Pelvis	$272.64	$299.60	$191.74–$284.62	—	9%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Rt w/ Pelvis	$272.64	$299.60	$191.74–$284.62	—	9%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 1 View Rt w/ Pelvis	$272.64	$299.60	$191.74–$284.62	—	9%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View	$218.86	$240.50	$127.95–$228.48	16% below	9%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View	$218.86	$240.50	$153.92–$228.48	—	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 3rd Digit Rt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 4th Digit Rt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 5th Digit Rt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 3rd Digit Lt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views Thumb Lt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 2nd Digit Rt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views Thumb Rt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 4th Digit Lt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Fingers Min 2 Views 5th Digit Lt	$171.54	$188.50	$120.64–$179.08	28% below	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views Thumb Rt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 3rd Digit Rt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 4th Digit Rt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 5th Digit Rt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views Thumb Lt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 3rd Digit Lt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 4th Digit Lt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 5th Digit Lt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Fingers Min 2 Views 2nd Digit Rt	$171.54	$188.50	$120.64–$179.08	—	9%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee Standing Bil +1-2 Views Rt	$462.46	$508.20	$177.17–$482.79	70% above	9%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee Standing Bil +1-2 Views Rt	$462.46	$508.20	$325.25–$482.79	—	9%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$275.91	$303.20	$194.05–$288.04	31% below	9%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$275.91	$303.20	$194.05–$288.04	—	9%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral Min 4 Views w/ Obl	$383.20	$421.10	$269.50–$400.05	28% below	9%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral Min 4 Views w/ Obl	$383.20	$421.10	$269.50–$400.05	—	9%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$271.27	$298.10	$190.78–$310.89	23% below	9%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$271.27	$298.10	$190.78–$283.20	—	9%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones Comp Min 3 Views	$226.50	$248.90	$159.30–$236.46	22% below	9%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones Comp Min 3 Views	$226.50	$248.90	$159.30–$236.46	—	9%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cerv 2 or 3 Views	$274.91	$302.10	$193.34–$287.00	16% below	9%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cerv 2 or 3 Views	$274.91	$302.10	$193.34–$287.00	—	9%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$213.49	$234.60	$150.14–$222.87	33% below	9%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$213.49	$234.60	$150.14–$222.87	—	9%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum +Coccyx Min 2 Views	$230.78	$253.60	$162.30–$240.92	19% below	9%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum +Coccyx Min 2 Views	$230.78	$253.60	$162.30–$240.92	—	9%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase	$86.18	$94.70	$49.66–$89.97	64% above	9%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase	$86.18	$94.70	$60.61–$89.97	—	9%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase	$83.90	$92.20	$45.63–$87.59	60% above	9%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase	$83.90	$92.20	$59.01–$87.59	—	9%
Basic metabolic panel (blood test) CPT 80048 BMP 8	$44.14	$48.50	$31.04–$97.89	66% below	9%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel UCL	$44.14	$48.50	$31.04–$97.89	66% below	9%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP 8	$44.14	$48.50	$31.04–$46.08	—	9%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel UCL	$44.14	$48.50	$31.04–$46.08	—	9%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venous Draw Manual	$25.21	$27.70	$17.73–$26.32	12% above	9%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Manual	$25.21	$27.70	$17.73–$26.32	12% above	9%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$25.21	$27.70	$17.73–$26.32	12% above	9%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$25.21	$27.70	$17.73–$26.32	—	9%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venous Draw Manual	$25.21	$27.70	$17.73–$26.32	—	9%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture Manual	$25.21	$27.70	$17.73–$26.32	—	9%
Blood glucose (sugar) test CPT 82947 Glucose Level	$63.70	$70.00	$37.89–$66.50	94% above	9%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$63.70	$70.00	$44.80–$66.50	—	9%
Blood lead test CPT 83655 Lead Capillary UCL/Mayo	$31.30	$34.40	$22.02–$69.70	46% below	9%
Blood lead test CPT 83655 Lead, Whole Blood Elizabeth Only	$48.87	$53.70	$34.37–$69.70	15% below	9%
Blood lead test inpatient CPT 83655 Lead Capillary UCL/Mayo	$31.30	$34.40	$22.02–$32.68	—	9%
Blood lead test inpatient CPT 83655 Lead, Whole Blood Elizabeth Only	$48.87	$53.70	$34.37–$51.02	—	9%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 U beta hCG Ql POC	$74.26	$81.60	$52.22–$77.52	3% above	9%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 U beta hCG Ql POC	$74.26	$81.60	$52.22–$77.52	—	9%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Tube	$48.87	$53.70	$34.37–$51.02	41% below	9%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Tube	$48.87	$53.70	$34.37–$51.02	—	9%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$91.36	$100.40	$55.52–$95.38	35% above	9%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$91.36	$100.40	$64.26–$95.38	—	9%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) RNA (ID Now)	$208.94	$229.60	$122.15–$218.12	109% above	9%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 (COVID-19) RNA (ID Now)	$208.94	$229.60	$146.94–$218.12	—	9%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$148.51	$163.20	$104.45–$155.04	34% above	9%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$148.51	$163.20	$104.45–$155.04	—	9%
Complete blood count (CBC) with differential CPT 85025 CBC w/Auto Diff 3 BCE	$126.31	$138.80	$62.99–$131.86	61% above	9%
Complete blood count (CBC) with differential CPT 85025 No - Add Manual Diff	$126.31	$138.80	$62.99–$131.86	61% above	9%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Auto Diff 3	$126.31	$138.80	$62.99–$131.86	61% above	9%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Auto	$126.31	$138.80	$62.99–$131.86	61% above	9%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Auto	$126.31	$138.80	$88.83–$131.86	—	9%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/Auto Diff 3 BCE	$126.31	$138.80	$88.83–$131.86	—	9%
Complete blood count (CBC) with differential inpatient CPT 85025 No - Add Manual Diff	$126.31	$138.80	$88.83–$131.86	—	9%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Auto Diff 3	$126.31	$138.80	$88.83–$131.86	—	9%
Complete blood count (CBC), no differential CPT 85027 CBC w/ Auto Diff 8	$108.02	$118.70	$50.06–$112.77	69% above	9%
Complete blood count (CBC), no differential CPT 85027 Hemogram	$108.02	$118.70	$50.06–$112.77	69% above	9%
Complete blood count (CBC), no differential CPT 85027 Hemogram 11	$108.02	$118.70	$50.06–$112.77	69% above	9%
Complete blood count (CBC), no differential CPT 85027 Yes - Add Manual Diff	$108.02	$118.70	$50.06–$112.77	69% above	9%
Complete blood count (CBC), no differential inpatient CPT 85027 Yes - Add Manual Diff	$108.02	$118.70	$75.97–$112.77	—	9%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram	$108.02	$118.70	$75.97–$112.77	—	9%
Complete blood count (CBC), no differential inpatient CPT 85027 Hemogram 11	$108.02	$118.70	$75.97–$112.77	—	9%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/ Auto Diff 8	$108.02	$118.70	$75.97–$112.77	—	9%
Comprehensive metabolic panel (blood test) CPT 80053 CMP 8	$56.88	$62.50	$40.00–$141.11	62% below	9%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP 8	$56.88	$62.50	$40.00–$59.38	—	9%
