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Hospital

Stewart Memorial Community Hospital

Stewart Memorial Community Hospital in Lake City, IA publishes cash prices for 365 common procedures listed here, from its own machine-readable price file updated Oct 8, 2024. Compared with other hospitals in the state, its outpatient cash prices are above the Iowa median for 205 of 360 procedures and below it for 154. By typical cash price it ranks #53 of 85 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1301 West Main St, Lake City, IA 51449 Collected Sep 27, 2026 Source price file (712) 464-3171

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161350 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs IowaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W WO CONTRAST $2,069.00 $2,587.00 $967.00–$2,587.00 6% above 20%
Abdominal X-ray, 2 views CPT 74019 X-RAY EXAM ABDOMEN 2 VIEWS $230.00 $288.00 $81.00–$269.00 8% below 20%
Ankle X-ray, complete, 3 or more views CPT 73610 ANKLE MIN 3 VIEWS $228.00 $286.00 $81.00–$267.00 3% above 20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS $301.00 $377.00 $142.00–$351.00 11% below 20%
Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTR WO CONTRAST $1,543.00 $1,929.00 $385.00–$1,767.00 27% above 20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGRAM SGL CONTRAST STUDY $630.00 $788.00 $788.00 74% above 20%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE IMAGING WHOLE BODY $1,036.00 $1,296.00 $488.00–$1,274.00 16% below 20%
Breast ultrasound, complete, one breast CPT 76641 US BREAST COMPLETE $468.00 $586.00 $586.00 30% above 20%
Breast ultrasound, limited (one breast or one area) CPT 76642 US BREAST LIMITED $384.00 $481.00 $207.00–$448.00 5% above 20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD AND PELV WO W CONTRAST $2,220.00 $2,775.00 $1,218.00–$2,775.00 25% below 20%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W WO CONTRAST $1,963.00 $2,454.00 $749.00–$2,454.00 1% above 20%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W WO CONTRAST $1,963.00 $2,454.00 $374.00–$2,454.00 6% below 20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST W WO CONTRAST $1,963.00 $2,454.00 $828.00–$2,454.00 8% below 20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART WO CONTRAST W CALCIUM SCORE $79.00 $99.00 $38.00–$95.00 10% below 20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS WO CONTRAST $2,368.00 $2,961.00 $967.00–$2,179.00 10% below 20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CONTRAST $3,419.00 $4,274.00 $940.00–$3,676.00 7% above 20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS W WO CONTR 1+ REG/SEC $3,858.00 $4,823.00 $967.00–$4,116.00 13% above 20%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST $1,881.00 $2,352.00 $914.00–$2,352.00 12% above 20%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST $1,710.00 $2,138.00 $643.00–$1,593.00 29% above 20%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST $1,543.00 $1,929.00 $366.00–$1,515.00 20% above 20%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD OR BRAIN WO CONTRAST $1,543.00 $1,929.00 $683.00–$1,506.00 15% above 20%
CT scan of the head with contrast CPT 70460 CT HEAD OR BRAIN W CONTRAST $1,840.00 $2,301.00 $2,301.00 22% above 20%
CT scan of the head without and with contrast CPT 70470 CT HEAD OR BRAIN W WO CONTRAST $2,037.00 $2,547.00 $836.00–$2,071.00 13% above 20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST $1,745.00 $2,182.00 $360.00–$1,537.00 15% above 20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST $1,728.00 $2,160.00 $198.00–$1,545.00 15% above 20%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST $1,881.00 $2,352.00 $914.00–$2,352.00 8% above 20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CAROTID DUPLEX SCAN; BILAT $860.00 $1,076.00 $420.00–$1,003.00 — 20%
Chest CT scan without and with contrast CPT 71270 CT CHEST W WO CONTRAST DIAG $2,091.00 $2,614.00 $503.00–$2,347.00 8% above 20%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS $210.00 $263.00 $63.00–$245.00 2% above 20%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW $161.00 $202.00 $76.00–$188.00 4% below 20%
Collarbone (clavicle) X-ray, complete CPT 73000 CLAVICLE COMPLETE $200.00 $250.00 $81.00–$233.00 6% above 20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM RETROPERITONEAL COMPL $665.00 $832.00 $347.00–$776.00 9% above 20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL $402.00 $503.00 $210.00–$468.00 2% above 20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO CONTRAST DIAG $1,728.00 $2,160.00 $385.00–$1,578.00 25% above 20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST DIAG $1,900.00 $2,376.00 $606.00–$1,980.00 7% above 20%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BILAT $427.00 $534.00 $223.00–$497.00 — 20%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNIL $337.00 $422.00 $190.00–$405.00 15% above 20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 DUPLEX LE ART/BPG; BILAT $662.00 $828.00 $146.00–$772.00 — 20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX EXT VEINS; BILAT $625.00 $782.00 $294.00–$729.00 — 20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/ DOPPLER COMPLETE $1,444.00 $1,805.00 $653.00–$1,682.00 5% below 20%
Elbow X-ray, 2 views CPT 73070 ELBOW 2 VIEWS $181.00 $227.00 $88.00–$218.00 15% above 20%
Elbow X-ray, complete, 3 or more views CPT 73080 ELBOW MIN 3 VIEWS $202.00 $253.00 $81.00–$236.00 7% below 20%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT SELLA MID INNER EAR WO CONTR $1,543.00 $1,929.00 $424.00–$1,808.00 19% above 20%
Facial bones X-ray, complete, 3 or more views CPT 70150 FACIAL BONES MIN 3 VIEWS $297.00 $372.00 $67.00–$321.00 10% above 20%
Forearm X-ray (radius and ulna), 2 views CPT 73090 FOREARM 2 VIEWS $181.00 $227.00 $81.00–$211.00 7% below 20%
Hand X-ray, 2 views CPT 73120 HAND 2 VIEWS $193.00 $242.00 $242.00 19% above 20%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 CALCANEUS MIN 2 VIEWS $180.00 $225.00 $85.00–$209.00 8% above 20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT & RESP EFFT $483.00 $604.00 $253.00–$604.00 13% below 20%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSS W 4/> PARAM W CPAP/BIPAP 6+ YRS $2,984.00 $3,731.00 $1,549.00–$3,477.00 5% below 20%
