Hospital Grand Forks, ND-MN

Northwood Deaconess Health Center

Northwood Deaconess Health Center in Northwood, ND publishes cash prices for 292 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 North Dakota median for 166 of 290 procedures and below it for 110. By typical cash price it ranks #15 of 22 North Dakota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

Po Box 190, Northwood, ND 58267 Collected Sep 27, 2026 Source price file (701) 587-6060

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 351312 · 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 2 actions for a hospital named Northwood Deaconess Health Center in Northwood, ND:

Apr 17, 2026 Warning notice
Jul 24, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE MIN 3 VIEWS	$138.00	$173.00	$173.00–$138.00	17% below	20%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE MIN 3 VIEWS	$138.00	$173.00	$173.00–$138.00	—	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST	$2,167.00	$2,709.00	$2,709.00–$2,167.00	1% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CTA CHEST	$2,167.00	$2,709.00	$2,709.00–$2,167.00	—	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD/PELVIS W/O CONTRAST	$1,587.00	$1,984.00	$1,984.00–$1,587.00	20% above	20%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD/PELVIS W/O CONTRAST	$1,587.00	$1,984.00	$1,984.00–$1,587.00	—	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABD/PELVIS W/CONTRAST	$2,578.00	$3,222.00	$3,222.00–$2,578.00	6% above	20%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABD/PELVIS W/CONTRAST	$2,578.00	$3,222.00	$3,222.00–$2,578.00	—	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD/PELVIS W/O&W CONTRAST	$2,969.00	$3,711.00	$3,711.00–$2,969.00	3% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD/PELVIS W/O&W CONTRAST	$2,969.00	$3,711.00	$3,711.00–$2,969.00	—	20%
CT scan of the abdomen with contrast CPT 74160 HC CT ABD W/DYE	$1,272.00	$1,590.00	$1,590.00–$1,272.00	19% below	20%
CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABD W/DYE	$1,272.00	$1,590.00	$1,590.00–$1,272.00	—	20%
CT scan of the abdomen without contrast CPT 74150 HC CT ABD W/O DYE	$887.00	$1,109.00	$1,109.00–$887.00	20% below	20%
CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABD W/O DYE	$887.00	$1,109.00	$1,109.00–$887.00	—	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT FACIAL BONES W/O CONTRAST	$1,010.00	$1,263.00	$1,263.00–$1,010.00	5% below	20%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT FACIAL BONES W/O CONTRAST	$1,010.00	$1,263.00	$1,263.00–$1,010.00	—	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT BRAIN W/O CONTRAST	$1,472.00	$1,840.00	$1,840.00–$1,472.00	56% above	20%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT BRAIN W/O CONTRAST	$1,472.00	$1,840.00	$1,840.00–$1,472.00	—	20%
CT scan of the head with contrast CPT 70460 HC CT BRAIN W/CONTRAST	$1,596.00	$1,995.00	$1,995.00–$1,596.00	25% above	20%
CT scan of the head with contrast inpatient CPT 70460 HC CT BRAIN W/CONTRAST	$1,596.00	$1,995.00	$1,995.00–$1,596.00	—	20%
CT scan of the head without and with contrast CPT 70470 HC CT BRAIN W/WO CONTRAST	$1,184.00	$1,480.00	$1,480.00–$1,184.00	18% below	20%
CT scan of the head without and with contrast inpatient CPT 70470 HC CT BRAIN W/WO CONTRAST	$1,184.00	$1,480.00	$1,480.00–$1,184.00	—	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT SPINE LUMBAR W/O DYE	$1,368.00	$1,710.00	$1,710.00–$1,368.00	7% above	20%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT SPINE LUMBAR W/O DYE	$1,368.00	$1,710.00	$1,710.00–$1,368.00	—	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT SPINE CERVICAL W/O DYE	$1,368.00	$1,710.00	$1,710.00–$1,368.00	4% above	20%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT SPINE CERVICAL W/O DYE	$1,368.00	$1,710.00	$1,710.00–$1,368.00	—	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/DYE	$1,282.00	$1,603.00	$1,603.00–$1,282.00	18% below	20%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W/DYE	$1,282.00	$1,603.00	$1,603.00–$1,282.00	—	20%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 HC CAROTID DOPPLER	$730.00	$913.00	$913.00–$730.00	16% above	20%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 HC CAROTID DOPPLER	$730.00	$913.00	$913.00–$730.00	—	20%
Chest X-ray, 2 views CPT 71046 HC XRAY CHEST 2 VIEWS	$158.00	$198.00	$198.00–$158.00	at median	20%
Chest X-ray, 2 views inpatient CPT 71046 HC XRAY CHEST 2 VIEWS	$158.00	$198.00	$198.00–$158.00	—	20%
Chest X-ray, single view CPT 71045 HC XRAY CHEST 1 VIEW	$150.00	$187.00	$187.00–$150.00	13% above	20%
Chest X-ray, single view inpatient CPT 71045 HC XRAY CHEST 1 VIEW	$150.00	$187.00	$187.00–$150.00	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERIT (RENAL LAAA)	$402.00	$503.00	$503.00–$402.00	at median	20%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US RETROPERIT (RENAL LAAA)	$402.00	$503.00	$503.00–$402.00	—	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DEXASCAN	$303.00	$379.00	$379.00–$303.00	13% above	20%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DEXASCAN	$303.00	$379.00	$379.00–$303.00	—	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT THORAX WO CONTRAST	$1,233.00	$1,541.00	$1,541.00–$1,233.00	5% above	20%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT THORAX WO CONTRAST	$1,233.00	$1,541.00	$1,541.00–$1,233.00	—	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT THORAX W CONTRAST	$1,694.00	$2,117.00	$2,117.00–$1,694.00	20% above	20%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT THORAX W CONTRAST	$1,694.00	$2,117.00	$2,117.00–$1,694.00	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC DIAGNOSTIC MAMMO CAD BILATERAL	$581.00	$726.00	$726.00–$581.00	—	20%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC DIAGNOSTIC MAMMO CAD BILATERAL	$581.00	$726.00	$726.00–$581.00	—	20%
Diagnostic mammogram, one breast one side CPT 77065 HC DIAGNOSTIC MAMMO CAD UNILATERAL	$440.00	$550.00	$550.00–$440.00	15% above	20%
Diagnostic mammogram, one breast inpatient one side CPT 77065 HC DIAGNOSTIC MAMMO CAD UNILATERAL	$440.00	$550.00	$550.00–$440.00	—	20%
Duplex ultrasound of the leg arteries, both legs CPT 93925 HC DUPLEX LOWER EXTREMITY	$891.00	$1,114.00	$1,114.00–$891.00	5% above	20%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 HC DUPLEX LOWER EXTREMITY	$891.00	$1,114.00	$1,114.00–$891.00	—	20%
Duplex ultrasound of the leg veins, both legs CPT 93970 HC VENOUS IMAGING	$415.00	$519.00	$519.00–$415.00	30% below	20%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 HC VENOUS IMAGING	$415.00	$519.00	$519.00–$415.00	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/DOPPLER COMPLETE	$902.00	$1,128.00	$1,128.00–$902.00	10% above	20%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/DOPPLER COMPLETE	$902.00	$1,128.00	$1,128.00–$902.00	—	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC POLYSOMNOGRAM;SLEEP STG;4+CPAP	$1,652.00	$2,065.00	$2,065.00–$1,652.00	29% below	20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC POLYSOMNOGRAM;SLEEP STG;4+CPAP	$1,652.00	$2,065.00	$2,065.00–$1,652.00	—	20%
Knee X-ray, 3 views CPT 73562 HC KNEE MIN 3 VIEWS	$176.00	$220.00	$220.00–$176.00	12% below	20%
Knee X-ray, 3 views inpatient CPT 73562 HC KNEE MIN 3 VIEWS	$176.00	$220.00	$220.00–$176.00	—	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ECHO EXAM OF ABDOMEN	$432.00	$540.00	$540.00–$432.00	14% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US ECHO EXAM OF ABDOMEN	$432.00	$540.00	$540.00–$432.00	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC LDCT FOR LUNG CANCER SCREEN	$841.00	$1,051.00	$1,051.00–$841.00	28% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CHG COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$873.00	$1,091.00	$1,091.00–$873.00	33% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC LDCT FOR LUNG CANCER SCREEN	$841.00	$1,051.00	$1,051.00–$841.00	—	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CHG COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-	$873.00	$1,091.00	$1,091.00–$873.00	—	20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI-LOWER EXT JOINT W/O DYE	$2,002.00	$2,502.00	$2,502.00–$2,002.00	4% above	20%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI-LOWER EXT JOINT W/O DYE	$2,002.00	$2,502.00	$2,502.00–$2,002.00	—	20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOWER EXT JOINT W/WO DYE	$3,029.00	$3,786.00	$3,786.00–$3,029.00	5% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOWER EXT JOINT W/WO DYE	$3,029.00	$3,786.00	$3,786.00–$3,029.00	—	20%
MRI of the abdomen without contrast CPT 74181 HC MRI-ABDOMEN W/O DYE	$2,019.00	$2,524.00	$2,524.00–$2,019.00	6% above	20%
MRI of the abdomen without contrast inpatient CPT 74181 HC MRI-ABDOMEN W/O DYE	$2,019.00	$2,524.00	$2,524.00–$2,019.00	—	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO DYE	$3,569.00	$4,461.00	$4,461.00–$3,569.00	11% above	20%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W/WO DYE	$3,569.00	$4,461.00	$4,461.00–$3,569.00	—	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI-BRAIN/BRAIN STEM	$2,346.00	$2,932.00	$2,932.00–$2,346.00	43% above	20%
MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI-BRAIN/BRAIN STEM	$2,346.00	$2,932.00	$2,932.00–$2,346.00	—	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI-BRAIN W/WO DYE	$3,491.00	$4,364.00	$4,364.00–$3,491.00	22% above	20%
MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-BRAIN W/WO DYE	$3,491.00	$4,364.00	$4,364.00–$3,491.00	—	20%
MRI of the lower back, no contrast dye CPT 72148 HC MRI-L-SPINE W/O DYE	$2,056.00	$2,570.00	$2,570.00–$2,056.00	12% above	20%
MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-L-SPINE W/O DYE	$2,056.00	$2,570.00	$2,570.00–$2,056.00	—	20%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI L-SPINE W/WO DYE	$3,708.00	$4,635.00	$4,635.00–$3,708.00	12% above	20%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI L-SPINE W/WO DYE	$3,708.00	$4,635.00	$4,635.00–$3,708.00	—	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI-T-SPINE W/O DYE	$2,564.00	$3,205.00	$3,205.00–$2,564.00	31% above	20%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI-T-SPINE W/O DYE	$2,564.00	$3,205.00	$3,205.00–$2,564.00	—	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI C-SPINE W/WO DYE	$3,708.00	$4,635.00	$4,635.00–$3,708.00	20% above	20%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI C-SPINE W/WO DYE	$3,708.00	$4,635.00	$4,635.00–$3,708.00	—	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI-C-SPINE W/O DYE	$2,107.00	$2,634.00	$2,634.00–$2,107.00	13% above	20%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI-C-SPINE W/O DYE	$2,107.00	$2,634.00	$2,634.00–$2,107.00	—	20%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/WO DYE	$3,732.00	$4,665.00	$4,665.00–$3,732.00	21% above	20%
MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W/WO DYE	$3,732.00	$4,665.00	$4,665.00–$3,732.00	—	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO DYE	$2,308.00	$2,885.00	$2,885.00–$2,308.00	13% above	20%
MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO DYE	$2,308.00	$2,885.00	$2,885.00–$2,308.00	—	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI-UPPER EXT JOINT W/O DYE	$1,975.00	$2,469.00	$2,469.00–$1,975.00	2% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI-UPPER EXT JOINT W/O DYE	$1,975.00	$2,469.00	$2,469.00–$1,975.00	—	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIC LIMITED	$100.00	$125.00	$125.00–$100.00	68% below	20%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US PELVIC LIMITED	$100.00	$125.00	$125.00–$100.00	—	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIC COMPLETE	$390.00	$487.00	$487.00–$390.00	at median	20%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US PELVIC COMPLETE	$390.00	$487.00	$487.00–$390.00	—	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US PREGNANCY >=14WKS SNGL FETUS	$427.00	$534.00	$534.00–$427.00	7% below	20%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US PREGNANCY >=14WKS SNGL FETUS	$427.00	$534.00	$534.00–$427.00	—	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB COMPLETE(<14 WKS)	$376.00	$470.00	$470.00–$376.00	at median	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB COMPLETE(<14 WKS)	$376.00	$470.00	$470.00–$376.00	—	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US PREGNANCY LMTD	$286.00	$358.00	$358.00–$286.00	3% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US PREGNANCY LMTD	$286.00	$358.00	$358.00–$286.00	—	20%
Screening mammogram, both breasts both sides CPT 77067 HC SCREENING MAMMO CAD BILATERAL	$464.00	$580.00	$580.00–$464.00	—	20%
Screening mammogram, both breasts inpatient both sides CPT 77067 HC SCREENING MAMMO CAD BILATERAL	$464.00	$580.00	$580.00–$464.00	—	20%
Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER MIN 2 VIEWS	$133.00	$166.00	$166.00–$133.00	23% below	20%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER MIN 2 VIEWS	$133.00	$166.00	$166.00–$133.00	—	20%
Sleep study in a lab (polysomnography) CPT 95810 HC POLYSOMNOGRAM;SLEEP STG;4+	$1,652.00	$2,065.00	$2,065.00–$1,652.00	26% below	20%
Sleep study in a lab (polysomnography) inpatient CPT 95810 HC POLYSOMNOGRAM;SLEEP STG;4+	$1,652.00	$2,065.00	$2,065.00–$1,652.00	—	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING FCN W CINE/VIDEO	$622.00	$777.00	$777.00–$622.00	25% above	20%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOWING FCN W CINE/VIDEO	$622.00	$777.00	$777.00–$622.00	—	20%
Transvaginal pelvic ultrasound CPT 76830 HC US TRANSVAGINAL	$494.00	$617.00	$617.00–$494.00	9% above	20%
Transvaginal pelvic ultrasound inpatient CPT 76830 HC US TRANSVAGINAL	$494.00	$617.00	$617.00–$494.00	—	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC US TRANSVAGINAL(OB)	$296.00	$370.00	$370.00–$296.00	at median	20%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US TRANSVAGINAL(OB)	$296.00	$370.00	$370.00–$296.00	—	20%
Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE	$411.00	$514.00	$514.00–$411.00	19% below	20%
Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE	$411.00	$514.00	$514.00–$411.00	—	20%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM	$431.00	$539.00	$539.00–$431.00	12% above	20%
Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM	$431.00	$539.00	$539.00–$431.00	—	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM HEAD/NECK	$444.00	$555.00	$555.00–$444.00	2% below	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM HEAD/NECK	$444.00	$555.00	$555.00–$444.00	—	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC UNILAT/LTD VENOUS	$925.00	$1,156.00	$1,156.00–$925.00	65% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 HC UNILAT/LTD VENOUS	$925.00	$1,156.00	$1,156.00–$925.00	—	20%
Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMP MIN 3 VIEWS	$157.00	$196.00	$196.00–$157.00	16% below	20%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMP MIN 3 VIEWS	$157.00	$196.00	$196.00–$157.00	—	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VW	$193.00	$241.00	$241.00–$193.00	at median	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VW	$193.00	$241.00	$241.00–$193.00	—	20%
X-ray of the abdomen, 1 view CPT 74018 HC XRAY ABDOMEN 1 VIEW	$153.00	$191.00	$191.00–$153.00	33% above	20%
X-ray of the abdomen, 1 view inpatient CPT 74018 HC XRAY ABDOMEN 1 VIEW	$153.00	$191.00	$191.00–$153.00	—	20%
X-ray of the ankle, 2 views CPT 73600 HC X-RAY ANKLE 2 VIEWS	$140.00	$175.00	$175.00–$140.00	7% below	20%
X-ray of the ankle, 2 views inpatient CPT 73600 HC X-RAY ANKLE 2 VIEWS	$140.00	$175.00	$175.00–$140.00	—	20%
X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER MIN 2 VIEWS	$142.00	$177.00	$177.00–$142.00	10% below	20%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER MIN 2 VIEWS	$142.00	$177.00	$177.00–$142.00	—	20%
X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEWS	$158.00	$198.00	$198.00–$158.00	1% below	20%
X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEWS	$158.00	$198.00	$198.00–$158.00	—	20%
X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT MIN 3 VIEWS	$137.00	$171.00	$171.00–$137.00	17% below	20%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT MIN 3 VIEWS	$137.00	$171.00	$171.00–$137.00	—	20%
X-ray of the hand, 3 or more views CPT 73130 HC HAND MIN 3 VIEWS	$130.00	$162.00	$162.00–$130.00	33% below	20%
X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND MIN 3 VIEWS	$130.00	$162.00	$162.00–$130.00	—	20%
X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VIEWS	$137.00	$171.00	$171.00–$137.00	27% below	20%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VIEWS	$137.00	$171.00	$171.00–$137.00	—	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBAR SPINE 2 VIEWS	$147.00	$184.00	$184.00–$147.00	14% below	20%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBAR SPINE 2 VIEWS	$147.00	$184.00	$184.00–$147.00	—	20%
X-ray of the lower back, 4 or more views CPT 72110 HC LUMBAR SPINE COM	$196.00	$245.00	$245.00–$196.00	16% below	20%
X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBAR SPINE COM	$196.00	$245.00	$245.00–$196.00	—	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC SPINE THORACIC 2 VIEWS	$132.00	$165.00	$165.00–$132.00	8% below	20%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC SPINE THORACIC 2 VIEWS	$132.00	$165.00	$165.00–$132.00	—	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC NOSE BONES MIN 3 VIEWS	$146.00	$183.00	$183.00–$146.00	1% below	20%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NOSE BONES MIN 3 VIEWS	$146.00	$183.00	$183.00–$146.00	—	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2/3 VIEWS	$189.00	$236.00	$236.00–$189.00	20% above	20%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2/3 VIEWS	$189.00	$236.00	$236.00–$189.00	—	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS	$167.00	$209.00	$209.00–$167.00	12% above	20%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS	$167.00	$209.00	$209.00–$167.00	—	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUN COCCYX MIN 2 VIEWS	$146.00	$183.00	$183.00–$146.00	at median	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUN COCCYX MIN 2 VIEWS	$146.00	$183.00	$183.00–$146.00	—	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ND ALT/SGPT	$40.00	$50.00	$50.00–$40.00	1% below	20%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ND ALT/SGPT	$40.00	$50.00	$50.00–$40.00	—	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 ND AST/SGOT	$38.00	$47.00	$47.00–$38.00	15% below	19%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 ND AST/SGOT	$38.00	$47.00	$47.00–$38.00	—	19%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ND ACUTE HEPATITIS PANEL	$320.00	$400.00	$400.00–$320.00	47% above	20%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ND ACUTE HEPATITIS PANEL	$320.00	$400.00	$400.00–$320.00	—	20%
Allergy blood test, specific IgE, per allergen CPT 86003 ND ALLERGEN SPECIFIC IGE	$48.00	$60.00	$60.00–$48.00	233% above	20%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ND ALLERGEN SPECIFIC IGE	$48.00	$60.00	$60.00–$48.00	—	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ND ANTI-CCP	$116.00	$145.00	$145.00–$116.00	104% above	20%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ND ANTI-CCP	$116.00	$145.00	$145.00–$116.00	—	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ND ANA (FANA) SCREEN	$93.00	$116.00	$116.00–$93.00	64% above	20%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ND ANA (FANA) SCREEN	$93.00	$116.00	$116.00–$93.00	—	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ND BNP (NATRIURETIC PEPTIDE) SEND OUT	$236.00	$295.00	$295.00–$236.00	11% above	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ND BNP	$271.00	$339.00	$339.00–$271.00	27% above	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ND BNP (NATRIURETIC PEPTIDE) SEND OUT	$236.00	$295.00	$295.00–$236.00	—	20%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ND BNP	$271.00	$339.00	$339.00–$271.00	—	20%
Basic metabolic panel (blood test) CPT 80048 ND BASIC METABOLIC PANEL	$73.00	$91.00	$91.00–$73.00	1% below	20%
Basic metabolic panel (blood test) inpatient CPT 80048 ND BASIC METABOLIC PANEL	$73.00	$91.00	$91.00–$73.00	—	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURGICAL PATH-LEVEL IV	$169.00	$211.00	$211.00–$169.00	50% above	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 ND PATHOLOGY- SURGICAL- GROSS & MICRO	$177.00	$221.00	$221.00–$177.00	57% above	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURGICAL PATH-LEVEL IV	$169.00	$211.00	$211.00–$169.00	—	20%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 ND PATHOLOGY- SURGICAL- GROSS & MICRO	$177.00	$221.00	$221.00–$177.00	—	20%
Blood culture for bacteria CPT 87040 ND CULTURE- BLOOD (AERO/ANAEROBIC)	$104.00	$130.00	$130.00–$104.00	38% above	20%
Blood culture for bacteria inpatient CPT 87040 ND CULTURE- BLOOD (AERO/ANAEROBIC)	$104.00	$130.00	$130.00–$104.00	—	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ND INSURANCE BLOOD DRAW >3 YRS	$18.00	$23.00	$23.00–$18.00	5% above	22%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ND VENOUS BLOOD DRAW	$20.00	$25.00	$25.00–$20.00	16% above	20%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ND INSURANCE BLOOD DRAW >3 YRS	$18.00	$23.00	$23.00–$18.00	—	22%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ND VENOUS BLOOD DRAW	$20.00	$25.00	$25.00–$20.00	—	20%
Blood glucose (sugar) test CPT 82947 ND GLUCOSE	$30.00	$38.00	$38.00–$30.00	16% above	21%
Blood glucose (sugar) test inpatient CPT 82947 ND GLUCOSE	$30.00	$38.00	$38.00–$30.00	—	21%
Blood lead test CPT 83655 ND LEAD LEVEL	$86.00	$107.00	$107.00–$86.00	191% above	20%
