Hospital

Nevada City Hospital

Nevada City Hospital in Nevada, MO publishes cash prices for 332 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Missouri median for 302 of 332 procedures and above it for 28. By typical cash price it ranks #6 of 60 Missouri hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

800 S Ash St, Nevada, MO, 64772 Collected Sep 27, 2026 Source price file (417) 667-3355

Acute care hospital Emergency department CCN 260061 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US LE ART DOPPLR 1 LEVEL BIL	$280.80	$624.00	—	18% below	55%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US LE ART DOPPLR 1 LEVEL BIL	$280.80	$624.00	—	—	55%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR ESOPHAGUS	$275.85	$613.00	—	37% below	55%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR ESOPHAGUS	$275.85	$613.00	—	—	55%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE WHOLE BODY	$884.25	$1,965.00	—	41% below	55%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE WHOLE BODY	$884.25	$1,965.00	—	—	55%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIO CHEST	$394.20	$876.00	—	80% below	55%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIO CHEST	$394.20	$876.00	—	—	55%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS W/O CONT	$525.60	$1,168.00	—	75% below	55%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS W/O CONT	$525.60	$1,168.00	—	—	55%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W CONT	$824.85	$1,833.00	—	65% below	55%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W CONT	$824.85	$1,833.00	—	—	55%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W/WO CONT	$824.85	$1,833.00	—	72% below	55%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W/WO CONT	$824.85	$1,833.00	—	—	55%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONT	$394.20	$876.00	—	75% below	55%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONT	$394.20	$876.00	—	—	55%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONT	$235.80	$524.00	—	78% below	55%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONT	$235.80	$524.00	—	—	55%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CONT	$235.80	$524.00	—	78% below	55%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONT	$235.80	$524.00	—	78% below	55%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONT	$235.80	$524.00	—	—	55%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CONT	$235.80	$524.00	—	—	55%
CT scan of the head or brain, no contrast dye CPT 70450 CT STROKE STUDY	$235.80	$524.00	—	81% below	55%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD OR BRAIN W/O CONT	$235.80	$524.00	—	81% below	55%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD OR BRAIN W/O CONT	$235.80	$524.00	—	—	55%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT STROKE STUDY	$235.80	$524.00	—	—	55%
CT scan of the head with contrast CPT 70460 CT HEAD OR BRAIN W CONT	$394.20	$876.00	—	73% below	55%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD OR BRAIN W CONT	$394.20	$876.00	—	—	55%
CT scan of the head without and with contrast CPT 70470 CT HEAD OR BRAIN W/WO CONT	$394.20	$876.00	—	78% below	55%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD OR BRAIN W/WO CONT	$394.20	$876.00	—	—	55%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SPINE LUMBAR W/O CONT	$235.80	$524.00	—	83% below	55%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT SPINE LUMBAR W/O CONT	$235.80	$524.00	—	—	55%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SPINE CERVICAL W/O CONT	$235.80	$524.00	—	85% below	55%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT SPINE CERVICAL W/O CONT	$235.80	$524.00	—	—	55%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONT	$394.20	$876.00	—	76% below	55%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONT	$394.20	$876.00	—	—	55%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX BIL	$739.35	$1,643.00	—	11% below	55%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX BIL	$739.35	$1,643.00	—	—	55%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS	$165.15	$367.00	—	34% below	55%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS	$165.15	$367.00	—	—	55%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$136.80	$304.00	—	35% below	55%
Chest X-ray, single view CPT 71045 XR CHEST STEREO FRONTAL	$136.80	$304.00	—	35% below	55%
Chest X-ray, single view inpatient CPT 71045 XR CHEST STEREO FRONTAL	$136.80	$304.00	—	—	55%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$136.80	$304.00	—	—	55%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMP	$235.80	$524.00	—	58% below	55%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMP	$235.80	$524.00	—	—	55%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD DEXA AXIAL SKELETON	$165.15	$367.00	—	52% below	55%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD DEXA AXIAL SKELETON	$165.15	$367.00	—	—	55%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BD DEXA APPENDICULR SKELETON	$136.80	$304.00	—	25% below	55%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BD DEXA APPENDICULR SKELETON	$136.80	$304.00	—	—	55%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PREG DETAILED 1ST GEST	$525.60	$1,168.00	—	21% below	55%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PREG DETAILED 1ST GEST	$525.60	$1,168.00	—	—	55%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONT	$235.80	$524.00	—	82% below	55%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONT	$235.80	$524.00	—	—	55%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONT	$394.20	$876.00	—	76% below	55%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONT	$394.20	$876.00	—	—	55%
Diagnostic mammogram, both breasts CPT 77066 MA DIAG BIL	$218.70	$486.00	—	1% below	55%
Diagnostic mammogram, both breasts inpatient CPT 77066 MA DIAG BIL	$218.70	$486.00	—	—	55%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US LE ART DUPLEX BIL	$805.95	$1,791.00	—	15% above	55%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US LE ART DUPLEX BIL	$805.95	$1,791.00	—	—	55%
Duplex ultrasound of the leg veins, both legs CPT 93970 US LE VEINS DUPLEX BIL	$814.95	$1,811.00	—	1% above	55%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US LE VEINS DUPLEX BIL	$814.95	$1,811.00	—	—	55%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO 2D COMP W/ COLOR FLOW	$739.35	$1,643.00	—	51% below	55%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO 2D COMP W/ COLOR FLOW	$739.35	$1,643.00	—	—	55%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPA DUCT SYSTEM	$884.25	$1,965.00	—	36% below	55%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPA DUCT SYSTM WO PHARM	$884.25	$1,965.00	—	36% below	55%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPA DUCT SYSTEM	$884.25	$1,965.00	—	—	55%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPA DUCT SYSTM WO PHARM	$884.25	$1,965.00	—	—	55%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 RT SLEEP HST PROFESSIONAL FEE	$65.25	$145.00	—	90% below	55%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 RT HOME SLEEP STUDY	$301.05	$669.00	—	55% below	55%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 RT SLEEP HST PROFESSIONAL FEE	$65.25	$145.00	—	—	55%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 RT HOME SLEEP STUDY	$301.05	$669.00	—	—	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RT SLEEP W CPAP PROFESSIONAL FEE	$420.30	$934.00	—	84% below	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RT POLYSOMNOGRAPHY SPLIT NIGHT	$1,833.75	$4,075.00	—	30% below	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 RT POLYSOMNOGRAPHY W/CPAP	$1,833.75	$4,075.00	—	30% below	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RT SLEEP W CPAP PROFESSIONAL FEE	$420.30	$934.00	—	—	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RT POLYSOMNOGRAPHY W/CPAP	$1,833.75	$4,075.00	—	—	55%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 RT POLYSOMNOGRAPHY SPLIT NIGHT	$1,833.75	$4,075.00	—	—	55%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LTD	$235.80	$524.00	—	53% below	55%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LTD	$235.80	$524.00	—	—	55%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LOW DOSE	$235.80	$524.00	—	46% below	55%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST LOW DOSE	$235.80	$524.00	—	—	55%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONT	$525.60	$1,168.00	—	68% below	55%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONT	$525.60	$1,168.00	—	—	55%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONT	$937.35	$2,083.00	—	61% below	55%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONT	$937.35	$2,083.00	—	—	55%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONT	$525.60	$1,168.00	—	67% below	55%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONT	$525.60	$1,168.00	—	—	55%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONT	$937.35	$2,083.00	—	63% below	55%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONT	$937.35	$2,083.00	—	—	55%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR W/O CONT	$525.60	$1,168.00	—	72% below	55%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINE LUMBAR W/O CONT	$525.60	$1,168.00	—	—	55%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W/WO	$937.35	$2,083.00	—	62% below	55%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SPINE LUMBAR W/WO	$937.35	$2,083.00	—	—	55%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC W/O CONT	$525.60	$1,168.00	—	70% below	55%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI SPINE THORACIC W/O CONT	$525.60	$1,168.00	—	—	55%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W/WO	$937.35	$2,083.00	—	62% below	55%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI SPINE CERVICAL W/WO	$937.35	$2,083.00	—	—	55%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL W/O CONT	$525.60	$1,168.00	—	73% below	55%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI SPINE CERVICAL W/O CONT	$525.60	$1,168.00	—	—	55%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONT	$937.35	$2,083.00	—	63% below	55%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONT	$937.35	$2,083.00	—	—	55%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONT	$525.60	$1,168.00	—	72% below	55%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONT	$525.60	$1,168.00	—	—	55%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARD PERF SPECT MULT	$3,044.25	$6,765.00	—	26% below	55%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARD PERF SPECT MULT	$3,044.25	$6,765.00	—	—	55%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC NON-OB LTD	$235.80	$524.00	—	41% below	55%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC NON-OB LTD	$235.80	$524.00	—	—	55%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC NON-OB COMP	$235.80	$524.00	—	64% below	55%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC NON-OB COMP	$235.80	$524.00	—	—	55%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG > 14 WEEKS 1ST GEST	$235.80	$524.00	—	59% below	55%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG > 14 WEEKS 1ST GEST	$235.80	$524.00	—	—	55%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG < 14 WEEKS 1ST GEST	$235.80	$524.00	—	54% below	55%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG < 14 WEEKS 1ST GEST	$235.80	$524.00	—	—	55%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT LTD	$235.80	$524.00	—	34% below	55%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT LTD	$235.80	$524.00	—	—	55%
Screening mammogram, both breasts CPT 77067 MA ROUTINE SCREEN BIL	$175.95	$391.00	—	7% above	55%
Screening mammogram, both breasts inpatient CPT 77067 MA ROUTINE SCREEN BIL	$175.95	$391.00	—	—	55%
Sleep study in a lab (polysomnography) CPT 95810 RT SLEEP W/O CPAP PROFESSIONAL FEE	$420.30	$934.00	—	83% below	55%
Sleep study in a lab (polysomnography) CPT 95810 RT POLYSOMNOGRAPHY 4 OR MORE	$1,617.30	$3,594.00	—	36% below	55%
Sleep study in a lab (polysomnography) inpatient CPT 95810 RT SLEEP W/O CPAP PROFESSIONAL FEE	$420.30	$934.00	—	—	55%
Sleep study in a lab (polysomnography) inpatient CPT 95810 RT POLYSOMNOGRAPHY 4 OR MORE	$1,617.30	$3,594.00	—	—	55%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR SWALLOWING FUNCT W/ VIDEO	$275.85	$613.00	—	38% below	55%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR SWALLOWING FUNCT W/ VIDEO	$275.85	$613.00	—	—	55%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$235.80	$524.00	—	59% below	55%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$235.80	$524.00	—	—	55%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANT TRANSVAGINAL	$235.80	$524.00	—	50% below	55%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANT TRANSVAGINAL	$235.80	$524.00	—	—	55%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMP	$235.80	$524.00	—	70% below	55%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMP	$235.80	$524.00	—	—	55%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM / CONTENTS	$235.80	$524.00	—	59% below	55%
Ultrasound of the scrotum and testicles CPT 76870 NM US SCROTUM AND CONTENTS	$235.80	$524.00	—	59% below	55%
Ultrasound of the scrotum and testicles inpatient CPT 76870 NM US SCROTUM AND CONTENTS	$235.80	$524.00	—	—	55%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM / CONTENTS	$235.80	$524.00	—	—	55%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US HEAD / NECK SOFT TISSUE	$235.80	$524.00	—	58% below	55%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US HEAD / NECK SOFT TISSUE	$235.80	$524.00	—	—	55%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI W/O KUB	$275.85	$613.00	—	51% below	55%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI W/O KUB	$275.85	$613.00	—	—	55%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US UE VEINS DUPLEX BIL	$814.95	$1,811.00	—	45% above	55%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US UE VEINS DUPLEX BIL	$814.95	$1,811.00	—	—	55%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW	$136.80	$304.00	—	37% below	55%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW	$136.80	$304.00	—	—	55%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRL 2/3 VIEW	$165.15	$367.00	—	44% below	55%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRL 2/3 VIEW	$165.15	$367.00	—	—	55%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSAC MIN 4 VIEW	$165.15	$367.00	—	61% below	55%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSAC MIN 4 VIEW	$165.15	$367.00	—	—	55%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS	$165.15	$367.00	—	37% below	55%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS	$165.15	$367.00	—	—	55%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONE COMP MIN 3VIEW	$136.80	$304.00	—	45% below	55%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONE COMP MIN 3VIEW	$136.80	$304.00	—	—	55%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERV 2 OR 3 VIEWS	$136.80	$304.00	—	54% below	55%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERV 2 OR 3 VIEWS	$136.80	$304.00	—	—	55%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 VIEW	$165.15	$367.00	—	27% below	55%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 VIEW	$165.15	$367.00	—	—	55%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM / COCCYX MIN 2 VIEW	$136.80	$304.00	—	48% below	55%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM / COCCYX MIN 2 VIEW	$136.80	$304.00	—	—	55%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$12.15	$27.00	—	75% below	55%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) P5P	$58.50	$130.00	—	21% above	55%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 NRMC HCV FIBROSURE 4	$61.65	$137.00	—	27% above	55%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$12.15	$27.00	—	—	55%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) P5P	$58.50	$130.00	—	—	55%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 NRMC HCV FIBROSURE 4	$61.65	$137.00	—	—	55%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$11.70	$26.00	—	75% below	55%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$11.70	$26.00	—	—	55%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE W/RFLX QST 10306	$222.75	$495.00	—	5% below	55%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE W/RFLX QST 10306	$222.75	$495.00	—	—	55%
Allergy blood test, specific IgE, per allergen CPT 86003 D FARINAE MITE IGG4 QST	$18.00	$40.00	—	19% below	55%
Allergy blood test, specific IgE, per allergen CPT 86003 ADD-ON 86003	$22.05	$49.00	—	at median	55%
Allergy blood test, specific IgE, per allergen CPT 86003 E072-IGE MOUSE URINE	$22.95	$51.00	—	4% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 D FARINAE IGE QST 34908	$22.95	$51.00	—	4% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 NRMC ALLERGEN SPECIFIC IGE; QNT OR SEMI-	$22.95	$51.00	—	4% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 Nectarine IgE Allergen QST 15323	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 APRICOT IGE QST 2563	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY IGE QST 2609	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 RASPBERRY IGE QST 26281	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE IGE QST 2675	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 PEA IGE QST 2812	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 CARROT IGE QST 2831	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE QST 2833	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 POTATO IGE QST 2835	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 APPLE IGE QST 2849	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 CELERY IGE QST 2860	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 KIWI FRUIT IGE QST 2884	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 MELONS IGE QST 2887	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX IGE QST 8927	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELON IGE QST 30755	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE QST 8926	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 PEAR IGE QST 8884	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 AMOXICILLIN IGE QST 38476	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLOYL G IGE QST 702	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 PEACH IGE QST 8405	$32.40	$72.00	—	47% above	55%