Knee X-ray, 3 views CPT 73562 KNEE 3 VIEWS $254.00 $318.00 $81.00–$297.00 19% above 20%
Knee X-ray, complete, 4 or more views CPT 73564 KNEE MIN 4 VIEWS $288.00 $361.00 $90.00–$336.00 5% above 20%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTR WO CONTRAST $1,543.00 $1,929.00 $385.00–$1,537.00 16% above 20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US EXAM ABDOMEN LIMITED $397.00 $497.00 $210.00–$464.00 18% below 20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US XTR NON-VASC LTD $440.00 $551.00 $207.00–$514.00 26% above 20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCREEN $420.00 $525.00 $220.00–$490.00 3% below 20%
Lower leg X-ray (tibia and fibula), 2 views CPT 73590 TIBIA FIBULA 2 VIEWS $196.00 $245.00 $73.00–$228.00 2% above 20%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST $1,854.00 $2,318.00 $357.00–$2,263.00 18% below 20%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTR ANY JOINT WO CONTRAST $1,945.00 $2,432.00 $840.00–$1,933.00 13% below 20%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTR ANY JOINT W WO CONTR $2,685.00 $3,357.00 $1,232.00–$3,357.00 15% below 20%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST $1,998.00 $2,498.00 $761.00–$1,884.00 4% below 20%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W WO CONTRAST $2,806.00 $3,508.00 $1,119.00–$3,270.00 17% below 20%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST $1,973.00 $2,467.00 $758.00–$1,877.00 14% below 20%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W WO CONTRAST $1,984.00 $2,480.00 $592.00–$2,480.00 44% below 20%
MRI of the lower back, no contrast dye CPT 72148 MRI SPINE LUMBAR WO CONTRAST $1,900.00 $2,375.00 $840.00–$2,114.00 20% below 20%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SPINE LUMBAR W WO CONTRAST $2,656.00 $3,321.00 $1,183.00–$3,321.00 23% below 20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SPINE THORACIC WO CONTRAST $1,889.00 $2,362.00 $851.00–$2,107.00 19% below 20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SPINE CERVICAL W WO CONTRAST $2,664.00 $3,331.00 $1,432.00–$3,331.00 19% below 20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SPINE CERVICAL WO CONTRAST $1,889.00 $2,362.00 $76.00–$2,110.00 17% below 20%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W WO CONTRAST $2,801.00 $3,502.00 $1,183.00–$3,264.00 14% below 20%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST $1,884.00 $2,355.00 $885.00–$2,192.00 9% below 20%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UP EXTR ANY JOINT WO CONTRAST $1,837.00 $2,297.00 $840.00–$1,936.00 17% below 20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 CERVICAL SPINE MIN 4 VIEWS $332.00 $416.00 $81.00–$388.00 2% above 20%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST $1,840.00 $2,301.00 $627.00–$2,203.00 15% above 20%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO CONTRAST $1,543.00 $1,929.00 $212.00–$1,713.00 22% above 20%
Neck soft tissue X-ray CPT 70360 SOFT TISSUE NECK $196.00 $245.00 $89.00–$221.00 12% above 20%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM HEART MUSCLE SPECT MULT $2,445.00 $3,057.00 $3,057.00 13% below 20%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 NM PET IMAGE W CT SKULL THIGH $4,460.00 $5,576.00 $5,576.00 6% above 20%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST $1,710.00 $2,138.00 $183.00–$1,582.00 32% above 20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LTD TRANSABDOMINAL $376.00 $471.00 $166.00–$412.00 7% above 20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMP TRANSABDOMINAL $502.00 $628.00 $274.00–$586.00 7% below 20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB COMPLETE SNGL FETUS $640.00 $800.00 $231.00–$746.00 16% above 20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB LESS THAN 14 WKS SNGL FETUS $558.00 $698.00 $231.00–$651.00 21% above 20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED FETUS(S) $385.00 $482.00 $192.00–$449.00 13% above 20%
Rib X-ray, one side, 2 views one side CPT 71100 RIBS UNILATERAL 2 VIEWS $230.00 $288.00 $90.00–$269.00 8% above 20%
Rib X-ray, one side, with a chest view, 3 or more views CPT 71101 RIBS CHEST UNIL MIN 3 VIEWS $264.00 $331.00 $124.00–$308.00 8% below 20%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO INCL CAD BILAT $306.00 $383.00 $144.00–$370.00 — 20%
Shoulder X-ray, complete, 2 or more views CPT 73030 SHOULDER MIN 2 VIEWS $215.00 $269.00 $81.00–$251.00 7% below 20%
Sinus X-ray, complete, 3 or more views CPT 70220 SINUSES MIN 3 VIEWS $236.00 $296.00 $104.00–$256.00 4% below 20%
Skull X-ray, fewer than 4 views CPT 70250 SKULL LESS THAN 4 VIEWS $223.00 $279.00 $279.00 9% above 20%
Sleep study in a lab (polysomnography) CPT 95810 PSS W 4/> PARAM W TECH 6+ YRS $2,859.00 $3,574.00 $1,345.00–$3,331.00 1% below 20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION W CINE VIDEO $813.00 $1,017.00 $1,017.00 98% above 20%
Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/> VW $219.00 $274.00 $81.00–$255.00 12% above 20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTRAST $1,745.00 $2,182.00 $424.00–$1,474.00 26% above 20%
Toe X-ray, 2 or more views CPT 73660 TOE OR TOES MIN 2 VIEWS $181.00 $227.00 $73.00–$197.00 5% above 20%
Transvaginal pelvic ultrasound CPT 76830 US NON OB TRANSVAG $568.00 $710.00 $272.00–$661.00 11% above 20%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL $440.00 $551.00 $219.00–$514.00 3% below 20%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOMEN COMPLETE $673.00 $842.00 $358.00–$784.00 3% below 20%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CONTENTS $477.00 $597.00 $182.00–$557.00 12% below 20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK $505.00 $632.00 $267.00–$589.00 9% above 20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W OR WO KUB $792.00 $990.00 $990.00 83% above 20%
Upper arm X-ray (humerus), 2 views CPT 73060 HUMERUS MIN 2 VIEWS $197.00 $247.00 $34.00–$213.00 6% above 20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DUPLEX EXT VEINS UNIL/LIMIT $629.00 $787.00 $274.00–$733.00 3% below 20%