D-dimer blood test (blood clot marker) CPT 85379 D-Dimer	$114.57	$125.90	$80.58–$119.61	9% above	9%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-Dimer	$114.57	$125.90	$80.58–$119.61	—	9%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4	$124.85	$137.20	$87.81–$130.34	9% above	9%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4	$124.85	$137.20	$87.81–$130.34	—	9%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 Hour (100gm)	$272.82	$299.80	$132.10–$284.81	118% above	9%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 Hour (100gm)	$272.82	$299.80	$191.87–$284.81	—	9%
HIV-1 and HIV-2 antibody test CPT 86703 Rapid HIV 1/2	$80.35	$88.30	$56.51–$99.95	33% below	9%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 Rapid HIV 1/2	$80.35	$88.30	$56.51–$83.89	—	9%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgb A1c POC MHC	$98.19	$107.90	$69.06–$102.51	21% above	9%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c	$98.19	$107.90	$69.06–$102.51	21% above	9%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c	$98.19	$107.90	$69.06–$102.51	—	9%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hgb A1c POC MHC	$98.19	$107.90	$69.06–$102.51	—	9%
Herpes blood test, HSV-1 antibody CPT 86695 86695 -Herpes Simplex Virus (HSV) Type 1 and 2 Specific Antibodies IgG, Serum UCL	$25.48	$28.00	$17.92–$78.94	61% below	9%
Herpes blood test, HSV-1 antibody CPT 86695 HSV Type 1 Ab, IgG UCL	$25.48	$28.00	$17.92–$78.94	61% below	9%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV Type 1 Ab, IgG UCL	$25.48	$28.00	$17.92–$26.60	—	9%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 -Herpes Simplex Virus (HSV) Type 1 and 2 Specific Antibodies IgG, Serum UCL	$25.48	$28.00	$17.92–$26.60	—	9%
Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Virus (HSV) Type 1 and 2 Specific Antibodies, IgG Serum UCL	$37.22	$40.90	$26.18–$71.44	59% below	9%
Herpes blood test, HSV-2 antibody CPT 86696 HSV Type 2 Ab, IgG UCL	$37.22	$40.90	$26.18–$71.44	59% below	9%
Herpes blood test, HSV-2 antibody CPT 86696 86696 -Herpes Simplex Virus (HSV) Type 1 and 2 Specific Antibodies IgG, Serum UCL	$37.22	$40.90	$26.18–$71.44	59% below	9%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV Type 2 Ab, IgG UCL	$37.22	$40.90	$26.18–$38.86	—	9%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 -Herpes Simplex Virus (HSV) Type 1 and 2 Specific Antibodies IgG, Serum UCL	$37.22	$40.90	$26.18–$38.86	—	9%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Herpes Simplex Virus (HSV) Type 1 and 2 Specific Antibodies, IgG Serum UCL	$37.22	$40.90	$26.18–$38.86	—	9%
Kidney function blood test panel CPT 80069 Renal Panel 11	$145.42	$159.80	$102.27–$151.81	1% above	9%
Kidney function blood test panel inpatient CPT 80069 Renal Panel 11	$145.42	$159.80	$102.27–$151.81	—	9%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$112.02	$123.10	$74.39–$116.95	40% above	9%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase UCL	$112.02	$123.10	$74.39–$116.95	40% above	9%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase UCL	$112.02	$123.10	$78.78–$116.95	—	9%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$112.02	$123.10	$78.78–$116.95	—	9%
Liver function blood test panel CPT 80076 Hepatic Function Panel 3	$141.23	$155.20	$99.33–$147.44	17% above	9%
Liver function blood test panel CPT 80076 Hepatic Panel	$141.23	$155.20	$99.33–$147.44	17% above	9%
Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel 3	$141.23	$155.20	$99.33–$147.44	—	9%
Liver function blood test panel inpatient CPT 80076 Hepatic Panel	$141.23	$155.20	$99.33–$147.44	—	9%
Magnesium blood test CPT 83735 Magnesium Level	$109.11	$119.90	$57.45–$113.91	53% above	9%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$109.11	$119.90	$76.74–$113.91	—	9%
Mono test (heterophile antibody, Monospot) CPT 86308 Rapid Mononucleosis Screen	$84.45	$92.80	$59.39–$88.16	17% above	9%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Rapid Mononucleosis Screen	$84.45	$92.80	$59.39–$88.16	—	9%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic	$142.78	$156.90	$100.42–$149.06	33% above	9%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic	$142.78	$156.90	$100.42–$149.06	—	9%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Bill Pap Manual Screen Under Physician Supervision	$119.21	$131.00	$53.41–$124.45	8% above	9%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Bill Pap Manual Screen Under Physician Supervision	$119.21	$131.00	$83.84–$124.45	—	9%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$97.64	$107.30	$57.16–$101.94	77% above	9%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$97.64	$107.30	$68.67–$101.94	—	9%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time	$22.02	$24.20	$15.49–$43.85	29% below	9%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time	$22.02	$24.20	$15.49–$22.99	—	9%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 Urine Drug Screen 9	$199.75	$219.50	$116.77–$208.53	144% above	9%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Urine Drug Screen 9	$199.75	$219.50	$140.48–$208.53	—	9%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool	$39.40	$43.30	$27.71–$41.14	52% above	9%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood POC	$39.40	$43.30	$27.71–$41.14	52% above	9%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool POC	$39.40	$43.30	$27.71–$41.14	52% above	9%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screen 1	$39.40	$43.30	$27.71–$41.14	52% above	9%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool	$39.40	$43.30	$27.71–$41.14	—	9%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Screen 1	$39.40	$43.30	$27.71–$41.14	—	9%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool POC	$39.40	$43.30	$27.71–$41.14	—	9%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood POC	$39.40	$43.30	$27.71–$41.14	—	9%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, Response to Therapy, S UCL Mayo	$101.28	$111.30	$44.24–$105.74	98% above	9%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, Response to Therapy, S UCL Mayo	$101.28	$111.30	$71.23–$105.74	—	9%
Testosterone blood test, total (not free testosterone) CPT 84403 Bill Testosterone Total	$66.89	$73.50	$47.04–$129.08	46% below	9%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Bill Testosterone Total	$66.89	$73.50	$47.04–$69.83	—	9%
Thyroid peroxidase (TPO) antibody test CPT 86376 Bill TPL Antibody	$348.62	$383.10	$87.83–$363.95	288% above	9%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Bill TPL Antibody	$348.62	$383.10	$245.18–$363.95	—	9%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$167.44	$184.00	$101.95–$174.80	28% above	9%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$167.44	$184.00	$117.76–$174.80	—	9%
Uric acid blood test CPT 84550 Uric Acid	$73.53	$80.80	$45.33–$76.76	4% above	9%
Uric acid blood test inpatient CPT 84550 Uric Acid	$73.53	$80.80	$51.71–$76.76	—	9%
Urinalysis with microscope exam, automated CPT 81001 UA Complete 1	$49.60	$54.50	$34.88–$51.78	17% below	9%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA Complete 1	$49.60	$54.50	$34.88–$51.78	—	9%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis	$36.58	$40.20	$25.73–$38.19	104% above	9%
Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis	$36.58	$40.20	$25.73–$38.19	—	9%
Urinalysis without microscope exam, manual CPT 81002 Dipstick Urine POC	$35.04	$38.50	$21.10–$36.58	43% above	9%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC - Clinic	$35.04	$38.50	$21.10–$36.58	43% above	9%
Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick POC	$35.04	$38.50	$21.10–$36.58	43% above	9%
Urinalysis without microscope exam, manual CPT 81002 Nitrite Urine Dipstick	$35.04	$38.50	$21.10–$36.58	43% above	9%
Urinalysis without microscope exam, manual inpatient CPT 81002 Nitrite Urine Dipstick	$35.04	$38.50	$24.64–$36.58	—	9%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC - Clinic	$35.04	$38.50	$24.64–$36.58	—	9%
Urinalysis without microscope exam, manual inpatient CPT 81002 Dipstick Urine POC	$35.04	$38.50	$24.64–$36.58	—	9%
Urinalysis without microscope exam, manual inpatient CPT 81002 Urine Dipstick POC	$35.04	$38.50	$24.64–$36.58	—	9%
Urine culture for bacteria, with colony count CPT 87086 Urine Cult	$42.22	$46.40	$29.70–$79.54	53% below	9%
Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Cult	$42.22	$46.40	$29.70–$44.08	—	9%
