SelfPayRates
Hospital New Orleans-Metairie, LA

St Charles Surgical Hospital

St Charles Surgical Hospital in New Orleans, LA publishes cash prices for 208 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Louisiana median for 183 of 206 procedures and below it for 23. By typical cash price it ranks #45 of 58 Louisiana hospitals and #12 of 14 hospitals in the New Orleans, LA area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1717 St. Charles Ave., New Orleans, LA 70130 Collected Sep 27, 2026 Source price file (504) 529-6600

Acute care hospital No emergency department CCN 190300 · CMS hospital register NPI 1639323595

Scans and imaging

ProcedureCash price List priceInsurers payvs LouisianaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/O & W/ CONTR $1,085.84 $3,079.00 $160.55–$1,410.18 6% above 65%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/O & W/ CONTR $1,085.84 $3,079.00 $160.55–$1,410.18 — 65%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VWS $225.01 $638.04 $89.28–$292.22 23% above 65%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VWS $225.01 $638.04 $89.28–$292.22 — 65%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE COMP MIN 3 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 56% above 65%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE COMP MIN 3 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 56% above 65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE COMP MIN 3 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE COMP MIN 3 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 — 65%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O CO $619.98 $1,758.00 $95.70–$840.00 4% below 65%
Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O CO $619.98 $1,758.00 $95.70–$840.00 — 65%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL $248.41 $704.40 $79.66–$322.62 48% above 65%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL $248.41 $704.40 $79.66–$322.62 — 65%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN/PELVIS $1,500.00 $6,356.00 $319.35–$2,911.05 68% above 76%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN/PELVIS $1,500.00 $6,356.00 $319.35–$2,911.05 — 76%
CT angiography (CTA) of the head CPT 70496 CTA HEAD $1,120.75 $3,178.00 $160.55–$1,455.52 61% above 65%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD $1,120.75 $3,178.00 $160.55–$1,455.52 — 65%
CT angiography (CTA) of the neck CPT 70498 CTA NECK $1,120.75 $3,178.00 $160.55–$1,455.52 61% above 65%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK $1,120.75 $3,178.00 $160.55–$1,455.52 — 65%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST $1,120.75 $3,178.00 $160.55–$1,455.52 28% above 65%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST $1,120.75 $3,178.00 $160.55–$1,455.52 — 65%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WITHOUT CONTRAST $745.89 $2,115.05 $218.41–$968.69 34% below 65%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WITHOUT CONTRAST $745.89 $2,115.05 $218.41–$968.69 — 65%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W/ IV CONTRAST $1,102.02 $3,124.89 $319.35–$1,431.20 17% below 65%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN WITH RECTAL CONTRAST $1,102.02 $3,124.89 $319.35–$1,431.20 17% below 65%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W/ IV CONTRAST $1,102.02 $3,124.89 $319.35–$1,431.20 — 65%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN WITH RECTAL CONTRAST $1,102.02 $3,124.89 $319.35–$1,431.20 — 65%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W/ & W/0 $1,102.02 $3,124.89 $319.35–$1,431.20 24% below 65%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS W/ & W/0 $1,102.02 $3,124.89 $319.35–$1,431.20 — 65%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/ CONTRAST $980.04 $2,779.00 $160.55–$1,272.78 10% above 65%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST $980.04 $2,779.00 $160.55–$1,272.78 — 65%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 19% below 65%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 — 65%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O CON $619.98 $1,758.00 $95.70–$840.00 7% below 65%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTR $619.98 $1,758.00 $95.70–$840.00 7% below 65%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O CONTR $619.98 $1,758.00 $95.70–$840.00 — 65%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O CON $619.98 $1,758.00 $95.70–$840.00 — 65%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN STANDARD CT $619.98 $1,758.00 $95.70–$840.00 5% below 65%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN STANDARD CT $619.98 $1,758.00 $95.70–$840.00 — 65%
CT scan of the head with contrast CPT 70460 CT BRAIN OR HEAD W/ CONT $980.04 $2,779.00 $160.55–$1,272.78 34% above 65%
CT scan of the head with contrast inpatient CPT 70460 CT BRAIN OR HEAD W/ CONT $980.04 $2,779.00 $160.55–$1,272.78 — 65%
CT scan of the head without and with contrast CPT 70470 CT BRAIN OR HEAD W/O&W CO $1,085.84 $3,079.00 $160.55–$1,410.18 19% above 65%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN OR HEAD W/O&W CO $1,085.84 $3,079.00 $160.55–$1,410.18 — 65%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 18% below 65%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 — 65%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE W/O CONT $619.98 $1,758.00 $95.70–$840.00 16% below 65%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE W/O CONT $619.98 $1,758.00 $95.70–$840.00 — 65%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST $980.04 $2,779.00 $160.55–$1,272.78 22% above 65%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST $980.04 $2,779.00 $160.55–$1,272.78 — 65%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/O&W/ CONTRAST $1,085.84 $3,079.00 $160.55–$1,410.18 3% above 65%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/O&W/ CONTRAST $1,085.84 $3,079.00 $160.55–$1,410.18 — 65%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS $186.31 $528.30 $79.66–$241.96 41% above 65%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS $186.31 $528.30 $79.66–$241.96 — 65%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW $186.31 $528.30 $60.58–$241.96 69% above 65%
Chest X-ray, single view CPT 71045 XR NEEDLE COUNT CHEST $186.31 $528.30 $60.58–$241.96 69% above 65%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW $186.31 $528.30 $60.58–$241.96 — 65%
Chest X-ray, single view inpatient CPT 71045 XR NEEDLE COUNT CHEST $186.31 $528.30 $60.58–$241.96 — 65%
Collarbone (clavicle) X-ray, complete CPT 73000 XR CLAVICLE COMPLETE $186.31 $528.30 $79.66–$241.96 59% above 65%