Wrist X-ray, 2 views CPT 73100 WRIST 2 VIEWS $211.00 $264.00 $99.00–$246.00 16% above 20%
Wrist X-ray, complete, 3 or more views CPT 73110 WRIST COMPL MIN 3 VIEWS $254.00 $318.00 $81.00–$297.00 15% above 20%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS $292.00 $366.00 $81.00–$341.00 40% above 20%
X-ray of the abdomen, 1 view CPT 74018 X-RAY EXAM ABDOMEN 1 VIEW $188.00 $235.00 $81.00–$219.00 7% above 20%
X-ray of the ankle, 2 views CPT 73600 ANKLE 2 VIEWS $200.00 $250.00 $81.00–$233.00 19% above 20%
X-ray of the finger(s), 2 or more views CPT 73140 FINGER OR FINGERS MIN 2 VIEWS $232.00 $290.00 $90.00–$271.00 38% above 20%
X-ray of the foot, 2 views CPT 73620 FOOT 2 VIEWS $175.00 $219.00 $81.00–$204.00 8% above 20%
X-ray of the foot, complete, 3 or more views CPT 73630 FOOT MIN 3 VIEWS $215.00 $269.00 $81.00–$251.00 1% below 20%
X-ray of the hand, 3 or more views CPT 73130 HAND MIN 3 VIEWS $227.00 $284.00 $99.00–$265.00 12% above 20%
X-ray of the knee, 1 or 2 views CPT 73560 KNEE 1 OR 2 VIEWS $212.00 $266.00 $80.00–$248.00 8% above 20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBOSACR SPINE 2 OR 3 VIEWS $248.00 $311.00 $81.00–$290.00 13% below 20%
X-ray of the lower back, 4 or more views CPT 72110 LUMBOSACR SPINE MIN 4 VIEWS $320.00 $401.00 $81.00–$373.00 9% below 20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2 VIEWS $204.00 $256.00 $97.00–$239.00 18% below 20%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS $237.00 $297.00 $112.00–$276.00 20% above 20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2 OR 3 VIEWS $247.00 $309.00 $81.00–$288.00 at median 20%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1 OR 2 VIEWS $173.00 $217.00 $82.00–$203.00 12% below 20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX MIN 2 VIEWS $202.00 $253.00 $95.00–$236.00 7% below 20%

Lab tests

ProcedureCash price List priceInsurers payvs IowaOff list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIN MACTH QC/Q/Z/D/E/L/M/N/O/P/R/S/T/W/X/C1/S1/L1/W1/PL/G1/F1/C2/P1/V/Y/M2 $39.00 $49.00 $19.00–$47.00 77% below 20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT SGPT /ALL $44.00 $55.00 $5.00–$55.00 1% above 20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER FIBROSIS NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 $136.00 $171.00 $171.00 212% above 20%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST SGOT /ALL $44.00 $55.00 $10.00–$55.00 9% above 20%
AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER FIBROSIS NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 $136.00 $171.00 $171.00 237% above 20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS BATTERY E/J/L/M/O/P/R/T/W/C1/S1/L1/PL/G1/M2 $315.00 $394.00 $47.00–$367.00 34% above 20%
Albumin blood test CPT 82040 ALBUMIN /ALL $40.00 $50.00 $21.00–$48.00 11% above 20%
Aldosterone blood test CPT 82088 ALDOSTERONE MALDS QC/Q/Z/A/D/E/F/G/J/L/N/O/S/T/W/X/S1/P/L1/W1/PL/G1/F1/C2/P1/V/Y/M2 $170.00 $213.00 $55.00–$198.00 3% below 20%
Alkaline phosphatase (ALP) blood test CPT 84075 ALK PHOS /ALL $52.00 $66.00 $16.00–$58.00 27% above 21%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT FOOD ALLERGEN MBLW QC/Q/E/L/M/O/W/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE ALRG MRUSS QC/Q/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 RED ROUGH PIGWEED MRRRP QC/Q/E/L/M/O/W/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR ALLER MCED QC/Q/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F1/F/G/PMP/A/D/S/SA/N/T/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST MITES/DP MDP QC/Q/E/L/M/O/W/X/PL/J/C1/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST MITES/DF MDF QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE E/J/L/M/O/W/C1/S1/L1/PL/P/G1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 EASTERN SYCAMORE ALG MESYC QC/Q/E/L/M/O/W/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/T/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 ELM ALLERGEN MELM QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOPS ALLERGEN MSCALS QC/Q/E/L/M/O/W/PL/J/C1/P/G1/F/G/PMP/A/X/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN MEGG QC/Q/C1/E/L/M/O/W/X/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE MDOGD QC/Q/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD TREE ALRG MAYO $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 GERMAN COCKROACH ALG MCOCR QC/Q/Z/E/L/M/O/W/X/C1/PL/J/P/G1/F/G/PMP/A/D/S/SA/N/T/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN FOOD ALLERGEN MCORN QC/Q/Z/E/L/M/O/R/W/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH ALLERGEN MCOD QC/Q/E/L/M/O/W/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM ALLERGEN MCLAM QC/Q/E/L/M/O/W/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM ALLERGN MCLAD QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT EPITH ALLERGEN MCAT QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CHILD ALLERG PROFILE QC/Q/E/L/M/O/W/C1/L1/PL/J/P/G1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALB MOLD D/S/F1/L/M/W/PL/M2 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 BOX ELDER/MAPLE TREE MBXMPL Q/QC/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS ALLERG BERG QC/Q/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERN TENIUS ALLRGN MALTN QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPER FUMIGATIS ALLR MASP QC/Q/E/L/M/O/W/X/C1/S1/L1/W1/PL/J/P/G1/F/G/PMP/A $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH TREE ALLER MASHW QC/Q/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/T/W1 $23.00 $29.00 $11.00–$29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE ALG MSESA QC/Q/E/L/M/O/W/PL/J/C1/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP ALLERGEN MSHRI QC/Q/E/L/M/O/W/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN MSOY QC/Q/C1/E/L/M/O/W/L1/W1/PL/J/P/G1/S1/F/G/PMP/A $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE ALLERGEN MWALN QC/Q/E/L/M/O/W/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE HICKORY TREE MWHIC D/E/L/M/N/O/S/W/C1/L1/PL/J/P/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN MWHT QC/Q/C1/E/L/M/O/W/L1/PL/J/P/G1/S1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 SHORT RAGWEED ALLERG MSRW QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERG MTIMG QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH MARSH ELDER AL MMARS QC/Q/E/L/M/O/W/C1/L1/PL/J/P/Z/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 RESP ALLERG PROFILE E/L/M/O/W/C1/S1/L1/PL/J/P/G1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN MPEAN QC/Q/C1/E/L/M/O/W/X/L1/PL/J/P/G1/F/G/PMP/A/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM IGE MPENL QC/Q/E/L/M/O/W/X/C1/S1/L1/Z/PL/J/P/G1/F1/F/G/PMP/A/D/S/SA/N/T/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 OAK ALLERGEN MOAK QC/Q/E/L/M/O/W/X/C1/L1/PL/J/P/E/G1/F/G/PMP/A/T/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 MULBERRY ALLERGEN MMULB QC/Q/E/D/L/M/O/S/W/X/C1/S1/N/L1/PL/J/P/G1/F1/F/G/PMP/A/T/W1 $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN IGE MMILK QC/Q/C1/E/J/L/M/O/W/L1/X/W1/PL/P/G1/S1/F/G/PMP/A $23.00 $29.00 $29.00 41% below 21%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN MYOLK QC/Q/C1/E/L/M/R/W/S1/L1/PL/O/J/P/G1/F/G/PMP/A/W1 $24.00 $30.00 $30.00 38% below 20%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP TUMOR MARKER QC/V/Z/Y/D/I/J/L/M/N/O/P/R/C1/S1/L1/C2/P1/X/PL/G1/F1/M2 $75.00 $94.00 $41.00–$87.00 17% below 20%
Alpha-fetoprotein (AFP) blood test CPT 82105 MS Quad UHL U14000-0 A/D/E/L/M/P/Q/R/S/W/C1/S1/N/L1/W1/PL/G1/F1 $75.00 $94.00 $94.00 17% below 20%
Ammonia blood test CPT 82140 AMMONIA QC/V/Z/Y/A/B/D/E/F/J/L/M/N/O/P/R/S/U/W/X/C1/S1/L1/P1/W1/R1/PL/G1/F1/M2/B1/K $62.00 $78.00 $29.00–$72.00 30% below 21%
Amylase blood test CPT 82150 AMYLASE /ALL $56.00 $70.00 $29.00–$69.00 5% above 20%
Amylase blood test CPT 82150 AMYLASE FLUID QC/V/Z/Y/A/D/E/F/G/L/M/Q/R/S/T/X/W/C1/N/C2/L1/H/O/P1/W1/R1/PL/P/G1/F1/M2 $62.00 $78.00 $78.00 16% above 21%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODIES MAYO MCCP E/J/L/M/O/P/R/W/C1/S1/W1/PL $60.00 $75.00 $22.00–$69.00 24% below 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP IgG QC/Y/V/C1/E/J/L/M/N/O/P/R/T/W/S1/L1/C2/P1/R1/X/S/D/N/PL/G1/F1/M2 $60.00 $75.00 $75.00 24% below 20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CON TISS DIS CASCADE MCTDC O/Z/D/L/M/S/W/E/R/L1/X/PL/J/C1/P/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/T/QC/Q/W1 $68.00 $86.00 $86.00 14% below 21%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA 10 PANEL L/M/O/T/W/S1/R/P/J/E/L1/PL/G1/M2 $57.00 $72.00 $24.00–$72.00 22% below 21%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CON TISS DIS CASCADE MCTDC O/Z/D/L/M/S/W/E/R/L1/X/PL/J/C1/P/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/T/QC/Q/W1 $68.00 $86.00 $86.00 7% below 21%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA C1/E/J/L/L1/M/O/P/R/W/S1/PL/G1/M2 $90.00 $113.00 $113.00 24% above 20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA BY IFA W REFLEX C1/E/J/L/M/O/P/R/W/S1/X/PL/G1/M2 $90.00 $113.00 $113.00 24% above 20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 PRO-BNP E/J/M/N/O/P/Q/QC/D/S/X/Y/Z/C1/C2/L1/P1/PL/G1/M2/B1 $184.00 $231.00 $97.00–$220.00 17% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE W/O SMEAR M/P/E/O/S1/L1/PL/J/G1 $32.00 $40.00 $8.00–$39.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT EAR L/M/R/W/E/O/J/S1/L1/PL/C1/P/G1 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT EYE L/M/P/R/W/E/O/J/S1/L1/PL/C1/G1 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT CSF AND GRAM E/J/L/M/O/P/R/W/L1/PL/C1/G1 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT WOUND & GRAM STAIN L/M/O/P/R/W/E/J/S1/L1/PL/G1 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT RESPIR & GRAM L/M/P/R/W/E/O/J/S1/L1/PL/C1/G1/M2 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 ORGANISM WORKUP C1/E/L/M/P/R/W/H/L1/PL/O/J/G1/M2 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT GENITAL & GRAM $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT FLUID WITH GRAM E/J/L/M/O/P/R/W/S1/L1/PL/G1 $32.00 $40.00 $40.00 47% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT TISSUE & GRAM E/J/L/M/O/P/R/W/C1/S1/L1/PL/G1/M2 $39.00 $49.00 $49.00 35% below 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULT CATH TIP L/M/R/W/O/C1/L1/E/PL/J/P/G1 $80.00 $100.00 $100.00 33% above 20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BODY FLUID CULTURE BY AUTOMATION E/J/L/M/W/L1/O/PL/C1/P/G1 $80.00 $100.00 $100.00 33% above 20%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE /ALL $47.00 $59.00 $7.00–$59.00 46% below 20%
Basic metabolic panel (blood test) CPT 80048 BASIC FASTING PNL /ALL $47.00 $59.00 $59.00 46% below 20%
Bilirubin blood test, total CPT 82247 NEONATE BILIRUBIN A/B/E/F/G/O/M1/B1 $37.00 $47.00 $17.00–$40.00 19% below 21%
Bilirubin blood test, total CPT 82247 BILI TOTAL CORD E/PL/G1 $37.00 $47.00 $47.00 19% below 21%
Bilirubin blood test, total CPT 82247 BILI TOTAL NEONATE A/B/E/F/G/O/U/PL/G1/M2 $37.00 $47.00 $47.00 19% below 21%
Bilirubin blood test, total CPT 82247 BILIRUBIN GROUP QC/Z/A/E/H/N/Q/E/C1/C2/V1/D/S/W1 $37.00 $47.00 $47.00 19% below 21%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL /ALL $37.00 $47.00 $47.00 19% below 21%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATH 88305 /R1 $122.00 $153.00 $125.00–$153.00 31% below 20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH, LEVEL-IV $202.00 $253.00 $253.00 13% above 20%
Blood culture for bacteria CPT 87040 CULT BLOOD ROUTINE M/L/P/R/W/E/O/J/S1/L1/PL/G1 $77.00 $97.00 $97.00 16% below 21%
Blood culture for bacteria CPT 87040 CULTURE BLOOD E $87.00 $109.00 $109.00 5% below 20%
Blood culture for bacteria CPT 87040 REFERRAL BLOOD CULT M/E/P/R/L1/H/PL/J/G1/M2 $94.00 $118.00 $29.00–$101.00 3% above 20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SMH VENIPUNCTURE $16.00 $21.00 $9.00–$21.00 24% below 24%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE $16.00 $21.00 $21.00 24% below 24%
Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING /ALL $45.00 $57.00 $57.00 34% above 21%
Blood glucose (sugar) test CPT 82947 GLUCOSE /ALL $45.00 $57.00 $25.00–$57.00 34% above 21%