Urine pregnancy test, read by color change CPT 81025 Rapid Pregnancy Test Urine	$74.26	$81.60	$52.22–$77.52	10% above	9%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test POC	$74.26	$81.60	$52.22–$77.52	10% above	9%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST POC	$79.72	$87.60	$56.06–$83.22	18% above	9%
Urine pregnancy test, read by color change inpatient CPT 81025 Rapid Pregnancy Test Urine	$74.26	$81.60	$52.22–$77.52	—	9%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test POC	$74.26	$81.60	$52.22–$77.52	—	9%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST POC	$79.72	$87.60	$56.06–$83.22	—	9%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$82.90	$91.10	$58.30–$103.95	34% below	9%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12	$82.90	$91.10	$58.30–$103.95	34% below	9%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12	$82.90	$91.10	$58.30–$86.55	—	9%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$82.90	$91.10	$58.30–$86.55	—	9%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 hCG Quantitative	$122.03	$134.10	$85.82–$127.40	16% above	9%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 hCG Quantitative	$122.03	$134.10	$85.82–$127.40	—	9%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION	$883.52	$970.90	$381.12–$922.36	38% above	9%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLOSED TREATMENT OF METATARSAL FRACTURE; WITHOUT MANIPULATION	$883.52	$970.90	—	—	9%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion, Elective, Electrical Conversion of Arrhythmia; Ext Charge	$1,313.77	$1,443.70	$263.92–$1,371.52	15% above	9%
Cardioversion, elective (restoring heart rhythm) CPT 92960 18092960 CARDIOVERSION ED ED Charge	$1,359.81	$1,494.30	$850.26–$1,419.59	19% above	9%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion, Elective, Electrical Conversion of Arrhythmia; Ext Charge	$1,313.77	$1,443.70	—	—	9%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 18092960 CARDIOVERSION ED ED Charge	$1,359.81	$1,494.30	$850.26–$1,419.59	—	9%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 18025600 TREAT FRACTURE RADIUS/ULNA ED Charge	$206.30	$226.70	$128.99–$348.98	61% below	9%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TX OF DISTAL RADIAL FX OR EPIPHYSEAL SEPARATION INC CLOSED TX OF FX OF ULNAR W/O MANIPULATION	$1,205.57	$1,324.80	$586.58–$1,258.56	131% above	9%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 18025600 TREAT FRACTURE RADIUS/ULNA ED Charge	$206.30	$226.70	$128.99–$215.37	—	9%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TX OF DISTAL RADIAL FX OR EPIPHYSEAL SEPARATION INC CLOSED TX OF FX OF ULNAR W/O MANIPULATION	$1,205.57	$1,324.80	—	—	9%
Colonoscopy with tissue sample CPT 45380 17045380 COLONOSCOPY AND BIOPSY ED Charge	$1,674.67	$1,840.30	$1,047.13–$1,815.34	9% below	9%
Colonoscopy with tissue sample inpatient CPT 45380 17045380 COLONOSCOPY AND BIOPSY ED Charge	$1,674.67	$1,840.30	$1,047.13–$1,748.29	—	9%
Colonoscopy, diagnostic CPT 45378 17045378 COLONOSCOPY ED Charge	$1,490.76	$1,638.20	$932.14–$1,815.34	20% below	9%
Colonoscopy, diagnostic inpatient CPT 45378 17045378 COLONOSCOPY ED Charge	$1,490.76	$1,638.20	$932.14–$1,556.29	—	9%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION LESION	$243.79	$267.90	$115.11–$254.51	45% above	9%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION LESION	$243.79	$267.90	—	—	9%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 69433 CREATE EARDRUM OPENING	$1,163.89	$1,279.00	$350.09–$1,215.05	112% above	9%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 69433 CREATE EARDRUM OPENING	$1,163.89	$1,279.00	—	—	9%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 Remove impacted cerumen using irrigation/lavage, unilateral facility	$142.78	$156.90	$89.28–$149.06	26% above	9%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal impacted Cerumen using irrigation/lavage, unilateral.	$154.06	$169.30	$25.46–$160.84	35% above	9%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 Remove impacted cerumen using irrigation/lavage, unilateral facility	$142.78	$156.90	$89.28–$149.06	—	9%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 69209 Removal impacted Cerumen using irrigation/lavage, unilateral.	$154.06	$169.30	—	—	9%
Earwax removal with instruments, one ear CPT 69210 18069210 REMOVAL IMPACTED CERUMIEN ED ED Charge	$65.88	$72.40	$57.65–$93.08	47% below	9%
Earwax removal with instruments, one ear CPT 69210 17069210 REMOVAL IMPACTED CERUMIEN ED ED Charge	$65.88	$72.40	$41.20–$68.78	47% below	9%
Earwax removal with instruments, one ear CPT 69210 18069210 REMOVAL IMPACTED CERUMIEN ED ED Charge	$65.88	$72.40	$41.20–$68.78	47% below	9%
Earwax removal with instruments, one ear CPT 69210 Ear Lavage Charge	$152.15	$167.20	$82.25–$158.84	22% above	9%
Earwax removal with instruments, one ear one side CPT 69210 69210 Removal impacted Cerumen requiring instrumentation, unilateral.	$152.15	$167.20	$82.25–$158.84	22% above	9%
Earwax removal with instruments, one ear inpatient CPT 69210 18069210 REMOVAL IMPACTED CERUMIEN ED ED Charge	$65.88	$72.40	$57.65–$93.08	—	9%
Earwax removal with instruments, one ear inpatient CPT 69210 17069210 REMOVAL IMPACTED CERUMIEN ED ED Charge	$65.88	$72.40	$41.20–$68.78	—	9%
Earwax removal with instruments, one ear inpatient CPT 69210 18069210 REMOVAL IMPACTED CERUMIEN ED ED Charge	$65.88	$72.40	$41.20–$68.78	—	9%
Earwax removal with instruments, one ear inpatient CPT 69210 Ear Lavage Charge	$152.15	$167.20	—	—	9%
Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 Removal impacted Cerumen requiring instrumentation, unilateral.	$152.15	$167.20	—	—	9%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 18045330 DIAGNOSTIC SIGMOIDISCIPY ED Charge	$566.02	$622.00	$96.48–$590.90	38% below	9%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 17045330 DIAGNOSTIC SIGMOIDOSCOPY ED Charge	$566.02	$622.00	$353.92–$1,007.89	38% below	9%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 18045330 DIAGNOSTIC SIGMOIDISCIPY ED Charge	$566.02	$622.00	$353.92–$1,007.89	38% below	9%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 17045330 DIAGNOSTIC SIGMOIDOSCOPY ED Charge	$566.02	$622.00	$353.92–$590.90	—	9%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 18045330 DIAGNOSTIC SIGMOIDISCIPY ED Charge	$566.02	$622.00	$96.48–$590.90	—	9%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 18045330 DIAGNOSTIC SIGMOIDISCIPY ED Charge	$566.02	$622.00	$353.92–$590.90	—	9%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND	$618.16	$679.30	$507.42–$825.22	22% below	9%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY INTERNAL RUBBER BAND	$618.16	$679.30	—	—	9%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION OF IUD	$364.64	$400.70	$198.25–$380.67	26% above	9%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION OF IUD	$364.64	$400.70	—	—	9%
Incision and drainage of a simple or single skin abscess CPT 10060 18010060 DRAINAGE OF SKIN ABCESS ED Charge	$222.77	$244.80	$139.29–$297.96	45% below	9%
Incision and drainage of a simple or single skin abscess CPT 10060 18010060 DRAINAGE OF SKIN ABCESS ED Charge	$222.77	$244.80	$179.51–$288.83	45% below	9%
Incision and drainage of a simple or single skin abscess CPT 10060 17010060 DRAINAGE OF SKIN ABCESS ED Charge	$222.77	$244.80	$139.29–$297.96	45% below	9%