Collarbone (clavicle) X-ray, complete inpatient CPT 73000 XR CLAVICLE COMPLETE $186.31 $528.30 $79.66–$241.96 — 65%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US RENAL BILATERAL $316.34 $897.00 $95.70–$410.83 — 65%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US RENAL BILATERAL $316.34 $897.00 $95.70–$410.83 — 65%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 19% below 65%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 — 65%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/ CONTRAST $980.04 $2,779.00 $160.55–$1,272.78 15% above 65%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CONTRAST $980.04 $2,779.00 $160.55–$1,272.78 — 65%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US LOWER EXTREMITY BILATERAL $681.96 $1,933.76 $218.41–$885.66 — 65%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US LOWER EXTREMITY BILATERAL $681.96 $1,933.76 $218.41–$885.66 — 65%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TRANSTHORACIC ECHO (TEE) $1,403.56 $3,979.92 $500.18–$1,822.80 92% above 65%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TRANSTHORACIC ECHO (TEE) $1,403.56 $3,979.92 $500.18–$1,822.80 — 65%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $73.64–$241.96 59% above 65%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW RIGHT AP/LATERAL VIEW,Right side $186.31 $528.30 $73.64–$241.96 59% above 65%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $73.64–$241.96 — 65%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW RIGHT AP/LATERAL VIEW,Right side $186.31 $528.30 $73.64–$241.96 — 65%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMPLETE 3 VWS RT,Right side $186.31 $528.30 $79.66–$241.96 42% above 65%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW COMPLETE 3 VWS LT,Left side $186.31 $528.30 $79.66–$241.96 42% above 65%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW COMPLETE 3 VWS LT,Left side $186.31 $528.30 $79.66–$241.96 — 65%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW COMPLETE 3 VWS RT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/SELLA/P FOS W/O $619.98 $1,758.00 $95.70–$840.00 2% above 65%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/SELLA/P FOS W/O $619.98 $1,758.00 $95.70–$840.00 — 65%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COM MIN 3VWS $225.01 $638.04 $95.70–$292.22 44% above 65%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COM MIN 3VWS $225.01 $638.04 $95.70–$292.22 — 65%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT,Right side $186.31 $528.30 $74.94–$241.96 64% above 65%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT,Left side $186.31 $528.30 $74.94–$241.96 64% above 65%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT,Left side $186.31 $528.30 $74.94–$241.96 — 65%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT,Right side $186.31 $528.30 $74.94–$241.96 — 65%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT,Right side $225.01 $638.04 $80.15–$292.22 113% above 65%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT,Left side $225.01 $638.04 $80.15–$292.22 113% above 65%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT,Left side $225.01 $638.04 $80.15–$292.22 — 65%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT,Right side $225.01 $638.04 $80.15–$292.22 — 65%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL CALCANEUS 2 VIEWS RT,Right side $186.31 $528.30 $73.64–$241.96 71% above 65%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL CALCANEUS 2 VIEWS LT,Left side $186.31 $528.30 $73.64–$241.96 71% above 65%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL CALCANEUS 2 VIEWS LT,Left side $186.31 $528.30 $73.64–$241.96 — 65%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL CALCANEUS 2 VIEWS RT,Right side $186.31 $528.30 $73.64–$241.96 — 65%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 38% above 65%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 38% above 65%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 — 65%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Knee X-ray, complete, 4 or more views both sides CPT 73564 XR KNEE COMPLETE 4 VIEWS BI $225.01 $638.04 $95.70–$292.22 — 65%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE COMPLETE 4 VIEWS LT,Left side $225.01 $638.04 $95.70–$292.22 47% above 65%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE COMPLETE 4 VIEWS RT,Right side $225.01 $638.04 $95.70–$292.22 47% above 65%
Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR KNEE COMPLETE 4 VIEWS BI $225.01 $638.04 $95.70–$292.22 — 65%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE COMPLETE 4 VIEWS RT,Right side $225.01 $638.04 $95.70–$292.22 — 65%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE COMPLETE 4 VIEWS LT,Left side $225.01 $638.04 $95.70–$292.22 — 65%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOW EXTREMITY W/O CONT $619.98 $1,758.00 $95.70–$840.00 2% above 65%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOW EXTREMITY W/O CONT $619.98 $1,758.00 $95.70–$840.00 — 65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SOFT TISSUE ABDOMEN $317.39 $900.00 $95.70–$412.20 21% above 65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder one side CPT 76705 US RIGHT UPPER QUADRANT ABDOMEN,Right side $317.39 $900.00 $95.70–$412.20 21% above 65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SOFT TISSUE ABDOMEN $317.39 $900.00 $95.70–$412.20 — 65%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient one side CPT 76705 US RIGHT UPPER QUADRANT ABDOMEN,Right side $317.39 $900.00 $95.70–$412.20 — 65%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US EXT NONVAS W/IMAG LMTD $300.01 $850.72 $95.70–$389.63 73% above 65%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US EXT NONVAS W/IMAG LMTD $300.01 $850.72 $95.70–$389.63 — 65%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER EXTREMITY RIGHT AP/LAT,Right side $186.31 $528.30 $79.66–$241.96 58% above 65%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR LOWER EXTREMITY LEFT AP/LAT,Left side $186.31 $528.30 $79.66–$241.96 58% above 65%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER EXTREMITY RIGHT AP/LAT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER EXTREMITY LEFT AP/LAT,Left side $186.31 $528.30 $79.66–$241.96 — 65%
MRI of the lower back, no contrast dye CPT 72148 XR SPINAL LUMBAR MRI W/O $1,092.54 $3,098.00 $218.41–$1,540.00 3% below 65%
MRI of the lower back, no contrast dye inpatient CPT 72148 XR SPINAL LUMBAR MRI W/O $1,092.54 $3,098.00 $218.41–$1,540.00 — 65%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 XR SPINAL THORACIC MRI W/0 $1,092.54 $3,098.00 $218.41–$1,540.00 2% below 65%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 XR SPINAL THORACIC MRI W/0 $1,092.54 $3,098.00 $218.41–$1,540.00 — 65%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR SPINE CERVICAL 4 OR 5 VWS $225.01 $638.04 $95.70–$292.22 11% above 65%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR SPINE CERVICAL 4 OR 5 VWS $225.01 $638.04 $95.70–$292.22 — 65%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/ $980.04 $2,779.00 $160.55–$1,272.78 43% above 65%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/ $980.04 $2,779.00 $160.55–$1,272.78 — 65%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O $619.98 $1,758.00 $95.70–$840.00 8% below 65%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O $619.98 $1,758.00 $95.70–$840.00 — 65%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISS $186.31 $528.30 $78.86–$241.96 63% above 65%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISS $186.31 $528.30 $78.86–$241.96 — 65%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 10% below 65%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 — 65%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W/ PA CHEST MIN3 VW LT,Left side $225.01 $638.04 $95.70–$292.22 65% above 65%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS W/ PA CHEST MIN3 VW RT,Right side $225.01 $638.04 $95.70–$292.22 65% above 65%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W/ PA CHEST MIN3 VW LT,Left side $225.01 $638.04 $95.70–$292.22 — 65%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS W/ PA CHEST MIN3 VW RT,Right side $225.01 $638.04 $95.70–$292.22 — 