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA-GAL PANEL QST 10555	$60.30	$134.00	—	173% above	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D FARINAE MITE IGG4 QST	$18.00	$40.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ADD-ON 86003	$22.05	$49.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D FARINAE IGE QST 34908	$22.95	$51.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E072-IGE MOUSE URINE	$22.95	$51.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 NRMC ALLERGEN SPECIFIC IGE; QNT OR SEMI-	$22.95	$51.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELON IGE QST 30755	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE IGE QST 2849	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE QST 8926	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY IGE QST 2860	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLOYL G IGE QST 702	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI FRUIT IGE QST 2884	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR IGE QST 8884	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT IGE QST 2831	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMOXICILLIN IGE QST 38476	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE QST 2833	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELONS IGE QST 2887	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH IGE QST 8405	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO IGE QST 2835	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APRICOT IGE QST 2563	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY IGE QST 2609	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RASPBERRY IGE QST 26281	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nectarine IgE Allergen QST 15323	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE IGE QST 2675	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEA IGE QST 2812	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX IGE QST 8927	$32.40	$72.00	—	—	55%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA-GAL PANEL QST 10555	$60.30	$134.00	—	—	55%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP AB QST 11173	$72.00	$160.00	—	10% below	55%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP AB QST 11173	$72.00	$160.00	—	—	55%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCREEN QST	$69.75	$155.00	—	2% above	55%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN W/RFLX TITER/PATTERN QST 249	$99.90	$222.00	—	47% above	55%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/RFLX 11 AB CASCADE QST 16814	$99.90	$222.00	—	47% above	55%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCR IFA W/REFL TITER/PATTERN/LUPUS P	$99.90	$222.00	—	47% above	55%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCREEN QST	$69.75	$155.00	—	—	55%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCR IFA W/REFL TITER/PATTERN/LUPUS P	$99.90	$222.00	—	—	55%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/RFLX 11 AB CASCADE QST 16814	$99.90	$222.00	—	—	55%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN W/RFLX TITER/PATTERN QST 249	$99.90	$222.00	—	—	55%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$88.65	$197.00	—	28% below	55%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BRAIN NATRIURETIC PEPTIDE	$88.65	$197.00	—	—	55%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 10	$19.35	$43.00	—	84% below	55%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL 10	$19.35	$43.00	—	—	55%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$102.60	$228.00	—	8% below	55%
Blood culture for bacteria CPT 87040 Manual Blood Culture QST 7002	$102.60	$228.00	—	8% below	55%
Blood culture for bacteria CPT 87040 Blood Culture QST 389	$102.60	$228.00	—	8% below	55%
Blood culture for bacteria inpatient CPT 87040 Manual Blood Culture QST 7002	$102.60	$228.00	—	—	55%
Blood culture for bacteria inpatient CPT 87040 Blood Culture QST 389	$102.60	$228.00	—	—	55%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$102.60	$228.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 RHC VENIPUNCTURE	$11.70	$26.00	—	30% below	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 OXYGEN	$12.60	$28.00	—	25% below	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: VENOUS DRAW	$13.95	$31.00	—	17% below	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$13.95	$31.00	—	17% below	55%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BILL VENIPUNCTURE	$13.95	$31.00	—	17% below	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RHC VENIPUNCTURE	$11.70	$26.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 OXYGEN	$12.60	$28.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: VENOUS DRAW	$13.95	$31.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BILL VENIPUNCTURE	$13.95	$31.00	—	—	55%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$13.95	$31.00	—	—	55%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING (75GM)	$11.25	$25.00	—	65% below	55%
Blood glucose (sugar) test CPT 82947 BILL GLUCOSE FASTING	$11.25	$25.00	—	65% below	55%
Blood glucose (sugar) test CPT 82947 GLUCOSE LEVEL	$11.25	$25.00	—	65% below	55%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING	$11.25	$25.00	—	65% below	55%
Blood glucose (sugar) test CPT 82947 VET GLUCOSE	$29.25	$65.00	—	10% below	55%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING	$11.25	$25.00	—	—	55%
Blood glucose (sugar) test inpatient CPT 82947 BILL GLUCOSE FASTING	$11.25	$25.00	—	—	55%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING (75GM)	$11.25	$25.00	—	—	55%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE LEVEL	$11.25	$25.00	—	—	55%
Blood glucose (sugar) test inpatient CPT 82947 VET GLUCOSE	$29.25	$65.00	—	—	55%
Blood lead test CPT 83655 ADD-ON 83655	$57.60	$128.00	—	5% above	55%
Blood lead test CPT 83655 LEAD CAPILLARY QST 39027	$60.30	$134.00	—	10% above	55%
Blood lead test CPT 83655 LEAD PEDIATRIC QST 599	$60.30	$134.00	—	10% above	55%
Blood lead test inpatient CPT 83655 ADD-ON 83655	$57.60	$128.00	—	—	55%
Blood lead test inpatient CPT 83655 LEAD PEDIATRIC QST 599	$60.30	$134.00	—	—	55%
Blood lead test inpatient CPT 83655 LEAD CAPILLARY QST 39027	$60.30	$134.00	—	—	55%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM	$17.10	$38.00	—	68% below	55%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 RAPID PREGNANCY TEST SERUM	$17.10	$38.00	—	68% below	55%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 RAPID PREGNANCY TEST SERUM	$17.10	$38.00	—	—	55%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST SERUM	$17.10	$38.00	—	—	55%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO BLOOD TYPE	$62.10	$138.00	—	14% below	55%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB ABO/RHR2 INTERP	$62.10	$138.00	—	14% below	55%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO BLOOD TYPE	$62.10	$138.00	—	—	55%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB ABO/RHR2 INTERP	$62.10	$138.00	—	—	55%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$11.70	$26.00	—	80% below	55%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$11.70	$26.00	—	—	55%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN QST 16377	$72.90	$162.00	—	48% below	55%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIN B QL REAL TIME PCR QST	$72.90	$162.00	—	48% below	55%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE TOXIN B QL REAL TIME PCR QST	$72.90	$162.00	—	—	55%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN QST 16377	$72.90	$162.00	—	—	55%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9 QST	$80.55	$179.00	—	27% below	55%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 QST	$80.55	$179.00	—	—	55%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 QST 29256	$45.90	$102.00	—	58% below	55%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 QST 29256	$45.90	$102.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID19) QUALITAT NAAT QST	$72.90	$162.00	—	27% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CORONAVIRUS WITH COV-2 RNA QUALITAT	$72.90	$162.00	—	27% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RHC SARS-COV-2 RNA (ID NOW) POCT	$81.00	$180.00	—	19% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) RNA (ID NOW)	$81.00	$180.00	—	19% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 RHC SARS-COV-2 RNA (ID NOW) POCT-87635	$81.00	$180.00	—	19% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) one side CPT 87635 SARS-COV-2 RNA QUALITATIVE REAL-TIME RT-	$72.90	$162.00	—	27% below	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CORONAVIRUS WITH COV-2 RNA QUALITAT	$72.90	$162.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID19) QUALITAT NAAT QST	$72.90	$162.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 RHC SARS-COV-2 RNA (ID NOW) POCT-87635	$81.00	$180.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 RHC SARS-COV-2 RNA (ID NOW) POCT	$81.00	$180.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) RNA (ID NOW)	$81.00	$180.00	—	—	55%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient one side CPT 87635 SARS-COV-2 RNA QUALITATIVE REAL-TIME RT-	$72.90	$162.00	—	—	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS TMA URO QST	$60.75	$135.00	—	32% below	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 IMAGE GUIDED PAP WITH AGE-BASED SCREENIN	$60.75	$135.00	—	32% below	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 ADD-ON 87491	$60.75	$135.00	—	32% below	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS TMA URO QST	$60.75	$135.00	—	—	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 IMAGE GUIDED PAP WITH AGE-BASED SCREENIN	$60.75	$135.00	—	—	55%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 ADD-ON 87491	$60.75	$135.00	—	—	55%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$30.15	$67.00	—	71% below	55%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$30.15	$67.00	—	—	55%
Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD COUNT WITH AUTO DIFF	$17.55	$39.00	—	67% below	55%
Complete blood count (CBC) with differential CPT 85025 ZZZCBC WITH AUTO DIFF 8 CHARGE	$17.55	$39.00	—	67% below	55%
Complete blood count (CBC) with differential CPT 85025 CBC W/ AUTO DIFF 3	$17.55	$39.00	—	67% below	55%
Complete blood count (CBC) with differential CPT 85025 VET CBC	$70.20	$156.00	—	32% above	55%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/ AUTO DIFF 3	$17.55	$39.00	—	—	55%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE BLOOD COUNT WITH AUTO DIFF	$17.55	$39.00	—	—	55%
Complete blood count (CBC) with differential inpatient CPT 85025 ZZZCBC WITH AUTO DIFF 8 CHARGE	$17.55	$39.00	—	—	55%
Complete blood count (CBC) with differential inpatient CPT 85025 VET CBC	$70.20	$156.00	—	—	55%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM CHARGE	$14.85	$33.00	—	70% below	55%
Complete blood count (CBC), no differential CPT 85027 CBC	$14.85	$33.00	—	70% below	55%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$14.85	$33.00	—	—	55%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM CHARGE	$14.85	$33.00	—	—	55%
Comprehensive metabolic panel (blood test) CPT 80053 VET CMP	$23.85	$53.00	—	81% below	55%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 14	$23.85	$53.00	—	81% below	55%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL 14	$23.85	$53.00	—	—	55%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 VET CMP	$23.85	$53.00	—	—	55%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$89.10	$198.00	—	29% below	55%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$89.10	$198.00	—	—	55%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE QST 402	$78.75	$175.00	—	42% below	55%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE QST 402	$78.75	$175.00	—	—	55%
Estradiol blood test CPT 82670 ADD-ON 82670	$81.00	$180.00	—	44% below	55%
Estradiol blood test CPT 82670 ESTRADIOL QST 4021	$111.15	$247.00	—	23% below	55%
Estradiol blood test inpatient CPT 82670 ADD-ON 82670	$81.00	$180.00	—	—	55%
Estradiol blood test inpatient CPT 82670 ESTRADIOL QST 4021	$111.15	$247.00	—	—	55%
FSH (follicle-stimulating hormone) test CPT 83001 ..ZZ TEST ONLY COV2	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test CPT 83001 FSH QST 470	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test CPT 83001 FSH AND LH QST	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test CPT 83001 ..ZZ TEST ONLY T3 FREE	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test CPT 83001 ..ZZ TEST ONLY QUAD SCREEN	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test CPT 83001 ..ZZ TEST ONLY QNATAL(R)	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test CPT 83001 ..ZZ TEST GLUCOSE	$88.65	$197.00	—	13% below	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ..ZZ TEST ONLY COV2	$88.65	$197.00	—	—	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ..ZZ TEST ONLY QUAD SCREEN	$88.65	$197.00	—	—	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ..ZZ TEST GLUCOSE	$88.65	$197.00	—	—	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ..ZZ TEST ONLY T3 FREE	$88.65	$197.00	—	—	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH QST 470	$88.65	$197.00	—	—	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ..ZZ TEST ONLY QNATAL(R)	$88.65	$197.00	—	—	55%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH AND LH QST	$88.65	$197.00	—	—	55%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL QST 16796	$121.05	$269.00	—	35% below	55%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL QST 16796	$121.05	$269.00	—	—	55%
Ferritin blood test (iron stores) CPT 82728 FERRITIN LEVEL	$31.05	$69.00	—	63% below	55%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN LEVEL	$31.05	$69.00	—	—	55%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$23.40	$52.00	—	69% below	55%
Folate (folic acid) blood test CPT 82746 FOLATE SERUM LEVEL	$23.40	$52.00	—	69% below	55%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$23.40	$52.00	—	—	55%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SERUM LEVEL	$23.40	$52.00	—	—	55%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE (T3) FREE QST 34429	$77.40	$172.00	—	22% below	55%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE (T3) FREE QST 34429	$77.40	$172.00	—	—	55%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4	$20.25	$45.00	—	73% below	55%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4	$20.25	$45.00	—	—	55%
Free testosterone test CPT 84402 TESTOSTERONE FREE AND TOTAL QST	$137.25	$305.00	—	9% above	55%
Free testosterone test CPT 84402 TESTOSTERONE FREE QST 18944	$137.25	$305.00	—	9% above	55%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE AND TOTAL QST	$137.25	$305.00	—	—	55%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE QST 18944	$137.25	$305.00	—	—	55%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL NRMC	$231.75	$515.00	—	16% below	55%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL NRMC	$231.75	$515.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE FASTING	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 1 HOUR (50GM)	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 2 HOUR (75GM)	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT 2HR	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT-1 HR	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT-2 HR	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT-4 HR	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT-5 HR	$11.25	$25.00	—	74% below	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT 2HR	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT 1 HOUR (50GM)	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT 2 HOUR (75GM)	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT-2 HR	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT-1 HR	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE FASTING	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT-5 HR	$11.25	$25.00	—	—	55%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GTT-4 HR	$11.25	$25.00	—	—	55%
Glucose tolerance test, 3 samples CPT 82951 GESTATIONAL GLUCOSE FASTING	$29.25	$65.00	—	68% below	55%
Glucose tolerance test, 3 samples CPT 82951 GTT-30 MIN	$29.25	$65.00	—	68% below	55%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST GEST 3HR (100GM)	$29.25	$65.00	—	68% below	55%
Glucose tolerance test, 3 samples inpatient CPT 82951 GESTATIONAL GLUCOSE FASTING	$29.25	$65.00	—	—	55%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST GEST 3HR (100GM)	$29.25	$65.00	—	—	55%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT-30 MIN	$29.25	$65.00	—	—	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE TMA URO QST	$60.75	$135.00	—	25% below	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ADD ON 87591	$60.75	$135.00	—	25% below	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NRMC PAP 16 & 18 (1)	$60.75	$135.00	—	25% below	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 ADD-ON 87591	$60.75	$135.00	—	25% below	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE TMA URO QST	$60.75	$135.00	—	—	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ADD-ON 87591	$60.75	$135.00	—	—	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 ADD ON 87591	$60.75	$135.00	—	—	55%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NRMC PAP 16 & 18 (1)	$60.75	$135.00	—	—	55%
H. pylori antibody blood test CPT 86677 NRMC ANTIBODIES HELICO	$22.95	$51.00	—	69% below	55%