Blood glucose (sugar) test CPT 82947 LIVER FIBROSIS NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 $136.00 $171.00 $171.00 305% above 20%
Blood lead test CPT 83655 HEAVY MTL SCRN DEMOG MHMDB QC/Q/D/E/L/M/P/R/S/T/W/X/C1/S1/N/L1/PL/O/J/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/T $22.00 $28.00 $26.00–$28.00 59% below 21%
Blood lead test CPT 83655 LEAD $52.00 $65.00 $65.00 4% below 20%
Blood lead test CPT 83655 LEAD L/M/R/W/X/C1/S1/L1/PL/G1/M2 $52.00 $65.00 $65.00 4% below 20%
Blood lead test CPT 83655 LEAD BLOOD C1EOPCLINIC $52.00 $65.00 $65.00 4% below 20%
Blood lead test CPT 83655 LEAD VENOUS W/DEMO MPBDV C/C1/J/L/L1/M/O/P/Q/QC/R/S1/T/W/X/Z/PL/E/G1/F1/C2/P1/V/Y/M2/D/S/SA/N $52.00 $65.00 $65.00 4% below 20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SCREEN ��� /ALL EXCEPT/B/H/J/V/L1/P1 $51.00 $64.00 $19.00–$60.00 18% below 20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SCREEN URINE /ALL EXCEPT/J/Q $51.00 $64.00 $64.00 18% below 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN Z/D/E/E/L/M/N/Q/S/T/W/X/C1/Q/L1/A/W1/R1/PL/G1/F1/M2 $67.00 $84.00 $84.00 17% above 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/RH D V/Z/Y/A/D/E/F/G/H/J/L/M/N/O/P/T/QC/S1/L1/C2/P1/R1/W1/PL/G1/V1/F1/M2 $67.00 $84.00 $6.00–$79.00 17% above 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 CORD BLOOD /A/E/S/QC/F1/M2 $67.00 $84.00 $84.00 17% above 20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TRANSFUSION REACTION /Z/A/E/L/M/Q/T/W/X/QC/PL/G1/M2/W $67.00 $84.00 $84.00 17% above 20%
Blood urea nitrogen (BUN) test CPT 84520 BUN /ALL $19.00 $24.00 $9.00–$22.00 43% below 21%
C-peptide blood test CPT 84681 C-PEPTIDE QC/V/Y/C2/P1/L/W/M/S/D/N $27.00 $34.00 $13.00–$34.00 74% below 21%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN V/Y/A/B/E/F/G/H/I/J/L/M/O/P/Q/R/T/W/S1/B1/L1/N/P1/W1/PL/G1/V1/M1/F1/M2/R1 $80.00 $100.00 $42.00–$95.00 37% above 20%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE MOLECULAR E/J/K/L/M/O/P/QC/R/T/V/W/Y/Z/C1/S1/C2/L1/P1/PL/G1/M2 $53.00 $67.00 $67.00 51% below 21%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9 MAYO M9288 T/W1 $87.00 $109.00 $109.00 11% below 20%
CA 19-9 blood test (tumor marker) CPT 86301 CA19-9 QC/V/Y/D/S/E/J/L/M/N/O/P/R/W/C1/S1/L1/C2/P1/A/X/PL/G1/W1/F1/M2 $87.00 $109.00 $20.00–$101.00 11% below 20%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 D/L/M/N/O/P/R/S/X/W/E/J/C1/S1/L1/R1/PL/G1/F1 $87.00 $109.00 $41.00–$101.00 24% below 20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV 2 MOLECULAR /K/B/N/E $106.00 $133.00 $56.00–$116.00 10% below 20%
Calcium blood test, total CPT 82310 CALCIUM /ALL $23.00 $29.00 $11.00–$29.00 43% below 21%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA QC/V/Y/J/A/B/D/E/F/G/J/L/M/O/P/Q/R/W/X/C1/S1/L1/C2/P1/W1/R1/PL/G1/M2 $125.00 $157.00 $59.00–$146.00 18% above 20%
Chickenpox (varicella) immunity blood test CPT 86787 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 $26.00 $33.00 $33.00 59% below 21%
Chickenpox (varicella) immunity blood test CPT 86787 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 $28.00 $36.00 $24.00–$36.00 56% below 22%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA IgG AB E/J/L/M/N/O/P/R/W/C1 $48.00 $61.00 $61.00 25% below 21%
Chickenpox (varicella) immunity blood test CPT 86787 VZV ANTIBODY IgG Q/QC/Y/V/C1/E/J/L/M/O/P/R/W/S1/L1/P1/X/R1/PL/G1/M2 $48.00 $61.00 $61.00 25% below 21%
Chickenpox (varicella) immunity blood test CPT 86787 VZV AB IGG IGM VZGM QC/A/E/F/G/L/M/O/P/R/W/X/C1/S1/J/L1/W1/PL/G1/F1/C2/P1/V/Y/M2/D/S/SA/N $112.00 $141.00 $141.00 75% above 21%
Chickenpox (varicella) immunity blood test CPT 86787 VZV AB IgM MVZM QC/Q/D/E/J/L/M/N/P/R/S/W/X/C1/S1/L1/PL/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/W1 $144.00 $181.00 $181.00 125% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA URINE L/M/O/P/W/J/S1/L1/PL/G1/M2 $147.00 $184.00 $184.00 48% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY NAA E/J/L/M/S1/L1/PL/O/C1/P/G1/M2/X $147.00 $184.00 $34.00–$171.00 48% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA BY NAA OTHER E/L/M/W/S1/J/L1/PL/O/C1/P/G1/M2 $147.00 $184.00 $184.00 48% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GC/CHLAMYDIA BY NAA E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2 $147.00 $184.00 $184.00 48% above 20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 GONORRHEA/CHLAMYDIA URINE E/J/L/M/O/P/T/W/S1/L1/PL/C1/G1/M2 $147.00 $184.00 $184.00 48% above 20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 GEN WELL BASIC E $25.00 $32.00 $13.00–$32.00 71% below 22%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 GEN WELL COMP/LIPD E $37.00 $47.00 $47.00 58% below 21%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE H/P/E $92.00 $116.00 $116.00 6% above 21%
Complete blood count (CBC) with differential CPT 85025 AUTOMATED CBC BILL $33.00 $42.00 $17.00–$38.00 48% below 21%
Complete blood count (CBC), no differential CPT 85027 MANUAL DIFFERENTIAL BILL $27.00 $34.00 $34.00 41% below 21%
Complete blood count (CBC), no differential CPT 85027 CBC HEMOGRAM Z/P1/B1/C1/C2/H/L1/M1/QC/S1/X/W1/A/E/R1/J/N/O/P/Q/R/U/T/PL/G1/V1/F1/M2 $27.00 $34.00 $14.00–$32.00 41% below 21%
Comprehensive metabolic panel (blood test) CPT 80053 COMP FASTING PNL /ALL $80.00 $100.00 $42.00–$95.00 35% below 20%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL /ALL $80.00 $100.00 $100.00 35% below 20%
Cortisol blood test, total CPT 82533 CORTISOL PM Q/QC/Z/A/E/F/G/J/L/M/N/O/P/R/W/X/C1/S1/L1/R1/PL/G1/M2 $61.00 $77.00 $77.00 39% below 21%
Cortisol blood test, total CPT 82533 CORTISOL 60 MINUTES QC/Q/Z/D/J/R/S/C2/N/M/L/W/L1/O/PL/P/F1/M2 $76.00 $96.00 $55.00–$96.00 24% below 21%
Cortisol blood test, total CPT 82533 CORTISOL BASELINE D/E/J/N/P/R/S/Z/C1/L1/O/PL/F1/M2 $150.00 $188.00 $188.00 50% above 20%
Cortisol blood test, total CPT 82533 CORTISOL DST Q/Z/A/D/E/F/G/L/M/R/S/W/C1/L1/PL/O/J/P/G1/QC/F1/M2 $150.00 $188.00 $188.00 50% above 20%
Cortisol blood test, total CPT 82533 CORTISOL AM Q/QC/Z/A/E/F/G/J/L/M/N/O/P/R/L/W1/G1/M2 $150.00 $188.00 $188.00 50% above 20%
Creatine kinase (CK) blood test, total CPT 82550 CK /ALL $61.00 $77.00 $32.00–$75.00 25% above 21%