65%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RIGHT AP/LATERAL VIEW,Right side $186.31 $528.30 $79.66–$241.96 42% above 65%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $79.66–$241.96 42% above 65%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $79.66–$241.96 — 65%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER RIGHT AP/LATERAL VIEW,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS PARANAS COM MIN3VWS $186.31 $528.30 $79.66–$241.96 18% above 65%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS PARANAS COM MIN3VWS $186.31 $528.30 $79.66–$241.96 — 65%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL < 4 VIEWS $225.01 $638.04 $93.20–$292.22 67% above 65%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL < 4 VIEWS $225.01 $638.04 $93.20–$292.22 — 65%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THO SPINE W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 18% below 65%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THO SPINE W/O CONTRAST $619.98 $1,758.00 $95.70–$840.00 — 65%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE $316.34 $897.00 $95.70–$410.83 5% above 65%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE $316.34 $897.00 $95.70–$410.83 — 65%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR UPPER ARM RIGHT AP/LATERAL VIEW,Right side $186.31 $528.30 $79.66–$241.96 60% above 65%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR UPPER ARM LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $79.66–$241.96 60% above 65%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR UPPER ARM LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $79.66–$241.96 — 65%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR UPPER ARM RIGHT AP/LATERAL VIEW,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US LOWER EXTREMITY UNILATERAL $300.01 $850.72 $95.70–$389.63 17% above 65%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US LOWER EXTREMITY UNILATERAL $300.01 $850.72 $95.70–$389.63 — 65%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 71% above 65%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 71% above 65%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 — 65%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST RIGHT AP/LATERAL/OBLIQUE VIEW,Right side $186.31 $528.30 $79.66–$241.96 62% above 65%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST LEFT AP/LATERAL/OBLIQUE VIEW,Left side $186.31 $528.30 $79.66–$241.96 62% above 65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST RIGHT AP/LATERAL/OBLIQUE VIEW,Right side $186.31 $528.30 $79.66–$241.96 — 65%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST LEFT AP/LATERAL/OBLIQUE VIEW,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the abdomen, 1 view CPT 74018 XR NEEDLE COUNT ABDOMEN $186.31 $528.30 $73.64–$241.96 46% above 65%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW $186.31 $528.30 $73.64–$241.96 46% above 65%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR NEEDLE COUNT ABDOMEN $186.31 $528.30 $73.64–$241.96 — 65%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW $186.31 $528.30 $73.64–$241.96 — 65%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 72% above 65%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 72% above 65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS LT,Left side $186.31 $528.30 $73.64–$241.96 73% above 65%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 2 VIEWS RT,Right side $186.31 $528.30 $73.64–$241.96 73% above 65%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS RT,Right side $186.31 $528.30 $73.64–$241.96 — 65%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEWS LT,Left side $186.31 $528.30 $73.64–$241.96 — 65%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR ANKLE LEFT AP/LATERAL/MORTISE,Left side $186.31 $528.30 $79.66–$241.96 52% above 65%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT LEFT AP/LATERAL/OBLIQUE VIEW,Left side $186.31 $528.30 $79.66–$241.96 52% above 65%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT RIGHT AP/LATERAL/OBLIQUE VIEW,Right side $186.31 $528.30 $79.66–$241.96 52% above 65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT RIGHT AP/LATERAL/OBLIQUE VIEW,Right side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR ANKLE LEFT AP/LATERAL/MORTISE,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT LEFT AP/LATERAL/OBLIQUE VIEW,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND RIGHT AP/OBLIQUE VIEW ROUTINE,Right side $186.31 $528.30 $79.66–$241.96 47% above 65%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND LEFT AP/OBLIQUE VIEW ROUTINE,Left side $186.31 $528.30 $79.66–$241.96 47% above 65%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND RIGHT AP/OBLIQUE VIEW ROUTINE,Right side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND LEFT AP/OBLIQUE VIEW ROUTINE,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RIGHT AP/LATERAL VIEW ROUTINE,Right side $186.31 $528.30 $79.66–$241.96 64% above 65%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $79.66–$241.96 64% above 65%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LEFT AP/LATERAL VIEW ROUTINE,Left side $186.31 $528.30 $79.66–$241.96 64% above 65%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RIGHT,Right side $186.31 $528.30 $79.66–$241.96 64% above 65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RIGHT,Right side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RIGHT AP/LATERAL VIEW ROUTINE,Right side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LEFT AP/LATERAL VIEW,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LEFT AP/LATERAL VIEW ROUTINE,Left side $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSACRAL 2-3 VWS $225.01 $638.04 $95.70–$292.22 49% above 65%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSACRAL 2-3 VWS $225.01 $638.04 $95.70–$292.22 — 65%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACR MIN 4 VWS $225.01 $638.04 $95.70–$292.22 4% above 65%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACR MIN 4 VWS $225.01 $638.04 $95.70–$292.22 — 65%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE THORACIC 2 VIEWS $225.01 $638.04 $78.86–$292.22 43% above 65%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE THORACIC 2 VIEWS $225.01 $638.04 $78.86–$292.22 — 65%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COM MIN 3 VWS $186.31 $528.30 $79.66–$241.96 60% above 65%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COM MIN 3 VWS $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR SPINE CERVICAL 2+ VIEWS $186.31 $528.30 $79.66–$241.96 30% above 65%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR SPINE CERVICAL 2+ VIEWS $186.31 $528.30 $79.66–$241.96 — 65%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 OR 2 VIEWS $225.01 $638.04 $72.34–$292.22 70% above 65%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR NEEDLE COUNT PELVIS $225.01 $638.04 $72.34–$292.22 70% above 65%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 OR 2 VIEWS $225.01 $638.04 $72.34–$292.22 — 65%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR NEEDLE COUNT PELVIS $225.01 $638.04 $72.34–$292.22 — 65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM COCCYX MIN 2 VIEWS $186.31 $528.30 $79.66–$241.96 36% above 65%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM COCCYX MIN 2 VIEWS $186.31 $528.30 $79.66–$241.96 — 65%

Lab tests