Incision and drainage of a simple or single skin abscess CPT 10060 I AND D ABSCESS/CYST S	$344.25	$378.30	$215.23–$359.39	14% below	9%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 WC Incision and drainage simple/single	$514.06	$564.90	$215.23–$536.66	28% above	9%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 18010060 DRAINAGE OF SKIN ABCESS ED Charge	$222.77	$244.80	$139.29–$232.56	—	9%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 17010060 DRAINAGE OF SKIN ABCESS ED Charge	$222.77	$244.80	$139.29–$232.56	—	9%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 18010060 DRAINAGE OF SKIN ABCESS ED Charge	$222.77	$244.80	$179.51–$288.83	—	9%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I AND D ABSCESS/CYST S	$344.25	$378.30	—	—	9%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 WC Incision and drainage simple/single	$514.06	$564.90	—	—	9%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTION SINGLE TENDON SHEATH OR LIGAME	$206.48	$226.90	$97.72–$215.56	46% below	9%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJECTION SINGLE TENDON SHEATH OR LIGAME	$206.48	$226.90	—	—	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 17020610 ARTHROCENTESIS ASP OR INJ INT MAJ JOINT ED Charge	$438.98	$482.40	$274.49–$468.18	2% below	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 18020610 ARTHROCENTESIS ASP OR INJ MAJ JOINT ED ED Charge	$438.98	$482.40	$274.49–$468.18	2% below	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ASP/INJ LARGE JOINT	$537.54	$590.70	$110.78–$561.17	19% above	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, su	$646.10	$710.00	$110.78–$674.50	44% above	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 17020610 ARTHROCENTESIS ASP OR INJ INT MAJ JOINT ED Charge	$438.98	$482.40	$274.49–$458.28	—	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 18020610 ARTHROCENTESIS ASP OR INJ MAJ JOINT ED ED Charge	$438.98	$482.40	$274.49–$458.28	—	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 ASP/INJ LARGE JOINT	$537.54	$590.70	—	—	9%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, su	$646.10	$710.00	—	—	9%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NON BIODEGRADABLE	$534.44	$587.30	$178.88–$557.94	201% above	9%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION NON BIODEGRADABLE	$534.44	$587.30	—	—	9%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 17020605 ARTHROCENTESIS ASP OR INJ INT JOINT ED Charge	$427.97	$470.30	$267.60–$468.18	13% above	9%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 18020605 ARTHROCENTESIS ASP OR INJ INT JOINT ED ED Charge	$427.97	$470.30	$267.60–$468.18	13% above	9%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis, aspiration and or injection; intermediate joint or bursa Technical Charge	$622.80	$684.40	$93.80–$650.18	65% above	9%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 17020605 ARTHROCENTESIS ASP OR INJ INT JOINT ED Charge	$427.97	$470.30	$267.60–$446.79	—	9%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 18020605 ARTHROCENTESIS ASP OR INJ INT JOINT ED ED Charge	$427.97	$470.30	$267.60–$446.79	—	9%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Arthrocentesis, aspiration and or injection; intermediate joint or bursa Technical Charge	$622.80	$684.40	—	—	9%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 18020600 ARTHROCENTESIS ASP OR INJ SM JOINT ED ED Charge	$417.14	$458.40	$62.64–$435.48	41% above	9%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 17020600 ARTHROCENTESIS ASP OR INF SM JOINT E ED Charge	$417.14	$458.40	$260.83–$468.18	41% above	9%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 18020600 ARTHROCENTESIS ASP OR INJ SM JOINT ED ED Charge	$417.14	$458.40	$260.83–$468.18	41% above	9%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ASP/INJ SMALL JOINT	$486.85	$535.00	$90.15–$508.25	64% above	9%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Charge	$617.71	$678.80	$90.15–$644.86	109% above	9%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 17020600 ARTHROCENTESIS ASP OR INF SM JOINT E ED Charge	$417.14	$458.40	$260.83–$435.48	—	9%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 18020600 ARTHROCENTESIS ASP OR INJ SM JOINT ED ED Charge	$417.14	$458.40	$62.64–$435.48	—	9%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 18020600 ARTHROCENTESIS ASP OR INJ SM JOINT ED ED Charge	$417.14	$458.40	$260.83–$435.48	—	9%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 ASP/INJ SMALL JOINT	$486.85	$535.00	—	—	9%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Arthrocentesis, Aspirtn and/or Inj; Small Joint or Bursa (eg, Fingers, toes) Charge	$617.71	$678.80	—	—	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 18012031 LAYER CLOSURE OF WOUNDS ED Charge	$245.43	$269.70	$153.46–$307.30	59% below	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 17012031 LAYER CLOSURE OF WOUNDS ED Charge	$245.43	$269.70	$153.46–$307.30	59% below	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 18012031 LAYER CLOSURE OF WOUNDS ED Charge	$245.43	$269.70	$215.76–$422.21	59% below	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE OF WOUND	$711.17	$781.50	$460.32–$747.50	18% above	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 18012031 LAYER CLOSURE OF WOUNDS ED Charge	$245.43	$269.70	$153.46–$256.22	—	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 18012031 LAYER CLOSURE OF WOUNDS ED Charge	$245.43	$269.70	$215.76–$422.21	—	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 17012031 LAYER CLOSURE OF WOUNDS ED Charge	$245.43	$269.70	$153.46–$256.22	—	9%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE OF WOUND	$711.17	$781.50	—	—	9%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXCISION BENIGN LESION CHARGE.	$569.84	$626.20	$223.89–$594.89	18% below	9%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXCISION BENIGN LESION CHARGE.	$569.84	$626.20	—	—	9%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 EXC FACE-MM B9+Marg 0.5 CM/<	$317.68	$349.10	$251.12–$406.85	42% below	9%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440 EXC FACE-MM B9+Marg 0.5 CM/<	$317.68	$349.10	—	—	9%
Nail removal (partial or complete), one nail CPT 11730 18011730 AVULION NAIL PLATE ED ED Charge	$114.02	$125.30	$71.30–$119.04	61% below	9%
Nail removal (partial or complete), one nail CPT 11730 17011730 AVULION NIAL PLATE ED ED Charge	$114.02	$125.30	$71.30–$119.04	61% below	9%
Nail removal (partial or complete), one nail CPT 11730 18011730 AVULION NAIL PLATE ED ED Charge	$114.02	$125.30	$95.42–$150.65	61% below	9%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE	$474.38	$521.30	$204.33–$495.24	63% above	9%
Nail removal (partial or complete), one nail inpatient CPT 11730 17011730 AVULION NIAL PLATE ED ED Charge	$114.02	$125.30	$71.30–$119.04	—	9%
Nail removal (partial or complete), one nail inpatient CPT 11730 18011730 AVULION NAIL PLATE ED ED Charge	$114.02	$125.30	$71.30–$119.04	—	9%
Nail removal (partial or complete), one nail inpatient CPT 11730 18011730 AVULION NAIL PLATE ED ED Charge	$114.02	$125.30	$95.42–$150.65	—	9%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE	$474.38	$521.30	—	—	9%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC A	$540.54	$594.00	$127.34–$564.30	11% above	9%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION ANESTHETIC A	$540.54	$594.00	—	—	9%
Paracentesis with imaging guidance CPT 49083 US Abdomen Paracentesis	$1,134.68	$1,246.90	$663.35–$1,184.56	17% below	9%
Paracentesis with imaging guidance inpatient CPT 49083 US Abdomen Paracentesis	$1,134.68	$1,246.90	$709.49–$1,184.56	—	9%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 18011750 REMOVAL OF NAIL BED ED Charge	$501.59	$551.20	$313.63–$847.13	6% below	9%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 17011750 REMOVAL OF NAIL BED ED Charge	$501.59	$551.20	$313.63–$847.13	6% below	9%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 18011750 REMOVAL OF NAIL BED ED Charge	$501.59	$551.20	$178.75–$523.64	6% below	9%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 NAIL REMOVAL INGROWN	$583.58	$641.30	$284.72–$609.24	10% above	9%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 18011750 REMOVAL OF NAIL BED ED Charge	$501.59	$551.20	$313.63–$523.64	—	9%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 17011750 REMOVAL OF NAIL BED ED Charge	$501.59	$551.20	$313.63–$523.64	—	9%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 18011750 REMOVAL OF NAIL BED ED Charge	$501.59	$551.20	$178.75–$523.64	—	9%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 NAIL REMOVAL INGROWN	$583.58	$641.30	—	—	9%
Removal of a breast lump, open surgery CPT 19120 EXCISION OF CYST FIBROADENOMA OR OTHER	$1,533.62	$1,685.30	$888.63–$1,601.04	13% below	9%
Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION OF CYST FIBROADENOMA OR OTHER	$1,533.62	$1,685.30	—	—	9%
Removal of a foreign object under the skin, simple CPT 10120 18010120 REMOVE FORGEIN BODY ED Charge	$222.77	$244.80	$139.29–$297.96	52% below	9%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REMOVAL OF FO	$518.06	$569.30	$266.44–$540.84	11% above	9%
Removal of a foreign object under the skin, simple inpatient CPT 10120 18010120 REMOVE FORGEIN BODY ED Charge	$222.77	$244.80	$139.29–$232.56	—	9%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REMOVAL OF FO	$518.06	$569.30	—	—	9%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 17000121 COLONOSCOPY SCREENING ED Charge	$1,490.76	$1,638.20	$932.14–$1,556.29	40% below	9%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 17000121 COLONOSCOPY SCREENING ED Charge	$1,490.76	$1,638.20	$932.14–$1,556.29	—	9%