Blood lead test inpatient CPT 83655 ND LEAD LEVEL	$86.00	$107.00	$107.00–$86.00	—	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 ND HCG QUALITATIVE	$82.00	$102.00	$102.00–$82.00	21% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 ND HCG QUALITATIVE	$82.00	$102.00	$102.00–$82.00	—	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ND ABO BLOOD TYPE	$39.00	$49.00	$49.00–$39.00	1% below	20%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ND ABO BLOOD TYPE	$39.00	$49.00	$49.00–$39.00	—	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 ND CRP	$38.00	$48.00	$48.00–$38.00	53% above	21%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 ND C-REACTIVE PROTEIN	$38.00	$48.00	$48.00–$38.00	53% above	21%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 ND C-REACTIVE PROTEIN	$38.00	$48.00	$48.00–$38.00	—	21%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 ND CRP	$38.00	$48.00	$48.00–$38.00	—	21%
C. difficile toxin gene test (stool PCR) CPT 87493 ND C. DIFFICILE AMPLIFIED PROBE	$249.00	$311.00	$311.00–$249.00	35% above	20%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 ND C. DIFFICILE AMPLIFIED PROBE	$249.00	$311.00	$311.00–$249.00	—	20%
CA 19-9 blood test (tumor marker) CPT 86301 ND CA 19-9	$158.00	$197.00	$197.00–$158.00	56% above	20%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 ND CA 19-9	$158.00	$197.00	$197.00–$158.00	—	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 ND CA 125; IMMUNOASSAY TUMOR ANTIGEN	$160.00	$200.00	$200.00–$160.00	52% above	20%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 ND CA 125; IMMUNOASSAY TUMOR ANTIGEN	$160.00	$200.00	$200.00–$160.00	—	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 ND CORONAVIRUS (COVID-19) TEST	$136.00	$170.00	$170.00–$136.00	13% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 ND CORONAVIRUS (COVID-19) TEST	$136.00	$170.00	$170.00–$136.00	—	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ND CHLAMYDIA AMP ASSAY (GENITAL/URINE)	$238.00	$298.00	$298.00–$238.00	108% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ND CHLAMYDIA AMP ASSAY (GENITAL/URINE)	$238.00	$298.00	$298.00–$238.00	—	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 ND80061 - DERM ACUTANE PANEL	$22.00	$28.00	$28.00–$22.00	68% below	21%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 ND LIPID PANEL	$106.00	$132.00	$132.00–$106.00	56% above	20%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 ND80061 - DERM ACUTANE PANEL	$22.00	$28.00	$28.00–$22.00	—	21%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 ND LIPID PANEL	$106.00	$132.00	$132.00–$106.00	—	20%
Complete blood count (CBC) with differential CPT 85025 ND85025 - DERM ACUTANE PANEL	$22.00	$28.00	$28.00–$22.00	62% below	21%
Complete blood count (CBC) with differential CPT 85025 ND CBC WITH AUTO DIFF	$116.00	$145.00	$145.00–$116.00	100% above	20%
Complete blood count (CBC) with differential inpatient CPT 85025 ND85025 - DERM ACUTANE PANEL	$22.00	$28.00	$28.00–$22.00	—	21%
Complete blood count (CBC) with differential inpatient CPT 85025 ND CBC WITH AUTO DIFF	$116.00	$145.00	$145.00–$116.00	—	20%
Complete blood count (CBC), no differential CPT 85027 ND CBC	$47.00	$59.00	$59.00–$47.00	4% above	20%
Complete blood count (CBC), no differential inpatient CPT 85027 ND CBC	$47.00	$59.00	$59.00–$47.00	—	20%
Comprehensive metabolic panel (blood test) CPT 80053 ND COMPREHENSIVE METABOLIC PANEL	$98.00	$123.00	$123.00–$98.00	3% above	20%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 ND COMPREHENSIVE METABOLIC PANEL	$98.00	$123.00	$123.00–$98.00	—	20%
D-dimer blood test (blood clot marker) CPT 85379 ND D-DIMER	$78.00	$97.00	$97.00–$78.00	4% above	20%
D-dimer blood test (blood clot marker) inpatient CPT 85379 ND D-DIMER	$78.00	$97.00	$97.00–$78.00	—	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 ND DHEA-S	$158.00	$197.00	$197.00–$158.00	67% above	20%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 ND DHEA-S	$158.00	$197.00	$197.00–$158.00	—	20%
Estradiol blood test CPT 82670 ND ESTRADIOL	$182.00	$228.00	$228.00–$182.00	128% above	20%
Estradiol blood test inpatient CPT 82670 ND ESTRADIOL	$182.00	$228.00	$228.00–$182.00	—	20%
FSH (follicle-stimulating hormone) test CPT 83001 ND FSH	$88.00	$110.00	$110.00–$88.00	10% below	20%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ND FSH	$88.00	$110.00	$110.00–$88.00	—	20%
Fecal calprotectin (stool inflammation test) CPT 83993 ND CALPROTECTIN FECAL	$242.00	$302.00	$302.00–$242.00	106% above	20%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ND CALPROTECTIN FECAL	$242.00	$302.00	$302.00–$242.00	—	20%
Ferritin blood test (iron stores) CPT 82728 ND FERRITIN	$98.00	$122.00	$122.00–$98.00	38% above	20%
Ferritin blood test (iron stores) inpatient CPT 82728 ND FERRITIN	$98.00	$122.00	$122.00–$98.00	—	20%
Folate (folic acid) blood test CPT 82746 ND FOLIC ACID (FOLATE)	$94.00	$118.00	$118.00–$94.00	14% above	20%
Folate (folic acid) blood test inpatient CPT 82746 ND FOLIC ACID (FOLATE)	$94.00	$118.00	$118.00–$94.00	—	20%
Free T3 thyroid hormone test CPT 84481 ND T3 FREE	$132.00	$165.00	$165.00–$132.00	54% above	20%
Free T3 thyroid hormone test inpatient CPT 84481 ND T3 FREE	$132.00	$165.00	$165.00–$132.00	—	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ND T4 FREE (THYROXINE)	$63.00	$79.00	$79.00–$63.00	81% above	20%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ND T4 FREE (THYROXINE)	$63.00	$79.00	$79.00–$63.00	—	20%
Free testosterone test CPT 84402 ND TESTOSTERONE FREE	$178.00	$222.00	$222.00–$178.00	197% above	20%
Free testosterone test inpatient CPT 84402 ND TESTOSTERONE FREE	$178.00	$222.00	$222.00–$178.00	—	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 ND HEALTH PANEL: CBC, CMP, TSH	$255.00	$319.00	$319.00–$255.00	11% above	20%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 ND HEALTH PANEL: CBC, CMP, TSH	$255.00	$319.00	$319.00–$255.00	—	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 ND GLUCOSE POST DOSE	$35.00	$44.00	$44.00–$35.00	11% below	20%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 ND GLUCOSE POST DOSE	$35.00	$44.00	$44.00–$35.00	—	20%
Glucose tolerance test, 3 samples CPT 82951 ND GLUCOSE TOLERANCE TEST 3 SPECIMENS	$98.00	$123.00	$123.00–$98.00	3% above	20%
Glucose tolerance test, 3 samples inpatient CPT 82951 ND GLUCOSE TOLERANCE TEST 3 SPECIMENS	$98.00	$123.00	$123.00–$98.00	—	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ND GC NEISSERIA GON/AMP ASSAY (GEN/UR)	$238.00	$298.00	$298.00–$238.00	175% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ND GC NEISSERIA GON/AMP ASSAY (GEN/UR)	$238.00	$298.00	$298.00–$238.00	—	20%
H. pylori antibody blood test CPT 86677 ND HELICOBACTER PYLORI	$102.00	$127.00	$127.00–$102.00	20% above	20%
H. pylori antibody blood test inpatient CPT 86677 ND HELICOBACTER PYLORI	$102.00	$127.00	$127.00–$102.00	—	20%
H. pylori stool antigen test CPT 87338 ND H-PYLORI STOOL (SEND OUT)	$143.00	$179.00	$179.00–$143.00	46% above	20%
H. pylori stool antigen test CPT 87338 ND H-PYLORI STOOL (NOT SEND OUT)	$143.00	$179.00	$179.00–$143.00	46% above	20%
H. pylori stool antigen test inpatient CPT 87338 ND H-PYLORI STOOL (NOT SEND OUT)	$143.00	$179.00	$179.00–$143.00	—	20%
H. pylori stool antigen test inpatient CPT 87338 ND H-PYLORI STOOL (SEND OUT)	$143.00	$179.00	$179.00–$143.00	—	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 ND HIV-1,QUANTIFICATION	$434.00	$543.00	$543.00–$434.00	105% above	20%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 ND HIV-1,QUANTIFICATION	$434.00	$543.00	$543.00–$434.00	—	20%
HIV-1 and HIV-2 antibody test CPT 86703 ND HIV-1/HIV-2, SINGLE ASSAY (RAPID)	$77.00	$96.00	$96.00–$77.00	2% above	20%
HIV-1 and HIV-2 antibody test CPT 86703 ND HIV1/HIV2 IGG ABY SERUM SINGLE RESULT	$77.00	$96.00	$96.00–$77.00	2% above	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 ND HIV1/HIV2 IGG ABY SERUM SINGLE RESULT	$77.00	$96.00	$96.00–$77.00	—	20%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 ND HIV-1/HIV-2, SINGLE ASSAY (RAPID)	$77.00	$96.00	$96.00–$77.00	—	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 ND HIV1 ANTIGEN WITH HIV1&2 ANTIBODY	$145.00	$181.00	$181.00–$145.00	40% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 ND HIV1 ANTIGEN WITH HIV1&2 ANTIBODY	$145.00	$181.00	$181.00–$145.00	—	20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 ND HPV	$202.00	$253.00	$253.00–$202.00	109% above	20%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 ND HPV	$202.00	$253.00	$253.00–$202.00	—	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 ND GLYCOSYLATED HGB A1C	$74.00	$93.00	$93.00–$74.00	6% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 ND GLYCOSYLATED HGB A1C	$74.00	$93.00	$93.00–$74.00	—	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 ND ANTI-HBS AB (IMMUNITY)	$85.00	$106.00	$106.00–$85.00	148% above	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 ND ANTI-HBS AB (IMMUNITY)	$85.00	$106.00	$106.00–$85.00	—	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 ND ANTI-HBS AG	$87.00	$109.00	$109.00–$87.00	73% above	20%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 ND ANTI-HBS AG	$87.00	$109.00	$109.00–$87.00	—	20%
Hepatitis C antibody blood test (screening) CPT 86803 ND ANTI-HCV (HEP C ANTIBODY)	$109.00	$136.00	$136.00–$109.00	143% above	20%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 ND ANTI-HCV (HEP C ANTIBODY)	$109.00	$136.00	$136.00–$109.00	—	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 ND HEPATITIS C VIRAL LOAD, PCR	$299.00	$374.00	$374.00–$299.00	131% above	20%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 ND HEPATITIS C VIRAL LOAD, PCR	$299.00	$374.00	$374.00–$299.00	—	20%
Herpes blood test, HSV-1 antibody CPT 86695 ND HERPES SIMPLEX TYPE 1	$102.00	$127.00	$127.00–$102.00	207% above	20%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ND HERPES SIMPLEX TYPE 1	$102.00	$127.00	$127.00–$102.00	—	20%
Herpes blood test, HSV-2 antibody CPT 86696 ND HERPES SIMPLEX TYPE II	$148.00	$185.00	$185.00–$148.00	208% above	20%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ND HERPES SIMPLEX TYPE II	$148.00	$185.00	$185.00–$148.00	—	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 ND C-REACTIVE PROTEIN; HIGH SENSITIVITY	$67.00	$84.00	$84.00–$67.00	2% below	20%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 ND C-REACTIVE PROTEIN; HIGH SENSITIVITY	$67.00	$84.00	$84.00–$67.00	—	20%
Homocysteine blood test CPT 83090 ND HOMOCYSTINE	$130.00	$162.00	$162.00–$130.00	120% above	20%
Homocysteine blood test inpatient CPT 83090 ND HOMOCYSTINE	$130.00	$162.00	$162.00–$130.00	—	20%
Insulin blood test CPT 83525 ND FASTING INSULIN	$59.00	$74.00	$74.00–$59.00	2% above	20%
Insulin blood test inpatient CPT 83525 ND FASTING INSULIN	$59.00	$74.00	$74.00–$59.00	—	20%
Iron blood test (serum iron) CPT 83540 ND IRON	$50.00	$63.00	$63.00–$50.00	56% above	21%
Iron blood test (serum iron) inpatient CPT 83540 ND IRON	$50.00	$63.00	$63.00–$50.00	—	21%
Iron-binding capacity (TIBC) test CPT 83550 ND IRON BINDING CAPACITY	$66.00	$83.00	$83.00–$66.00	42% above	20%