H. pylori antibody blood test inpatient CPT 86677 NRMC ANTIBODIES HELICO	$22.95	$51.00	—	—	55%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN STOOL QST 34838	$96.30	$214.00	—	20% below	55%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN STOOL QST 34838	$96.30	$214.00	—	—	55%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV QUANT PCR QST 40085	$248.40	$552.00	—	29% below	55%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV QUANT PCR QST 40085	$248.40	$552.00	—	—	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCRN 4TH GEN W/RFLX QST 91431	$65.70	$146.00	—	19% below	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG W/ HIV-1 & HIV-2 AB	$65.70	$146.00	—	19% below	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV AG/AB WITH REFLEX	$65.70	$146.00	—	19% below	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV SCRN 4TH GEN W/RFLX QST 91431	$65.70	$146.00	—	—	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG W/ HIV-1 & HIV-2 AB	$65.70	$146.00	—	—	55%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV AG/AB WITH REFLEX	$65.70	$146.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV-HR QST 31532	$72.45	$161.00	—	34% below	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 ADD-ON 87624	$72.45	$161.00	—	34% below	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 SUREPATH IMAGING PAP AND HPV DNA REFLEX	$72.45	$161.00	—	34% below	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6/E7 QST	$72.45	$161.00	—	34% below	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 NRMC PAP 16 & 18 (3)	$76.05	$169.00	—	31% below	55%
HPV test for high-risk types, one combined (pooled) result CPT 87624 NRMC PAPILLOMAVIRUS HUMAN AMPLIFIED PROB	$76.05	$169.00	—	31% below	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV-HR QST 31532	$72.45	$161.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 SUREPATH IMAGING PAP AND HPV DNA REFLEX	$72.45	$161.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6/E7 QST	$72.45	$161.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 ADD-ON 87624	$72.45	$161.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 NRMC PAPILLOMAVIRUS HUMAN AMPLIFIED PROB	$76.05	$169.00	—	—	55%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 NRMC PAP 16 & 18 (3)	$76.05	$169.00	—	—	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$22.05	$49.00	—	64% below	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C 2	$22.05	$49.00	—	64% below	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C 2	$22.05	$49.00	—	—	55%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$22.05	$49.00	—	—	55%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QST 499	$66.60	$148.00	—	3% below	55%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB QST 499	$66.60	$148.00	—	—	55%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG SCREEN W/RFLX QST 498	$62.10	$138.00	—	4% below	55%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG SCREEN W/RFLX QST 498	$62.10	$138.00	—	—	55%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C GENOTYPE W/ RFLX QST 94345	$66.15	$147.00	—	22% below	55%
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB W/RFLX TO RNA QUANT QST 8472	$66.15	$147.00	—	22% below	55%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C GENOTYPE W/ RFLX QST 94345	$66.15	$147.00	—	—	55%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB W/RFLX TO RNA QUANT QST 8472	$66.15	$147.00	—	—	55%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS RNA QUANT W/ REFLEX	$191.70	$426.00	—	36% below	55%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA QUANT PCR QST 35645	$430.65	$957.00	—	45% above	55%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS RNA QUANT W/ REFLEX	$191.70	$426.00	—	—	55%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA QUANT PCR QST 35645	$430.65	$957.00	—	—	55%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPE 1 AB IGG QST 3636	$55.35	$123.00	—	16% below	55%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 AB (IGM) IFA W/RLF TO TITER SERU	$55.35	$123.00	—	16% below	55%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IGG AB QST	$55.35	$123.00	—	16% below	55%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 AB (IGM) IFA W/RLF TO TITER SERU	$55.35	$123.00	—	—	55%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 IGG AB QST	$55.35	$123.00	—	—	55%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPE 1 AB IGG QST 3636	$55.35	$123.00	—	—	55%
Herpes blood test, HSV-2 antibody CPT 86696 HSV TYPE 2 AB IGG QST 3640	$55.35	$123.00	—	9% below	55%
Herpes blood test, HSV-2 antibody CPT 86696 86696 ADD-ON	$55.35	$123.00	—	9% below	55%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV TYPE 2 AB IGG QST 3640	$55.35	$123.00	—	—	55%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 ADD-ON	$55.35	$123.00	—	—	55%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HS CARDIAC QST 10124	$70.20	$156.00	—	1% below	55%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP CARDIAC	$70.20	$156.00	—	1% below	55%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP CARDIAC	$70.20	$156.00	—	—	55%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HS CARDIAC QST 10124	$70.20	$156.00	—	—	55%
Homocysteine blood test CPT 83090 HOMOCYSTEINE QST 31789	$18.45	$41.00	—	83% below	55%
Homocysteine blood test CPT 83090 ADD ON 83090	$121.50	$270.00	—	11% above	55%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE QST 31789	$18.45	$41.00	—	—	55%
Homocysteine blood test inpatient CPT 83090 ADD ON 83090	$121.50	$270.00	—	—	55%
Insulin blood test CPT 83525 INSULIN QST 561	$52.65	$117.00	—	12% below	55%
Insulin blood test CPT 83525 NRMC INSULIN; TOTAL	$55.35	$123.00	—	7% below	55%
Insulin blood test inpatient CPT 83525 INSULIN QST 561	$52.65	$117.00	—	—	55%
Insulin blood test inpatient CPT 83525 NRMC INSULIN; TOTAL	$55.35	$123.00	—	—	55%
Iron blood test (serum iron) CPT 83540 IRON LEVEL	$14.85	$33.00	—	68% below	55%
Iron blood test (serum iron) inpatient CPT 83540 IRON LEVEL	$14.85	$33.00	—	—	55%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$19.80	$44.00	—	71% below	55%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$19.80	$44.00	—	—	55%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$19.80	$44.00	—	81% below	55%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$19.80	$44.00	—	—	55%
LH (luteinizing hormone) test CPT 83002 83002 ADD-ON	$90.00	$200.00	—	12% below	55%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE QST 615	$90.00	$200.00	—	12% below	55%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE QST 615	$90.00	$200.00	—	—	55%
LH (luteinizing hormone) test inpatient CPT 83002 83002 ADD-ON	$90.00	$200.00	—	—	55%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE LEVEL	$15.75	$35.00	—	75% below	55%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE LEVEL	$15.75	$35.00	—	—	55%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$18.45	$41.00	—	86% below	55%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$18.45	$41.00	—	—	55%
Lyme disease antibody test CPT 86618 Tick Panel AB QST 36942	$67.95	$151.00	—	26% below	55%
Lyme disease antibody test CPT 86618 LYME ANTIBODY TOTAL W/RFLX QST 6646	$151.20	$336.00	—	65% above	55%
Lyme disease antibody test CPT 86618 NRMC ANTIBODIES LYME	$158.85	$353.00	—	73% above	55%
Lyme disease antibody test inpatient CPT 86618 Tick Panel AB QST 36942	$67.95	$151.00	—	—	55%
Lyme disease antibody test inpatient CPT 86618 LYME ANTIBODY TOTAL W/RFLX QST 6646	$151.20	$336.00	—	—	55%
Lyme disease antibody test inpatient CPT 86618 NRMC ANTIBODIES LYME	$158.85	$353.00	—	—	55%
Magnesium blood test CPT 83735 MAGNESIUM LEVEL	$15.30	$34.00	—	67% below	55%
Magnesium blood test CPT 83735 MAGNESIUM URINE QST 6179	$52.65	$117.00	—	12% above	55%
Magnesium blood test CPT 83735 83735 ADD-ON	$52.65	$117.00	—	12% above	55%
Magnesium blood test inpatient CPT 83735 MAGNESIUM LEVEL	$15.30	$34.00	—	—	55%
Magnesium blood test inpatient CPT 83735 83735 ADD-ON	$52.65	$117.00	—	—	55%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE QST 6179	$52.65	$117.00	—	—	55%
Measles (rubeola) antibody test CPT 86765 ADD-ON 86765	$45.00	$100.00	—	24% below	55%
Measles (rubeola) antibody test inpatient CPT 86765 ADD-ON 86765	$45.00	$100.00	—	—	55%
Mono test (heterophile antibody, Monospot) CPT 86308 NMC RHC MONONUCLEOSIS	$11.70	$26.00	—	71% below	55%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE MONO SCREEN QST	$43.65	$97.00	—	7% above	55%
Mono test (heterophile antibody, Monospot) CPT 86308 RAPID MONONUCLEOSIS SCREEN	$65.25	$145.00	—	59% above	55%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 NMC RHC MONONUCLEOSIS	$11.70	$26.00	—	—	55%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE MONO SCREEN QST	$43.65	$97.00	—	—	55%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 RAPID MONONUCLEOSIS SCREEN	$65.25	$145.00	—	—	55%
PSA (prostate-specific antigen) blood test, free CPT 84154 ADD-ON 84154	$96.30	$214.00	—	26% above	55%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ADD-ON 84154	$96.30	$214.00	—	—	55%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC	$41.40	$92.00	—	46% below	55%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (FREE AND TOTAL) QST	$84.60	$188.00	—	10% above	55%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL W/RFLX FREE QST 17569	$87.75	$195.00	—	14% above	55%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC	$41.40	$92.00	—	—	55%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA (FREE AND TOTAL) QST	$84.60	$188.00	—	—	55%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL W/RFLX FREE QST 17569	$87.75	$195.00	—	—	55%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP RFX HPV MRNA E6/E7 QS 90934	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 IMAGE GUIDED PAP W/ AGE SCREEN QST 91384	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 ADD-ON 88175	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 NRMC PAP 16 & 18 (4)	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 SUREPATH FPGS PAP AND HPV MRNA E6/E7 QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 SUREPATH FPGS PAP AND HPV MRNA E6/E7 C T	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 SUREPATH FPGS PAP QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 SUREPATH FPGS PAP RFX HPV MRNA E6/E7 QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP RFLX HPV CT/NG/TRICH QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP W/ HPV DNA CT/NG QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP PAP W/ HPV CT/NG/TRICH QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP TIS AND HPV MRNA E6/E7 QST	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) CPT 88175 THINPREP TIS PAP REFLEX HPV MRNA E6/E7 Q	$58.50	$130.00	—	21% below	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 ADD-ON 88175	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP RFX HPV MRNA E6/E7 QS 90934	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP TIS PAP REFLEX HPV MRNA E6/E7 Q	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP RFLX HPV CT/NG/TRICH QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP TIS AND HPV MRNA E6/E7 QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP W/ HPV DNA CT/NG QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 IMAGE GUIDED PAP W/ AGE SCREEN QST 91384	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THINPREP PAP W/ HPV CT/NG/TRICH QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SUREPATH FPGS PAP RFX HPV MRNA E6/E7 QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SUREPATH FPGS PAP QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SUREPATH FPGS PAP AND HPV MRNA E6/E7 C T	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 SUREPATH FPGS PAP AND HPV MRNA E6/E7 QST	$58.50	$130.00	—	—	55%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 NRMC PAP 16 & 18 (4)	$58.50	$130.00	—	—	55%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 AO 88142	$72.45	$161.00	—	1% below	55%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 AO 88142	$72.45	$161.00	—	—	55%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT QST 35202	$121.95	$271.00	—	29% below	55%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT QST 35202	$121.95	$271.00	—	—	55%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$13.95	$31.00	—	73% below	55%
Partial thromboplastin time (PTT) clotting test CPT 85730 85730 ADD-ON	$46.35	$103.00	—	12% below	55%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$13.95	$31.00	—	—	55%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 85730 ADD-ON	$46.35	$103.00	—	—	55%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 QNATAL ADVANCED QST 92777	$1,146.15	$2,547.00	—	2% below	55%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 QNATAL ADVANCED QST 92777	$1,146.15	$2,547.00	—	—	55%
Progesterone blood test CPT 84144 PROGESTERONE QST 17183	$58.95	$131.00	—	47% below	55%
Progesterone blood test inpatient CPT 84144 PROGESTERONE QST 17183	$58.95	$131.00	—	—	55%
Prolactin blood test CPT 84146 PROLACTIN QST 746	$107.55	$239.00	—	12% below	55%
Prolactin blood test inpatient CPT 84146 PROLACTIN QST 746	$107.55	$239.00	—	—	55%
Prothrombin time (PT/INR) clotting test CPT 85610 NMC RHC PROTHOMBIN TIME	$11.25	$25.00	—	60% below	55%
Prothrombin time (PT/INR) clotting test CPT 85610 PT/INR	$11.25	$25.00	—	60% below	55%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 NMC RHC PROTHOMBIN TIME	$11.25	$25.00	—	—	55%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT/INR	$11.25	$25.00	—	—	55%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRESUMP OPTICAL	$27.00	$60.00	—	60% below	55%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 RHC URINE DRUG TOX POC-80305	$28.35	$63.00	—	58% below	55%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRESUMP OPTICAL	$27.00	$60.00	—	—	55%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 RHC URINE DRUG TOX POC-80305	$28.35	$63.00	—	—	55%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 NMC RHC RAPID STREP	$22.50	$50.00	—	43% below	55%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 NMC RHC RAPID STREP	$22.50	$50.00	—	—	55%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QST 4418	$62.10	$138.00	—	39% above	55%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QST 4418	$62.10	$138.00	—	—	55%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ABS IGG QST 802	$46.35	$103.00	—	12% below	55%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ABS IGG QST 802	$46.35	$103.00	—	—	55%
Stool ova and parasites exam CPT 87177 OVA & PARASITE CONCENTRATION & IDENTIFIC	$40.95	$91.00	—	29% below	55%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE CONCENTRATION & IDENTIFIC	$40.95	$91.00	—	—	55%
Stool test for hidden blood (guaiac FOBT) CPT 82270 NMC RHC STOOL OCCULT BLOOD POC	$11.25	$25.00	—	48% below	55%
Stool test for hidden blood (guaiac FOBT) CPT 82270 RHC STOOL OCCULT BLOOD POC-82270	$11.25	$25.00	—	48% below	55%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL FOR OCCULT BLOOD POC	$28.35	$63.00	—	32% above	55%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 RHC STOOL OCCULT BLOOD POC-82270	$11.25	$25.00	—	—	55%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 NMC RHC STOOL OCCULT BLOOD POC	$11.25	$25.00	—	—	55%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL FOR OCCULT BLOOD POC	$28.35	$63.00	—	—	55%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 RAPID OCCULT BLOOD IFOB STOOL	$36.00	$80.00	—	29% below	55%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 RAPID OCCULT BLOOD IFOB STOOL	$36.00	$80.00	—	—	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/RFLX TO CONFIRM QST 36126	$25.20	$56.00	—	15% below	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/RFLX TO TITER QST 799	$25.20	$56.00	—	15% below	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR W/REFLEX TITER QST	$25.20	$56.00	—	15% below	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR W/RFLX TO CONFIRM QST 36126	$25.20	$56.00	—	—	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR W/REFLEX TITER QST	$25.20	$56.00	—	—	55%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR W/RFLX TO TITER QST 799	$25.20	$56.00	—	—	55%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS 4 TUBES DRAW SI	$121.95	$271.00	—	36% below	55%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD QST 36970	$128.25	$285.00	—	33% below	55%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS 4 TUBES DRAW SI	$121.95	$271.00	—	—	55%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD QST 36970	$128.25	$285.00	—	—	55%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL QST 15983	$87.30	$194.00	—	27% below	55%
Testosterone blood test, total (not free testosterone) CPT 84403 ADD-ON 84403	$87.30	$194.00	—	27% below	55%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL QST 15983	$87.30	$194.00	—	—	55%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ADD-ON 84403	$87.30	$194.00	—	—	55%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB QST 5081	$53.55	$119.00	—	30% below	55%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE THYROGLOBULIN AB QST	$53.55	$119.00	—	30% below	55%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB QST 5081	$53.55	$119.00	—	—	55%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE THYROGLOBULIN AB QST	$53.55	$119.00	—	—	55%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$37.80	$84.00	—	17% below	55%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$37.80	$84.00	—	—	55%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS QL TMA PAP VIAL QS	$57.60	$128.00	—	58% below	55%
Trichomonas test (NAAT) CPT 87661 ADD-ON 87661	$57.60	$128.00	—	58% below	55%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA QUALITATIVE TM	$57.60	$128.00	—	58% below	55%
Trichomonas test (NAAT) CPT 87661 87661-STI PID PANEL QST	$69.75	$155.00	—	49% below	55%
Trichomonas test (NAAT) CPT 87661 87661 STI CERVICITIS PANEL	$69.75	$155.00	—	49% below	55%
Trichomonas test (NAAT) CPT 87661 87661-SEXUALLY-TRANSMITTED INFECTIONS (S	$69.75	$155.00	—	49% below	55%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS RNA QUALITATIVE TM	$57.60	$128.00	—	—	55%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS QL TMA PAP VIAL QS	$57.60	$128.00	—	—	55%
Trichomonas test (NAAT) inpatient CPT 87661 ADD-ON 87661	$57.60	$128.00	—	—	55%
Trichomonas test (NAAT) inpatient CPT 87661 87661-SEXUALLY-TRANSMITTED INFECTIONS (S	$69.75	$155.00	—	—	55%