Creatinine blood test CPT 82565 CREATININE /ALL $24.00 $30.00 $11.00–$29.00 33% below 20%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV AB IGG AND IGM E/J/L/M/P/R/W/C1/S1/L1/D/N/S/X/PL/G1/F1/M2 $128.00 $161.00 $14.00–$150.00 89% above 20%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT $38.00 $48.00 $19.00–$46.00 55% below 21%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE QC/V/Y/D/E/I/J/L/M/N/O/P/R/S/W/X/C1/S1/T/L1/C2/P1/PL/G1/F1/M2 $93.00 $117.00 $27.00–$108.00 20% below 21%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COTININE SERUM A/B/F/G/J/L/M/O/P/T/W/C1/L1/PL/G1/M2 $21.00 $27.00 $8.00–$27.00 83% below 22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 COTININE URINE Z/L/M/W/O/E/P/C1/L1/S/D/N/PL/J/R/G1/F1/M2/M1 $25.00 $32.00 $32.00 80% below 22%
Drug screen by lab instrument (any number of drug classes) CPT 80307 CORDSTAT DRUG ANALYS 5 L/M/E/W/S1/PL/F1/M2 $163.00 $204.00 $204.00 29% above 20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTES /ALL $66.00 $83.00 $83.00 4% below 20%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV ANTIBODIES MAYO MSEBV D/S/T/S1/N/W1/F1/F/G/PMP/A $36.00 $46.00 $18.00–$42.00 50% below 22%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IGM ARUP 50240 $36.00 $46.00 $46.00 50% below 22%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgM QC/Y/V/C1/E/J/L/M/O/P/R/T/W/L1/P1/PL/G1/M2 $36.00 $46.00 $46.00 50% below 22%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV VCA IgG QC/Y/V/C1/E/J/L/M/P/R/T/W/L1/P1/PL/G1/M2 $36.00 $46.00 $46.00 50% below 22%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV Ab Profile C1/E/J/L/M/O/P/R/T/W/S1/L1/X/PL/G1/M2 $36.00 $46.00 $46.00 50% below 22%
Estradiol blood test CPT 82670 ESTROGENS FRAC MESTF QC/Q/L/M/N/O/P/W/E/J/C1/S1/S/D/L1/X/PL/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/T/W1 $116.00 $146.00 $146.00 10% below 21%
Estradiol blood test CPT 82670 ESTRADIOL QC/V/Z/T/A/B/D/E/F/G/J/L/M/N/O/P/R/S/W/Z/C1/S1/L1/P1/W1/R1/PL/G1/F1/M2 $116.00 $146.00 $50.00–$135.00 10% below 21%
FSH (follicle-stimulating hormone) test CPT 83001 FSH QC/V/Z/Y/A/D/E/F/G/I/J/LM/N/O/P/Q/R/S/W/X/S1/C1/L1/P1/W1/R1/PL/G1/V1/F1/M2 $114.00 $143.00 $27.00–$132.00 11% above 20%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin F MCALPR Q/Z/X/W1/A/S/D/N/L/M/W/PL/F1/C2/P1/V/Y/M2 $127.00 $159.00 $48.00–$148.00 21% below 20%
Ferritin blood test (iron stores) CPT 82728 FERRITIN /ALL $100.00 $125.00 $13.00–$118.00 12% above 20%
Ferritin blood test (iron stores) CPT 82728 LIVER FIBROSIS NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 $136.00 $171.00 $171.00 52% above 20%
Fibrinogen blood test CPT 85384 FIBRINOGEN C2/QC/V/Z/Y/A/D/E/F/G/L/M/P/Q/S/T/X/N/L1/P1/W1/PL/G1/F1/M2 $129.00 $162.00 $33.00–$151.00 96% above 20%
Folate (folic acid) blood test CPT 82746 FOLATE /ALL EXCEPT/H/T/U/ $113.00 $142.00 $30.00–$136.00 28% above 20%
Folate (folic acid) blood test CPT 82746 FOLIC ACID; SERUM $115.00 $144.00 $144.00 31% above 20%
Free T3 thyroid hormone test CPT 84481 FREE T3 QC/V/Z/Y/A/D/E/F/G/J/L/M/N/O/P/Q/R/S/W/1/S1/L1/P1/W1/R1/PL/G1/F1/M2 $72.00 $91.00 $17.00–$84.00 34% below 21%
Free T4 (free thyroxine) thyroid blood test CPT 84439 GEN WELL T4 FREE E $21.00 $27.00 $9.00–$27.00 68% below 22%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE Y/V/E/H/N/O/U/C2/P1/R1/F1 $109.00 $137.00 $137.00 66% above 20%
Free testosterone test CPT 84402 TESTOSTERONE FRMALE C1/E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2 $81.00 $102.00 $25.00–$102.00 22% below 21%
Free testosterone test CPT 84402 TESTOSTERONE MTTFB Q/QC/L/M/W/E/P/S1/T/C1/L1/PL/G1/T/B/F/M2/F1/F/G/PMP/A/X/D/S/SA/N/W1 $108.00 $136.00 $136.00 5% above 21%
Free testosterone test CPT 84402 TEST FRFEMALE/CHILD C1/E/J/L/M/O/P/R/T/W/S1/L1/PL/G1/M2 $183.00 $229.00 $229.00 77% above 20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GAMMA GT /ALL EXCEPT/V1 $32.00 $40.00 $15.00–$36.00 37% below 20%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE D/E/L/M/P/S/L1/PL/G1/M2 $23.00 $29.00 $29.00 74% below 21%
Glucose tolerance test, 3 samples CPT 82951 GLU CHALLENGE 50 GM QC/V/Z/A/B/D/E/F/G/H/I/L/M/N/Q/R/S/T/R/W/S1/M1/C2/P1/W1/Y/R1/PL/P/G1/V1/F1/M2 $44.00 $55.00 $55.00 50% below 20%
Glucose tolerance test, 3 samples CPT 82951 GLU TOLERANCE GEST H/LV/E/C2/M2 $44.00 $55.00 $23.00–$55.00 50% below 20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 3 HR LV/E/U/L1 $44.00 $55.00 $55.00 50% below 20%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE 2HR Z/I/E/M1/W1/F1 $47.00 $59.00 $59.00 46% below 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY NAA E/L/M/W/J/S1/L1/PL/O/C1/P/G1/M2 $119.00 $149.00 $34.00–$149.00 28% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA URINE L/M/P/E/J/O/W/S1/L1/PL/C1/G1/M2 $147.00 $184.00 $184.00 58% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA BY NAA OTHER E/L/M/W/S1/J/L1/PL/O/C1/P/G1/M2 $147.00 $184.00 $184.00 58% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA BY NAA E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2 $147.00 $184.00 $184.00 58% above 20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GONORRHEA/CHLAMYDIA URINE E/J/L/M/O/P/T/W/S1/L1/PL/C1/G1/M2 $147.00 $184.00 $184.00 58% above 20%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN W1/A/E/F/G/J/L/M/N/O/P/QC/R/T/V/Y/Z/C1/S1/L1/P1/X/PL/G1/M2 $203.00 $254.00 $30.00–$236.00 81% above 20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV1 ULTRASENSITIVE VIRAL LOAD L/M/W/E/J/C1/L1/S/D/N/PL/O//G1/F1/M2 $352.00 $440.00 $166.00–$410.00 34% above 20%
HIV-1 and HIV-2 antibody test CPT 86703 HIV AB /J/L/M/O/P/R/W $100.00 $125.00 $125.00 106% above 20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV SCREEN B/E $60.00 $75.00 $18.00–$69.00 22% below 20%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK SCR PCR L/M/W/E/C1/S1/L1/PL/O/J/P/G1/M2 $147.00 $184.00 $34.00–$160.00 56% above 20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GEN HEALTH WELL A1C Y/E/G/P $17.00 $22.00 $18.00–$22.00 74% below 23%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C Z/A/E/H/I/P/O/R/T/C1/B1/M1/C2/W1/R1 $80.00 $100.00 $100.00 23% above 20%