Iron-binding capacity (TIBC) test inpatient CPT 83550 ND IRON BINDING CAPACITY	$66.00	$83.00	$83.00–$66.00	—	20%
Kidney function blood test panel CPT 80069 ND RENAL FUNCTION PANEL	$61.00	$76.00	$76.00–$61.00	9% below	20%
Kidney function blood test panel inpatient CPT 80069 ND RENAL FUNCTION PANEL	$61.00	$76.00	$76.00–$61.00	—	20%
LH (luteinizing hormone) test CPT 83002 ND GONADOTROPIN (LH)	$142.00	$178.00	$178.00–$142.00	44% above	20%
LH (luteinizing hormone) test inpatient CPT 83002 ND GONADOTROPIN (LH)	$142.00	$178.00	$178.00–$142.00	—	20%
Lipase blood test (pancreas enzyme) CPT 83690 ND LIPASE	$66.00	$82.00	$82.00–$66.00	30% above	20%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ND LIPASE	$66.00	$82.00	$82.00–$66.00	—	20%
Liver function blood test panel CPT 80076 ND HEPATIC PANEL	$61.00	$76.00	$76.00–$61.00	15% below	20%
Liver function blood test panel inpatient CPT 80076 ND HEPATIC PANEL	$61.00	$76.00	$76.00–$61.00	—	20%
Lyme disease antibody test CPT 86618 ND LYME DISEASE SEROLOGY	$92.00	$115.00	$115.00–$92.00	130% above	20%
Lyme disease antibody test inpatient CPT 86618 ND LYME DISEASE SEROLOGY	$92.00	$115.00	$115.00–$92.00	—	20%
Magnesium blood test CPT 83735 ND MAGNESIUM	$66.00	$82.00	$82.00–$66.00	224% above	20%
Magnesium blood test inpatient CPT 83735 ND MAGNESIUM	$66.00	$82.00	$82.00–$66.00	—	20%
Measles (rubeola) antibody test CPT 86765 ND RUBEOLA	$98.00	$123.00	$123.00–$98.00	78% above	20%
Measles (rubeola) antibody test inpatient CPT 86765 ND RUBEOLA	$98.00	$123.00	$123.00–$98.00	—	20%
Mono test (heterophile antibody, Monospot) CPT 86308 ND MONO TEST	$38.00	$47.00	$47.00–$38.00	at median	19%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 ND MONO TEST	$38.00	$47.00	$47.00–$38.00	—	19%
PSA (prostate-specific antigen) blood test, free CPT 84154 ND PSA FREE	$129.00	$161.00	$161.00–$129.00	111% above	20%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ND PSA FREE	$129.00	$161.00	$161.00–$129.00	—	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 ND PSA (SEND OUT)	$134.00	$168.00	$168.00–$134.00	107% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 ND PSA	$134.00	$168.00	$168.00–$134.00	107% above	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ND PSA	$134.00	$168.00	$168.00–$134.00	—	20%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ND PSA (SEND OUT)	$134.00	$168.00	$168.00–$134.00	—	20%
Pap test (liquid-based, automated screening with review) CPT 88175 ND PAP (CYTOPATHOLOGY) CERVICAL OR VAGINAL	$147.00	$184.00	$184.00–$147.00	22% above	20%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 ND PAP (CYTOPATHOLOGY) CERVICAL OR VAGINAL	$147.00	$184.00	$184.00–$147.00	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 HC PAP SMEAR (TL)	$121.00	$151.00	$151.00–$121.00	33% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 ND PAP	$121.00	$151.00	$151.00–$121.00	33% above	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 ND PAP	$121.00	$151.00	$151.00–$121.00	—	20%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 HC PAP SMEAR (TL)	$121.00	$151.00	$151.00–$121.00	—	20%
Parathyroid hormone (PTH) blood test CPT 83970 ND PARATHORMONE (PARATHYROID HORMONE)	$283.00	$354.00	$354.00–$283.00	36% above	20%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ND PARATHORMONE (PARATHYROID HORMONE)	$283.00	$354.00	$354.00–$283.00	—	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 ND THROMBOPLASTIN TIME PARTIAL (PTT)	$51.00	$64.00	$64.00–$51.00	62% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 ND THROMBOPLASTIN TIME PARTIAL	$55.00	$69.00	$69.00–$55.00	75% above	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ND THROMBOPLASTIN TIME PARTIAL (PTT)	$51.00	$64.00	$64.00–$51.00	—	20%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ND THROMBOPLASTIN TIME PARTIAL	$55.00	$69.00	$69.00–$55.00	—	20%
Progesterone blood test CPT 84144 ND PROGESTERONE	$160.00	$200.00	$200.00–$160.00	46% above	20%
Progesterone blood test inpatient CPT 84144 ND PROGESTERONE	$160.00	$200.00	$200.00–$160.00	—	20%
Prolactin blood test CPT 84146 ND PROLACTIN	$81.00	$101.00	$101.00–$81.00	66% above	20%
Prolactin blood test inpatient CPT 84146 ND PROLACTIN	$81.00	$101.00	$101.00–$81.00	—	20%
Prothrombin time (PT/INR) clotting test CPT 85610 ND PROTHROMBIN TIME/INR	$35.00	$44.00	$44.00–$35.00	75% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 ND PROTHROMBIN TIME/INR SEND OUT	$35.00	$44.00	$44.00–$35.00	75% above	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ND PROTHROMBIN TIME/INR SEND OUT	$35.00	$44.00	$44.00–$35.00	—	20%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 ND PROTHROMBIN TIME/INR	$35.00	$44.00	$44.00–$35.00	—	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 ND DRUG TEST PRSMV DIR OPT OBS	$86.00	$108.00	$108.00–$86.00	15% above	20%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 ND DRUG TEST PRSMV DIR OPT OBS	$86.00	$108.00	$108.00–$86.00	—	20%
Rapid flu test (influenza antigen) CPT 87804 ND INFLUENZA A&B	$86.00	$108.00	$108.00–$86.00	2% above	20%
Rapid flu test (influenza antigen) inpatient CPT 87804 ND INFLUENZA A&B	$86.00	$108.00	$108.00–$86.00	—	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 ND GROUP A STREP SCREEN THROAT	$92.00	$115.00	$115.00–$92.00	12% above	20%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 ND GROUP A STREP SCREEN THROAT	$92.00	$115.00	$115.00–$92.00	—	20%
Rheumatoid factor (RF) test CPT 86431 ND RHEUMATOID FACTOR; QUANTITATIVE	$37.00	$46.00	$46.00–$37.00	3% above	20%
Rheumatoid factor (RF) test inpatient CPT 86431 ND RHEUMATOID FACTOR; QUANTITATIVE	$37.00	$46.00	$46.00–$37.00	—	20%
Rubella antibody test (immunity check) CPT 86762 ND RUBELLA ANTIBODY	$110.00	$138.00	$138.00–$110.00	146% above	20%
Rubella antibody test (immunity check) inpatient CPT 86762 ND RUBELLA ANTIBODY	$110.00	$138.00	$138.00–$110.00	—	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ND SED RATE (AUTOMATED)	$32.00	$40.00	$40.00–$32.00	17% above	20%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ND SED RATE (AUTOMATED)	$32.00	$40.00	$40.00–$32.00	—	20%
Stool ova and parasites exam CPT 87177 ND OVA AND PARASITES	$67.00	$84.00	$84.00–$67.00	38% above	20%
Stool ova and parasites exam inpatient CPT 87177 ND OVA AND PARASITES	$67.00	$84.00	$84.00–$67.00	—	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER	$22.00	$27.00	$27.00–$22.00	20% below	19%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER	$22.00	$27.00	$27.00–$22.00	—	19%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ND OCCULT BLOOD DIAGNOSTIC IFOB COMPLETE	$110.00	$137.00	$137.00–$110.00	91% above	20%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ND OCCULT BLOOD DIAGNOSTIC IFOB COMPLETE	$110.00	$137.00	$137.00–$110.00	—	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 ND SYPHILIS QUALITATIVE (RPR)	$32.00	$40.00	$40.00–$32.00	38% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 ND SYPHILIS QUALITATIVE (RPR)	$32.00	$40.00	$40.00–$32.00	—	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 ND TB GOLD	$26.00	$32.00	$32.00–$26.00	77% below	19%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 ND TUBERCULOSIS TEST,CELL MEDIATED IMMUNIT	$46.00	$57.00	$57.00–$46.00	59% below	19%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 ND TB GOLD	$26.00	$32.00	$32.00–$26.00	—	19%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 ND TUBERCULOSIS TEST,CELL MEDIATED IMMUNIT	$46.00	$57.00	$57.00–$46.00	—	19%
Testosterone blood test, total (not free testosterone) CPT 84403 ND TESTOSTERONE; TOTAL	$182.00	$228.00	$228.00–$182.00	199% above	20%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ND TESTOSTERONE; TOTAL	$182.00	$228.00	$228.00–$182.00	—	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 ND MICROSOMAL ANTIBODY	$114.00	$143.00	$143.00–$114.00	107% above	20%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ND MICROSOMAL ANTIBODY	$114.00	$143.00	$143.00–$114.00	—	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ND TSH	$117.00	$146.00	$146.00–$117.00	33% above	20%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ND TSH	$117.00	$146.00	$146.00–$117.00	—	20%
Uric acid blood test CPT 84550 ND URIC ACID	$43.00	$54.00	$54.00–$43.00	17% above	20%
Uric acid blood test inpatient CPT 84550 ND URIC ACID	$43.00	$54.00	$54.00–$43.00	—	20%
Urinalysis with microscope exam, automated CPT 81001 ND UA WITH MICROSCOPY	$38.00	$47.00	$47.00–$38.00	6% above	19%
Urinalysis with microscope exam, automated inpatient CPT 81001 ND UA WITH MICROSCOPY	$38.00	$47.00	$47.00–$38.00	—	19%
Urinalysis without microscope exam, automated CPT 81003 ND UA WITHOUT MICROSCOPY	$20.00	$25.00	$25.00–$20.00	16% above	20%
Urinalysis without microscope exam, automated CPT 81003 ND MYOGLOBIN SCREEN	$20.00	$25.00	$25.00–$20.00	16% above	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 ND UA WITHOUT MICROSCOPY	$20.00	$25.00	$25.00–$20.00	—	20%
Urinalysis without microscope exam, automated inpatient CPT 81003 ND MYOGLOBIN SCREEN	$20.00	$25.00	$25.00–$20.00	—	20%
Urinalysis without microscope exam, manual CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$18.00	$23.00	$23.00–$18.00	at median	22%
Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP	$18.00	$23.00	$23.00–$18.00	—	22%
Urine culture for bacteria, with colony count CPT 87086 ND URINE CULTURE	$72.00	$90.00	$90.00–$72.00	12% above	20%
Urine culture for bacteria, with colony count inpatient CPT 87086 ND URINE CULTURE	$72.00	$90.00	$90.00–$72.00	—	20%
Urine pregnancy test, read by color change CPT 81025 ND URINE HCG	$78.00	$97.00	$97.00–$78.00	39% above	20%
Urine pregnancy test, read by color change inpatient CPT 81025 ND URINE HCG	$78.00	$97.00	$97.00–$78.00	—	20%
Vitamin B12 (cobalamin) blood test CPT 82607 ND VITAMIN B12	$114.00	$143.00	$143.00–$114.00	42% above	20%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 ND VITAMIN B12	$114.00	$143.00	$143.00–$114.00	—	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 ND VITAMIN D ASSAY	$202.00	$252.00	$252.00–$202.00	109% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 ND VITAMIN D ASSAY	$202.00	$252.00	$252.00–$202.00	—	20%
Zinc blood test CPT 84630 ND ZINC ASSAY	$117.00	$146.00	$146.00–$117.00	343% above	20%
Zinc blood test inpatient CPT 84630 ND ZINC ASSAY	$117.00	$146.00	$146.00–$117.00	—	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 ND HCG QUANTITATIVE	$106.00	$133.00	$133.00–$106.00	46% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 ND HCG QUANTITATIVE	$106.00	$133.00	$133.00–$106.00	—	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$597.00	$746.00	$746.00–$597.00	55% above	20%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 PR CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ	$597.00	$746.00	$746.00–$597.00	—	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PR CLTX METATARSAL FRACTURE W/O MANIPULATION EACH	$530.00	$663.00	$663.00–$530.00	33% above	20%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 PR CLTX METATARSAL FRACTURE W/O MANIPULATION EACH	$530.00	$663.00	$663.00–$530.00	—	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$517.00	$646.00	$646.00–$517.00	49% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION	$1,010.00	$1,263.00	$1,263.00–$1,010.00	1% below	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$517.00	$646.00	$646.00–$517.00	—	20%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 HC CARDIOVERSION	$1,010.00	$1,263.00	$1,263.00–$1,010.00	—	20%