Trichomonas test (NAAT) inpatient CPT 87661 87661-STI PID PANEL QST	$69.75	$155.00	—	—	55%
Trichomonas test (NAAT) inpatient CPT 87661 87661 STI CERVICITIS PANEL	$69.75	$155.00	—	—	55%
Uric acid blood test CPT 84550 URIC ACID	$11.25	$25.00	—	73% below	55%
Uric acid blood test inpatient CPT 84550 URIC ACID	$11.25	$25.00	—	—	55%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS MICROSCOPIC CHARGE	$11.25	$25.00	—	70% below	55%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICROSCOPIC 4	$11.25	$25.00	—	70% below	55%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS MICROSCOPIC CHARGE	$11.25	$25.00	—	—	55%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICROSCOPIC 4	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, automated CPT 81003 UA CHARGE	$11.25	$25.00	—	44% below	55%
Urinalysis without microscope exam, automated CPT 81003 RHC URINE DIPSTICK Auto POC-81003	$11.25	$25.00	—	44% below	55%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK CHARGE ONLY	$11.25	$25.00	—	44% below	55%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIPSTICK	$11.25	$25.00	—	44% below	55%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIPSTICK CHARGE ONLY	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, automated inpatient CPT 81003 RHC URINE DIPSTICK Auto POC-81003	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIPSTICK	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA CHARGE	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, manual CPT 81002 RHC URINE DIPSTICK POC	$11.25	$25.00	—	13% below	55%
Urinalysis without microscope exam, manual CPT 81002 RHC URINE DIPSTICK POC-81002	$11.25	$25.00	—	13% below	55%
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK POC	$11.25	$25.00	—	13% below	55%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK POC	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, manual inpatient CPT 81002 RHC URINE DIPSTICK POC	$11.25	$25.00	—	—	55%
Urinalysis without microscope exam, manual inpatient CPT 81002 RHC URINE DIPSTICK POC-81002	$11.25	$25.00	—	—	55%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE CATH SPECIMEN QST 3021	$76.05	$169.00	—	18% above	55%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE SO	$76.05	$169.00	—	18% above	55%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE	$76.05	$169.00	—	18% above	55%
Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE QST 395	$76.05	$169.00	—	18% above	55%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE SO	$76.05	$169.00	—	—	55%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE QST 395	$76.05	$169.00	—	—	55%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE CATH SPECIMEN QST 3021	$76.05	$169.00	—	—	55%
Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE	$76.05	$169.00	—	—	55%
Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE RAPID	$19.35	$43.00	—	61% below	55%
Urine pregnancy test, read by color change CPT 81025 NMC RHC URINE PREGNANCY TEST POC	$19.80	$44.00	—	60% below	55%
Urine pregnancy test, read by color change CPT 81025 RHC URINE PREGNANCY TEST POC-81025	$61.65	$137.00	—	24% above	55%
Urine pregnancy test, read by color change inpatient CPT 81025 PREGNANCY TEST URINE RAPID	$19.35	$43.00	—	—	55%
Urine pregnancy test, read by color change inpatient CPT 81025 NMC RHC URINE PREGNANCY TEST POC	$19.80	$44.00	—	—	55%
Urine pregnancy test, read by color change inpatient CPT 81025 RHC URINE PREGNANCY TEST POC-81025	$61.65	$137.00	—	—	55%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$34.20	$76.00	—	56% below	55%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$34.20	$76.00	—	—	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25-HYDROXY	$46.80	$104.00	—	66% below	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 HYDROXY VIT D 92889	$85.95	$191.00	—	37% below	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 QUESTASSURED 25 HYDROXY VIT D	$85.95	$191.00	—	37% below	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25-HYDROXY	$46.80	$104.00	—	—	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 HYDROXY VIT D 92889	$85.95	$191.00	—	—	55%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 QUESTASSURED 25 HYDROXY VIT D	$85.95	$191.00	—	—	55%
Zinc blood test CPT 84630 ZINC PLASMA QST 945	$53.55	$119.00	—	12% below	55%
Zinc blood test inpatient CPT 84630 ZINC PLASMA QST 945	$53.55	$119.00	—	—	55%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE	$34.20	$76.00	—	60% below	55%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 84702 ADD-ON	$96.30	$214.00	—	13% above	55%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 AFP TETRA RESULTS	$101.25	$225.00	—	19% above	55%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE	$34.20	$76.00	—	—	55%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 84702 ADD-ON	$96.30	$214.00	—	—	55%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 AFP TETRA RESULTS	$101.25	$225.00	—	—	55%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 ADENOIDECTOMY <AGE 12 PF	$270.00	$600.00	—	92% below	55%
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS	$4,348.80	$9,664.00	—	35% above	55%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 ADENOIDECTOMY <AGE 12 PF	$270.00	$600.00	—	—	55%
Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 REMOVAL OF ADENOIDS	$4,348.80	$9,664.00	—	—	55%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY	$15,480.90	$34,402.00	—	20% below	55%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 KNEE ARTHROSCOPY/SURGERY	$15,480.90	$34,402.00	—	—	55%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR PF	$1,359.45	$3,021.00	—	89% below	55%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 SHO ARTHRS SRG RT8TR CUF RPR PF	$1,359.45	$3,021.00	—	—	55%
Botox injections for chronic migraine CPT 64615 CHEMODENERV FACIAL NERVE BIL PF	$256.50	$570.00	—	1% below	55%
Botox injections for chronic migraine CPT 64615 CHEMODENERV FACIAL NERVE BIL	$444.60	$988.00	—	71% above	55%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV FACIAL NERVE BIL PF	$256.50	$570.00	—	—	55%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV FACIAL NERVE BIL	$444.60	$988.00	—	—	55%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLSD DISTAL FIB FX W/O MP PF	$301.95	$671.00	—	38% below	55%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLSD DISTAL FIB FX W/O MP PF	$301.95	$671.00	—	—	55%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLSD METATARSAL W/O MP EA PF	$213.75	$475.00	—	45% below	55%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLSD METATARSAL W/O MP EA PF	$213.75	$475.00	—	—	55%
Bunion correction with removal of part of the big toe joint CPT 28292 BUNIONECTOMY W. RESECTION PF	$1,174.05	$2,609.00	—	at median	55%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 BUNIONECTOMY W. RESECTION PF	$1,174.05	$2,609.00	—	—	55%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELEC EXTL PF	$112.05	$249.00	—	86% below	55%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$459.00	$1,020.00	—	44% below	55%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$769.05	$1,709.00	—	7% below	55%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXTRL	$976.95	$2,171.00	—	19% above	55%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELEC EXTL PF	$112.05	$249.00	—	—	55%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$459.00	$1,020.00	—	—	55%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL	$769.05	$1,709.00	—	—	55%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE EXTRL	$976.95	$2,171.00	—	—	55%
Carpal tunnel release, open surgery CPT 64721 NPLASTY &/TRANSPOS MEDIAN NRV CARPAL PF	$552.60	$1,228.00	—	82% below	55%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$4,722.30	$10,494.00	—	56% above	55%
Carpal tunnel release, open surgery inpatient CPT 64721 NPLASTY &/TRANSPOS MEDIAN NRV CARPAL PF	$552.60	$1,228.00	—	—	55%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$4,722.30	$10,494.00	—	—	55%
Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY W/ANTE&POST ASSIST	$827.55	$1,839.00	—	79% below	55%
Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY W/ANTE&POST PF	$2,758.95	$6,131.00	—	28% below	55%
Cesarean delivery, including prenatal and postpartum care CPT 59510 CESAREAN DELIVERY W/ANTE&POST	$2,758.95	$6,131.00	—	28% below	55%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 CESAREAN DELIVERY W/ANTE&POST ASSIST	$827.55	$1,839.00	—	—	55%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 CESAREAN DELIVERY W/ANTE&POST PF	$2,758.95	$6,131.00	—	—	55%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 CESAREAN DELIVERY W/ANTE&POST	$2,758.95	$6,131.00	—	—	55%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 RHC CIRCUM 28 DAYS OR OLDER-54161	$373.95	$831.00	—	88% below	55%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 RHC CIRCUM 28 DAYS OR OLDER-54161	$373.95	$831.00	—	—	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION PF	$121.50	$270.00	—	64% below	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 NEWBORN CIRCUMCISION PF	$123.75	$275.00	—	63% below	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 RHC CIRCUMCISION W/REGIONL BLOCK-54150	$286.65	$637.00	—	14% below	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$834.75	$1,855.00	—	150% above	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION PF	$121.50	$270.00	—	—	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 NEWBORN CIRCUMCISION PF	$123.75	$275.00	—	—	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 RHC CIRCUMCISION W/REGIONL BLOCK-54150	$286.65	$637.00	—	—	55%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$834.75	$1,855.00	—	—	55%
Circumcision, surgical, older than a newborn CPT 54160 RHC CIRCUMCISION OTHER-54160	$403.65	$897.00	—	22% below	55%
Circumcision, surgical, older than a newborn inpatient CPT 54160 RHC CIRCUMCISION OTHER-54160	$403.65	$897.00	—	—	55%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSD TX COLLES FX W/O MAN PF	$338.85	$753.00	—	42% below	55%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSD TX COLLES FX W/O MAN PF	$338.85	$753.00	—	—	55%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/ SNARE PF	$750.60	$1,668.00	—	56% below	55%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/SNARE	$1,771.20	$3,936.00	—	4% above	55%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/ SNARE PF	$750.60	$1,668.00	—	—	55%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/SNARE	$1,771.20	$3,936.00	—	—	55%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/ BIOPSY PF	$664.20	$1,476.00	—	63% below	55%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/ BIOPSY	$1,771.20	$3,936.00	—	1% below	55%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/ BIOPSY PF	$664.20	$1,476.00	—	—	55%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/ BIOPSY	$1,771.20	$3,936.00	—	—	55%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEX DIAG BRUSH/WASH PF	$562.50	$1,250.00	—	56% below	55%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY	$1,371.60	$3,048.00	—	8% above	55%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEX DIAG BRUSH/WASH PF	$562.50	$1,250.00	—	—	55%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY	$1,371.60	$3,048.00	—	—	55%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE PF	$237.15	$527.00	—	47% below	55%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$237.15	$527.00	—	47% below	55%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 RHC CERV COLPOSCOPY W BIO/CURETTAG 57454	$256.05	$569.00	—	43% below	55%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$237.15	$527.00	—	—	55%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE PF	$237.15	$527.00	—	—	55%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 RHC CERV COLPOSCOPY W BIO/CURETTAG 57454	$256.05	$569.00	—	—	55%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY PF	$108.45	$241.00	—	90% below	55%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$1,025.55	$2,279.00	—	4% below	55%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY PF	$108.45	$241.00	—	—	55%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$1,025.55	$2,279.00	—	—	55%
D&C (dilation and curettage), not related to pregnancy CPT 58120 D & C DX&/THER NONOBSTETR PF	$298.35	$663.00	—	90% below	55%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 D & C DX&/THER NONOBSTETR PF	$298.35	$663.00	—	—	55%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 RHC DESTRUCT PREMALG LESION 1ST	$67.95	$151.00	—	42% below	55%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PRE-MALIG LESION 1ST LESN PF	$88.65	$197.00	—	24% below	55%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PRE-MALIG LESION 1ST LESN	$300.60	$668.00	—	157% above	55%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 RHC DESTRUCT PREMALG LESION 1ST	$67.95	$151.00	—	—	55%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PRE-MALIG LESION 1ST LESN PF	$88.65	$197.00	—	—	55%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PRE-MALIG LESION 1ST LESN	$300.60	$668.00	—	—	55%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY PF	$202.50	$450.00	—	94% below	55%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY 69436	$2,288.70	$5,086.00	—	30% below	55%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING	$2,328.30	$5,174.00	—	29% below	55%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY PF	$202.50	$450.00	—	—	55%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 TYMPANOSTOMY 69436	$2,288.70	$5,086.00	—	—	55%
Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 CREATE EARDRUM OPENING	$2,328.30	$5,174.00	—	—	55%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY INS VENT TUBE PF	$172.80	$384.00	—	58% below	55%
Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 TYMPANOSTOMY INT VENT TUBE	$825.75	$1,835.00	—	100% above	55%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY INS VENT TUBE PF	$172.80	$384.00	—	—	55%
Ear tube placement (tympanostomy) with local anesthesia, one ear inpatient CPT 69433 TYMPANOSTOMY INT VENT TUBE	$825.75	$1,835.00	—	—	55%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPACTED CERUMEN W/ IRRIG PF	$49.50	$110.00	—	33% below	55%
Earwax removal by irrigation (rinsing), one ear CPT 69209 RHC REM IMPACTED CERUMEN W/ IRRIG-69209	$49.50	$110.00	—	33% below	55%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REM IMPACTED CERUMEN W/ IRRIG	$50.40	$112.00	—	32% below	55%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPACTED CERUMEN W/ IRRIG PF	$49.50	$110.00	—	—	55%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 RHC REM IMPACTED CERUMEN W/ IRRIG-69209	$49.50	$110.00	—	—	55%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REM IMPACTED CERUMEN W/ IRRIG	$50.40	$112.00	—	—	55%
Earwax removal with instruments, one ear CPT 69210 REM IMPAT CER W/INSTR UNI PF	$34.20	$76.00	—	63% below	55%
Earwax removal with instruments, one ear CPT 69210 REM IMPACT CERUM W/ INSTR PF	$57.60	$128.00	—	37% below	55%
Earwax removal with instruments, one ear CPT 69210 RHC REM IMPCT CERUMEN W/INSRMT UNI-69210	$57.60	$128.00	—	37% below	55%
Earwax removal with instruments, one ear CPT 69210 REM IMPACT CERUM W/INSTR UNI	$75.15	$167.00	—	18% below	55%
Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL W/ INSTRU 69210	$91.80	$204.00	—	at median	55%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$2,639.70	$5,866.00	—	2780% above	55%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPAT CER W/INSTR UNI PF	$34.20	$76.00	—	—	55%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPACT CERUM W/ INSTR PF	$57.60	$128.00	—	—	55%
Earwax removal with instruments, one ear inpatient CPT 69210 RHC REM IMPCT CERUMEN W/INSRMT UNI-69210	$57.60	$128.00	—	—	55%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPACT CERUM W/INSTR UNI	$75.15	$167.00	—	—	55%
Earwax removal with instruments, one ear inpatient CPT 69210 CERUMEN REMOVAL W/ INSTRU 69210	$91.80	$204.00	—	—	55%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$2,639.70	$5,866.00	—	—	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING PF	$168.30	$374.00	—	36% below	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$168.30	$374.00	—	36% below	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 RHC ENDOMETRIAL BIOPSY WO CERV DIL 58100	$195.30	$434.00	—	25% below	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING PF	$168.30	$374.00	—	—	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$168.30	$374.00	—	—	55%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 RHC ENDOMETRIAL BIOPSY WO CERV DIL 58100	$195.30	$434.00	—	—	55%
Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 NSL/SINS NDSC W/ TOTAL ETHOIDECTOMY PF	$415.80	$924.00	—	95% below	55%
Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 NSL/SINS NDSC W/ TOTAL ETHOIDECTOMY PF	$415.80	$924.00	—	—	55%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 NSL/SINS NDSC FRNT TISS RMVL PF	$486.00	$1,080.00	—	94% below	55%
Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 NSL/SINS NDSC FRNT TISS RMVL PF	$486.00	$1,080.00	—	—	55%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 NSL/SINS NDSC W/ MAXIL ANTROSTOMY PF	$231.30	$514.00	—	92% below	55%
Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 NSL/SINS NDSC W/ MAXIL ANTROSTOMY PF	$231.30	$514.00	—	—	55%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS PF	$341.10	$758.00	—	96% below	55%
Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 ENDOSCOPY MAXILLARY SINUS PF	$341.10	$758.00	—	—	55%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC PF	$250.65	$557.00	—	75% below	55%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,038.15	$2,307.00	—	2% above	55%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC PF	$250.65	$557.00	—	—	55%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,038.15	$2,307.00	—	—	55%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 PM INJ PARAV F JNT L/S 1 LEV	$1,368.00	$3,040.00	—	32% above	55%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 PM INJ PARAV F JNT L/S 1 LEV	$1,368.00	$3,040.00	—	—	55%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE PF	$742.50	$1,650.00	—	88% below	55%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE PF	$742.50	$1,650.00	—	—	55%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE PF	$996.75	$2,215.00	—	47% below	55%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 RPR AA HERNIA 1ST > 10 CM REDUCIBLE PF	$996.75	$2,215.00	—	—	55%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANTERIOR ABDOMINAL HERNIA PF	$445.50	$990.00	—	91% below	55%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANTERIOR ABDOMINAL HERNIA PF	$445.50	$990.00	—	—	55%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEX SEDATION PF	$184.50	$410.00	—	84% below	55%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEX SEDATION	$1,371.60	$3,048.00	—	22% above	55%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEX SEDATION PF	$184.50	$410.00	—	—	55%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEX SEDATION	$1,371.60	$3,048.00	—	—	55%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY PF	$975.60	$2,168.00	—	84% below	55%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$11,168.55	$24,819.00	—	85% above	55%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY PF	$975.60	$2,168.00	—	—	55%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$11,168.55	$24,819.00	—	—	55%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE W/ CHOLANGIOGRAPHY PF	$924.30	$2,054.00	—	85% below	55%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$8,948.25	$19,885.00	—	43% above	55%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE W/ CHOLANGIOGRAPHY PF	$924.30	$2,054.00	—	—	55%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$8,948.25	$19,885.00	—	—	55%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE PF	$557.55	$1,239.00	—	77% below	55%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE PF	$557.55	$1,239.00	—	—	55%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOID BANDING PF	$273.60	$608.00	—	80% below	55%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOID BANDING	$1,371.60	$3,048.00	—	1% above	55%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOID BANDING PF	$273.60	$608.00	—	—	55%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOID BANDING	$1,371.60	$3,048.00	—	—	55%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 NM HYSTEROSALPINGOGR	$364.05	$809.00	—	27% above	55%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 NM HYSTEROSALPINGOGR	$364.05	$809.00	—	—	55%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$5,953.50	$13,230.00	—	21% below	55%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ABLATION	$5,953.50	$13,230.00	—	—	55%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY PF	$417.15	$927.00	—	90% below	55%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY PF	$417.15	$927.00	—	—	55%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION IUD PF	$319.95	$711.00	—	48% below	55%
IUD insertion (the device itself billed separately) CPT 58300 INSERTION IUD	$319.95	$711.00	—	48% below	55%
IUD insertion (the device itself billed separately) CPT 58300 RHC IUD INSERTION 58300	$337.50	$750.00	—	45% below	55%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION IUD	$319.95	$711.00	—	—	55%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERTION IUD PF	$319.95	$711.00	—	—	55%
IUD insertion (the device itself billed separately) inpatient CPT 58300 RHC IUD INSERTION 58300	$337.50	$750.00	—	—	55%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE SNGL PF	$118.80	$264.00	—	47% below	55%
Incision and drainage of a simple or single skin abscess CPT 10060 RHC I&D ABSCESS SIMPLE SNGL-10060	$139.05	$309.00	—	38% below	55%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE SNGL	$300.60	$668.00	—	34% above	55%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE SNGL PF	$118.80	$264.00	—	—	55%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 RHC I&D ABSCESS SIMPLE SNGL-10060	$139.05	$309.00	—	—	55%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE SNGL	$300.60	$668.00	—	—	55%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INIT INGUINAL HERNIA AGE >5YR PF	$688.50	$1,530.00	—	89% below	55%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INIT INGUINAL HERNIA AGE >5YR PF	$688.50	$1,530.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIG PF	$41.40	$92.00	—	79% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PM INJECTION LIGAMENT PF	$91.80	$204.00	—	54% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PM INJECTION TENDON PF	$91.80	$204.00	—	54% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION TENDON	$122.40	$272.00	—	38% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION LIGAMENT PF	$131.40	$292.00	—	34% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 RHC INJECTION LIGAMENT - 20550	$131.40	$292.00	—	34% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PM INJECTION LIGAMENT	$137.70	$306.00	—	30% below	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJECTION LIGAMENT	$444.60	$988.00	—	124% above	55%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PM INJECTION TENDON	$444.60	$988.00	—	124% above	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIG PF	$41.40	$92.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PM INJECTION LIGAMENT PF	$91.80	$204.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PM INJECTION TENDON PF	$91.80	$204.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION TENDON	$122.40	$272.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 RHC INJECTION LIGAMENT - 20550	$131.40	$292.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION LIGAMENT PF	$131.40	$292.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PM INJECTION LIGAMENT	$137.70	$306.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PM INJECTION TENDON	$444.60	$988.00	—	—	55%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJECTION LIGAMENT	$444.60	$988.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/IJ MAJOR JT/BURSA W/O PF	$47.70	$106.00	—	78% below	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 RHC ASP/INJECT MAJ JT/BURSA W/O US-20610	$93.15	$207.00	—	56% below	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO INJ/ASP LG JT PF	$123.30	$274.00	—	42% below	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PM INJECTION MAJOR PF	$123.30	$274.00	—	42% below	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT ASPIRATION MAJOR	$151.20	$336.00	—	29% below	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHRO INJ/ASP LG JT	$444.60	$988.00	—	108% above	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PM INJECTION MAJOR	$444.60	$988.00	—	108% above	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR ARTHRO INJ/ASP LG JT	$444.60	$988.00	—	108% above	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/IJ MAJOR JT/BURSA W/O PF	$47.70	$106.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 RHC ASP/INJECT MAJ JT/BURSA W/O US-20610	$93.15	$207.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PM INJECTION MAJOR PF	$123.30	$274.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO INJ/ASP LG JT PF	$123.30	$274.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JOINT ASPIRATION MAJOR	$151.20	$336.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PM INJECTION MAJOR	$444.60	$988.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHRO INJ/ASP LG JT	$444.60	$988.00	—	—	55%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XR ARTHRO INJ/ASP LG JT	$444.60	$988.00	—	—	55%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NONBIO DRUG DEL SYST 11981 PF	$80.55	$179.00	—	55% below	55%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION NONBIO DRUG DEL SYST 11981	$191.70	$426.00	—	6% above	55%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 RHC INSERTION NONBIO DRUG DEL SYST 11981	$248.85	$553.00	—	38% above	55%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION NONBIO DRUG DEL SYST 11981 PF	$80.55	$179.00	—	—	55%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION NONBIO DRUG DEL SYST 11981	$191.70	$426.00	—	—	55%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 RHC INSERTION NONBIO DRUG DEL SYST 11981	$248.85	$553.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PM INJECTION INTERMEDIATE PF	$104.40	$232.00	—	48% below	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 RHC ASP/INJECT INT JT/BURSA W/O US-20605	$131.40	$292.00	—	34% below	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION INTERMEDIATE PF	$131.40	$292.00	—	34% below	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 JT ASPIRATION INTRMEDIATE	$137.70	$306.00	—	31% below	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PM INJECTION INTERMEDIATE	$248.85	$553.00	—	24% above	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INJECTION INTERMEDIATE	$444.60	$988.00	—	122% above	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PM INJECTION INTERMEDIATE PF	$104.40	$232.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECTION INTERMEDIATE PF	$131.40	$292.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 RHC ASP/INJECT INT JT/BURSA W/O US-20605	$131.40	$292.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 JT ASPIRATION INTRMEDIATE	$137.70	$306.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PM INJECTION INTERMEDIATE	$248.85	$553.00	—	—	55%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INJECTION INTERMEDIATE	$444.60	$988.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ASP/IJ SMALL JT/BURSA W/O PF	$37.80	$84.00	—	81% below	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 RHC ASP/INJECT SM JT/BURSA W/O US-20600	$70.20	$156.00	—	65% below	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PM INJECTION SMALL PF	$100.35	$223.00	—	50% below	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECTION SMALL PF	$131.40	$292.00	—	35% below	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 JOINT ASPIRATION SMALL	$137.70	$306.00	—	31% below	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 PM INJECTION SMALL	$444.60	$988.00	—	121% above	55%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECTION SMALL	$444.60	$988.00	—	121% above	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/IJ SMALL JT/BURSA W/O PF	$37.80	$84.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 RHC ASP/INJECT SM JT/BURSA W/O US-20600	$70.20	$156.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PM INJECTION SMALL PF	$100.35	$223.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJECTION SMALL PF	$131.40	$292.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 JOINT ASPIRATION SMALL	$137.70	$306.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJECTION SMALL	$444.60	$988.00	—	—	55%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PM INJECTION SMALL	$444.60	$988.00	—	—	55%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHRSC KNEE W/MENISCUS RPR MEDIAL/L PF	$877.05	$1,949.00	—	92% below	55%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY	$8,922.15	$19,827.00	—	18% below	55%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHRSC KNEE W/MENISCUS RPR MEDIAL/L PF	$877.05	$1,949.00	—	—	55%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 KNEE ARTHROSCOPY/SURGERY	$8,922.15	$19,827.00	—	—	55%
Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W	$688.50	$1,530.00	—	90% below	55%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY	$8,922.15	$19,827.00	—	29% above	55%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W	$688.50	$1,530.00	—	—	55%
Knee arthroscopy with meniscus trim inpatient CPT 29881 KNEE ARTHROSCOPY/SURGERY	$8,922.15	$19,827.00	—	—	55%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR C	$790.20	$1,756.00	—	87% below	55%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR C	$790.20	$1,756.00	—	—	55%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPROSCOPIC APPENDECTOMY PF	$774.45	$1,721.00	—	90% below	55%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$10,419.75	$23,155.00	—	31% above	55%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPROSCOPIC APPENDECTOMY PF	$774.45	$1,721.00	—	—	55%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$10,419.75	$23,155.00	—	—	55%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP SURG RPR INITIAL INGUINAL HERNIA PF	$546.75	$1,215.00	—	93% below	55%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP SURG RPR INITIAL INGUINAL HERNIA PF	$546.75	$1,215.00	—	—	55%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG CAPSULOTOMY SEC MEMBRA	$872.55	$1,939.00	—	23% above	55%
Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 YAG CAPSULOTOMY SEC MEMBRA	$872.55	$1,939.00	—	—	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER SCLP/TK/EXT <2.5PF	$155.25	$345.00	—	59% below	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER SCLP/TK/EXT <2.5	$298.35	$663.00	—	21% below	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC INTER SCLP/TK/EXT <2.5 PF	$412.65	$917.00	—	9% above	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER SCLP/TK/EXT <2.5PF	$155.25	$345.00	—	—	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER SCLP/TK/EXT <2.5	$298.35	$663.00	—	—	55%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC INTER SCLP/TK/EXT <2.5 PF	$412.65	$917.00	—	—	55%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC PF	$119.25	$265.00	—	88% below	55%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,038.15	$2,307.00	—	7% above	55%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC PF	$119.25	$265.00	—	—	55%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$1,038.15	$2,307.00	—	—	55%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PM LUMBAR TRANSFORAMIL INJ 1 PF	$256.05	$569.00	—	83% below	55%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 LUMBAR TRANSFORAMINAL INJ 1	$383.40	$852.00	—	74% below	55%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 PM LUMBAR TRANSFORAMIL INJ 1	$1,368.00	$3,040.00	—	8% below	55%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PM LUMBAR TRANSFORAMIL INJ 1 PF	$256.05	$569.00	—	—	55%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 LUMBAR TRANSFORAMINAL INJ 1	$383.40	$852.00	—	—	55%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 PM LUMBAR TRANSFORAMIL INJ 1	$1,368.00	$3,040.00	—	—	55%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY PF	$846.45	$1,881.00	—	34% below	55%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY PF	$846.45	$1,881.00	—	—	55%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMP COMPLETE PF	$1,228.95	$2,731.00	—	17% below	55%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMP COMPLETE PF	$1,228.95	$2,731.00	—	—	55%
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORTION 1ST TRIMESTER SURG	$537.30	$1,194.00	—	89% below	55%
Miscarriage treatment with D&C, first trimester CPT 59820 TX MISSED ABORTION 1ST TRIM	$4,691.70	$10,426.00	—	4% below	55%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORTION 1ST TRIMESTER SURG	$537.30	$1,194.00	—	—	55%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TX MISSED ABORTION 1ST TRIM	$4,691.70	$10,426.00	—	—	55%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 RHC EX B9 LESN TRK ARM LEG 0.5CM OR <	$205.65	$457.00	—	17% below	55%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EX B9 LESN TRK ARM LEG 0.5CM OR < PF	$205.65	$457.00	—	17% below	55%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EX B9 LESN TRK ARM LEG 0.5CM OR <	$1,056.15	$2,347.00	—	328% above	55%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 RHC EX B9 LESN TRK ARM LEG 0.5CM OR <	$205.65	$457.00	—	—	55%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EX B9 LESN TRK ARM LEG 0.5CM OR < PF	$205.65	$457.00	—	—	55%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EX B9 LESN TRK ARM LEG 0.5CM OR <	$1,056.15	$2,347.00	—	—	55%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EX B9 LESN FACE <.5CM PF	$185.85	$413.00	—	36% below	55%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 RHC EX B9 LESN FACE <.5CM-11440	$185.85	$413.00	—	36% below	55%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EX B9 LESN FACE <.5CM	$1,056.15	$2,347.00	—	266% above	55%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EX B9 LESN FACE <.5CM PF	$185.85	$413.00	—	—	55%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 RHC EX B9 LESN FACE <.5CM-11440	$185.85	$413.00	—	—	55%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EX B9 LESN FACE <.5CM	$1,056.15	$2,347.00	—	—	55%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLATE SGL SIMP PF	$56.70	$126.00	—	65% below	55%
Nail removal (partial or complete), one nail CPT 11730 RHC AVUL NAIL PLATE SNGL SIMPLE	$73.80	$164.00	—	55% below	55%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLATE SINGLE SIMPLE PF	$216.00	$480.00	—	31% above	55%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLATE SINGLE SIMPLE	$300.60	$668.00	—	83% above	55%
Nail removal (partial or complete), one nail CPT 11730 AVUL NAIL PLATE SINGLE SIMP	$300.60	$668.00	—	83% above	55%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLATE SGL SIMP PF	$56.70	$126.00	—	—	55%
Nail removal (partial or complete), one nail inpatient CPT 11730 RHC AVUL NAIL PLATE SNGL SIMPLE	$73.80	$164.00	—	—	55%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLATE SINGLE SIMPLE PF	$216.00	$480.00	—	—	55%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLATE SINGLE SIMPLE	$300.60	$668.00	—	—	55%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVUL NAIL PLATE SINGLE SIMP	$300.60	$668.00	—	—	55%
Occipital nerve block (injection for headaches) CPT 64405 GREATER OCCIPITAL NERVE BLOK	$137.70	$306.00	—	55% below	55%
Occipital nerve block (injection for headaches) CPT 64405 PM GREATER OCCIP NERVE BLOCK PF	$159.75	$355.00	—	48% below	55%
Occipital nerve block (injection for headaches) CPT 64405 PM GREATER OCCIP NERVE BLOCK	$248.85	$553.00	—	18% below	55%
Occipital nerve block (injection for headaches) inpatient CPT 64405 GREATER OCCIPITAL NERVE BLOK	$137.70	$306.00	—	—	55%
Occipital nerve block (injection for headaches) inpatient CPT 64405 PM GREATER OCCIP NERVE BLOCK PF	$159.75	$355.00	—	—	55%