Hemoglobin blood test CPT 85018 HGB AND HCT Z/B1/C2/S/D/H/K/L1/P1/S1/X/W1/E/J/N/Y/V/O/P/Q/R/U/PL/G1/V1/F1/M2/C1 $11.00 $14.00 $6.00–$14.00 61% below 21%
Hemoglobin blood test CPT 85018 HGB Z/S/D/W1/B1/C1/C2/M1/X/H/K/A/E/S1/P1/R1/J/N/O/P/Q/R/U/PL/G1/V1/F1/M2 $11.00 $14.00 $14.00 61% below 21%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE TOT AB Z/E/J/L/M/R/W/C1/S1/L1/X/D/N/S/P/PL/G1/F1/M2 $51.00 $64.00 $24.00–$60.00 29% below 20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 $45.00 $57.00 $57.00 35% below 21%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB Q/QC/V/Y/E/J/L/M/O/P/R/W/S1/L1/C2/P1/PL/G1/M2 $48.00 $61.00 $23.00–$57.00 30% below 21%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP PANEL CHRONIC B MCHSBP QC/Q/E/J/L/M/T/W/S1/L1/W1/PL/C1/P/G1/F1/C2/P1/V/Y/M2/D/S/SA/N $38.00 $48.00 $48.00 46% below 21%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURF AG E/J/L/M/O/P/R/W/C1/S1/L1/PL/G1/M2 $42.00 $53.00 $18.00–$49.00 40% below 21%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB E/J/L/M/O/P/T/W/C1/S1/L1/PL/G1/M2 $61.00 $77.00 $77.00 24% below 21%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB QC/V/Z/Y/A/D/E/F/G/Q/S/X/N/P1/W1/F1 $61.00 $77.00 $32.00–$73.00 24% below 21%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HEPATITIS C RT PCR E/J/L/M/O/P/R/W/C1/S1/L1/D/N/S/X/A/PL/G1/W1/F1/M2 $107.00 $134.00 $40.00–$125.00 59% below 20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 AB IGG MHSVG D/N/S/Z/W1/X/E/F1/M2 $20.00 $25.00 $25.00 70% below 20%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 12 IGG QC/Y/V/P1/L/M/W/PL/M2 $28.00 $36.00 $13.00–$36.00 58% below 22%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 1/2 AB IGG MHSVG D/N/S/Z/W1/X/E/F1/M2 $20.00 $25.00 $25.00 65% below 20%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 12 IGG QC/Y/V/P1/L/M/W/PL/M2 $28.00 $36.00 $13.00–$33.00 52% below 22%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP A/D/E/F/G/J/L/M/N/O/P/QC/R/S/W/V/Z/Y/L1/S1/P1/X/PL/G1/F1/M2 $92.00 $116.00 $21.00–$108.00 15% above 21%
Homocysteine blood test CPT 83090 HOMOCYSTEINE QC/V/Y/D/E/J/L/M/N/O/P/R/S/W/C1/S1/L1/P1/X/PL/G1/F1/M2 $212.00 $265.00 $72.00–$240.00 121% above 20%
Insulin blood test CPT 83525 INSULIN QC/V/Y/D/E/J/L/M/N/O/P/R/S/W/C1/S1/L1/P1/PL/G1/F1/M2 $19.00 $24.00 $9.00–$24.00 75% below 21%
Iron blood test (serum iron) CPT 83540 IRON /ALL EXCEPT/H/T/U $31.00 $39.00 $16.00–$39.00 26% below 21%
Iron blood test (serum iron) CPT 83540 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/X/S1/C2/P1/W1/R1/J/N1 $72.00 $90.00 $90.00 71% above 20%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY N/Z/A/D/E/F/G/K/O/Q/R/S/T/L1/R1/PL/J/G1/F1/M2/C1 $33.00 $42.00 $9.00–$38.00 32% below 21%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PNL P/QC/V/Y/B/D/E/H/N/R/S/T/X/Q/C1/S1/B1/M1/L1/C2/P1/R1/V1/F1/M2 $40.00 $50.00 $19.00–$50.00 58% below 20%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE QC/V/Z/Y/A/B/D/E/F/G/I/J/L/M/N/O/P/Q/R/S/W1/S1/L1/C1/C2/P1/W1/R1/PL/G1/F1/M2 $114.00 $143.00 $27.00–$132.00 25% above 20%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID /ALL EXCEPT/J/QC/Z/V1 $52.00 $66.00 $25.00–$65.00 31% below 21%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH FLUID QC/V/Z/Y/A/E/F/G/H/J/L/M/Q/R/T/X/C1/C2/L1/P1/W1/R1/PL/P/G1/M2/D/S/F1/N1/N $25.00 $32.00 $10.00–$32.00 42% below 22%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH /ALL $25.00 $32.00 $32.00 42% below 22%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE /ALL $31.00 $39.00 $16.00–$36.00 53% below 21%
Liver function blood test panel CPT 80076 HEPATIC FUNC PANEL /ALL EXCEPT M/L/W/PL/G1 $47.00 $59.00 $25.00–$59.00 47% below 20%
Liver function blood test panel CPT 80076 RENAL FASTING PNL /ALL $47.00 $59.00 $59.00 47% below 20%
Lyme disease antibody test CPT 86618 LYME DIS AB SERO A/C1/C2/E/J/L/L1/M/O/P/QC/R/S1/V/W/Y/P1/R1/X/PL/G1/M2 $155.00 $194.00 $194.00 78% above 20%
Lyme disease antibody test CPT 86618 LYME AB IGM J/L/M/P/W/L1/PL/O/C1/G1/T/M2 $244.00 $306.00 $17.00–$180.00 180% above 20%
Magnesium blood test CPT 83735 MAGNESIUM URINE 24HR U/A/E/F/G/L/M/P/Q/S/W/X/S1/O/C1/L1/PL/J/G1/F1/M2 $32.00 $40.00 $40.00 34% below 20%
Magnesium blood test CPT 83735 MAGNESIUM /ALL $60.00 $75.00 $6.00–$69.00 23% above 20%
Magnesium blood test CPT 83735 MAGNESIUM URINE L/M/W/PL/O/J/R/P/G1/M2 $75.00 $94.00 $94.00 54% above 20%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IgG QC/Y/V/C1/E/J/L/M/P/W/S1/L1/P1/X/R1/PL/R/G1/M2 $41.00 $52.00 $18.00–$45.00 28% below 21%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IgG MROPG QC/Q/Z/E/J/L/M/O/P/W/C1/S1/W1/PL/G1/M2/X/D/S/SA/N $41.00 $52.00 $52.00 28% below 21%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB TITER ARUP M/L/E/L1/PL/O/J/C1/P/G1 $52.00 $65.00 $28.00–$62.00 7% above 20%
Mono test (heterophile antibody, Monospot) CPT 86308 INFECTIOUS MONO SCRN /ALL $53.00 $67.00 $67.00 9% above 21%
Mumps immunity blood test CPT 86735 MUMPS AB IGG/IGM MMMPGM QC/Z/D/E/L/M/N/O/R/S/W/X/C1/S1/T/L1/W1/PL/G1/F1/C2/P1/V/Y/M2 $21.00 $27.00 $27.00 60% below 22%
Mumps immunity blood test CPT 86735 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 $60.00 $76.00 $76.00 14% above 21%
Mumps immunity blood test CPT 86735 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 $60.00 $76.00 $76.00 14% above 21%
Mumps immunity blood test CPT 86735 MUMPS AB IgG QC/Y/V/C1/E/J/L/M/O/P/W/S1/L1/P1/X/PL/R/G1/M2 $123.00 $154.00 $154.00 134% above 20%
Mumps immunity blood test CPT 86735 MUMPS IgG SCREEN MMPPG Z/E/J/L/M/O/W/C1/W1/PL/G1/M2/X/D/S/SA/N/QC/Q $123.00 $154.00 $13.00–$65.00 134% above 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 GEN WELL PSA E $21.00 $27.00 $27.00 78% below 22%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREEN Z/Y/V/E/K/L/M/N/W/C2/P1/R1/PL/G1/M2 $125.00 $157.00 $157.00 29% above 20%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA V/Z/E/K/L/M/N/P/W/C1/C2/M1/P1/R1/PL/G1/M2 $125.00 $157.00 $157.00 29% above 20%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT /ALL EXCEPT/H/U $227.00 $284.00 $85.00–$264.00 27% above 20%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT /ALL $23.00 $29.00 $11.00–$27.00 50% below 21%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS /ALL $21.00 $27.00 $11.00–$25.00 41% below 22%