Cervical biopsy CPT 57500 PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$328.00	$410.00	$410.00–$328.00	58% below	20%
Cervical biopsy inpatient CPT 57500 PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX	$328.00	$410.00	$410.00–$328.00	—	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ	$657.00	$821.00	$821.00–$657.00	50% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PR CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ	$657.00	$821.00	$821.00–$657.00	—	20%
Colonoscopy with polyp removal CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$550.00	$688.00	$688.00–$550.00	72% below	20%
Colonoscopy with polyp removal CPT 45385 HC COLONOSCOPY/POLYPECTOMY SNARE	$1,817.00	$2,271.00	$2,271.00–$1,817.00	7% below	20%
Colonoscopy with polyp removal inpatient CPT 45385 PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ	$550.00	$688.00	$688.00–$550.00	—	20%
Colonoscopy with polyp removal inpatient CPT 45385 HC COLONOSCOPY/POLYPECTOMY SNARE	$1,817.00	$2,271.00	$2,271.00–$1,817.00	—	20%
Colonoscopy with tissue sample CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$459.00	$574.00	$574.00–$459.00	42% below	20%
Colonoscopy with tissue sample CPT 45380 HC COLONOSCOPY W/BIOPSY(S)	$1,817.00	$2,271.00	$2,271.00–$1,817.00	128% above	20%
Colonoscopy with tissue sample inpatient CPT 45380 PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE	$459.00	$574.00	$574.00–$459.00	—	20%
Colonoscopy with tissue sample inpatient CPT 45380 HC COLONOSCOPY W/BIOPSY(S)	$1,817.00	$2,271.00	$2,271.00–$1,817.00	—	20%
Colonoscopy, diagnostic CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$414.00	$517.00	$517.00–$414.00	37% below	20%
Colonoscopy, diagnostic CPT 45378 HC COLONOSCOPY	$1,515.00	$1,894.00	$1,894.00–$1,515.00	130% above	20%
Colonoscopy, diagnostic inpatient CPT 45378 PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD	$414.00	$517.00	$517.00–$414.00	—	20%
Colonoscopy, diagnostic inpatient CPT 45378 HC COLONOSCOPY	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PR DESTRUCTION PREMALIGNANT LESION 1ST	$143.00	$179.00	$179.00–$143.00	3% below	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALG LESION	$273.00	$341.00	$341.00–$273.00	86% above	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PR DESTRUCTION PREMALIGNANT LESION 1ST	$143.00	$179.00	$179.00–$143.00	—	20%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT PREMALG LESION	$273.00	$341.00	$341.00–$273.00	—	20%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$35.00	$44.00	$44.00–$35.00	50% below	20%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT	$35.00	$44.00	$44.00–$35.00	—	20%
Earwax removal with instruments, one ear CPT 69210 HC REMOVE IMPACTED EAR WAX	$116.00	$145.00	$145.00–$116.00	28% above	20%
Earwax removal with instruments, one ear one side CPT 69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$82.00	$103.00	$103.00–$82.00	10% below	20%
Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVE IMPACTED EAR WAX	$116.00	$145.00	$145.00–$116.00	—	20%
Earwax removal with instruments, one ear inpatient one side CPT 69210 PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT	$82.00	$103.00	$103.00–$82.00	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$258.00	$323.00	$323.00–$258.00	25% above	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 HC BIOPSY OF UTERUS LINING	$282.00	$353.00	$353.00–$282.00	36% above	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 PR ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX	$258.00	$323.00	$323.00–$258.00	—	20%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 HC BIOPSY OF UTERUS LINING	$282.00	$353.00	$353.00–$282.00	—	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$322.00	$402.00	$402.00–$322.00	66% below	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 HC DIAGNOSTIC SIGMOIDOSCOPY	$1,515.00	$1,894.00	$1,894.00–$1,515.00	62% above	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 PR SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD	$322.00	$402.00	$402.00–$322.00	—	20%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 HC DIAGNOSTIC SIGMOIDOSCOPY	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Hemorrhoid banding (rubber band ligation) CPT 46221 PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$498.00	$622.00	$622.00–$498.00	57% below	20%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS	$498.00	$622.00	$622.00–$498.00	—	20%
IUD insertion (the device itself billed separately) CPT 58300 PR INSERTION INTRAUTERINE DEVICE IUD	$240.00	$300.00	$300.00–$240.00	47% above	20%
IUD insertion (the device itself billed separately) inpatient CPT 58300 PR INSERTION INTRAUTERINE DEVICE IUD	$240.00	$300.00	$300.00–$240.00	—	20%
Incision and drainage of a simple or single skin abscess CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$253.00	$316.00	$316.00–$253.00	at median	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC I & D ABSCESS, SMPL	$303.00	$379.00	$379.00–$303.00	20% above	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE	$253.00	$316.00	$316.00–$253.00	—	20%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I & D ABSCESS, SMPL	$303.00	$379.00	$379.00–$303.00	—	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$104.00	$130.00	$130.00–$104.00	44% below	20%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS	$104.00	$130.00	$130.00–$104.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$115.00	$144.00	$144.00–$115.00	54% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$440.00	$550.00	$550.00–$440.00	75% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC RAD INJECT/ASPIR JNTMAJOR	$440.00	$550.00	$550.00–$440.00	75% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$115.00	$144.00	$144.00–$115.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US	$440.00	$550.00	$550.00–$440.00	—	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC RAD INJECT/ASPIR JNTMAJOR	$440.00	$550.00	$550.00–$440.00	—	20%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PR INSERTION DRUG DELIVERY IMPLANT	$219.00	$274.00	$274.00–$219.00	14% above	20%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 PR INSERTION DRUG DELIVERY IMPLANT	$219.00	$274.00	$274.00–$219.00	—	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT MEDIUM JOINT/BURSA	$62.00	$77.00	$77.00–$62.00	80% below	19%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$134.00	$167.00	$167.00–$134.00	56% below	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 HC DRAIN/INJECT MEDIUM JOINT/BURSA	$62.00	$77.00	$77.00–$62.00	—	19%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US	$134.00	$167.00	$167.00–$134.00	—	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$88.00	$110.00	$110.00–$88.00	67% below	20%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US	$88.00	$110.00	$110.00–$88.00	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$394.00	$492.00	$492.00–$394.00	7% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5CM	$546.00	$683.00	$683.00–$546.00	29% above	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$394.00	$492.00	$492.00–$394.00	—	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC LAYR CLOS WND TRUNK,ARM,LEG <2.5CM	$546.00	$683.00	$683.00–$546.00	—	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$193.00	$241.00	$241.00–$193.00	64% below	20%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<	$193.00	$241.00	$241.00–$193.00	—	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$319.00	$399.00	$399.00–$319.00	22% below	20%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 PR EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<	$319.00	$399.00	$399.00–$319.00	—	20%
Nail removal (partial or complete), one nail CPT 11730 HC REMOVE NAIL PLATE	$115.00	$144.00	$144.00–$115.00	52% below	20%
Nail removal (partial or complete), one nail CPT 11730 PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$240.00	$300.00	$300.00–$240.00	1% below	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 HC REMOVE NAIL PLATE	$115.00	$144.00	$144.00–$115.00	—	20%
Nail removal (partial or complete), one nail inpatient CPT 11730 PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1	$240.00	$300.00	$300.00–$240.00	—	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 PR EXCISION NAIL&NAIL MATRIX PRTL/COMPL PERM RMVL	$440.00	$550.00	$550.00–$440.00	7% above	20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVE NAIL BED	$808.00	$1,010.00	$1,010.00–$808.00	97% above	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PR EXCISION NAIL&NAIL MATRIX PRTL/COMPL PERM RMVL	$440.00	$550.00	$550.00–$440.00	—	20%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVE NAIL BED	$808.00	$1,010.00	$1,010.00–$808.00	—	20%
Removal of a foreign object under the skin, simple CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$334.00	$417.00	$417.00–$334.00	19% below	20%
Removal of a foreign object under the skin, simple CPT 10120 HC REMOVE FOREIGN BODY,SMPL	$505.00	$631.00	$631.00–$505.00	23% above	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE	$334.00	$417.00	$417.00–$334.00	—	20%
Removal of a foreign object under the skin, simple inpatient CPT 10120 HC REMOVE FOREIGN BODY,SMPL	$505.00	$631.00	$631.00–$505.00	—	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 PR COLON CA SCRN NOT HI RSK IND	$414.00	$517.00	$517.00–$414.00	76% below	20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 HC SCRN COLONOSCOPY NOT HI RISK	$1,515.00	$1,894.00	$1,894.00–$1,515.00	12% below	20%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 PR COLON CA SCRN NOT HI RSK IND	$414.00	$517.00	$517.00–$414.00	—	20%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 HC SCRN COLONOSCOPY NOT HI RISK	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 PR COLORECTAL SCRN; HI RISK IND	$414.00	$517.00	$517.00–$414.00	76% below	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC SCRN COLONOSCOPY HI RISK	$1,515.00	$1,894.00	$1,894.00–$1,515.00	13% below	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND	$1,515.00	$1,894.00	$1,894.00–$1,515.00	13% below	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 PR COLORECTAL SCRN; HI RISK IND	$414.00	$517.00	$517.00–$414.00	—	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC COLORECTAL SCRN; HI RISK IND	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 HC SCRN COLONOSCOPY HI RISK	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Short arm cast (elbow to hand) CPT 29075 PR APPLICATION CAST ELBOW TO FINGER SHORT ARM	$138.00	$172.00	$172.00–$138.00	49% below	20%