Occipital nerve block (injection for headaches) inpatient CPT 64405 PM GREATER OCCIP NERVE BLOCK	$248.85	$553.00	—	—	55%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/ IMAG PF	$135.90	$302.00	—	84% below	55%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGE	$685.80	$1,524.00	—	21% below	55%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$1,360.35	$3,023.00	—	58% above	55%
Paracentesis with imaging guidance CPT 49083 US GUIDE PARACENTESIS	$1,943.55	$4,319.00	—	125% above	55%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/ IMAG PF	$135.90	$302.00	—	—	55%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGE	$685.80	$1,524.00	—	—	55%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$1,360.35	$3,023.00	—	—	55%
Paracentesis with imaging guidance inpatient CPT 49083 US GUIDE PARACENTESIS	$1,943.55	$4,319.00	—	—	55%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EX NAIL AND NAIL MATRIX PF	$215.10	$478.00	—	46% below	55%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 RHC EXCISION NAIL AND NAIL MATRIX-11750	$215.10	$478.00	—	46% below	55%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 HBC EX NAIL AND NAIL MATRIX	$598.50	$1,330.00	—	51% above	55%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EX NAIL AND NAIL MATRIX PF	$215.10	$478.00	—	—	55%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 RHC EXCISION NAIL AND NAIL MATRIX-11750	$215.10	$478.00	—	—	55%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HBC EX NAIL AND NAIL MATRIX	$598.50	$1,330.00	—	—	55%
Prostate biopsy CPT 55700 US PROSTATE BIOPSY	$1,620.00	$3,600.00	—	45% below	55%
Prostate biopsy inpatient CPT 55700 US PROSTATE BIOPSY	$1,620.00	$3,600.00	—	—	55%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PM DESTROY LUMB/SAC FACT JNT PF	$338.85	$753.00	—	76% below	55%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 PM DESTROY LUMB/SAC FACT JNT	$2,897.55	$6,439.00	—	102% above	55%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PM DESTROY LUMB/SAC FACT JNT PF	$338.85	$753.00	—	—	55%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 PM DESTROY LUMB/SAC FACT JNT	$2,897.55	$6,439.00	—	—	55%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION PF	$602.10	$1,338.00	—	39% below	55%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION	$7,018.20	$15,596.00	—	605% above	55%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION PF	$602.10	$1,338.00	—	—	55%
Removal of a breast lump, open surgery inpatient CPT 19120 REMOVAL OF BREAST LESION	$7,018.20	$15,596.00	—	—	55%
Removal of a foreign object under the skin, simple CPT 10120 RHC FB REM SQ TIS SIMPLE W/INCISN-10120	$195.30	$434.00	—	36% below	55%
Removal of a foreign object under the skin, simple CPT 10120 FB REM SQ TIS SIMP W/INC PF	$243.45	$541.00	—	20% below	55%
Removal of a foreign object under the skin, simple CPT 10120 FB REM SQ TIS SIMP W/INC	$364.05	$809.00	—	20% above	55%
Removal of a foreign object under the skin, simple inpatient CPT 10120 RHC FB REM SQ TIS SIMPLE W/INCISN-10120	$195.30	$434.00	—	—	55%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REM SQ TIS SIMP W/INC PF	$243.45	$541.00	—	—	55%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REM SQ TIS SIMP W/INC	$364.05	$809.00	—	—	55%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON SCREEN NOT HI RISK PF	$680.40	$1,512.00	—	11% below	55%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON SCREEN NOT HI RISK	$1,371.60	$3,048.00	—	79% above	55%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON SCREEN NOT HI RISK PF	$680.40	$1,512.00	—	—	55%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLON SCREEN NOT HI RISK	$1,371.60	$3,048.00	—	—	55%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCRN HIGH RISK PF	$680.40	$1,512.00	—	10% below	55%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLONOSCOPY SCREEN MEDICARE	$1,371.60	$3,048.00	—	82% above	55%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCRN HIGH RISK PF	$680.40	$1,512.00	—	—	55%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLONOSCOPY SCREEN MEDICARE	$1,371.60	$3,048.00	—	—	55%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR NASAL SEPTUM/ SEPTOPLASTY PF	$848.70	$1,886.00	—	88% below	55%
Septoplasty to straighten the nasal septum CPT 30520 REPAIR OF NASAL SEPTUM	$6,466.50	$14,370.00	—	5% below	55%
Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR NASAL SEPTUM/ SEPTOPLASTY PF	$848.70	$1,886.00	—	—	55%
Septoplasty to straighten the nasal septum inpatient CPT 30520 REPAIR OF NASAL SEPTUM	$6,466.50	$14,370.00	—	—	55%
Short arm cast (elbow to hand) CPT 29075 APPLY SHORT ARM CAST	$403.20	$896.00	—	68% above	55%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY SHORT ARM CAST	$403.20	$896.00	—	—	55%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT PF	$41.85	$93.00	—	72% below	55%
Short arm splint (forearm and hand) CPT 29125 RHC APPLY SHORT ARM SPLINT	$104.85	$233.00	—	29% below	55%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT	$191.70	$426.00	—	30% above	55%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT PF	$41.85	$93.00	—	—	55%
Short arm splint (forearm and hand) inpatient CPT 29125 RHC APPLY SHORT ARM SPLINT	$104.85	$233.00	—	—	55%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT	$191.70	$426.00	—	—	55%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$403.20	$896.00	—	44% above	55%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$403.20	$896.00	—	—	55%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT PF	$51.75	$115.00	—	69% below	55%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$236.70	$526.00	—	43% above	55%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT PF	$51.75	$115.00	—	—	55%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT	$236.70	$526.00	—	—	55%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC PF	$860.85	$1,913.00	—	92% below	55%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 SHO ARTHRS SRG DSTL CLAVICLC PF	$860.85	$1,913.00	—	—	55%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$13,632.30	$30,294.00	—	at median	55%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 SHO ARTHRS SRG DECOMPRESSION	$13,632.30	$30,294.00	—	—	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMP SCALP/TRK<=2.5CM PF	$47.70	$106.00	—	78% below	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE SCALP/TRNK<=2.5CM	$99.45	$221.00	—	55% below	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RHC LAC SIMPLE SCALP/TRNK<=2.5CM-12001	$214.65	$477.00	—	3% below	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC SIMPLE SCALP/TRNK<=2.5CM PF	$273.15	$607.00	—	23% above	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMP SCALP/TRK<=2.5CM PF	$47.70	$106.00	—	—	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE SCALP/TRNK<=2.5CM	$99.45	$221.00	—	—	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RHC LAC SIMPLE SCALP/TRNK<=2.5CM-12001	$214.65	$477.00	—	—	55%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC SIMPLE SCALP/TRNK<=2.5CM PF	$273.15	$607.00	—	—	55%
Skin biopsy, punch, one lesion CPT 11104 RHC PUNCH BX SKIN SINGLE LESION-11104	$80.55	$179.00	—	69% below	55%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION PF	$80.55	$179.00	—	69% below	55%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$598.50	$1,330.00	—	128% above	55%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION PF	$80.55	$179.00	—	—	55%
Skin biopsy, punch, one lesion inpatient CPT 11104 RHC PUNCH BX SKIN SINGLE LESION-11104	$80.55	$179.00	—	—	55%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$598.50	$1,330.00	—	—	55%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 RHC EX MALIG LESN TRNK/ARM/LEG <0.5CM	$330.75	$735.00	—	4% below	55%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EX MALIG LESN TRNK/ARM/LEG <0.5CM PF	$330.75	$735.00	—	4% below	55%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EX MALIG LESN TRNK/ARM/LEG <0.5CM	$330.75	$735.00	—	4% below	55%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EX MALIG LESN TRNK/ARM/LEG <0.5CM PF	$330.75	$735.00	—	—	55%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 RHC EX MALIG LESN TRNK/ARM/LEG <0.5CM	$330.75	$735.00	—	—	55%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EX MALIG LESN TRNK/ARM/LEG <0.5CM	$330.75	$735.00	—	—	55%
Skin tag removal, up to 15 tags CPT 11200 RHC REMOVAL SKIN TAG 1-15	$162.90	$362.00	—	11% above	55%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG 1-15 PF PF	$162.90	$362.00	—	11% above	55%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAGS 1-15 PF	$162.90	$362.00	—	11% above	55%
Skin tag removal, up to 15 tags CPT 11200 REMOVAL SKIN TAG 1-15 PF	$300.60	$668.00	—	104% above	55%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAGS 1-15 PF	$162.90	$362.00	—	—	55%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAG 1-15 PF PF	$162.90	$362.00	—	—	55%
Skin tag removal, up to 15 tags inpatient CPT 11200 RHC REMOVAL SKIN TAG 1-15	$162.90	$362.00	—	—	55%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVAL SKIN TAG 1-15 PF	$300.60	$668.00	—	—	55%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PM LUMBAR PUNCTURE PF	$126.45	$281.00	—	75% below	55%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE	$289.80	$644.00	—	42% below	55%
Spinal tap (lumbar puncture), diagnostic CPT 62270 PM LUMBAR PUNCTURE	$649.35	$1,443.00	—	29% above	55%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DX	$1,038.15	$2,307.00	—	106% above	55%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PM LUMBAR PUNCTURE PF	$126.45	$281.00	—	—	55%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE	$289.80	$644.00	—	—	55%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 PM LUMBAR PUNCTURE	$649.35	$1,443.00	—	—	55%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DX	$1,038.15	$2,307.00	—	—	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMP SCLP/TRK 2.6-7.5 PF	$62.55	$139.00	—	78% below	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMP SCALP/TRNK 2.6-7.5	$129.60	$288.00	—	55% below	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC SIMP SCALP/TRNK 2.6-7.5 PF	$339.30	$754.00	—	18% above	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RHC LAC SIMP SCALP/TRNK 2.6-7.5	$339.30	$754.00	—	18% above	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMP SCLP/TRK 2.6-7.5 PF	$62.55	$139.00	—	—	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMP SCALP/TRNK 2.6-7.5	$129.60	$288.00	—	—	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC SIMP SCALP/TRNK 2.6-7.5 PF	$339.30	$754.00	—	—	55%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RHC LAC SIMP SCALP/TRNK 2.6-7.5	$339.30	$754.00	—	—	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMP FACE/LIP <=2.5 PF	$59.40	$132.00	—	78% below	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RHC LAC SIMP FACE/EAR/LIP <=2.5	$95.85	$213.00	—	64% below	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMP FACE/EAR/LIP <=2.5	$122.40	$272.00	—	54% below	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC SIMP FACE/EAR/LIP <=2.5 PF	$291.15	$647.00	—	10% above	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMP FACE/LIP <=2.5 PF	$59.40	$132.00	—	—	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RHC LAC SIMP FACE/EAR/LIP <=2.5	$95.85	$213.00	—	—	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMP FACE/EAR/LIP <=2.5	$122.40	$272.00	—	—	55%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC SIMP FACE/EAR/LIP <=2.5 PF	$291.15	$647.00	—	—	55%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES PF	$63.90	$142.00	—	67% below	55%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 RHC TANGNTL BX SKIN SINGLE LES-11102	$141.75	$315.00	—	26% below	55%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$300.60	$668.00	—	57% above	55%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES PF	$63.90	$142.00	—	—	55%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 RHC TANGNTL BX SKIN SINGLE LES-11102	$141.75	$315.00	—	—	55%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$300.60	$668.00	—	—	55%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W IMAGING PF	$135.45	$301.00	—	85% below	55%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W IMAGING	$942.75	$2,095.00	—	5% above	55%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMAGING	$942.75	$2,095.00	—	5% above	55%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS	$1,346.85	$2,993.00	—	50% above	55%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W IMAGING PF	$135.45	$301.00	—	—	55%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ IMAGING	$942.75	$2,095.00	—	—	55%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W IMAGING	$942.75	$2,095.00	—	—	55%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS	$1,346.85	$2,993.00	—	—	55%
Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILECTOMY/ADENOIDECTOMY >12YRS PF	$371.25	$825.00	—	91% below	55%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS	$4,785.75	$10,635.00	—	17% above	55%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 TONSILECTOMY/ADENOIDECTOMY >12YRS PF	$371.25	$825.00	—	—	55%
Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 REMOVE TONSILS AND ADENOIDS	$4,785.75	$10,635.00	—	—	55%
Tonsil and adenoid removal, child under 12 CPT 42820 TONSILECTOMY/ADENOIDECTOMY <12YRS PF	$371.25	$825.00	—	90% below	55%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS	$4,785.75	$10,635.00	—	27% above	55%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 TONSILECTOMY/ADENOIDECTOMY <12YRS PF	$371.25	$825.00	—	—	55%
Tonsil and adenoid removal, child under 12 inpatient CPT 42820 REMOVE TONSILS AND ADENOIDS	$4,785.75	$10,635.00	—	—	55%
Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 TONSILLECTOMY >12YRS PF	$924.30	$2,054.00	—	72% below	55%
Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 TONSILLECTOMY >12YRS PF	$924.30	$2,054.00	—	—	55%
Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 TONSILLECTMY PRIMY/SECONDARY <AGE 12 PF	$340.20	$756.00	—	92% below	55%
Tonsil removal (tonsillectomy) only, child under 12 inpatient CPT 42825 TONSILLECTMY PRIMY/SECONDARY <AGE 12 PF	$340.20	$756.00	—	—	55%
Total knee replacement CPT 27447 ARTHRP KNE CONDYL&PLATU MEDL&LAT COM PF	$1,633.50	$3,630.00	—	47% below	55%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY	$41,486.85	$92,193.00	—	1243% above	55%
Total knee replacement inpatient CPT 27447 ARTHRP KNE CONDYL&PLATU MEDL&LAT COM PF	$1,633.50	$3,630.00	—	—	55%
Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY	$41,486.85	$92,193.00	—	—	55%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL/COMPLETE PF ASSIST	$426.15	$947.00	—	97% below	55%
Total thyroid removal (thyroidectomy) CPT 60240 THYROIDECTOMY TOTAL/COMPLETE PF	$1,420.20	$3,156.00	—	90% below	55%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL/COMPLETE PF ASSIST	$426.15	$947.00	—	—	55%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 THYROIDECTOMY TOTAL/COMPLETE PF	$1,420.20	$3,156.00	—	—	55%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION FINGER PF	$369.45	$821.00	—	77% below	55%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION FINGER PF	$369.45	$821.00	—	—	55%
Trigger point injections, 1 or 2 muscles CPT 20552 PM TRIG POINT INJ 1-2 MUSCLE PF	$60.30	$134.00	—	71% below	55%
Trigger point injections, 1 or 2 muscles CPT 20552 RHC INJ TRIGER POINT 1-2 MUSCLE-20552	$72.00	$160.00	—	65% below	55%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIG POINT INJ 1-2 MUSCLE	$137.70	$306.00	—	33% below	55%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIG POINT INJ 1-2 MUSCLES PF	$137.70	$306.00	—	33% below	55%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIG POINT INJ 1-2 MUSCLE PF	$137.70	$306.00	—	33% below	55%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLE	$137.70	$306.00	—	33% below	55%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIG POINT INJ 1-2 MUSCLES	$444.60	$988.00	—	117% above	55%
Trigger point injections, 1 or 2 muscles CPT 20552 PM TRIG POINT INJ 1-2 MUSCLE	$444.60	$988.00	—	117% above	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PM TRIG POINT INJ 1-2 MUSCLE PF	$60.30	$134.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 RHC INJ TRIGER POINT 1-2 MUSCLE-20552	$72.00	$160.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIG POINT INJ 1-2 MUSCLE	$137.70	$306.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIG POINT INJ 1-2 MUSCLE PF	$137.70	$306.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIG POINT INJ 1-2 MUSCLES PF	$137.70	$306.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLE	$137.70	$306.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PM TRIG POINT INJ 1-2 MUSCLE	$444.60	$988.00	—	—	55%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIG POINT INJ 1-2 MUSCLES	$444.60	$988.00	—	—	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W/US GUIDE 1ST LESION PF	$327.60	$728.00	—	82% below	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST W/US GUIDE 1ST LESION	$1,575.00	$3,500.00	—	11% below	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US BREAST BIOPSY BIL	$3,475.80	$7,724.00	—	95% above	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST W/US GUIDE 1ST LESION PF	$327.60	$728.00	—	—	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST W/US GUIDE 1ST LESION	$1,575.00	$3,500.00	—	—	55%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US BREAST BIOPSY BIL	$3,475.80	$7,724.00	—	—	55%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 ESOPH EGD DILATION <30 MM	$2,855.70	$6,346.00	—	16% above	55%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 ESOPH EGD DILATION <30 MM	$2,855.70	$6,346.00	—	—	55%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD W/ BIOPSY PF	$250.65	$557.00	—	85% below	55%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,360.35	$3,023.00	—	20% below	55%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD W/ BIOPSY PF	$250.65	$557.00	—	—	55%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD BIOPSY SINGLE/MULTIPLE	$1,360.35	$3,023.00	—	—	55%