Septoplasty to straighten the nasal septum CPT 30520 30520 REPAIR OF NASAL SEPTUM	$4,038.22	$4,437.60	$1,170.00–$4,215.72	70% below	9%
Septoplasty to straighten the nasal septum inpatient CPT 30520 30520 REPAIR OF NASAL SEPTUM	$4,038.22	$4,437.60	—	—	9%
Short arm cast (elbow to hand) CPT 29075 APPL CAST ELBOW TO FINGER SHORT ARM	$257.53	$283.00	$148.67–$268.85	16% below	9%
Short arm cast (elbow to hand) CPT 29075 18029075 APPLICATION OF FOREARM CAST ED Charge	$267.27	$293.70	$106.52–$279.02	13% below	9%
Short arm cast (elbow to hand) CPT 29075 18029075 APPLICATION OF FOREARM CAST ED Charge	$267.27	$293.70	$167.12–$471.56	13% below	9%
Short arm cast (elbow to hand) CPT 29075 17029075 APPLICAITON OF FOREARM CAST ED Charge	$267.27	$293.70	$167.12–$471.56	13% below	9%
Short arm cast (elbow to hand) inpatient CPT 29075 APPL CAST ELBOW TO FINGER SHORT ARM	$257.53	$283.00	—	—	9%
Short arm cast (elbow to hand) inpatient CPT 29075 17029075 APPLICAITON OF FOREARM CAST ED Charge	$267.27	$293.70	$167.12–$279.02	—	9%
Short arm cast (elbow to hand) inpatient CPT 29075 18029075 APPLICATION OF FOREARM CAST ED Charge	$267.27	$293.70	$106.52–$279.02	—	9%
Short arm cast (elbow to hand) inpatient CPT 29075 18029075 APPLICATION OF FOREARM CAST ED Charge	$267.27	$293.70	$167.12–$279.02	—	9%
Short arm splint (forearm and hand) CPT 29125 18029125 APPLY SHORT ARM SPLINT ED ED Charge	$122.30	$134.40	$68.12–$127.68	51% below	9%
Short arm splint (forearm and hand) CPT 29125 17029125 APPLY SHORT ARM SPLINT ED ED Charge	$122.30	$134.40	$76.47–$127.68	51% below	9%
Short arm splint (forearm and hand) CPT 29125 18029125 APPLY SHORT ARM SPLINT ED ED Charge	$122.30	$134.40	$76.47–$127.68	51% below	9%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SHORT A	$346.16	$380.40	$110.85–$361.38	39% above	9%
Short arm splint (forearm and hand) inpatient CPT 29125 17029125 APPLY SHORT ARM SPLINT ED ED Charge	$122.30	$134.40	$76.47–$127.68	—	9%
Short arm splint (forearm and hand) inpatient CPT 29125 18029125 APPLY SHORT ARM SPLINT ED ED Charge	$122.30	$134.40	$68.12–$127.68	—	9%
Short arm splint (forearm and hand) inpatient CPT 29125 18029125 APPLY SHORT ARM SPLINT ED ED Charge	$122.30	$134.40	$76.47–$127.68	—	9%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SHORT A	$346.16	$380.40	—	—	9%
Short leg cast (below the knee) CPT 29405 18029405 APPLY SHORT LEG CAST ED Charge	$267.27	$293.70	$167.12–$471.56	14% below	9%
Short leg cast (below the knee) CPT 29405 17029405 APPLY SHORT LEG CAST ED Charge	$267.27	$293.70	$167.12–$471.56	14% below	9%
Short leg cast (below the knee) CPT 29405 18029405 APPLY SHORT LEG CAST ED Charge	$267.27	$293.70	$100.88–$279.02	14% below	9%
Short leg cast (below the knee) CPT 29405 APPLICATION OF SHORT LEG CAST	$339.79	$373.40	$137.18–$354.73	9% above	9%
Short leg cast (below the knee) inpatient CPT 29405 18029405 APPLY SHORT LEG CAST ED Charge	$267.27	$293.70	$167.12–$279.02	—	9%
Short leg cast (below the knee) inpatient CPT 29405 17029405 APPLY SHORT LEG CAST ED Charge	$267.27	$293.70	$167.12–$279.02	—	9%
Short leg cast (below the knee) inpatient CPT 29405 18029405 APPLY SHORT LEG CAST ED Charge	$267.27	$293.70	$100.88–$279.02	—	9%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION OF SHORT LEG CAST	$339.79	$373.40	—	—	9%
Short leg splint (calf to foot) CPT 29515 17029515 APPLICATION OF SHORT LEG SPLINT ED Charge	$127.40	$140.00	$79.66–$219.59	52% below	9%
Short leg splint (calf to foot) CPT 29515 18029515 APPLICATION OF SHORT LEG SPLINT ED ED Charge	$127.40	$140.00	$84.69–$137.22	52% below	9%
Short leg splint (calf to foot) CPT 29515 18029515 APPLICATION OF SHORT LEG SPLINT ED ED Charge	$127.40	$140.00	$79.66–$219.59	52% below	9%
Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT L	$261.90	$287.80	$121.56–$273.41	1% below	9%
Short leg splint (calf to foot) inpatient CPT 29515 18029515 APPLICATION OF SHORT LEG SPLINT ED ED Charge	$127.40	$140.00	$84.69–$137.22	—	9%
Short leg splint (calf to foot) inpatient CPT 29515 18029515 APPLICATION OF SHORT LEG SPLINT ED ED Charge	$127.40	$140.00	$79.66–$133.00	—	9%
Short leg splint (calf to foot) inpatient CPT 29515 17029515 APPLICATION OF SHORT LEG SPLINT ED Charge	$127.40	$140.00	$79.66–$133.00	—	9%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION OF SHORT L	$261.90	$287.80	—	—	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 18012001 SIM LAC<2.6CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	60% below	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 18012001 SIM LAC<2.6CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$76.50–$155.61	60% below	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 17012001 SIM LAC 2.6CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	60% below	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 RPR S/N/AX/Gen/TRNK 2.5CM/<	$399.67	$439.20	$161.97–$417.24	8% above	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 WC Wound Repair Simple: =<2.5Cm Tc	$514.06	$564.90	$161.97–$536.66	39% above	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 18012001 SIM LAC<2.6CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	—	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 17012001 SIM LAC 2.6CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	—	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 18012001 SIM LAC<2.6CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$76.50–$155.61	—	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 RPR S/N/AX/Gen/TRNK 2.5CM/<	$399.67	$439.20	—	—	9%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 WC Wound Repair Simple: =<2.5Cm Tc	$514.06	$564.90	—	—	9%
Skin biopsy, punch, one lesion CPT 11104 11104 Punch biopsy of single skin lesion	$536.90	$590.00	$225.85–$560.50	55% above	9%
Skin biopsy, punch, one lesion CPT 11104 11104 WC Punch biopsy of single skin lesion	$536.90	$590.00	$225.85–$560.50	55% above	9%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 WC Punch biopsy of single skin lesion	$536.90	$590.00	—	—	9%
Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch biopsy of single skin lesion	$536.90	$590.00	—	—	9%
Skin tag removal, up to 15 tags CPT 11200 18011200 REMOVAL OF SKIN TAGS ED Charge	$114.02	$125.30	$100.24–$209.18	54% below	9%
Skin tag removal, up to 15 tags CPT 11200 18011200 REMOVAL OF SKIN TAGS ED Charge	$114.02	$125.30	$71.30–$119.04	54% below	9%
Skin tag removal, up to 15 tags CPT 11200 17011200 REMOVAL OF SKIN TAGS ED Charge	$114.02	$125.30	$71.30–$119.04	54% below	9%
Skin tag removal, up to 15 tags CPT 11200 SKIN TAG REM UP TO 15	$291.20	$320.00	$156.10–$304.00	18% above	9%
Skin tag removal, up to 15 tags inpatient CPT 11200 17011200 REMOVAL OF SKIN TAGS ED Charge	$114.02	$125.30	$71.30–$119.04	—	9%
Skin tag removal, up to 15 tags inpatient CPT 11200 18011200 REMOVAL OF SKIN TAGS ED Charge	$114.02	$125.30	$100.24–$209.18	—	9%
Skin tag removal, up to 15 tags inpatient CPT 11200 18011200 REMOVAL OF SKIN TAGS ED Charge	$114.02	$125.30	$71.30–$119.04	—	9%
Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAG REM UP TO 15	$291.20	$320.00	—	—	9%