Short arm cast (elbow to hand) inpatient CPT 29075 PR APPLICATION CAST ELBOW TO FINGER SHORT ARM	$138.00	$172.00	$172.00–$138.00	—	20%
Short arm splint (forearm and hand) CPT 29125 PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$103.00	$129.00	$129.00–$103.00	41% below	20%
Short arm splint (forearm and hand) CPT 29125 HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$158.00	$443.00	$443.00–$158.00	10% below	64%
Short arm splint (forearm and hand) inpatient CPT 29125 PR APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$103.00	$129.00	$129.00–$103.00	—	20%
Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$158.00	$443.00	$443.00–$158.00	—	64%
Short leg cast (below the knee) CPT 29405 PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$153.00	$191.00	$191.00–$153.00	44% below	20%
Short leg cast (below the knee) inpatient CPT 29405 PR APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$153.00	$191.00	$191.00–$153.00	—	20%
Short leg splint (calf to foot) CPT 29515 PR APPLICATION SHORT LEG SPLINT CALF TO FOOT	$128.00	$160.00	$160.00–$128.00	37% below	20%
Short leg splint (calf to foot) CPT 29515 HC APPLICATION SHORT LEG SPLINT CALF TO FOOT	$354.00	$443.00	$443.00–$354.00	74% above	20%
Short leg splint (calf to foot) inpatient CPT 29515 PR APPLICATION SHORT LEG SPLINT CALF TO FOOT	$128.00	$160.00	$160.00–$128.00	—	20%
Short leg splint (calf to foot) inpatient CPT 29515 HC APPLICATION SHORT LEG SPLINT CALF TO FOOT	$354.00	$443.00	$443.00–$354.00	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$213.00	$266.00	$266.00–$213.00	17% below	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC REPR SUPERF WND BODY <2.5CM	$307.00	$384.00	$384.00–$307.00	20% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PR SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<	$213.00	$266.00	$266.00–$213.00	—	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC REPR SUPERF WND BODY <2.5CM	$307.00	$384.00	$384.00–$307.00	—	20%
Skin biopsy, punch, one lesion CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION	$262.00	$328.00	$328.00–$262.00	13% below	20%
Skin biopsy, punch, one lesion inpatient CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION	$262.00	$328.00	$328.00–$262.00	—	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$461.00	$576.00	$576.00–$461.00	22% below	20%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<	$461.00	$576.00	$576.00–$461.00	—	20%
Skin tag removal, up to 15 tags CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$162.00	$202.00	$202.00–$162.00	21% below	20%
Skin tag removal, up to 15 tags CPT 11200 HC REMOVAL OF SKIN TAGS	$232.00	$290.00	$290.00–$232.00	14% above	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15	$162.00	$202.00	$202.00–$162.00	—	20%
Skin tag removal, up to 15 tags inpatient CPT 11200 HC REMOVAL OF SKIN TAGS	$232.00	$290.00	$290.00–$232.00	—	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$198.00	$248.00	$248.00–$198.00	77% below	20%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE	$198.00	$248.00	$248.00–$198.00	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$253.00	$316.00	$316.00–$253.00	20% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC REPR SUP NPTERF WND BODY 2.6-7.5	$307.00	$384.00	$384.00–$307.00	45% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PR SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM	$253.00	$316.00	$316.00–$253.00	—	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC REPR SUP NPTERF WND BODY 2.6-7.5	$307.00	$384.00	$384.00–$307.00	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PR SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$253.00	$316.00	$316.00–$253.00	at median	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC REPR SUPERF WND FACE <2.5CM	$307.00	$384.00	$384.00–$307.00	21% above	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PR SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<	$253.00	$316.00	$316.00–$253.00	—	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC REPR SUPERF WND FACE <2.5CM	$307.00	$384.00	$384.00–$307.00	—	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 PR TANGENTIAL BIOPSY SKIN SINGLE LESION	$230.00	$287.00	$287.00–$230.00	15% above	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGENTIAL BX SNGL SKIN LESION	$444.00	$555.00	$555.00–$444.00	123% above	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 PR TANGENTIAL BIOPSY SKIN SINGLE LESION	$230.00	$287.00	$287.00–$230.00	—	20%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGENTIAL BX SNGL SKIN LESION	$444.00	$555.00	$555.00–$444.00	—	20%
Trigger point injections, 1 or 2 muscles CPT 20552 PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$94.00	$118.00	$118.00–$94.00	69% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ TRIGGER POINT,1 OR 2	$455.00	$569.00	$569.00–$455.00	50% above	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PR INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES	$94.00	$118.00	$118.00–$94.00	—	20%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 HC INJ TRIGGER POINT,1 OR 2	$455.00	$569.00	$569.00–$455.00	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$414.00	$517.00	$517.00–$414.00	83% below	20%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 HC UPPER GI BALLOON DILATION	$2,525.00	$3,156.00	$3,156.00–$2,525.00	5% above	20%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM	$414.00	$517.00	$517.00–$414.00	—	20%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 HC UPPER GI BALLOON DILATION	$2,525.00	$3,156.00	$3,156.00–$2,525.00	—	20%
Upper endoscopy (EGD) with biopsy CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$322.00	$402.00	$402.00–$322.00	72% below	20%
Upper endoscopy (EGD) with biopsy CPT 43239 PR UPPER GI ENDOSCOPY,BIOPSY	$322.00	$402.00	$402.00–$322.00	72% below	20%
Upper endoscopy (EGD) with biopsy CPT 43239 HC UPPER GI ENDOSCOPY,BIOPSY	$1,515.00	$1,894.00	$1,894.00–$1,515.00	34% above	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR UPPER GI ENDOSCOPY,BIOPSY	$322.00	$402.00	$402.00–$322.00	—	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE	$322.00	$402.00	$402.00–$322.00	—	20%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 HC UPPER GI ENDOSCOPY,BIOPSY	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Upper endoscopy (EGD) with injection into the lining CPT 43236 PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$660.00	$825.00	$825.00–$660.00	67% below	20%
Upper endoscopy (EGD) with injection into the lining CPT 43236 HC UPPER GI SCOPE W/SUBMUC INJ	$1,515.00	$1,894.00	$1,894.00–$1,515.00	24% below	20%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 PR ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION	$660.00	$825.00	$825.00–$660.00	—	20%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 HC UPPER GI SCOPE W/SUBMUC INJ	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$811.00	$1,014.00	$1,014.00–$811.00	66% below	20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 HC UP GI ENDOSCOPY,REMV TUMOR,SNARE	$811.00	$1,014.00	$1,014.00–$811.00	66% below	20%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 HC UP GI ENDOSCOPY,REMV TUMOR,SNARE	$811.00	$1,014.00	$1,014.00–$811.00	—	20%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH	$811.00	$1,014.00	$1,014.00–$811.00	—	20%
Upper endoscopy (EGD), diagnostic CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$275.00	$344.00	$344.00–$275.00	81% below	20%
Upper endoscopy (EGD), diagnostic CPT 43235 HC UPPER GI ENDOSCOPY,DX	$1,515.00	$1,894.00	$1,894.00–$1,515.00	3% above	20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC	$275.00	$344.00	$344.00–$275.00	—	20%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC UPPER GI ENDOSCOPY,DX	$1,515.00	$1,894.00	$1,894.00–$1,515.00	—	20%
Vein ablation, radiofrequency, first vein CPT 36475 PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN	$656.00	$820.00	$820.00–$656.00	80% below	20%
Vein ablation, radiofrequency, first vein CPT 36475 HC ENDOVENOUS RF,1ST VEIN	$5,245.00	$6,556.00	$6,556.00–$5,245.00	62% above	20%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN	$656.00	$820.00	$820.00–$656.00	—	20%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 HC ENDOVENOUS RF,1ST VEIN	$5,245.00	$6,556.00	$6,556.00–$5,245.00	—	20%
Wart removal, up to 14 warts CPT 17110 PR DESTRUCTION BENIGN LESIONS UP TO 14	$180.00	$225.00	$225.00–$180.00	12% below	20%
Wart removal, up to 14 warts CPT 17110 HC DESTRUCT BENIGN LESION, 1-14	$232.00	$290.00	$290.00–$232.00	14% above	20%
Wart removal, up to 14 warts inpatient CPT 17110 PR DESTRUCTION BENIGN LESIONS UP TO 14	$180.00	$225.00	$225.00–$180.00	—	20%
Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT BENIGN LESION, 1-14	$232.00	$290.00	$290.00–$232.00	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<	$263.00	$329.00	$329.00–$263.00	36% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC DEBRIDE SKIN/TISSUE	$450.00	$562.00	$562.00–$450.00	10% above	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/<	$263.00	$329.00	$329.00–$263.00	—	20%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 HC DEBRIDE SKIN/TISSUE	$450.00	$562.00	$562.00–$450.00	—	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 3 HOURS	$642.00	$803.00	$803.00–$642.00	14% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 6 HOURS	$642.00	$803.00	$803.00–$642.00	14% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 4 HOURS	$642.00	$803.00	$803.00–$642.00	14% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 2 HOURS	$642.00	$803.00	$803.00–$642.00	14% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 5 HOURS	$642.00	$803.00	$803.00–$642.00	14% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 1 HOUR	$642.00	$803.00	$803.00–$642.00	14% below	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 9 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	23% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 8 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	23% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 7 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	23% above	20%