Upper endoscopy (EGD) with injection into the lining CPT 43236 EGD UPPR GI SCOPE W/SUB INJ	$2,104.65	$4,677.00	—	3% above	55%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 EGD UPPR GI SCOPE W/SUB INJ	$2,104.65	$4,677.00	—	—	55%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE PF	$247.50	$550.00	—	87% below	55%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD REMOVE LESION SNARE	$1,883.70	$4,186.00	—	5% below	55%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVE LESION SNARE PF	$247.50	$550.00	—	—	55%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD REMOVE LESION SNARE	$1,883.70	$4,186.00	—	—	55%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUID WIRE INSERTION PF	$262.35	$583.00	—	77% below	55%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION	$1,360.35	$3,023.00	—	19% above	55%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUID WIRE INSERTION PF	$262.35	$583.00	—	—	55%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD GUIDE WIRE INSERTION	$1,360.35	$3,023.00	—	—	55%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC PF	$155.25	$345.00	—	86% below	55%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC	$1,360.35	$3,023.00	—	25% above	55%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC PF	$155.25	$345.00	—	—	55%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC	$1,360.35	$3,023.00	—	—	55%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY	$2,178.45	$4,841.00	—	32% below	55%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 VBAC DELIVERY PF	$2,178.45	$4,841.00	—	32% below	55%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC DELIVERY PF	$2,178.45	$4,841.00	—	—	55%
Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 VBAC DELIVERY	$2,178.45	$4,841.00	—	—	55%
Vaginal delivery, including prenatal and postpartum care CPT 59400 ROUTINE OB CARE	$2,434.95	$5,411.00	—	13% below	55%
Vaginal delivery, including prenatal and postpartum care CPT 59400 ROUTINE OB CARE PF	$2,434.95	$5,411.00	—	13% below	55%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 ROUTINE OB CARE PF	$2,434.95	$5,411.00	—	—	55%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 ROUTINE OB CARE	$2,434.95	$5,411.00	—	—	55%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY PF	$193.50	$430.00	—	77% below	55%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$225.00	$500.00	—	73% below	55%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY PF	$193.50	$430.00	—	—	55%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$225.00	$500.00	—	—	55%
Vein ablation, radiofrequency, first vein CPT 36475 VNUS PROCEDURE	$4,220.55	$9,379.00	—	16% below	55%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 VNUS PROCEDURE	$4,220.55	$9,379.00	—	—	55%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION 1-14 PF	$187.65	$417.00	—	18% above	55%
Wart removal, up to 14 warts CPT 17110 RHC DESTRUCTION BENIGN LESION1-14 -17110	$187.65	$417.00	—	18% above	55%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESION 1-14	$300.60	$668.00	—	90% above	55%
Wart removal, up to 14 warts inpatient CPT 17110 RHC DESTRUCTION BENIGN LESION1-14 -17110	$187.65	$417.00	—	—	55%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESION 1-14 PF	$187.65	$417.00	—	—	55%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESION 1-14	$300.60	$668.00	—	—	55%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SUBCUTANIOU TISS 1ST 20 SQ CM PF	$84.60	$188.00	—	78% below	55%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SQ TISSUE 1ST 20CM PF	$123.30	$274.00	—	68% below	55%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SQ TISSUE 1ST 20CM	$598.50	$1,330.00	—	56% above	55%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN/SQ TISSUE 1ST 20CM	$598.50	$1,330.00	—	56% above	55%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SUBCUTANIOU TISS 1ST 20 SQ CM PF	$84.60	$188.00	—	—	55%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBR SKIN/SQ TISSUE 1ST 20CM PF	$123.30	$274.00	—	—	55%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN/SQ TISSUE 1ST 20CM	$598.50	$1,330.00	—	—	55%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBR SKIN/SQ TISSUE 1ST 20CM	$598.50	$1,330.00	—	—	55%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$455.40	$1,012.00	—	31% below	55%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION 0-4 HRS	$455.40	$1,012.00	—	31% below	55%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION 0-4 HRS	$455.40	$1,012.00	—	—	55%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$455.40	$1,012.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RHC AEROSOL TX-94640	$35.55	$79.00	—	78% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RHC INITIAL NEB TX-94640	$35.55	$79.00	—	78% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT IPPB INITIAL	$86.40	$192.00	—	45% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT IPPB SUBSEQUENT	$86.40	$192.00	—	45% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT SPUTUM INDUCTION SUBSEQ	$86.40	$192.00	—	45% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT EZPAP INITIAL	$86.40	$192.00	—	45% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT MDI SUBSEQUENT	$86.40	$192.00	—	45% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT EZPAP SUBSEQUENT	$86.40	$192.00	—	45% below	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL SUBSEQ 3	$166.05	$369.00	—	5% above	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL SUBSEQ	$166.05	$369.00	—	5% above	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL SUBSEQ 2	$166.05	$369.00	—	5% above	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT AEROSOL INITIAL	$166.05	$369.00	—	5% above	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT MDI INITIAL	$166.05	$369.00	—	5% above	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT INHALATION TREATMENT	$166.05	$369.00	—	5% above	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RHC INITIAL NEB TX-94640	$35.55	$79.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RHC AEROSOL TX-94640	$35.55	$79.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT EZPAP INITIAL	$86.40	$192.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT EZPAP SUBSEQUENT	$86.40	$192.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT SPUTUM INDUCTION SUBSEQ	$86.40	$192.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT MDI SUBSEQUENT	$86.40	$192.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT IPPB SUBSEQUENT	$86.40	$192.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT IPPB INITIAL	$86.40	$192.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL SUBSEQ	$166.05	$369.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL SUBSEQ 3	$166.05	$369.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT MDI INITIAL	$166.05	$369.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT INHALATION TREATMENT	$166.05	$369.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL SUBSEQ 2	$166.05	$369.00	—	—	55%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT AEROSOL INITIAL	$166.05	$369.00	—	—	55%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADM IV INFUS UP TO 1 HR	$508.50	$1,130.00	—	17% above	55%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADM IV INFUS UP TO 1 HR	$508.50	$1,130.00	—	—	55%
Critical care, first 30 to 74 minutes CPT 99291 ER CRIT CARE 1ST 30-74MIN PF	$225.00	$500.00	—	83% below	55%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST 30-74 MIN PF	$422.55	$939.00	—	69% below	55%
Critical care, first 30 to 74 minutes CPT 99291 ER- CRITICAL CARE 1ST 30-74MIN	$1,332.00	$2,960.00	—	1% below	55%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER CRIT CARE 1ST 30-74MIN PF	$225.00	$500.00	—	—	55%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST 30-74 MIN PF	$422.55	$939.00	—	—	55%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER- CRITICAL CARE 1ST 30-74MIN	$1,332.00	$2,960.00	—	—	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RHC EKG 93005	$41.40	$92.00	—	78% below	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RT EKG	$67.05	$149.00	—	65% below	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RT EKG 149	$67.05	$149.00	—	65% below	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RHC EKG 93005	$41.40	$92.00	—	—	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RT EKG 149	$67.05	$149.00	—	—	55%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RT EKG	$67.05	$149.00	—	—	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED SUTURE REMOVAL	$125.55	$279.00	—	10% below	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1	$133.65	$297.00	—	4% below	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor one side CPT 99281 ER LEFT W/0 BEING SEEN	$133.65	$297.00	—	4% below	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED SUTURE REMOVAL	$125.55	$279.00	—	—	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL 1	$133.65	$297.00	—	—	55%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient one side CPT 99281 ER LEFT W/0 BEING SEEN	$133.65	$297.00	—	—	55%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 PF	$44.55	$99.00	—	81% below	55%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2	$245.70	$546.00	—	3% above	55%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2 PF	$44.55	$99.00	—	—	55%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2	$245.70	$546.00	—	—	55%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 PF	$76.05	$169.00	—	83% below	55%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3	$428.40	$952.00	—	2% below	55%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3 PF	$76.05	$169.00	—	—	55%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3	$428.40	$952.00	—	—	55%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 PF	$129.15	$287.00	—	81% below	55%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4	$664.65	$1,477.00	—	1% below	55%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4 PF	$129.15	$287.00	—	—	55%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4	$664.65	$1,477.00	—	—	55%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5 PF	$187.20	$416.00	—	82% below	55%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5	$963.90	$2,142.00	—	9% below	55%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5 PF	$187.20	$416.00	—	—	55%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5	$963.90	$2,142.00	—	—	55%
Exercise stress test, tracing only, the hospital charge CPT 93017 RT CARDIOLITE STRESS TEST	$819.90	$1,822.00	—	at median	55%
Exercise stress test, tracing only, the hospital charge CPT 93017 RT CARDIAC ECH W/STRESS	$819.90	$1,822.00	—	at median	55%
Exercise stress test, tracing only, the hospital charge CPT 93017 RT LEXISCAN STRESS TEST	$819.90	$1,822.00	—	at median	55%
Exercise stress test, tracing only, the hospital charge CPT 93017 RT STRESS TEST	$819.90	$1,822.00	—	at median	55%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 RT LEXISCAN STRESS TEST	$819.90	$1,822.00	—	—	55%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 RT CARDIAC ECH W/STRESS	$819.90	$1,822.00	—	—	55%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 RT CARDIOLITE STRESS TEST	$819.90	$1,822.00	—	—	55%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 RT STRESS TEST	$819.90	$1,822.00	—	—	55%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PT 50MIN PF	$106.65	$237.00	—	38% below	55%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PT 50MIN PF	$106.65	$237.00	—	—	55%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PT 50MIN PF	$131.40	$292.00	—	44% below	55%
Family therapy without the patient, 50 minutes CPT 90846 BHU FAM THERAPY W/O PT 50MIN PF	$131.40	$292.00	—	44% below	55%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PT 50MIN PF	$131.40	$292.00	—	—	55%
Family therapy without the patient, 50 minutes inpatient CPT 90846 BHU FAM THERAPY W/O PT 50MIN PF	$131.40	$292.00	—	—	55%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 RT AMBULATORY ECG MONITOR	$72.90	$162.00	—	40% below	55%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 RT AMBULATORY ECG MONITOR	$72.90	$162.00	—	—	55%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31MIN TO 1HR	$321.75	$715.00	—	30% above	55%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31MIN TO 1HR	$321.75	$715.00	—	—	55%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION THERAPY INIT HR	$321.75	$715.00	—	6% above	55%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION THERAPY INIT HR	$321.75	$715.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM THER/PROPH/DX INJECT IM/SQ PF	$33.75	$75.00	—	65% below	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM INTRAMUSCULAR INJECTION PF	$33.75	$75.00	—	65% below	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM SUBCUTANEOUS INJECTION PF	$33.75	$75.00	—	65% below	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM THER/PROPH/DX INJECT IM/SQ	$95.40	$212.00	—	2% below	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM INTRAMUSCULAR INJECTION	$105.75	$235.00	—	9% above	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DX INJECT IM/SQ	$105.75	$235.00	—	9% above	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DX INJECT IN/SQ	$105.75	$235.00	—	9% above	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PM SUBCUTANEOUS INJECTION	$105.75	$235.00	—	9% above	55%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PHOPH/DX INJECT IM/SQ - 96372	$105.75	$235.00	—	9% above	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM SUBCUTANEOUS INJECTION PF	$33.75	$75.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM INTRAMUSCULAR INJECTION PF	$33.75	$75.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM THER/PROPH/DX INJECT IM/SQ PF	$33.75	$75.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM THER/PROPH/DX INJECT IM/SQ	$95.40	$212.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DX INJECT IM/SQ	$105.75	$235.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM SUBCUTANEOUS INJECTION	$105.75	$235.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PM INTRAMUSCULAR INJECTION	$105.75	$235.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PHOPH/DX INJECT IM/SQ - 96372	$105.75	$235.00	—	—	55%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DX INJECT IN/SQ	$105.75	$235.00	—	—	55%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 RHC PSYCH DIAGNOSTIC EVAL -90791	$102.60	$228.00	—	54% below	55%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL PF	$239.40	$532.00	—	7% above	55%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 RHC PSYCH DIAGNOSTIC EVAL -90791	$102.60	$228.00	—	—	55%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PSYCHIATRIC DIAGNOSTIC EVAL PF	$239.40	$532.00	—	—	55%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES PF	$125.55	$279.00	—	73% below	55%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES	$349.65	$777.00	—	25% below	55%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES PF	$125.55	$279.00	—	—	55%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION STUDIES 7-8 STUDIES	$349.65	$777.00	—	—	55%
New patient office visit, about 30 minutes CPT 99203 OFFICE NEW 30-44 MIN-99203	$62.10	$138.00	—	54% below	55%
New patient office visit, about 30 minutes CPT 99203 RHC OUTPT LEVEL 3 NEW-99203	$128.70	$286.00	—	5% below	55%
New patient office visit, about 30 minutes CPT 99203 OFFICE NEW 30-44 MIN PF	$151.20	$336.00	—	12% above	55%
New patient office visit, about 30 minutes CPT 99203 COMM OFFICE NEW 30-44 MIN 99203 PF	$175.50	$390.00	—	30% above	55%
New patient office visit, about 30 minutes CPT 99203 SPLIT OFFICE NEW 30-44 MIN-99203	$175.50	$390.00	—	30% above	55%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE NEW 30-44 MIN-99203	$62.10	$138.00	—	—	55%
New patient office visit, about 30 minutes inpatient CPT 99203 RHC OUTPT LEVEL 3 NEW-99203	$128.70	$286.00	—	—	55%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE NEW 30-44 MIN PF	$151.20	$336.00	—	—	55%
New patient office visit, about 30 minutes inpatient CPT 99203 COMM OFFICE NEW 30-44 MIN 99203 PF	$175.50	$390.00	—	—	55%
New patient office visit, about 30 minutes inpatient CPT 99203 SPLIT OFFICE NEW 30-44 MIN-99203	$175.50	$390.00	—	—	55%
New patient office visit, about 45 minutes CPT 99204 OFFICE NEW 45-59 MIN-99204	$71.55	$159.00	—	61% below	55%
New patient office visit, about 45 minutes CPT 99204 RHC OUTPT LEVE 4 NEW-99204	$182.70	$406.00	—	1% above	55%
New patient office visit, about 45 minutes CPT 99204 COMM OFFICE NEW 45-59 MIN 99204 PF	$200.25	$445.00	—	11% above	55%
New patient office visit, about 45 minutes CPT 99204 SPLIT OFFICE NEW 45-59 MIN-99204	$200.25	$445.00	—	11% above	55%
New patient office visit, about 45 minutes CPT 99204 OFFICE NEW 45-59 MIN PF	$257.40	$572.00	—	42% above	55%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE NEW 45-59 MIN-99204	$71.55	$159.00	—	—	55%
New patient office visit, about 45 minutes inpatient CPT 99204 RHC OUTPT LEVE 4 NEW-99204	$182.70	$406.00	—	—	55%
New patient office visit, about 45 minutes inpatient CPT 99204 SPLIT OFFICE NEW 45-59 MIN-99204	$200.25	$445.00	—	—	55%
New patient office visit, about 45 minutes inpatient CPT 99204 COMM OFFICE NEW 45-59 MIN 99204 PF	$200.25	$445.00	—	—	55%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE NEW 45-59 MIN PF	$257.40	$572.00	—	—	55%
New patient office visit, about 60 minutes CPT 99205 OFFICE NEW 60-74 MIN-99205	$90.90	$202.00	—	65% below	55%
New patient office visit, about 60 minutes CPT 99205 COMM OFFICE NEW 60-74 MIN 99205 PF	$225.00	$500.00	—	13% below	55%
New patient office visit, about 60 minutes CPT 99205 SPLIT OFFICE NEW 60-74 MIN-99205	$225.00	$500.00	—	13% below	55%
New patient office visit, about 60 minutes CPT 99205 RHC OUTPT LEVEL 5 NEW-99205	$232.65	$517.00	—	10% below	55%
New patient office visit, about 60 minutes CPT 99205 OFFICE NEW 60-74 MIN PF	$330.75	$735.00	—	28% above	55%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE NEW 60-74 MIN-99205	$90.90	$202.00	—	—	55%
New patient office visit, about 60 minutes inpatient CPT 99205 COMM OFFICE NEW 60-74 MIN 99205 PF	$225.00	$500.00	—	—	55%