ProcedureCash price List priceInsurers payvs LouisianaOff list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORM $261.67 $742.00 $37.85–$339.84 147% above 65%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORM $261.67 $742.00 $37.85–$339.84 — 65%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LCMC ALT $35.97 $102.00 $5.19–$46.72 86% above 65%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 LCMC ALT $35.97 $102.00 $5.19–$46.72 — 65%
AST (aspartate aminotransferase) enzyme test CPT 84450 URIC ACID BLOOD $35.27 $100.00 $5.08–$45.80 79% above 65%
AST (aspartate aminotransferase) enzyme test CPT 84450 LCMC AST (SGOT) $35.27 $100.00 $5.08–$45.80 79% above 65%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 LCMC AST (SGOT) $35.27 $100.00 $5.08–$45.80 — 65%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 URIC ACID BLOOD $35.27 $100.00 $5.08–$45.80 — 65%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANEL $322.33 $914.00 $46.68–$418.61 191% above 65%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANEL $322.33 $914.00 $46.68–$418.61 — 65%
Albumin blood test CPT 82040 LCMC ALBUMIN $33.50 $95.00 $4.85–$43.51 137% above 65%
Albumin blood test CPT 82040 ALBUMIN $33.50 $95.00 $4.85–$43.51 137% above 65%
Albumin blood test inpatient CPT 82040 LCMC ALBUMIN $33.50 $95.00 $4.85–$43.51 — 65%
Albumin blood test inpatient CPT 82040 ALBUMIN $33.50 $95.00 $4.85–$43.51 — 65%
Aldosterone blood test CPT 82088 ALDOSTERONE URINE $275.78 $782.00 $39.94–$358.16 189% above 65%
Aldosterone blood test CPT 82088 ALDOSTERONE LC/MS/MS SERU $275.78 $782.00 $39.94–$358.16 189% above 65%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE URINE $275.78 $782.00 $39.94–$358.16 — 65%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE LC/MS/MS SERU $275.78 $782.00 $39.94–$358.16 — 65%
Alkaline phosphatase (ALP) blood test CPT 84075 LCMC ALKALINE PHOSPHATASE $35.27 $100.00 $5.08–$45.80 84% above 65%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 LCMC ALKALINE PHOSPHATASE $35.27 $100.00 $5.08–$45.80 — 65%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG IGE QNT/SEMI CR EX $35.62 $101.00 $5.12–$46.26 264% above 65%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG IGE QNT/SEMI CR EX $35.62 $101.00 $5.12–$46.26 — 65%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALFA FETOPROTEIN TUMOR MARKER $70.98 $201.28 $16.43–$92.19 45% above 65%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALFA FETOPROTEIN TUMOR MARKER $70.98 $201.28 $16.43–$92.19 — 65%
Ammonia blood test CPT 82140 AMMONIA $98.39 $279.00 $14.28–$127.78 100% above 65%
Ammonia blood test inpatient CPT 82140 AMMONIA $98.39 $279.00 $14.28–$127.78 — 65%
Amylase blood test CPT 82150 LCMC AMYLASE $43.73 $124.00 $6.35–$56.79 97% above 65%
Amylase blood test CPT 82150 AMYLASE ISOENZYMES $43.73 $124.00 $6.35–$56.79 97% above 65%
Amylase blood test CPT 82150 AMYLASE BODY FLUID $43.73 $124.00 $6.35–$56.79 97% above 65%
Amylase blood test CPT 82150 AMYLASE URINE $43.73 $124.00 $6.35–$56.79 97% above 65%
Amylase blood test inpatient CPT 82150 AMYLASE BODY FLUID $43.73 $124.00 $6.35–$56.79 — 65%
Amylase blood test inpatient CPT 82150 AMYLASE ISOENZYMES $43.73 $124.00 $6.35–$56.79 — 65%
Amylase blood test inpatient CPT 82150 AMYLASE URINE $43.73 $124.00 $6.35–$56.79 — 65%
Amylase blood test inpatient CPT 82150 LCMC AMYLASE $43.73 $124.00 $6.35–$56.79 — 65%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI CCP AB $87.46 $248.00 $12.69–$113.58 108% above 65%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI CCP AB $87.46 $248.00 $12.69–$113.58 — 65%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA $81.82 $232.00 $11.85–$106.26 77% above 65%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA $81.82 $232.00 $11.85–$106.26 — 65%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BETA-TYPE NATRIUR PEPTIDE $229.93 $652.00 $38.47–$298.62 251% above 65%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BETA-TYPE NATRIUR PEPTIDE $229.93 $652.00 $38.47–$298.62 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ENVIRONMENTAL $20.82 $59.04 $8.45–$27.04 26% below 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCMC TISSUE CU $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCMC CULTURE TISSUE OR BONE WITH SMEAR $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 AEROBIC BACTERIA CULTURE $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCMC CULTURE DEEP WOUND WITH SMEAR $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE SPUTUM $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIA EYE $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BACTERIA EAR $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 NOSE THROAT CULTURE $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 LCMC CULTURE ENVIRONMENTAL $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE MISC CERVIX $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ROUTINE CULTURE $58.19 $165.00 $8.45–$75.57 107% above 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ENVIRONMENTAL $20.82 $59.04 $8.45–$27.04 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCMC TISSUE CU $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 ROUTINE CULTURE $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE MISC CERVIX $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCMC CULTURE ENVIRONMENTAL $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 NOSE THROAT CULTURE $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIA EAR $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BACTERIA EYE $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE SPUTUM $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCMC CULTURE DEEP WOUND WITH SMEAR $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 AEROBIC BACTERIA CULTURE $58.19 $165.00 $8.45–$75.57 — 65%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 LCMC CULTURE TISSUE OR BONE WITH SMEAR $58.19 $165.00 $8.45–$75.57 — 65%
Basic metabolic panel (blood test) CPT 80048 LCMC BASIC METABOLIC PANEL $57.48 $163.00 $8.29–$74.65 64% above 65%
Basic metabolic panel (blood test) inpatient CPT 80048 LCMC BASIC METABOLIC PANEL $57.48 $163.00 $8.29–$74.65 — 65%
Bilirubin blood test, total CPT 82247 LCMC BILIRUBIN TOTAL $23.28 $66.00 $4.92–$30.23 41% above 65%
Bilirubin blood test, total inpatient CPT 82247 LCMC BILIRUBIN TOTAL $23.28 $66.00 $4.92–$30.23 — 65%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST LEVEL IV,Technical Component $113.06 $320.58 $32.42–$146.83 45% above 65%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST LEVEL IV,Technical Component $113.06 $320.58 $32.42–$146.83 — 65%
Blood culture for bacteria CPT 87040 LCMC CULTURE BLOOD $69.83 $198.00 $10.11–$90.68 55% above 65%
Blood culture for bacteria inpatient CPT 87040 LCMC CULTURE BLOOD $69.83 $198.00 $10.11–$90.68 — 65%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $14.46 $41.00 $9.15–$18.78 75% above 65%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE $14.46 $41.00 $9.15–$18.78 — 65%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM $26.45 $75.00 $3.85–$34.35 103% above 65%
Blood glucose (sugar) test CPT 82947 LCMC GLUCOSE SERUM $26.45 $75.00 $3.85–$34.35 103% above 65%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM $26.45 $75.00 $3.85–$34.35 — 65%
Blood glucose (sugar) test inpatient CPT 82947 LCMC GLUCOSE SERUM $26.45 $75.00 $3.85–$34.35 — 65%
Blood lead test CPT 83655 LEAD URINE RANDOM (HM) $81.82 $232.00 $11.87–$106.26 203% above 65%