Blood transfusion (giving blood or blood components) CPT 36430 ND BLOOD ADMIN OUTPATIENT 10 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	23% above	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 3 HOURS	$642.00	$803.00	$803.00–$642.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 2 HOURS	$642.00	$803.00	$803.00–$642.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 6 HOURS	$642.00	$803.00	$803.00–$642.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 1 HOUR	$642.00	$803.00	$803.00–$642.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 4 HOURS	$642.00	$803.00	$803.00–$642.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 5 HOURS	$642.00	$803.00	$803.00–$642.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 10 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 8 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 9 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	—	20%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ND BLOOD ADMIN OUTPATIENT 7 HOURS	$918.00	$1,147.00	$1,147.00–$918.00	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$47.00	$59.00	$59.00–$47.00	63% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TRMT	$68.00	$85.00	$85.00–$68.00	47% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$47.00	$59.00	$59.00–$47.00	—	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TRMT	$68.00	$85.00	$85.00–$68.00	—	20%
Critical care, first 30 to 74 minutes CPT 99291 PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$874.00	$1,093.00	$1,093.00–$874.00	at median	20%
Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 1ST HOUR	$1,545.00	$1,931.00	$1,931.00–$1,545.00	77% above	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 PR CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN	$874.00	$1,093.00	$1,093.00–$874.00	—	20%
Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 1ST HOUR	$1,545.00	$1,931.00	$1,931.00–$1,545.00	—	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC ROUTINE EKG	$122.00	$153.00	$153.00–$122.00	1% above	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC ROUTINE EKG	$122.00	$153.00	$153.00–$122.00	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$87.00	$109.00	$109.00–$87.00	33% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL I	$232.00	$290.00	$290.00–$232.00	78% above	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 PR EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP	$87.00	$109.00	$109.00–$87.00	—	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL I	$232.00	$290.00	$290.00–$232.00	—	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$132.00	$165.00	$165.00–$132.00	43% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL II	$299.00	$374.00	$374.00–$299.00	30% above	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 PR EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM	$132.00	$165.00	$165.00–$132.00	—	20%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL II	$299.00	$374.00	$374.00–$299.00	—	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 PR EMERGENCY DEPARTMENT VISIT LOW MDM	$174.00	$218.00	$218.00–$174.00	53% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL III	$421.00	$526.00	$526.00–$421.00	14% above	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 PR EMERGENCY DEPARTMENT VISIT LOW MDM	$174.00	$218.00	$218.00–$174.00	—	20%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL III	$421.00	$526.00	$526.00–$421.00	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$306.00	$383.00	$383.00–$306.00	54% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL IV	$710.00	$887.00	$887.00–$710.00	8% above	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 PR EMERGENCY DEPARTMENT VISIT MODERATE MDM	$306.00	$383.00	$383.00–$306.00	—	20%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL IV	$710.00	$887.00	$887.00–$710.00	—	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$437.00	$546.00	$546.00–$437.00	56% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL V	$1,198.00	$1,498.00	$1,498.00–$1,198.00	20% above	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 PR EMERGENCY DEPARTMENT VISIT HIGH MDM	$437.00	$546.00	$546.00–$437.00	—	20%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL V	$1,198.00	$1,498.00	$1,498.00–$1,198.00	—	20%
Family therapy with the patient, 50 minutes CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT	$696.00	$870.00	$870.00–$696.00	31% above	20%
Family therapy with the patient, 50 minutes inpatient CPT 90847 HC FAMILY PSYCHOTHERAPY W/PATIENT	$696.00	$870.00	$870.00–$696.00	—	20%
Family therapy without the patient, 50 minutes CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT	$663.00	$829.00	$829.00–$663.00	36% above	20%
Family therapy without the patient, 50 minutes inpatient CPT 90846 HC FAMILY PSYCHOTHERAPY W/O PATIENT	$663.00	$829.00	$829.00–$663.00	—	20%
Group psychotherapy session CPT 90853 HC GROUP PSYCHOTHERAPY	$606.00	$757.00	$757.00–$606.00	36% above	20%
Group psychotherapy session inpatient CPT 90853 HC GROUP PSYCHOTHERAPY	$606.00	$757.00	$757.00–$606.00	—	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION IV INFUSION,INIT	$322.00	$402.00	$402.00–$322.00	at median	20%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION IV INFUSION,INIT	$322.00	$402.00	$402.00–$322.00	—	20%
IV infusion of a medicine, first hour CPT 96365 HC THER/PROPH/DIAG IV INF,INIT	$377.00	$471.00	$471.00–$377.00	4% below	20%
IV infusion of a medicine, first hour inpatient CPT 96365 HC THER/PROPH/DIAG IV INF,INIT	$377.00	$471.00	$471.00–$377.00	—	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$58.00	$72.00	$72.00–$58.00	65% above	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$58.00	$72.00	$72.00–$58.00	65% above	19%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ,SC/IM	$102.00	$127.00	$127.00–$102.00	191% above	20%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$58.00	$72.00	$72.00–$58.00	—	19%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM	$58.00	$72.00	$72.00–$58.00	—	19%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ,SC/IM	$102.00	$127.00	$127.00–$102.00	—	20%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION	$362.00	$452.00	$452.00–$362.00	70% above	20%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION	$362.00	$452.00	$452.00–$362.00	—	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSC RE-ED 15MIN	$112.00	$140.00	$140.00–$112.00	1% above	20%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSC RE-ED 15MIN	$112.00	$140.00	$140.00–$112.00	—	20%
New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES	$253.00	$316.00	$316.00–$253.00	32% above	20%
New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES	$354.00	$443.00	$443.00–$354.00	33% above	20%
New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES	$430.00	$538.00	$538.00–$430.00	30% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES	$177.00	$221.00	$221.00–$177.00	28% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$78.00	$98.00	$98.00–$78.00	16% below	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 ND MNT;INITIAL ASSESS IND PER 15 MIN	$110.00	$138.00	$138.00–$110.00	19% above	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI	$78.00	$98.00	$98.00–$78.00	—	20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 ND MNT;INITIAL ASSESS IND PER 15 MIN	$110.00	$138.00	$138.00–$110.00	—	20%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX 30 MIN	$298.00	$373.00	$373.00–$298.00	15% above	20%
Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX 30 MIN	$298.00	$373.00	$373.00–$298.00	—	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX 45 MIN	$354.00	$443.00	$443.00–$354.00	18% above	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX 45 MIN	$354.00	$443.00	$443.00–$354.00	—	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX 20 MIN	$298.00	$373.00	$373.00–$298.00	14% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX 20 MIN	$298.00	$373.00	$373.00–$298.00	—	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX 30 MIN	$329.00	$411.00	$411.00–$329.00	19% above	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX 30 MIN	$329.00	$411.00	$411.00–$329.00	—	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY 15MIN	$97.00	$121.00	$121.00–$97.00	5% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY 15MIN	$97.00	$121.00	$121.00–$97.00	—	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAP EX 15MIN	$107.00	$134.00	$134.00–$107.00	1% above	20%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAP EX 15MIN	$107.00	$134.00	$134.00–$107.00	—	20%
Preventive checkup, new patient aged 18–39 CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$279.00	$349.00	$349.00–$279.00	117% above	20%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS	$279.00	$349.00	$349.00–$279.00	—	20%
Preventive checkup, new patient aged 40–64 CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$323.00	$404.00	$404.00–$323.00	131% above	20%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS	$323.00	$404.00	$404.00–$323.00	—	20%
Preventive checkup, new patient aged 65 or older CPT 99387 PR INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>	$344.00	$430.00	$430.00–$344.00	132% above	20%
Preventive checkup, returning patient aged 18–39 CPT 99395 PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$253.00	$316.00	$316.00–$253.00	105% above	20%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS	$253.00	$316.00	$316.00–$253.00	—	20%
Preventive checkup, returning patient aged 40–64 CPT 99396 PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$263.00	$329.00	$329.00–$263.00	105% above	20%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS	$263.00	$329.00	$329.00–$263.00	—	20%
Preventive checkup, returning patient aged 65 or older CPT 99397 PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$283.00	$354.00	$354.00–$283.00	116% above	20%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER	$283.00	$354.00	$354.00–$283.00	—	20%
Psychiatric evaluation with medical services CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$406.00	$507.00	$507.00–$406.00	146% above	20%
Psychiatric evaluation with medical services inpatient CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES	$406.00	$507.00	$507.00–$406.00	—	20%
Psychotherapy for crisis, first 60 minutes CPT 90839 PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$294.00	$368.00	$368.00–$294.00	78% above	20%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PR PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES	$294.00	$368.00	$368.00–$294.00	—	20%
Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$310.00	$388.00	$388.00–$310.00	at median	20%
Psychotherapy session, 30 minutes CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES	$502.00	$628.00	$628.00–$502.00	62% above	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES	$310.00	$388.00	$388.00–$310.00	—	20%
Psychotherapy session, 30 minutes inpatient CPT 90832 HC PSYCHOTHERAPY W/PATIENT 30 MINUTES	$502.00	$628.00	$628.00–$502.00	—	20%
Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$385.00	$481.00	$481.00–$385.00	at median	20%
Psychotherapy session, 45 minutes CPT 90834 HC PSYCHOTHERAPY W/PATIENT 45 MINUTES	$622.00	$778.00	$778.00–$622.00	62% above	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES	$385.00	$481.00	$481.00–$385.00	—	20%