New patient office visit, about 60 minutes inpatient CPT 99205 SPLIT OFFICE NEW 60-74 MIN-99205	$225.00	$500.00	—	—	55%
New patient office visit, about 60 minutes inpatient CPT 99205 RHC OUTPT LEVEL 5 NEW-99205	$232.65	$517.00	—	—	55%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE NEW 60-74 MIN PF	$330.75	$735.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE NEW 15-29 MIN-G0463	$32.40	$72.00	—	68% below	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 RHC OUTPT LEVEL 2 NEW-99202	$86.85	$193.00	—	13% below	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE NEW 15-29 MIN - 99202 PF	$99.45	$221.00	—	1% below	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 COMM OFFICE NEW 15-29 MIN - 99202 PF	$150.75	$335.00	—	51% above	55%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 SPLIT OFFICE NEW 15-29 MIN-99202	$150.75	$335.00	—	51% above	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE NEW 15-29 MIN-G0463	$32.40	$72.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 RHC OUTPT LEVEL 2 NEW-99202	$86.85	$193.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE NEW 15-29 MIN - 99202 PF	$99.45	$221.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 SPLIT OFFICE NEW 15-29 MIN-99202	$150.75	$335.00	—	—	55%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 COMM OFFICE NEW 15-29 MIN - 99202 PF	$150.75	$335.00	—	—	55%
Preventive checkup, new patient aged 18–39 CPT 99385 INITAL PREV E&M NEW 18-39YR PF-99385	$175.50	$390.00	—	25% above	55%
Preventive checkup, new patient aged 18–39 CPT 99385 RHC INITIAL PREV E&M NEW 18-39 YR-99385	$175.50	$390.00	—	25% above	55%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITAL PREV E&M NEW 18-39YR PF-99385	$175.50	$390.00	—	—	55%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 RHC INITIAL PREV E&M NEW 18-39 YR-99385	$175.50	$390.00	—	—	55%
Preventive checkup, new patient aged 40–64 CPT 99386 RHC INITIAL PREV E&M NEW 40-64YR-99386	$206.55	$459.00	—	23% above	55%
Preventive checkup, new patient aged 40–64 CPT 99386 INITAL PREV E&M NEW 40-64YR PF	$206.55	$459.00	—	23% above	55%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 RHC INITIAL PREV E&M NEW 40-64YR-99386	$206.55	$459.00	—	—	55%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITAL PREV E&M NEW 40-64YR PF	$206.55	$459.00	—	—	55%
Preventive checkup, new patient aged 65 or older CPT 99387 RHC INITIAL PREV E&M NEW 65+-99387	$222.75	$495.00	—	35% above	55%
Preventive checkup, new patient aged 65 or older CPT 99387 INITIAL PREV E&M NEW 65+ PF	$222.75	$495.00	—	35% above	55%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INITIAL PREV E&M NEW 65+ PF	$222.75	$495.00	—	—	55%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 RHC INITIAL PREV E&M NEW 65+-99387	$222.75	$495.00	—	—	55%
Preventive checkup, returning patient aged 18–39 CPT 99395 INITIAL PREV E&M EST 18-39YR PF	$142.65	$317.00	—	15% above	55%
Preventive checkup, returning patient aged 18–39 CPT 99395 RHC INITIAL PREV E&M EST 18-39YR-99395	$142.65	$317.00	—	15% above	55%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 INITIAL PREV E&M EST 18-39YR PF	$142.65	$317.00	—	—	55%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 RHC INITIAL PREV E&M EST 18-39YR-99395	$142.65	$317.00	—	—	55%
Preventive checkup, returning patient aged 40–64 CPT 99396 INITIAL PREV E&M EST 40-64YR PF	$158.85	$353.00	—	21% above	55%
Preventive checkup, returning patient aged 40–64 CPT 99396 RHC INITIAL PREV E&M EST 40-64YR-99396	$158.85	$353.00	—	21% above	55%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 INITIAL PREV E&M EST 40-64YR PF	$158.85	$353.00	—	—	55%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 RHC INITIAL PREV E&M EST 40-64YR-99396	$158.85	$353.00	—	—	55%
Preventive checkup, returning patient aged 65 or older CPT 99397 RHC INITIAL PREV E&M EST 65+-99397	$174.15	$387.00	—	19% above	55%
Preventive checkup, returning patient aged 65 or older CPT 99397 INITIAL PREV E&M EST 65+ PF	$174.15	$387.00	—	19% above	55%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 INITIAL PREV E&M EST 65+ PF	$174.15	$387.00	—	—	55%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 RHC INITIAL PREV E&M EST 65+-99397	$174.15	$387.00	—	—	55%
Psychiatric evaluation with medical services CPT 90792 RHC PSYCH DIAG EVAL W/ MED - 90792	$102.60	$228.00	—	45% below	55%
Psychiatric evaluation with medical services CPT 90792 PSYCHIATRIC DIAG EVAL W/ MED SERVICE PF	$248.40	$552.00	—	34% above	55%
Psychiatric evaluation with medical services inpatient CPT 90792 RHC PSYCH DIAG EVAL W/ MED - 90792	$102.60	$228.00	—	—	55%
Psychiatric evaluation with medical services inpatient CPT 90792 PSYCHIATRIC DIAG EVAL W/ MED SERVICE PF	$248.40	$552.00	—	—	55%
Psychotherapy session, 30 minutes CPT 90832 PSYTX W PT 30 MINUTES PF	$92.25	$205.00	—	28% below	55%
Psychotherapy session, 30 minutes CPT 90832 RHC PSYTX W PT 30 MINUTES-90832	$102.60	$228.00	—	20% below	55%
Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX W PT 30 MINUTES PF	$92.25	$205.00	—	—	55%
Psychotherapy session, 30 minutes inpatient CPT 90832 RHC PSYTX W PT 30 MINUTES-90832	$102.60	$228.00	—	—	55%
Psychotherapy session, 45 minutes CPT 90834 PSYTX W PT 45 MINUTES PF	$129.15	$287.00	—	24% below	55%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX W PT 45 MINUTES PF	$129.15	$287.00	—	—	55%
Psychotherapy session, 60 minutes CPT 90837 RHC PSYTX W PT 60 MINUTES-90837	$206.55	$459.00	—	8% below	55%
Psychotherapy session, 60 minutes inpatient CPT 90837 RHC PSYTX W PT 60 MINUTES-90837	$206.55	$459.00	—	—	55%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CESSATION 3-10 MIN PF	$15.30	$34.00	—	31% below	55%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 RHC TOBACCO CESSATION 3-10 MIN	$15.30	$34.00	—	31% below	55%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 RHC TOBACCO CESSATION 3-10 MIN	$15.30	$34.00	—	—	55%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CESSATION 3-10 MIN PF	$15.30	$34.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 RHC OFFICE VISIT 40-54 MIN-99215	$159.75	$355.00	—	21% below	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 SPLIT OFFICE EST 40-60 MIN-99215	$180.00	$400.00	—	11% below	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 COMM OFFICE VISIT 40-54 MIN 99215 PF	$180.00	$400.00	—	11% below	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OB LEVEL 5 FACILITY FEE	$202.50	$450.00	—	at median	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PM OFFICE VISIT 40-54 MIN PF	$215.55	$479.00	—	7% above	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PM OFFICE VISIT 40-54 MIN	$215.55	$479.00	—	7% above	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT 40-54 MIN-99215	$215.55	$479.00	—	7% above	55%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE VISIT 40-54 MIN PF	$217.80	$484.00	—	8% above	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 RHC OFFICE VISIT 40-54 MIN-99215	$159.75	$355.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 COMM OFFICE VISIT 40-54 MIN 99215 PF	$180.00	$400.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 SPLIT OFFICE EST 40-60 MIN-99215	$180.00	$400.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OB LEVEL 5 FACILITY FEE	$202.50	$450.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PM OFFICE VISIT 40-54 MIN	$215.55	$479.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PM OFFICE VISIT 40-54 MIN PF	$215.55	$479.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT 40-54 MIN-99215	$215.55	$479.00	—	—	55%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VISIT 40-54 MIN PF	$217.80	$484.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT 20-29 MIN-99213	$50.40	$112.00	—	57% below	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 RHC OFFICE VISIT 20-29 MIN-99213	$70.20	$156.00	—	40% below	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PM OFFICE VISIT 20-29 MIN PF	$99.90	$222.00	—	14% below	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PM OFFICE VISIT 20-29 MIN	$99.90	$222.00	—	14% below	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE VISIT 20-29 MIN PF	$100.35	$223.00	—	14% below	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 COMM OFFICE VISIT 20-29 MIN 99213 PF	$139.50	$310.00	—	20% above	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 SPLIT OFFICE VISIT 20-29 MIN-99213	$139.50	$310.00	—	20% above	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OB LEVEL 3 FACILITY FEE	$146.25	$325.00	—	26% above	55%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 TREATMENT ROOM	$146.25	$325.00	—	26% above	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT 20-29 MIN-99213	$50.40	$112.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RHC OFFICE VISIT 20-29 MIN-99213	$70.20	$156.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PM OFFICE VISIT 20-29 MIN PF	$99.90	$222.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PM OFFICE VISIT 20-29 MIN	$99.90	$222.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE VISIT 20-29 MIN PF	$100.35	$223.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 COMM OFFICE VISIT 20-29 MIN 99213 PF	$139.50	$310.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 SPLIT OFFICE VISIT 20-29 MIN-99213	$139.50	$310.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OB LEVEL 3 FACILITY FEE	$146.25	$325.00	—	—	55%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TREATMENT ROOM	$146.25	$325.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RHC OFFICE VISIT 30-39 MIN-99214	$110.70	$246.00	—	31% below	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT 30-39 MIN-99214	$152.55	$339.00	—	4% below	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PM OFFICE VISIT 30-39 MIN PF	$152.55	$339.00	—	4% below	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PM OFFICE VISIT 30-39 MIN	$152.55	$339.00	—	4% below	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE VISIT 30-39 MIN PF	$154.35	$343.00	—	3% below	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 SPLIT OFFICE VISIT 30-39 MIN-99214	$164.25	$365.00	—	3% above	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 COMM OFFICE VISIT 30-39 MIN 99214 PF	$164.25	$365.00	—	3% above	55%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OB LEVEL 4 FACILITY FEE	$168.75	$375.00	—	6% above	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RHC OFFICE VISIT 30-39 MIN-99214	$110.70	$246.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PM OFFICE VISIT 30-39 MIN PF	$152.55	$339.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PM OFFICE VISIT 30-39 MIN	$152.55	$339.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT 30-39 MIN-99214	$152.55	$339.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE VISIT 30-39 MIN PF	$154.35	$343.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 SPLIT OFFICE VISIT 30-39 MIN-99214	$164.25	$365.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 COMM OFFICE VISIT 30-39 MIN 99214 PF	$164.25	$365.00	—	—	55%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OB LEVEL 4 FACILITY FEE	$168.75	$375.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE VISIT 10-19 MIN PF	$49.50	$110.00	—	28% below	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RHC OFFICE VISIT 10-19 MIN- 99212	$50.85	$113.00	—	26% below	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PM OFFICE VISIT 10-19 MIN PF	$52.65	$117.00	—	23% below	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PM OFFICE VISIT 10-19 MIN	$52.65	$117.00	—	23% below	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 SPLIT OFFICE VISIT 10-19 MIN-99212	$112.50	$250.00	—	64% above	55%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 COMM OFFICE VISIT 10-19 MIN 99212 PF	$112.50	$250.00	—	64% above	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE VISIT 10-19 MIN PF	$49.50	$110.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RHC OFFICE VISIT 10-19 MIN- 99212	$50.85	$113.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PM OFFICE VISIT 10-19 MIN PF	$52.65	$117.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PM OFFICE VISIT 10-19 MIN	$52.65	$117.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 COMM OFFICE VISIT 10-19 MIN 99212 PF	$112.50	$250.00	—	—	55%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 SPLIT OFFICE VISIT 10-19 MIN-99212	$112.50	$250.00	—	—	55%
Specialist consultation, low complexity or 30+ minutes CPT 99243 RHC CONSULT 30 MIN-99243	$163.80	$364.00	—	8% below	55%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 RHC CONSULT 30 MIN-99243	$163.80	$364.00	—	—	55%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 RHC CONSULT 40 MIN-99244	$230.85	$513.00	—	6% below	55%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 RHC CONSULT 40 MIN-99244	$230.85	$513.00	—	—	55%
Spirometry (breathing test) CPT 94010 RT BREATHING CAPACITY TEST	$138.15	$307.00	—	36% below	55%
Spirometry (breathing test) CPT 94010 RT SPIROMETRY ONLY	$138.15	$307.00	—	36% below	55%
Spirometry (breathing test) inpatient CPT 94010 RT SPIROMETRY ONLY	$138.15	$307.00	—	—	55%
Spirometry (breathing test) inpatient CPT 94010 RT BREATHING CAPACITY TEST	$138.15	$307.00	—	—	55%
Spirometry before and after a bronchodilator CPT 94060 RT PRE/POST SPRIOMETRY PROFESSIONAL FEE	$101.70	$226.00	—	77% below	55%
Spirometry before and after a bronchodilator CPT 94060 RT PRE/POST SPIROMETRY	$273.60	$608.00	—	39% below	55%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT PRE/POST SPRIOMETRY PROFESSIONAL FEE	$101.70	$226.00	—	—	55%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT PRE/POST SPIROMETRY	$273.60	$608.00	—	—	55%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDUR	$91.35	$203.00	—	51% below	55%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDUR	$91.35	$203.00	—	—	55%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Missouri	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza vax, 6 mo+(Fluarix IIV3) 0.5mL	$11.25	$25.00	—	81% below	55%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 influenza vax, 6 mo+(Fluzone IIV3) 0.5mL	$11.25	$25.00	—	81% below	55%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza vax, 6 mo+(Fluarix IIV3) 0.5mL	$11.25	$25.00	—	—	55%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 influenza vax, 6 mo+(Fluzone IIV3) 0.5mL	$11.25	$25.00	—	—	55%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Papillomavirus 9-valent (Gardasil-9)	$225.00	$500.00	—	32% below	55%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Papillomavirus 9-valent (Gardasil-9)	$225.00	$500.00	—	—	55%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza hi-dose(Fluzone HD-IIV3) 0.5mL	$27.00	$60.00	—	73% below	55%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 influenza hi-dose (Fluzone HD QIV) 0.7mL	$27.00	$60.00	—	73% below	55%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza hi-dose(Fluzone HD-IIV3) 0.5mL	$27.00	$60.00	—	—	55%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 influenza hi-dose (Fluzone HD QIV) 0.7mL	$27.00	$60.00	—	—	55%
MMR vaccine (measles, mumps and rubella), live CPT 90707 measles/mumps/rubella (MMR II)	$72.00	$160.00	—	57% below	55%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 measles/mumps/rubella (MMR II)	$72.00	$160.00	—	—	55%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 meningococcal B Vax 4-comp (Bexsero)	$171.00	$380.00	—	45% below	55%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 meningococcal B Vax 4-comp (Bexsero)	$171.00	$380.00	—	—	55%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 pneumococcal conjugate (Prevnar 20)	$225.00	$500.00	—	58% below	55%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 pneumococcal conjugate (Prevnar 20)	$225.00	$500.00	—	—	55%
Rabies vaccine, one dose CPT 90675 rabies vaccine (RabAvert) 2.5 IU	$257.92	$573.16	—	70% below	55%
Rabies vaccine, one dose inpatient CPT 90675 rabies vaccine (RabAvert) 2.5 IU	$257.92	$573.16	—	—	55%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 zoster recombinant (Shingrix) Vax 2-shot	$152.27	$338.38	—	37% below	55%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 zoster recombinant (Shingrix) Vax 2-shot	$152.27	$338.38	—	—	55%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 tetanus/diphth (Tenivac - Td) 0.5 mL Vax	$43.53	$96.74	—	39% below	55%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 tetanus/diphth (Tenivac - Td) 0.5 mL Vax	$43.53	$96.74	—	—	55%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tet/diph/pertuss(Boostrix - Tdap) Clinic	$38.70	$86.00	—	62% below	55%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 tetanus/diphth/pertuss (Adacel) 0.5 mL	$58.38	$129.74	—	42% below	55%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tet/diph/pertuss(Boostrix - Tdap) Clinic	$38.70	$86.00	—	—	55%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 tetanus/diphth/pertuss (Adacel) 0.5 mL	$58.38	$129.74	—	—	55%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VFC SELFPAY IMMUNIZATION ADMINISTRATION	$9.69	$21.53	—	84% below	55%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 RHC IMMUNIZATION ADMINISTRATION-90471	$20.25	$45.00	—	66% below	55%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$31.95	$71.00	—	46% below	55%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VFC SELFPAY IMMUNIZATION ADMINISTRATION	$9.69	$21.53	—	—	55%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 RHC IMMUNIZATION ADMINISTRATION-90471	$20.25	$45.00	—	—	55%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$31.95	$71.00	—	—	55%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL	$20.25	$45.00	—	57% below	55%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 RHC IMMUNIZATION ADMIN EA ADDL	$20.25	$45.00	—	57% below	55%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL PF	$31.95	$71.00	—	33% below	55%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 RHC IMMUNIZATION ADMIN EA ADDL	$20.25	$45.00	—	—	55%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADDL	$20.25	$45.00	—	—	55%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADDL PF	$31.95	$71.00	—	—	55%

Source file: https://www.nrmchealth.com/pricing-transparency-mrf-url