Blood lead test CPT 83655 LEAD BLOOD $81.82 $232.00 $11.87–$106.26 203% above 65%
Blood lead test inpatient CPT 83655 LEAD URINE RANDOM (HM) $81.82 $232.00 $11.87–$106.26 — 65%
Blood lead test inpatient CPT 83655 LEAD BLOOD $81.82 $232.00 $11.87–$106.26 — 65%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPE ABO $39.15 $111.00 $2.93–$50.84 11% below 65%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPE ABO $39.15 $111.00 $2.93–$50.84 — 65%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN (BUN) SERUM $26.80 $76.00 $3.87–$34.81 60% above 65%
Blood urea nitrogen (BUN) test CPT 84520 LCMC BUN $26.80 $76.00 $3.87–$34.81 60% above 65%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN (BUN) SERUM $26.80 $76.00 $3.87–$34.81 — 65%
Blood urea nitrogen (BUN) test inpatient CPT 84520 LCMC BUN $26.80 $76.00 $3.87–$34.81 — 65%
C-peptide blood test CPT 84681 C-PEPTIDE SERUM $140.71 $399.00 $20.39–$182.74 175% above 65%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE SERUM $140.71 $399.00 $20.39–$182.74 — 65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 LCMC C-REACTIVE PROTEIN $35.27 $100.00 $5.08–$45.80 51% above 65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $35.27 $100.00 $5.08–$45.80 51% above 65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $35.27 $100.00 $5.08–$45.80 — 65%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 LCMC C-REACTIVE PROTEIN $35.27 $100.00 $5.08–$45.80 — 65%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOAS TUM AG QUAN CA $140.71 $399.00 $20.39–$182.74 193% above 65%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOAS TUM AG QUAN CA $140.71 $399.00 $20.39–$182.74 — 65%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125 $140.71 $399.00 $20.39–$182.74 170% above 65%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125 $140.71 $399.00 $20.39–$182.74 — 65%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 IA DNA/RNA SARS COV-2 COVID-19 APT $86.85 $246.28 $50.28–$112.80 21% above 65%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HI THRUPUT IADNA/RNA SARS-COV2 COVID APT $86.85 $246.28 $50.28–$112.80 21% above 65%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HI THRUPUT IADNA/RNA SARS-COV2 COVID APT $86.85 $246.28 $50.28–$112.80 — 65%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 IA DNA/RNA SARS COV-2 COVID-19 APT $86.85 $246.28 $50.28–$112.80 — 65%
Calcium blood test, total CPT 82310 ISTAT CALCIUM $34.56 $98.00 $5.06–$44.88 74% above 65%
Calcium blood test, total CPT 82310 LCMC CALCIUM $34.56 $98.00 $5.06–$44.88 74% above 65%
Calcium blood test, total inpatient CPT 82310 LCMC CALCIUM $34.56 $98.00 $5.06–$44.88 — 65%
Calcium blood test, total inpatient CPT 82310 ISTAT CALCIUM $34.56 $98.00 $5.06–$44.88 — 65%
Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC AG (CEA) $54.62 $154.88 $18.58–$70.94 7% below 65%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC AG (CEA) $54.62 $154.88 $18.58–$70.94 — 65%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER IGG AB $75.82 $215.00 $12.62–$98.47 108% above 65%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IGG AB $75.82 $215.00 $12.62–$98.47 — 65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC AMPL PROBE $237.34 $673.00 $34.39–$308.23 313% above 65%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA/GC AMPL PROBE $237.34 $673.00 $34.39–$308.23 — 65%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LCMC LIPID PROFILE $80.76 $229.00 $13.12–$104.88 61% above 65%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LCMC LIPID PROFILE $80.76 $229.00 $13.12–$104.88 — 65%
Complete blood count (CBC) with differential CPT 85025 LCMC CBC WITH DIFFERENTIAL $52.90 $150.00 $7.61–$68.70 102% above 65%
Complete blood count (CBC) with differential inpatient CPT 85025 LCMC CBC WITH DIFFERENTIAL $52.90 $150.00 $7.61–$68.70 — 65%
Complete blood count (CBC), no differential CPT 85027 LCMC COMPLETE BLOOD COUNT - NO DIFF $43.73 $124.00 $6.34–$56.79 57% above 65%
Complete blood count (CBC), no differential CPT 85027 LCMC CBC NO DIFF $43.73 $124.00 $6.34–$56.79 57% above 65%
Complete blood count (CBC), no differential inpatient CPT 85027 LCMC COMPLETE BLOOD COUNT - NO DIFF $43.73 $124.00 $6.34–$56.79 — 65%
Complete blood count (CBC), no differential inpatient CPT 85027 LCMC CBC NO DIFF $43.73 $124.00 $6.34–$56.79 — 65%
Comprehensive metabolic panel (blood test) CPT 80053 LCMC COMPREHENSIVE METABOLIC PANEL $71.59 $203.00 $10.35–$92.97 3% below 65%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 LCMC COMPREHENSIVE METABOLIC PANEL $71.59 $203.00 $10.35–$92.97 — 65%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL $110.03 $312.00 $15.97–$142.90 191% above 65%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL $110.03 $312.00 $15.97–$142.90 — 65%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE(CK TOTAL) $44.08 $125.00 $6.38–$57.25 99% above 65%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE(CK TOTAL) $44.08 $125.00 $6.38–$57.25 — 65%
Creatinine blood test CPT 82565 LCMC CREATININE SERUM $34.56 $98.00 $5.02–$44.88 108% above 65%
Creatinine blood test CPT 82565 CREATININE SERUM $34.56 $98.00 $5.02–$44.88 108% above 65%
Creatinine blood test CPT 82565 LCMC CREATININE $34.56 $98.00 $5.02–$44.88 108% above 65%
Creatinine blood test inpatient CPT 82565 LCMC CREATININE $34.56 $98.00 $5.02–$44.88 — 65%
Creatinine blood test inpatient CPT 82565 LCMC CREATININE SERUM $34.56 $98.00 $5.02–$44.88 — 65%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM $34.56 $98.00 $5.02–$44.88 — 65%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS $97.33 $276.00 $14.10–$126.41 147% above 65%
Cytomegalovirus (CMV) antibody test CPT 86644 DONOR CMV AB TOTAL $97.33 $276.00 $14.10–$126.41 147% above 65%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 DONOR CMV AB TOTAL $97.33 $276.00 $14.10–$126.41 — 65%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS $97.33 $276.00 $14.10–$126.41 — 65%
D-dimer blood test (blood clot marker) CPT 85379 LCMC D DIMER QUANTITATIVE PLASMA $69.12 $196.00 $9.98–$89.77 37% above 65%
D-dimer blood test (blood clot marker) inpatient CPT 85379 LCMC D DIMER QUANTITATIVE PLASMA $69.12 $196.00 $9.98–$89.77 — 65%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S $150.59 $427.00 $21.79–$195.57 166% above 65%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S $150.59 $427.00 $21.79–$195.57 — 65%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 LCMC ELECTROLYTES PANEL SERUM $46.90 $133.00 $6.87–$60.91 28% above 65%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 LCMC ELECTROLYTES PANEL SERUM $46.90 $133.00 $6.87–$60.91 — 65%
Estradiol blood test CPT 82670 LCMC ESTRADIOL SERUM $189.03 $536.00 $27.38–$245.49 231% above 65%
Estradiol blood test inpatient CPT 82670 LCMC ESTRADIOL SERUM $189.03 $536.00 $27.38–$245.49 — 65%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FSH $107.12 $303.76 $18.21–$139.12 94% above 65%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FSH $107.12 $303.76 $18.21–$139.12 — 65%
Ferritin blood test (iron stores) CPT 82728 LCMC FERRITIN $92.04 $261.00 $13.36–$119.54 101% above 65%
Ferritin blood test (iron stores) inpatient CPT 82728 LCMC FERRITIN $92.04 $261.00 $13.36–$119.54 — 65%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY $57.48 $163.00 $9.53–$74.65 85% above 65%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY $57.48 $163.00 $9.53–$74.65 — 65%