Psychotherapy session, 45 minutes inpatient CPT 90834 HC PSYCHOTHERAPY W/PATIENT 45 MINUTES	$622.00	$778.00	$778.00–$622.00	—	20%
Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$392.00	$490.00	$490.00–$392.00	at median	20%
Psychotherapy session, 60 minutes CPT 90837 HC PSYCHOTHERAPY W/PATIENT 60 MINUTES	$634.00	$793.00	$793.00–$634.00	62% above	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES	$392.00	$490.00	$490.00–$392.00	—	20%
Psychotherapy session, 60 minutes inpatient CPT 90837 HC PSYCHOTHERAPY W/PATIENT 60 MINUTES	$634.00	$793.00	$793.00–$634.00	—	20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$35.00	$44.00	$44.00–$35.00	3% below	20%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES	$35.00	$44.00	$44.00–$35.00	—	20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN	$344.00	$430.00	$430.00–$344.00	12% above	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ND OUTPATIENT TREATMENT ROOM	$120.00	$150.00	$150.00–$120.00	20% below	20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN	$172.00	$215.00	$215.00–$172.00	14% above	20%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ND OUTPATIENT TREATMENT ROOM	$120.00	$150.00	$150.00–$120.00	—	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC URGENT CARE VISIT-EST PT LEVEL IV	$82.00	$103.00	$103.00–$82.00	57% below	20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN	$253.00	$316.00	$316.00–$253.00	32% above	20%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC URGENT CARE VISIT-EST PT LEVEL IV	$82.00	$103.00	$103.00–$82.00	—	20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN	$102.00	$127.00	$127.00–$102.00	88% above	20%
Speech and language evaluation CPT 92523 HC EVAL OF SPEECH SOUND LANG COMPREHEN	$657.00	$821.00	$821.00–$657.00	36% above	20%
Speech and language evaluation inpatient CPT 92523 HC EVAL OF SPEECH SOUND LANG COMPREHEN	$657.00	$821.00	$821.00–$657.00	—	20%
Speech therapy session, individual CPT 92507 HC SPEECH/HEARING THERAPY INDIV	$278.00	$348.00	$348.00–$278.00	17% above	20%
Speech therapy session, individual inpatient CPT 92507 HC SPEECH/HEARING THERAPY INDIV	$278.00	$348.00	$348.00–$278.00	—	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAP ACTIVITY 15MIN	$152.00	$190.00	$190.00–$152.00	32% above	20%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAP ACTIVITY 15MIN	$152.00	$190.00	$190.00–$152.00	—	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEBOTOMY IN INFUSION CTR	$312.00	$390.00	$390.00–$312.00	18% above	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 ND PHLEBOTOMY; THERAPEUTIC	$350.00	$437.00	$437.00–$350.00	33% above	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 HC PHLEBOTOMY IN INFUSION CTR	$312.00	$390.00	$390.00–$312.00	—	20%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 ND PHLEBOTOMY; THERAPEUTIC	$350.00	$437.00	$437.00–$350.00	—	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs North Dakota	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 PR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$153.00	$191.00	$191.00–$153.00	at median	20%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 PR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$153.00	$191.00	$191.00–$153.00	—	20%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PR SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$169.00	$211.00	$211.00–$169.00	10% below	20%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PR SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE	$169.00	$211.00	$211.00–$169.00	—	20%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$152.00	$190.00	$190.00–$152.00	7% below	20%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE	$152.00	$190.00	$190.00–$152.00	—	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Influenza Virus Vaccine Split PF Susp Pref Syringe 0.5 ML	$32.00	$40.00	$40.00–$32.00	5% below	20%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$37.00	$46.00	$46.00–$37.00	9% above	20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Influenza Virus Vaccine Split PF Susp Pref Syringe 0.5 ML	$32.00	$40.00	$40.00–$32.00	—	20%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE	$37.00	$46.00	$46.00–$37.00	—	20%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE	$255.00	$319.00	$319.00–$255.00	19% below	20%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE	$255.00	$319.00	$319.00–$255.00	—	20%
Hepatitis A vaccine, adult dose CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$45.00	$56.00	$56.00–$45.00	22% below	20%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE	$45.00	$56.00	$56.00–$45.00	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 20 MCG/ML	$67.00	$84.00	$84.00–$67.00	16% below	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$85.00	$106.00	$106.00–$85.00	6% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 20 MCG/ML	$67.00	$84.00	$84.00–$67.00	—	20%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE	$85.00	$106.00	$106.00–$85.00	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$78.00	$98.00	$98.00–$78.00	at median	20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vac Split High-Dose PF Susp Pref Syr 0.5ML	$104.00	$130.00	$130.00–$104.00	33% above	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM	$78.00	$98.00	$98.00–$78.00	—	20%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vac Split High-Dose PF Susp Pref Syr 0.5ML	$104.00	$130.00	$130.00–$104.00	—	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ	$90.00	$112.00	$112.00–$90.00	33% below	20%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ	$90.00	$112.00	$112.00–$90.00	—	20%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$178.00	$222.00	$222.00–$178.00	at median	20%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE	$178.00	$222.00	$222.00–$178.00	—	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENB-4C RECOMBNT PRTN & OUTER MEMB VESIC VACC IM	$219.00	$274.00	$274.00–$219.00	8% below	20%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENB-4C RECOMBNT PRTN & OUTER MEMB VESIC VACC IM	$219.00	$274.00	$274.00–$219.00	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal 20-Valent Conjugate Vaccine Sus Pref Syr 0.5 ML	$275.00	$344.00	$344.00–$275.00	22% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$301.00	$376.00	$376.00–$301.00	14% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal 20-Valent Conjugate Vaccine Sus Pref Syr 0.5 ML	$275.00	$344.00	$344.00–$275.00	—	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE	$301.00	$376.00	$376.00–$301.00	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine Polyvalent Soln Pref Syr 25 MCG/0.5ML	$110.00	$138.00	$138.00–$110.00	27% below	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$144.00	$180.00	$180.00–$144.00	5% below	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine Polyvalent Soln Pref Syr 25 MCG/0.5ML	$110.00	$138.00	$138.00–$110.00	—	20%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE	$144.00	$180.00	$180.00–$144.00	—	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab-alip IM Soln Prefilled Syringe 50 MG/0.5ML	$583.00	$729.00	$729.00–$583.00	35% below	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$637.00	$796.00	$796.00–$637.00	29% below	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab-alip IM Soln Prefilled Syringe 50 MG/0.5ML	$583.00	$729.00	$729.00–$583.00	—	20%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE	$637.00	$796.00	$796.00–$637.00	—	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV Pre-Fusion F A&B Vac Recomb For IM Soln 120 MCG/0.5ML	$326.00	$408.00	$408.00–$326.00	44% below	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$355.00	$444.00	$444.00–$355.00	39% below	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV Pre-Fusion F A&B Vac Recomb For IM Soln 120 MCG/0.5ML	$326.00	$408.00	$408.00–$326.00	—	20%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$355.00	$444.00	$444.00–$355.00	—	20%
Rabies vaccine, one dose CPT 90675 Rabies Virus Vaccine, HDC For Inj Susp	$361.00	$451.00	$451.00–$361.00	44% below	20%
Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE INTRAMUSCULAR	$394.00	$493.00	$493.00–$394.00	39% below	20%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Virus Vaccine, HDC For Inj Susp	$361.00	$451.00	$451.00–$361.00	—	20%
Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE INTRAMUSCULAR	$394.00	$493.00	$493.00–$394.00	—	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster Vac Recombinant Adjuvanted for IM Inj 50 MCG/0.5ML	$163.00	$204.00	$204.00–$163.00	2% above	20%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX	$174.00	$218.00	$218.00–$174.00	9% above	20%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster Vac Recombinant Adjuvanted for IM Inj 50 MCG/0.5ML	$163.00	$204.00	$204.00–$163.00	—	20%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX	$174.00	$218.00	$218.00–$174.00	—	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$34.00	$43.00	$43.00–$34.00	39% below	21%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphtheria Toxoids (Td) Inj 5-2 LFU	$39.00	$49.00	$49.00–$39.00	30% below	20%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE	$34.00	$43.00	$43.00–$34.00	—	21%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphtheria Toxoids (Td) Inj 5-2 LFU	$39.00	$49.00	$49.00–$39.00	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2.5-18.5 LF-MCG/0.5ML	$48.00	$60.00	$60.00–$48.00	31% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2.5-18.5 LF-LF-MCG/0.5ML	$51.00	$64.00	$64.00–$51.00	27% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2-15.5 LF-LF-MCG/0.5ML	$51.00	$64.00	$64.00–$51.00	27% below	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$54.00	$68.00	$68.00–$54.00	22% below	21%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2.5-18.5 LF-MCG/0.5ML	$48.00	$60.00	$60.00–$48.00	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2.5-18.5 LF-LF-MCG/0.5ML	$51.00	$64.00	$64.00–$51.00	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet Tox-Diph-Acell Pertuss Ad Inj 5-2-15.5 LF-LF-MCG/0.5ML	$51.00	$64.00	$64.00–$51.00	—	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TDAP VACCINE 7 YRS/> IM	$54.00	$68.00	$68.00–$54.00	—	21%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$18.00	$22.00	$22.00–$18.00	20% below	18%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADMINISTRATION	$51.00	$64.00	$64.00–$51.00	127% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE	$18.00	$22.00	$22.00–$18.00	—	18%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADMINISTRATION	$51.00	$64.00	$64.00–$51.00	—	20%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$18.00	$22.00	$22.00–$18.00	38% below	18%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE	$18.00	$22.00	$22.00–$18.00	—	18%

Source file: https://www.ndhc.net/_files/ugd/8ba1dd_18b3f75094504d9c8a93bfefac18feb2.csv?dn=450226472-1356449136_northwood-deaconess-health-center_standardcharges.csv