Spinal tap (lumbar puncture), diagnostic CPT 62270 18062270 LUMBAR PUNCTURE ED Charge	$1,154.70	$1,268.90	$468.18–$1,205.46	45% above	9%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 18062270 LUMBAR PUNCTURE ED Charge	$1,154.70	$1,268.90	$722.00–$1,205.46	—	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 18012002 SIM LAC 2.6-7.5CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	64% below	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 18012002 SIM LAC 2.6-7.5CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$101.01–$165.04	64% below	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 17012002 SIM LAV 2.6-7.5CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	64% below	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$509.60	$560.00	$195.86–$532.00	23% above	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 WC Wound Repair Simple: 2.6-7.5Cm	$539.45	$592.80	$195.86–$563.16	31% above	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 17012002 SIM LAV 2.6-7.5CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	—	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 18012002 SIM LAC 2.6-7.5CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$101.01–$165.04	—	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 18012002 SIM LAC 2.6-7.5CM BODY SCALP HAND FT ED ED Charge	$149.06	$163.80	$93.20–$155.61	—	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$509.60	$560.00	—	—	9%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 WC Wound Repair Simple: 2.6-7.5Cm	$539.45	$592.80	—	—	9%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 18012011 SIM LAC<2.6CM FACE CHINE EAR E ED Charge	$149.06	$163.80	$93.20–$155.61	63% below	9%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 17012011 SIM LAC 2.6 CM FACE SHINE EAR ED Charge	$149.06	$163.80	$93.20–$155.61	63% below	9%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 18012011 SIM LAC<2.6CM FACE CHINE EAR E ED Charge	$149.06	$163.80	$95.33–$156.41	63% below	9%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 18012011 SIM LAC<2.6CM FACE CHINE EAR E ED Charge	$149.06	$163.80	$93.20–$155.61	—	9%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 17012011 SIM LAC 2.6 CM FACE SHINE EAR ED Charge	$149.06	$163.80	$93.20–$155.61	—	9%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 18012011 SIM LAC<2.6CM FACE CHINE EAR E ED Charge	$149.06	$163.80	$95.33–$156.41	—	9%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 WC Tangential biopsy of single skin lesion	$536.90	$590.00	$180.99–$560.50	99% above	9%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential biopsy of single skin lesion.	$536.90	$590.00	$180.99–$560.50	99% above	9%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Tangential biopsy of single skin lesion.	$536.90	$590.00	—	—	9%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 WC Tangential biopsy of single skin lesion	$536.90	$590.00	—	—	9%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJ TRIGGER PT 1-2 MUS	$207.84	$228.40	$94.26–$216.98	58% below	9%
Trigger point injections, 1 or 2 muscles CPT 20552 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$537.26	$590.40	$335.94–$560.88	9% above	9%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 INJ TRIGGER PT 1-2 MUS	$207.84	$228.40	—	—	9%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$537.26	$590.40	$335.94–$560.88	—	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BIOPSY OF BREAST PERCAUTANOUS NEEDLE COR	$1,825.64	$2,006.20	$997.54–$1,905.89	18% below	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 19083 Bx Breast. 1st. lesion US Imag	$3,281.64	$3,606.20	$997.54–$3,425.89	48% above	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy Lt	$2,055.51	$2,258.80	$1,201.68–$2,145.86	8% below	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy Rt	$2,055.51	$2,258.80	$1,201.68–$2,145.86	8% below	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BIOPSY OF BREAST PERCAUTANOUS NEEDLE COR	$1,825.64	$2,006.20	—	—	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 19083 Bx Breast. 1st. lesion US Imag	$3,281.64	$3,606.20	—	—	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy Lt	$2,055.51	$2,258.80	$1,285.26–$2,145.86	—	9%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy Rt	$2,055.51	$2,258.80	$1,285.26–$2,145.86	—	9%
Vasectomy, one or both sides, including follow-up semen testing one side CPT 55250 VASECTOMY UNILATERAL O	$2,353.08	$2,585.80	$618.18–$2,456.51	85% above	9%
Vasectomy, one or both sides, including follow-up semen testing inpatient one side CPT 55250 VASECTOMY UNILATERAL O	$2,353.08	$2,585.80	—	—	9%
Wart removal, up to 14 warts CPT 17110 WART DESTRUC UP TO 14	$331.79	$364.60	$197.30–$346.37	43% above	9%
Wart removal, up to 14 warts inpatient CPT 17110 WART DESTRUC UP TO 14	$331.79	$364.60	—	—	9%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN AND S	$289.11	$317.70	$225.68–$366.55	57% below	9%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, subcutaneous tissue, includes epidermis and dermis, if performed; first 20 sq cm or les	$378.29	$415.70	$236.53–$553.77	43% below	9%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 WC Debridement, subcutaneous tissue; first 20 sq cm or less	$945.67	$1,039.20	$225.68–$987.24	42% above	9%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN AND S	$289.11	$317.70	—	—	9%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debridement, subcutaneous tissue, includes epidermis and dermis, if performed; first 20 sq cm or les	$378.29	$415.70	$236.53–$394.92	—	9%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 WC Debridement, subcutaneous tissue; first 20 sq cm or less	$945.67	$1,039.20	—	—	9%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 18036430 BLOOD TRANSFUSION SERVICE ED Charge	$948.04	$1,041.80	$592.78–$989.71	4% above	9%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Admin BCE	$948.04	$1,041.80	$592.78–$989.71	4% above	9%
Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Blood Products	$948.04	$1,041.80	$592.78–$989.71	4% above	9%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 18036430 BLOOD TRANSFUSION SERVICE ED Charge	$948.04	$1,041.80	$592.78–$989.71	—	9%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Blood Products	$948.04	$1,041.80	$592.78–$989.71	—	9%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Admin BCE	$948.04	$1,041.80	$592.78–$989.71	—	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol treatment - Initial Charge Type	$142.69	$156.80	$89.22–$148.96	24% below	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 17094640 AIRWAY INHALATION TREATMENT ED Charge	$142.69	$156.80	$89.22–$148.96	24% below	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol Subsequent	$142.69	$156.80	$89.22–$148.96	24% below	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL/NEBULIZER TREATMENT CHARGE	$142.69	$156.80	$89.22–$148.96	24% below	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Aerosol treatment - Subsequent Charge Type	$142.69	$156.80	$89.22–$148.96	24% below	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol Subsequent	$142.69	$156.80	$89.22–$148.96	—	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol treatment - Initial Charge Type	$142.69	$156.80	$89.22–$148.96	—	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 17094640 AIRWAY INHALATION TREATMENT ED Charge	$142.69	$156.80	$89.22–$148.96	—	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL/NEBULIZER TREATMENT CHARGE	$142.69	$156.80	$89.22–$148.96	—	9%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 Aerosol treatment - Subsequent Charge Type	$142.69	$156.80	$89.22–$148.96	—	9%
Critical care, first 30 to 74 minutes CPT 99291 Critical Care Services Evaluation and Treatment for First 30 - 74 Minutes	$1,248.34	$1,371.80	$409.77–$1,303.21	30% below	9%
Critical care, first 30 to 74 minutes CPT 99291 99291 - FAC ED Critical Care	$2,025.11	$2,225.40	$1,266.25–$2,114.13	14% above	9%
Critical care, first 30 to 74 minutes CPT 99291 99291 - Critical Care - Lynx Visit Level	$2,025.11	$2,225.40	$1,266.25–$2,114.13	14% above	9%
Critical care, first 30 to 74 minutes CPT 99291 99291 Critical Care, evaluation and management of the critically ill - or critically injured patient	$2,025.11	$2,225.40	$1,266.25–$2,114.13	14% above	9%
Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Services Evaluation and Treatment for First 30 - 74 Minutes	$1,248.34	$1,371.80	—	—	9%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - Critical Care - Lynx Visit Level	$2,025.11	$2,225.40	$1,266.25–$2,114.13	—	9%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 - FAC ED Critical Care	$2,025.11	$2,225.40	$1,266.25–$2,114.13	—	9%
Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 Critical Care, evaluation and management of the critically ill - or critically injured patient	$2,025.11	$2,225.40	$1,266.25–$2,114.13	—	9%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG 12 Lead, Interp/Report Only Charge	$169.26	$186.00	$24.19–$176.70	208% above	9%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG 12 Lead, Interp/Report Only Charge	$169.26	$186.00	—	—	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead - NSG	$232.69	$255.70	$145.49–$242.92	6% above	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Radiology Request	$232.69	$255.70	$145.49–$242.92	6% above	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead, Tracing Only Charge (JMC only)	$232.69	$255.70	$9.05–$242.92	6% above	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 Lead, Tracing Only Charge (JMC only)	$232.69	$255.70	$145.49–$242.92	6% above	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead - NSG	$232.69	$255.70	$145.49–$242.92	—	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead, Tracing Only Charge (JMC only)	$232.69	$255.70	$9.05–$242.92	—	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 Lead, Tracing Only Charge (JMC only)	$232.69	$255.70	$145.49–$242.92	—	9%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Radiology Request	$232.69	$255.70	$145.49–$242.92	—	9%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - Level 1 - Lynx Visit Level	$223.04	$245.10	$139.46–$232.85	25% above	9%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 - FAC ED Level 1	$223.04	$245.10	$139.46–$232.85	25% above	9%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 17061000 POISON CONTROL ED Charge	$234.33	$257.50	$146.52–$244.63	32% above	9%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - Level 1 - Lynx Visit Level	$223.04	$245.10	$139.46–$232.85	—	9%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 - FAC ED Level 1	$223.04	$245.10	$139.46–$232.85	—	9%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 17061000 POISON CONTROL ED Charge	$234.33	$257.50	$146.52–$244.63	—	9%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2 - Lynx Visit Level	$344.80	$378.90	$215.59–$359.96	8% below	9%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - FAC ED Level 2 Room Charge	$344.80	$378.90	$215.59–$359.96	8% below	9%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2 - Lynx Visit Level	$344.80	$378.90	$215.59–$359.96	—	9%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - FAC ED Level 2 Room Charge	$344.80	$378.90	$215.59–$359.96	—	9%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - FAC ED Level 3	$481.75	$529.40	$301.23–$502.93	23% below	9%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3 - Lynx Visit Level	$481.75	$529.40	$301.23–$502.93	23% below	9%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - FAC ED Level 3	$481.75	$529.40	$301.23–$502.93	—	9%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3 - Lynx Visit Level	$481.75	$529.40	$301.23–$502.93	—	9%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4 - Lynx Visit Level	$806.35	$886.10	$504.19–$841.80	21% below	9%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - FAC ED Level 4	$806.35	$886.10	$504.19–$841.80	21% below	9%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4 - Lynx Visit Level	$806.35	$886.10	$504.19–$841.80	—	9%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - FAC ED Level 4	$806.35	$886.10	$504.19–$841.80	—	9%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5 - Lynx Visit Level	$1,323.60	$1,454.50	$827.61–$1,381.78	11% below	9%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - FAC ED Level 5	$1,323.60	$1,454.50	$827.61–$1,381.78	11% below	9%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - FAC ED Level 5	$1,323.60	$1,454.50	$827.61–$1,381.78	—	9%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5 - Lynx Visit Level	$1,323.60	$1,454.50	$827.61–$1,381.78	—	9%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INITIAL INFUSION, IV HYDRATION, 1ST HOURCHARGE	$472.02	$518.70	$295.14–$492.77	46% above	9%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - ED HYDRATION FIRST HOUR	$472.02	$518.70	$295.14–$492.77	46% above	9%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INITIAL INFUSION, IV HYDRATION, 1ST HOURCHARGE	$472.02	$518.70	$295.14–$492.77	—	9%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - ED HYDRATION FIRST HOUR	$472.02	$518.70	$295.14–$492.77	—	9%
IV infusion of a medicine, first hour CPT 96365 IV RX, 1ST HOUR (IV WITH ADDITIVE)CHARGE	$472.02	$518.70	$295.14–$492.77	21% above	9%
IV infusion of a medicine, first hour CPT 96365 96365 ED IV Infusion Initial up to 1 hour	$472.02	$518.70	$295.14–$492.77	21% above	9%
IV infusion of a medicine, first hour inpatient CPT 96365 IV RX, 1ST HOUR (IV WITH ADDITIVE)CHARGE	$472.02	$518.70	$295.14–$492.77	—	9%
IV infusion of a medicine, first hour inpatient CPT 96365 96365 ED IV Infusion Initial up to 1 hour	$472.02	$518.70	$295.14–$492.77	—	9%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION X_CHARGE	$108.75	$119.50	$68.00–$113.53	4% above	9%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Therapeutic, prophylactic, or diagnostic injection, SQ/IM (Ofc)	$108.75	$119.50	$68.00–$113.53	4% above	9%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 17090782 THERAPEUTIC OR DIAGNOSTIC INJECTION ED ED Charge	$108.75	$119.50	$68.00–$113.53	4% above	9%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 17096372 THERAPEUTIC OR DIAGNOSTIC INJECTION ED ED Charge	$108.75	$119.50	$68.00–$113.53	4% above	9%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 - ED Subq/IM Injection	$108.75	$119.50	$68.00–$113.53	4% above	9%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 - ED Subq/IM Injection	$108.75	$119.50	$68.00–$113.53	—	9%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 17096372 THERAPEUTIC OR DIAGNOSTIC INJECTION ED ED Charge	$108.75	$119.50	$68.00–$113.53	—	9%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 17090782 THERAPEUTIC OR DIAGNOSTIC INJECTION ED ED Charge	$108.75	$119.50	$68.00–$113.53	—	9%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION X_CHARGE	$108.75	$119.50	$68.00–$113.53	—	9%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 Therapeutic, prophylactic, or diagnostic injection, SQ/IM (Ofc)	$108.75	$119.50	$68.00–$113.53	—	9%
New patient office visit, about 30 minutes CPT 99203 99203 Office/Outpatient Visit Level 3 New	$219.04	$240.70	$164.05–$228.67	2% above	9%
New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office/Outpatient Visit Level 3 New	$219.04	$240.70	—	—	9%
New patient office visit, about 45 minutes CPT 99204 99204 Office Visit Level 4 New (Ofc)	$313.95	$345.00	$245.97–$327.75	12% above	9%
New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office Visit Level 4 New (Ofc)	$313.95	$345.00	—	—	9%
New patient office visit, about 60 minutes CPT 99205 Office Visit Level 5 New - 99205	$387.11	$425.40	$324.94–$417.95	3% above	9%
New patient office visit, about 60 minutes inpatient CPT 99205 Office Visit Level 5 New - 99205	$387.11	$425.40	—	—	9%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/Outpt Visit Level 2 New - 99202	$151.88	$166.90	$106.33–$158.56	1% above	9%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office/Outpt Visit Level 2 New - 99202	$151.88	$166.90	—	—	9%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MNT INDIVIDUAL INITIAL ASSESS EA 15 MIN CHARGE MMC	$50.60	$55.60	$31.64–$52.82	8% below	9%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MNT INDIVIDUAL INITIAL ASSESS EA 15 MIN CHARGE MMC	$50.60	$55.60	$31.64–$52.82	—	9%
Preventive checkup, new patient aged 18–39 CPT 99385 Preventive Medicine 18-39 years New - 99385	$288.74	$317.30	$212.71–$301.44	60% above	9%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Preventive Medicine 18-39 years New - 99385	$288.74	$317.30	—	—	9%
Preventive checkup, new patient aged 40–64 CPT 99386 Preventive Medicine 40-64 years New - 99386	$322.32	$354.20	$246.21–$336.49	45% above	9%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Preventive Medicine 40-64 years New - 99386	$322.32	$354.20	—	—	9%
Preventive checkup, new patient aged 65 or older CPT 99387 Preventive Medicine 65+ years New - 99387	$311.49	$342.30	$256.73–$325.19	80% above	9%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Preventive Medicine 65+ years New - 99387	$311.49	$342.30	—	—	9%
Preventive checkup, returning patient aged 18–39 CPT 99395 Preventive Medicine 18-39 years Established - 99395	$230.23	$253.00	$189.75–$240.35	29% above	9%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Preventive Medicine 18-39 years Established - 99395	$230.23	$253.00	—	—	9%
Preventive checkup, returning patient aged 40–64 CPT 99396 Preventive Medicine 40-64 years Established - 99396	$237.15	$260.60	$195.45–$247.57	19% above	9%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Preventive Medicine 40-64 years Established - 99396	$237.15	$260.60	—	—	9%