Folate (folic acid) blood test CPT 82746 LCMC FOLATE (FOLIC ACID) $99.45 $282.00 $14.41–$129.16 163% above 65%
Folate (folic acid) blood test inpatient CPT 82746 LCMC FOLATE (FOLIC ACID) $99.45 $282.00 $14.41–$129.16 — 65%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) $66.65 $189.00 $16.60–$86.56 35% above 65%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY FT-3 $66.65 $189.00 $16.60–$86.56 35% above 65%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY FT-3 $66.65 $189.00 $16.60–$86.56 — 65%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3) $66.65 $189.00 $16.60–$86.56 — 65%
Free T4 (free thyroxine) thyroid blood test CPT 84439 LCMC T4 FREE $61.01 $173.00 $8.84–$79.23 74% above 65%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 LCMC T4 FREE $61.01 $173.00 $8.84–$79.23 — 65%
Free testosterone test CPT 84402 TESTOSTERONE FREE $172.45 $489.00 $24.96–$223.96 186% above 65%
Free testosterone test CPT 84402 FREE TESTOSTERONE $172.45 $489.00 $24.96–$223.96 186% above 65%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE $172.45 $489.00 $24.96–$223.96 — 65%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE $172.45 $489.00 $24.96–$223.96 — 65%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAM GLUTAMYL TRANSFERASE $48.67 $138.00 $7.06–$63.20 97% above 65%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAM GLUTAMYL TRANSFERASE $48.67 $138.00 $7.06–$63.20 — 65%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 POST DOSE GLUCOSE $32.09 $91.00 $4.66–$41.68 100% above 65%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 POST DOSE GLUCOSE $32.09 $91.00 $4.66–$41.68 — 65%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 3 SPECIMENS $87.11 $247.00 $12.61–$113.13 94% above 65%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 3 SPECIMENS $87.11 $247.00 $12.61–$113.13 — 65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORR DNA PCR $237.34 $673.00 $34.39–$308.23 316% above 65%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORR DNA PCR $237.34 $673.00 $34.39–$308.23 — 65%
H. pylori antibody blood test CPT 86677 AB HELICOBACTER PYLORI $79.00 $224.00 $16.51–$102.59 72% above 65%
H. pylori antibody blood test inpatient CPT 86677 AB HELICOBACTER PYLORI $79.00 $224.00 $16.51–$102.59 — 65%
HIV-1 and HIV-2 antibody test CPT 86703 LCMC HIV 1/2 AG/AB COMBO SCREE $71.24 $202.00 $13.44–$92.52 108% above 65%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 LCMC HIV 1/2 AG/AB COMBO SCREE $71.24 $202.00 $13.44–$92.52 — 65%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 LCMC HEMOGLOBIN A1C $65.59 $186.00 $9.52–$85.19 85% above 65%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 LCMC HEMOGLOBIN A1C $65.59 $186.00 $9.52–$85.19 — 65%
Hemoglobin blood test CPT 85018 POC HEMOGLOBIN $15.87 $45.00 $2.32–$20.61 52% above 65%
Hemoglobin blood test CPT 85018 POC HEMOGLOBIN BLOOD $15.87 $45.00 $2.32–$20.61 52% above 65%
Hemoglobin blood test CPT 85018 LCMC HEMOGLOBIN $15.87 $45.00 $2.32–$20.61 52% above 65%
Hemoglobin blood test inpatient CPT 85018 POC HEMOGLOBIN $15.87 $45.00 $2.32–$20.61 — 65%
Hemoglobin blood test inpatient CPT 85018 LCMC HEMOGLOBIN $15.87 $45.00 $2.32–$20.61 — 65%
Hemoglobin blood test inpatient CPT 85018 POC HEMOGLOBIN BLOOD $15.87 $45.00 $2.32–$20.61 — 65%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS B CORE AB TOTA $81.46 $231.00 $11.81–$105.80 187% above 65%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTA $81.46 $231.00 $11.81–$105.80 — 65%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB $73.00 $207.00 $10.53–$94.81 144% above 65%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB $73.00 $207.00 $10.53–$94.81 — 65%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG $69.83 $198.00 $10.12–$90.68 96% above 65%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG $69.83 $198.00 $10.12–$90.68 — 65%
Hepatitis C antibody blood test (screening) CPT 86803 LCMC HEPATITIS C ANTIBODY PERF $96.63 $274.00 $13.98–$125.49 115% above 65%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 LCMC HEPATITIS C ANTIBODY PERF $96.63 $274.00 $13.98–$125.49 — 65%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RNA BY PCR RT QNT $289.89 $822.00 $41.98–$376.48 163% above 65%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RNA RT QUANT (HCPQ) $289.89 $822.00 $41.98–$376.48 163% above 65%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RNA RT QUANT (HCPQ) $289.89 $822.00 $41.98–$376.48 — 65%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RNA BY PCR RT QNT $289.89 $822.00 $41.98–$376.48 — 65%
Herpes blood test, HSV-1 antibody CPT 86695 AB HERPES SIMPLEX TYPE 1 $89.22 $253.00 $12.93–$115.87 254% above 65%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 AB HERPES SIMPLEX TYPE 1 $89.22 $253.00 $12.93–$115.87 — 65%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX 2 IGG $130.84 $371.00 $18.96–$169.92 203% above 65%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX 2 IGG $130.84 $371.00 $18.96–$169.92 — 65%
High-sensitivity CRP (hs-CRP) test CPT 86141 HSCRP (CARDIO CRP) $87.46 $248.00 $12.69–$113.58 104% above 65%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HSCRP (CARDIO CRP) $87.46 $248.00 $12.69–$113.58 — 65%
Homocysteine blood test CPT 83090 HOMOCYSTEINE CU $113.91 $323.00 $17.56–$147.93 100% above 65%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE CU $113.91 $323.00 $17.56–$147.93 — 65%
Insulin blood test CPT 83525 INSULIN TOTAL $77.23 $219.00 $11.20–$100.30 170% above 65%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL $77.23 $219.00 $11.20–$100.30 — 65%
Iron blood test (serum iron) CPT 83540 IRON SERUM $36.32 $103.00 $6.34–$47.17 67% above 65%
Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM $36.32 $103.00 $6.34–$47.17 — 65%
Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON BIND CAPACITY $59.25 $168.00 $8.57–$76.94 84% above 65%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BIND CAPACITY $59.25 $168.00 $8.57–$76.94 — 65%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $58.89 $167.00 $8.51–$76.49 17% above 65%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $58.89 $167.00 $8.51–$76.49 — 65%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE $125.19 $355.00 $18.15–$162.59 132% above 65%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE $125.19 $355.00 $18.15–$162.59 — 65%
Lactate (lactic acid) blood test CPT 83605 LCMC LACTIC ACID $72.30 $205.00 $11.34–$93.89 160% above 65%
Lactate (lactic acid) blood test inpatient CPT 83605 LCMC LACTIC ACID $72.30 $205.00 $11.34–$93.89 — 65%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACT DEHYDROGEN LD LDH $40.91 $116.00 $5.92–$53.13 101% above 65%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACT DEHYDROGEN LD LDH $40.91 $116.00 $5.92–$53.13 — 65%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $46.90 $133.00 $6.75–$60.91 87% above 65%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $46.90 $133.00 $6.75–$60.91 — 65%
Liver function blood test panel CPT 80076 LCMC HEPATIC FUNCTION PANEL $55.01 $156.00 $8.01–$71.45 10% above 65%
Liver function blood test panel inpatient CPT 80076 LCMC HEPATIC FUNCTION PANEL $55.01 $156.00 $8.01–$71.45 — 65%
Lyme disease antibody test CPT 86618 LYME DIS AB $114.97 $326.00 $16.69–$149.31 128% above 65%
Lyme disease antibody test inpatient CPT 86618 LYME DIS AB $114.97 $326.00 $16.69–$149.31 — 65%
Magnesium blood test CPT 83735 LCMC MAGNESIUM $45.14 $128.00 $6.57–$58.62 110% above 65%
Magnesium blood test inpatient CPT 83735 LCMC MAGNESIUM $45.14 $128.00 $6.57–$58.62 — 65%
Measles (rubeola) antibody test CPT 86765 RUBEOLA $88.17 $250.00 $12.62–$114.50 203% above 65%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA $88.17 $250.00 $12.62–$114.50 — 65%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREEN $35.27 $100.00 $5.08–$45.80 46% above 65%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREEN $35.27 $100.00 $5.08–$45.80 — 65%
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS $88.17 $250.00 $12.79–$114.50 198% above 65%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS $88.17 $250.00 $12.79–$114.50 — 65%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA $124.49 $353.00 $18.02–$161.67 156% above 65%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE $124.49 $353.00 $18.02–$161.67 156% above 65%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA $124.49 $353.00 $18.02–$161.67 — 65%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE $124.49 $353.00 $18.02–$161.67 — 65%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL $124.49 $353.00 $18.02–$161.67 182% above 65%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL $124.49 $353.00 $18.02–$161.67 182% above 65%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL $124.49 $353.00 $18.02–$161.67 — 65%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL $124.49 $353.00 $18.02–$161.67 — 65%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE $279.31 $792.00 $40.45–$362.74 207% above 65%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHYROID HORMONE $279.31 $792.00 $40.45–$362.74 — 65%
Partial thromboplastin time (PTT) clotting test CPT 85730 LCMC APTT $40.91 $116.00 $5.89–$53.13 101% above 65%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LCMC APTT $40.91 $116.00 $5.89–$53.13 — 65%
Phosphorus (phosphate) blood test CPT 84100 LCMC PHOSPHORUS $32.09 $91.00 $4.65–$41.68 91% above 65%
Phosphorus (phosphate) blood test inpatient CPT 84100 LCMC PHOSPHORUS $32.09 $91.00 $4.65–$41.68 — 65%
Potassium blood test CPT 84132 POTASSIUM SERUM $31.03 $88.00 $4.66–$40.30 76% above 65%
Potassium blood test CPT 84132 LCMC POTASSIUM $31.03 $88.00 $4.66–$40.30 76% above 65%
Potassium blood test inpatient CPT 84132 LCMC POTASSIUM $31.03 $88.00 $4.66–$40.30 — 65%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM $31.03 $88.00 $4.66–$40.30 — 65%
Progesterone blood test CPT 84144 PROGESTERONE $141.06 $400.00 $20.44–$183.20 158% above 65%
Progesterone blood test inpatient CPT 84144 PROGESTERONE $141.06 $400.00 $20.44–$183.20 — 65%
Prolactin blood test CPT 84146 PROLACTIN $131.19 $372.00 $18.99–$170.38 105% above 65%
Prolactin blood test inpatient CPT 84146 PROLACTIN $131.19 $372.00 $18.99–$170.38 — 65%
Prothrombin time (PT/INR) clotting test CPT 85610 LCMC PROTIME/INR $26.45 $75.00 $4.20–$34.35 83% above 65%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME BLOOD $26.45 $75.00 $4.20–$34.35 83% above 65%
Prothrombin time (PT/INR) clotting test CPT 85610 LCMC PROTIME $26.45 $75.00 $4.20–$34.35 83% above 65%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LCMC PROTIME/INR $26.45 $75.00 $4.20–$34.35 — 65%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME BLOOD $26.45 $75.00 $4.20–$34.35 — 65%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LCMC PROTIME $26.45 $75.00 $4.20–$34.35 — 65%
Rapid flu test (influenza antigen) CPT 87804 INF ANTIGEN DETECTION FLU $81.11 $230.00 $16.22–$105.34 260% above 65%
Rapid flu test (influenza antigen) inpatient CPT 87804 INF ANTIGEN DETECTION FLU $81.11 $230.00 $16.22–$105.34 — 65%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN GROUP A $81.11 $230.00 $16.20–$105.34 265% above 65%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN GROUP A $81.11 $230.00 $16.20–$105.34 — 65%
Renin blood test CPT 84244 PLASMA RENIN ACTIVITY $148.82 $422.00 $21.55–$193.28 150% above 65%
Renin blood test inpatient CPT 84244 PLASMA RENIN ACTIVITY $148.82 $422.00 $21.55–$193.28 — 65%
Rh blood typing CPT 86901 BLOOD TYPE RH (D) $39.15 $111.00 $2.93–$50.84 83% above 65%
Rh blood typing inpatient CPT 86901 BLOOD TYPE RH (D) $39.15 $111.00 $2.93–$50.84 — 65%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT $38.44 $109.00 $5.56–$49.92 63% above 65%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT $38.44 $109.00 $5.56–$49.92 — 65%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODIES $97.33 $276.00 $14.10–$126.41 192% above 65%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODIES $97.33 $276.00 $14.10–$126.41 — 65%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE AUTO $17.99 $51.00 $2.65–$23.36 26% below 65%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE AUTO $17.99 $51.00 $2.65–$23.36 — 65%
Sodium blood test CPT 84295 SODIUM SERUM $32.44 $92.00 $4.71–$42.14 90% above 65%
Sodium blood test CPT 84295 LCMC SODIUM $32.44 $92.00 $4.71–$42.14 90% above 65%
Sodium blood test inpatient CPT 84295 LCMC SODIUM $32.44 $92.00 $4.71–$42.14 — 65%
Sodium blood test inpatient CPT 84295 SODIUM SERUM $32.44 $92.00 $4.71–$42.14 — 65%
Stool ova and parasites exam CPT 87177 O&P STOOL CONC&PERM SMEAR $59.25 $168.00 $8.72–$76.94 98% above 65%
Stool ova and parasites exam inpatient CPT 87177 O&P STOOL CONC&PERM SMEAR $59.25 $168.00 $8.72–$76.94 — 65%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD - STOOL $21.86 $62.00 $4.29–$28.40 62% above 65%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD - STOOL $21.86 $62.00 $4.29–$28.40 — 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RAPID PLASMA REAGIN $28.92 $82.00 $4.18–$37.56 101% above 65%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN $28.92 $82.00 $4.18–$37.56 — 65%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB CELL MED IM AG GAM INT $359.01 $1,018.00 $60.74–$466.24 204% above 65%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB CELL MED IM AG GAM INT $359.01 $1,018.00 $60.74–$466.24 — 65%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL $174.57 $495.00 $25.29–$226.71 198% above 65%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL $174.57 $495.00 $25.29–$226.71 — 65%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB $98.39 $279.00 $14.26–$127.78 173% above 65%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB $98.39 $279.00 $14.26–$127.78 — 65%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 LCMC TSH WITH REFLEX TO FREE T $113.56 $322.00 $16.46–$147.48 176% above 65%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 LCMC TSH WITH REFLEX TO FREE T $113.56 $322.00 $16.46–$147.48 — 65%
Total IgE blood test CPT 82785 GAMMAGLOBULIN IGE $111.44 $316.00 $16.13–$144.73 192% above 65%
Total IgE blood test inpatient CPT 82785 GAMMAGLOBULIN IGE $111.44 $316.00 $16.13–$144.73 — 65%
Total cholesterol blood test CPT 82465 LCMC CHOLESTEROL $29.27 $83.00 $4.26–$38.01 95% above 65%
Total cholesterol blood test inpatient CPT 82465 LCMC CHOLESTEROL $29.27 $83.00 $4.26–$38.01 — 65%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL $32.80 $93.00 $6.73–$42.59 41% above 65%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL $32.80 $93.00 $6.73–$42.59 — 65%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 $43.38 $123.00 $13.90–$56.33 9% below 65%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 $43.38 $123.00 $13.90–$56.33 — 65%
Transferrin blood test CPT 84466 TRANSFERRIN $86.40 $245.00 $12.50–$112.21 123% above 65%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN $86.40 $245.00 $12.50–$112.21 — 65%