Preventive checkup, returning patient aged 65 or older CPT 99397 Preventive Medicine 65+ years Established - 99397	$255.07	$280.30	$210.23–$266.29	27% above	9%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Preventive Medicine 65+ years Established - 99397	$255.07	$280.30	—	—	9%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoking Tobacco Counseling	$36.67	$40.30	$25.12–$38.29	10% above	9%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 Smoking Tobacco Counseling	$36.67	$40.30	—	—	9%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/Outpatient Visit Level 5 Established - 99215	$272.09	$299.00	$239.20–$341.25	3% above	9%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office/Outpatient Visit Level 5 Established - 99215	$272.09	$299.00	—	—	9%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Contracted Physical	$63.70	$70.00	$56.00–$172.25	57% below	9%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 DOT PE	$127.40	$140.00	$112.00–$172.25	14% below	9%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/Outpatient Visit Level 3 Est (Ofc)	$131.04	$144.00	$115.20–$172.25	11% below	9%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CONVENIENT CARE ED FACILITY CHARGE	$162.25	$178.30	$101.45–$169.39	10% above	9%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Contracted Physical	$63.70	$70.00	—	—	9%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 DOT PE	$127.40	$140.00	—	—	9%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office/Outpatient Visit Level 3 Est (Ofc)	$131.04	$144.00	—	—	9%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CONVENIENT CARE ED FACILITY CHARGE	$162.25	$178.30	$101.45–$169.39	—	9%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Outpatient Visit Level 4 Established (Ofc)	$193.01	$212.10	$169.68–$244.40	9% above	9%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Outpatient Visit Level 4 Established (Ofc)	$193.01	$212.10	—	—	9%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Office/Outpatient Visit Level 2 Established - 99212	$92.18	$101.30	$81.04–$105.95	19% below	9%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office/Outpatient Visit Level 2 Established - 99212	$92.18	$101.30	—	—	9%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT LEVEL 3 - 99243	$318.59	$350.10	$194.84–$332.60	64% above	9%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT LEVEL 3 - 99243	$318.59	$350.10	—	—	9%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT LEVEL 4 - 99244	$427.97	$470.30	$291.99–$446.79	26% above	9%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULT LEVEL 4 - 99244	$427.97	$470.30	—	—	9%
Spirometry (breathing test) CPT 94010 Spirometry POC	$239.24	$262.90	$15.60–$249.76	20% below	9%
Spirometry (breathing test) CPT 94010 94010 PFT Basic Spirometry Charge MMC	$318.68	$350.20	$199.26–$332.69	7% above	9%
Spirometry (breathing test) inpatient CPT 94010 Spirometry POC	$239.24	$262.90	—	—	9%
Spirometry (breathing test) inpatient CPT 94010 94010 PFT Basic Spirometry Charge MMC	$318.68	$350.20	$199.26–$332.69	—	9%
Spirometry before and after a bronchodilator CPT 94060 Bronchodilation Responsiveness, Spirometry Pre and Post Bronchodilator Admin Charge	$401.77	$441.50	$19.50–$419.43	23% below	9%
Spirometry before and after a bronchodilator one side CPT 94060 94060 RT PFT WBRONC Pre and Post Charge MMC	$592.41	$651.00	$370.42–$618.45	13% above	9%
Spirometry before and after a bronchodilator inpatient CPT 94060 Bronchodilation Responsiveness, Spirometry Pre and Post Bronchodilator Admin Charge	$401.77	$441.50	—	—	9%
Spirometry before and after a bronchodilator inpatient one side CPT 94060 94060 RT PFT WBRONC Pre and Post Charge MMC	$592.41	$651.00	$370.42–$618.45	—	9%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therapeutic Phlebotomy	$138.32	$152.00	$86.49–$144.40	33% below	9%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 Therapeutic Phlebotomy	$138.32	$152.00	$86.49–$144.40	—	9%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vaccine	$262.99	$289.00	$216.75–$274.55	12% above	9%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vaccine	$262.99	$289.00	—	—	9%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Adult Vaccine Vaqta	$198.20	$217.80	$163.35–$206.91	84% above	9%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Adult Vaccine Vaqta	$198.20	$217.80	—	—	9%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine, Adult	$260.26	$286.00	$214.50–$271.70	167% above	9%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine, Adult	$260.26	$286.00	—	—	9%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR Measles/Mumps/Rubella Virus Vaccine	$190.01	$208.80	$156.60–$198.36	4% below	9%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR Measles/Mumps/Rubella Virus Vaccine	$190.01	$208.80	—	—	9%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for IM Use	$169.08	$185.80	$139.35–$176.51	29% below	9%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal conjugate vaccine, serogroups A, C, Y and W-135 (tetravalent), for IM Use	$169.08	$185.80	—	—	9%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 MEDICARE PNEUMOCOCCAL VACCINE	$244.15	$268.30	$152.66–$254.89	48% above	9%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 90732 MEDICARE PNEUMOCOCCAL VACCINE	$244.15	$268.30	$152.66–$254.89	—	9%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine IM Charge	$335.97	$369.20	$276.90–$350.74	55% below	9%
Rabies vaccine, one dose CPT 90675 17090675 RABIES VACCINE ED Charge	$552.64	$607.30	$345.55–$576.94	27% below	9%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine IM Charge	$335.97	$369.20	—	—	9%
Rabies vaccine, one dose inpatient CPT 90675 17090675 RABIES VACCINE ED Charge	$552.64	$607.30	$345.55–$576.94	—	9%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Shingrix Vaccine	$295.93	$325.20	$243.90–$308.94	59% above	9%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 90750 Zoster (shingles) vaccine (HZV), recombinant, sub-unit	$420.33	$461.90	$346.43–$438.81	126% above	9%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Shingrix Vaccine	$295.93	$325.20	—	—	9%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 90750 Zoster (shingles) vaccine (HZV), recombinant, sub-unit	$420.33	$461.90	—	—	9%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, for use in individuals 7 yrs POC	$55.97	$61.50	$46.13–$58.43	27% below	9%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, for use in individuals 7 yrs POC	$55.97	$61.50	—	—	9%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 90691 Typhoid (TYPHIM) 25mcg/0.5ml Inj. Vaccine	$197.83	$217.40	$163.05–$206.53	18% above	9%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 90691 Typhoid (TYPHIM) 25mcg/0.5ml Inj. Vaccine	$197.83	$217.40	—	—	9%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 G0009 Admin of Pneumococcal Immz Medicare HMO	$45.32	$49.80	$27.81–$47.31	19% below	9%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUNIZATION ADMIN.	$45.32	$49.80	$28.34–$47.31	19% below	9%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 17090471 IMMUNIZATION ADMINISTRATION 1 VACCINE ED Charge	$45.32	$49.80	$28.34–$47.31	19% below	9%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IMMUNIZATION ADMIN.	$45.32	$49.80	$28.34–$47.31	—	9%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 17090471 IMMUNIZATION ADMINISTRATION 1 VACCINE ED Charge	$45.32	$49.80	$28.34–$47.31	—	9%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 G0009 Admin of Pneumococcal Immz Medicare HMO	$45.32	$49.80	—	—	9%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 VFC Additional immunization admin, no counseling	$21.29	$23.40	$18.72–$25.82	45% below	9%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 EACH ADDTN'L ADMIN UNDER 18	$41.59	$45.70	$21.05–$43.42	8% above	9%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472, Additional immunization admin, no counseling	$41.59	$45.70	$21.05–$43.42	8% above	9%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IMMUNIZATION EA ADDT'L VACCINE ED CHARGE	$45.96	$50.50	$28.73–$47.98	20% above	9%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 VFC Additional immunization admin, no counseling	$21.29	$23.40	—	—	9%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472, Additional immunization admin, no counseling	$41.59	$45.70	—	—	9%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 EACH ADDTN'L ADMIN UNDER 18	$41.59	$45.70	—	—	9%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IMMUNIZATION EA ADDT'L VACCINE ED CHARGE	$45.96	$50.50	$28.73–$47.98	—	9%

Source file: https://www.midwestmedicalcenter.org/content/pdfs/204560540_midwest-medical-center_standardcharges.csv