Triglycerides blood test CPT 84478 LCMC TRIGLYCERIDES $38.79 $110.00 $5.63–$50.38 63% above 65%
Triglycerides blood test inpatient CPT 84478 LCMC TRIGLYCERIDES $38.79 $110.00 $5.63–$50.38 — 65%
Troponin test, quantitative CPT 84484 TROPONIN QUANTITATIVE $66.30 $188.00 $12.22–$86.10 75% above 65%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUANTITATIVE $66.30 $188.00 $12.22–$86.10 — 65%
Urinalysis with microscope exam, automated CPT 81001 LCMC UA W REFLEX TO CULTURE $21.51 $61.00 $3.11–$27.94 14% below 65%
Urinalysis with microscope exam, automated inpatient CPT 81001 LCMC UA W REFLEX TO CULTURE $21.51 $61.00 $3.11–$27.94 — 65%
Urinalysis without microscope exam, automated CPT 81003 LCMC URINALYSIS (DIP ONLY) $15.16 $43.00 $2.20–$19.69 71% above 65%
Urinalysis without microscope exam, automated CPT 81003 POC UA DIPSTICK $15.16 $43.00 $2.20–$19.69 71% above 65%
Urinalysis without microscope exam, automated inpatient CPT 81003 POC UA DIPSTICK $15.16 $43.00 $2.20–$19.69 — 65%
Urinalysis without microscope exam, automated inpatient CPT 81003 LCMC URINALYSIS (DIP ONLY) $15.16 $43.00 $2.20–$19.69 — 65%
Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO $17.28 $49.00 $3.41–$22.44 150% above 65%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO $17.28 $49.00 $3.41–$22.44 — 65%
Urine culture for bacteria, with colony count CPT 87086 LCMC CULTURE URINE $54.66 $155.00 $7.91–$70.99 45% above 65%
Urine culture for bacteria, with colony count CPT 87086 COLONY COUNT URINE $54.66 $155.00 $7.91–$70.99 45% above 65%
Urine culture for bacteria, with colony count inpatient CPT 87086 COLONY COUNT URINE $54.66 $155.00 $7.91–$70.99 — 65%
Urine culture for bacteria, with colony count inpatient CPT 87086 LCMC CULTURE URINE $54.66 $155.00 $7.91–$70.99 — 65%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN UR RAND QUAN $39.15 $111.00 $5.66–$50.84 125% above 65%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN UR RAND QUAN $39.15 $111.00 $5.66–$50.84 — 65%
Urine pregnancy test, read by color change CPT 81025 POC URINE PREGNANCY TEST $42.67 $121.00 $8.44–$55.42 103% above 65%
Urine pregnancy test, read by color change inpatient CPT 81025 POC URINE PREGNANCY TEST $42.67 $121.00 $8.44–$55.42 — 65%
Vitamin B12 (cobalamin) blood test CPT 82607 LCMC VITAMIN B12 $101.92 $289.00 $14.78–$132.36 157% above 65%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 LCMC VITAMIN B12 $101.92 $289.00 $14.78–$132.36 — 65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 3 25-HYDROXY $200.31 $568.00 $29.01–$260.14 162% above 65%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 3 25-HYDROXY $200.31 $568.00 $29.01–$260.14 — 65%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 LCMC VITAMIN D 25 HYDROXY $260.26 $738.00 $37.73–$338.00 191% above 65%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 LCMC VITAMIN D 25 HYDROXY $260.26 $738.00 $37.73–$338.00 — 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG SERUM $101.92 $289.00 $14.75–$132.36 110% above 65%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA-HCG QUANTITATIVE $101.92 $289.00 $14.75–$132.36 110% above 65%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG SERUM $101.92 $289.00 $14.75–$132.36 — 65%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA-HCG QUANTITATIVE $101.92 $289.00 $14.75–$132.36 — 65%

Surgery and procedures

ProcedureCash price List priceInsurers payvs LouisianaOff list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXT ELECT $636.55 $1,805.00 $605.01–$826.69 17% above 65%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXT ELECT $636.55 $1,805.00 $605.01–$826.69 — 65%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSFORAMINAL EPIDURAL W/FLUORO $809.35 $2,295.00 $809.63–$2,259.00 78% above 65%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 INJ TRANSFORAMINAL EPIDURAL W/FLUORO $809.35 $2,295.00 $809.63–$2,259.00 — 65%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ SGL/MUL TRIG PTS 1-2M $290.94 $825.00 $280.98–$825.00 120% above 65%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ SGL/MUL TRIG PTS 1-2M $290.94 $825.00 $280.98–$825.00 — 65%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs LouisianaOff list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION COMP $1,072.99 $3,042.55 $403.84–$2,259.00 126% above 65%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION <2 HR $1,072.99 $3,042.55 $403.84–$2,259.00 126% above 65%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 2<4HR $1,096.42 $3,108.99 $403.84–$2,259.00 131% above 65%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION 4<6HR $1,119.36 $3,174.05 $403.84–$2,259.00 136% above 65%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION >6HR $1,222.36 $3,466.12 $403.84–$2,259.00 157% above 65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION <2 HR $1,072.99 $3,042.55 $403.84–$2,259.00 — 65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION COMP $1,072.99 $3,042.55 $403.84–$2,259.00 — 65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 2<4HR $1,096.42 $3,108.99 $403.84–$2,259.00 — 65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION 4<6HR $1,119.36 $3,174.05 $403.84–$2,259.00 — 65%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION >6HR $1,222.36 $3,466.12 $403.84–$2,259.00 — 65%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION THERAPY $319.90 $907.12 $200.44–$415.46 267% above 65%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION THERAPY $319.90 $907.12 $200.44–$415.46 — 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 SURG - EKG 12 LEAD $161.72 $458.57 $54.00–$210.03 96% above 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NURSING EKG 12 LEAD $161.72 $458.57 $54.00–$210.03 96% above 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD $161.72 $458.57 $54.00–$210.03 96% above 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 SURG - EKG 12 LEAD $161.72 $458.57 $54.00–$210.03 — 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NURSING EKG 12 LEAD $161.72 $458.57 $54.00–$210.03 — 65%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD $161.72 $458.57 $54.00–$210.03 — 65%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV INFUS HYDRAT 31-60 MIN $182.68 $518.00 $194.71–$237.24 23% above 65%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV INFUS HYDRAT 31-60 MIN $182.68 $518.00 $194.71–$237.24 — 65%
IV infusion of a medicine, first hour CPT 96365 IV INF TH PR DIA INIT 1-60 $232.76 $660.00 $194.71–$302.28 21% above 65%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TH PR DIA INIT 1-60 $232.76 $660.00 $194.71–$302.28 — 65%
IV push of a medicine, first drug CPT 96374 TH PR DI INJ IV PUSH 1 $81.46 $231.00 $103.95–$195.67 16% below 65%
IV push of a medicine, first drug inpatient CPT 96374 TH PR DI INJ IV PUSH 1 $81.46 $231.00 $103.95–$195.67 — 65%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 TH PR DI INJ SQ IM $79.35 $225.00 $65.90–$103.05 50% above 65%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 TH PR DI INJ SQ IM $79.35 $225.00 $65.90–$103.05 — 65%

Vaccines

ProcedureCash price List priceInsurers payvs LouisianaOff list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION FLU VACCIN $62.42 $177.00 $65.90–$81.07 54% above 65%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION FLU VACCIN $62.42 $177.00 $65.90–$81.07 — 65%

Source file: https://www.scsh.com/pricing-transparency/200094270_st.-charles-surgical-hospital-llc_standardcharges.csv