Potassium blood test CPT 84132 POTASSIUM /ALL $37.00 $47.00 $17.00–$43.00 8% above 21%
Progesterone blood test CPT 84144 NEONATAL SCREEN E/H/B/C1 $45.00 $57.00 $20.00–$57.00 55% below 21%
Progesterone blood test CPT 84144 PROGESTERONE Q/QC/V/Z/Y/A/B/E/F/G/J/L/M/O/P/R/W/X/S1/L1/P1/W1/PL/G1/M2 $125.00 $157.00 $157.00 25% above 20%
Prolactin blood test CPT 84146 PROLACTIN ALL EXCEPT B/B1/H/K/M1/T/U $136.00 $171.00 $27.00–$159.00 32% above 20%
Prothrombin time (PT/INR) clotting test CPT 85610 FINGER STICK INR I/E/F/W1/M2 $21.00 $27.00 $15.00–$27.00 36% below 22%
Prothrombin time (PT/INR) clotting test CPT 85610 VENOUS INR E $21.00 $27.00 $27.00 36% below 22%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME /ALL $40.00 $50.00 $50.00 22% above 20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG ABUSE SCN E $84.00 $105.00 $12.00–$103.00 15% above 20%
Rapid flu test (influenza antigen) CPT 87804 INFLU A/B AG QC/Z/A/D/E/F/G/K/L/M/N/P/Q/R/T/SA/W/M1/L1/C1/W1/PL/G1/M2 $76.00 $95.00 $17.00–$90.00 56% above 20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 BILL GROUP A AG SCREEN /C2/E $51.00 $64.00 $16.00–$60.00 1% below 20%
Renin blood test CPT 84244 RENIN MPRA QC/Q/Z/D/E/F/G/L/M/O/P/R/S/X/Y/W/S1/N/L1/W1/PL/G1/F1/C2/P1/V/Y/M2 $45.00 $57.00 $21.00–$53.00 59% below 21%
Rh blood typing CPT 86901 CORD BLOOD /A/E/S/QC/F1/M2 $14.00 $18.00 $18.00 69% below 22%
Rh blood typing CPT 86901 TRANSFUSION REACTION /Z/A/E/L/M/Q/T/W/X/QC/PL/G1/M2/W $16.00 $20.00 $20.00 64% below 20%
Rh blood typing CPT 86901 ABO/RH D V/Z/Y/A/D/E/F/G/H/J/L/M/N/O/P/T/QC/S1/L1/C2/P1/R1/W1/PL/G1/V1/F1/M2 $16.00 $20.00 $8.00–$20.00 64% below 20%
Rh blood typing CPT 86901 TYPE AND SCREEN Z/D/E/E/L/M/N/Q/S/T/W/X/C1/Q/L1/A/W1/R1/PL/G1/F1/M2 $16.00 $20.00 $20.00 64% below 20%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QC/V/Z/Y/A/D/E/F/G/I/J/L/M/N/O/P/S/W/X/C1/S1/L1/P1/PL/G1/F1/M2 $25.00 $32.00 $13.00–$30.00 49% below 22%
Rubella antibody test (immunity check) CPT 86762 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 $24.00 $31.00 $31.00 63% below 23%
Rubella antibody test (immunity check) CPT 86762 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 $24.00 $31.00 $31.00 63% below 23%
Rubella antibody test (immunity check) CPT 86762 RUBELLA SCREEN Z/D/E/L/M/N/O/P/Q/R/S/W/X/C1/R1/F1 $61.00 $77.00 $77.00 5% below 21%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGG IMMUNE Q/QC/A/E/F/G/W1 $89.00 $112.00 $112.00 39% above 21%
Sodium blood test CPT 84295 SODIUM /ALL $22.00 $28.00 $5.00–$26.00 34% below 21%
Stool ova and parasites exam CPT 87177 PARASITIC EXAMINATION MOPE QC/Q/W1/C2/P1/V/Y/X/D/S/SA/N $19.00 $24.00 $9.00–$24.00 62% below 21%
Stool ova and parasites exam CPT 87177 Expanded O&P UHL E/J/L/M/O/P/R/W/C1/L1/S1/PL/G1/M2 $20.00 $25.00 $25.00 60% below 20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN 3SPEC Z/E/G/N/Q/SA/U/B1/C1/P/R/L/M/W/X/A/R1/PL/G1/V1/M2 $51.00 $64.00 $4.00–$64.00 54% above 20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL $48.00 $60.00 $23.00–$58.00 17% below 20%
Syphilis antibody test (Treponema pallidum) CPT 86780 SYPHILIS IGG/IGM TOTAL V/Y/P1/C2/M/L/W/A/PL/E/W1/M2/C1/S/D/N/F1 $42.00 $53.00 $22.00–$49.00 22% below 21%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUALITATIVE QC/V/Y/D/E/F/N/O/P/R/S/T/X/S1/F1 $56.00 $71.00 $25.00–$61.00 15% above 21%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON TB GOLD B1/H/U $131.00 $164.00 $66.00–$164.00 13% below 20%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOT/BIOAVAIL MTTBS QC/Q/E/J/L/M/O/W/C1/S1/T/L1/PL/P/G1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/W1 $108.00 $136.00 $136.00 5% above 21%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE MTTFB Q/QC/L/M/W/E/P/S1/T/C1/L1/PL/G1/T/B/F/M2/F1/F/G/PMP/A/X/D/S/SA/N/W1 $108.00 $136.00 $27.00–$136.00 5% above 21%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONETOTAL Q/V/Y/A/E/F/G/J/L/M/O/P/R/W/C1/S1/L1/P1/W1/R1/PL/G1/M1/M2/X $197.00 $247.00 $247.00 91% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-TPO/MICROSOM QC/V/Y/E/L/M/O/P/R/W/C1/F/S1/L1/P1/X/R1/PL/G1/M2 $119.00 $149.00 $149.00 49% above 20%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID AB GROUP J/L/M/O/P/R/W/C1/S1/L1/X/PL/G1/M2 $120.00 $151.00 $151.00 50% above 21%
Thyroid peroxidase (TPO) antibody test CPT 86376 LKM ANTIBODIES MLKM QC/Q/D/E/L/M/N/O/S/W/C1/S1/L1/W1/J/PL/P/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1 $141.00 $177.00 $36.00–$140.00 77% above 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 GEN HEALTH WELL TSH E/G/H/J $17.00 $22.00 $22.00 83% below 23%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEONATAL SCREEN E/H/B/C1 $72.00 $90.00 $90.00 28% below 20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM HORMONE /ALL EXCEPT /K/L/M/W/P/U/B1/P1/Y/V/PL/G1/L1 $120.00 $150.00 $150.00 21% above 20%
Total IgE blood test CPT 82785 IMMUNOGLOBULIN E E/J/L/M/O/P/R/W/C1/L1/X/PL/G1/M2 $71.00 $89.00 $16.00–$83.00 6% below 20%
Total cholesterol blood test CPT 82465 CHOLESTEROL /ALL $20.00 $25.00 $9.00–$25.00 43% below 20%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL T4 QC/V/Z/Y/A/B/D/E/F/G/J/L/M/N/O/P/Q/R/S/T/W1/S1/L1/P1/W1/PL/G1/F1/M2 $29.00 $37.00 $14.00–$37.00 45% below 22%
Total triiodothyronine (T3) blood test CPT 84480 TRIIODOTHYRONINE A/D/E/F/G/J/L/M/N/O/P/S/W/R/C1/L1/W1/PL/G1/F1/M2 $54.00 $68.00 $27.00–$63.00 31% below 21%
Transferrin blood test CPT 84466 TRANSFERRIN QC/V/Y/A/E/F/G/I/J/L/M/O/P/W/C1/S1/R/L1/P1/N/D/S/PL/G1/F1/M2/X $88.00 $110.00 $41.00–$102.00 29% above 20%
Triglycerides blood test CPT 84478 TRIGLYCERIDES /ALL $40.00 $51.00 $13.00–$47.00 4% below 22%
Troponin test, quantitative CPT 84484 TROPONIN I K/Y/V/B/EP1/G1 $149.00 $187.00 $36.00–$174.00 28% above 20%
Uric acid blood test CPT 84550 URIC ACID /ALL $20.00 $26.00 $4.00–$24.00 48% below 23%
Urinalysis with microscope exam, automated CPT 81001 URINE MICROSCOPIC QC/Y/A/D/F/G/I/K/L/N/O/Q/R/S/T/U/W/X/C1/S1/C2/L1/P1/W1/B/B1/E/H/J/V/PL/V1/F1/M2 $40.00 $51.00 $51.00 7% below 22%
Urinalysis with microscope exam, automated CPT 81001 UA W/ CULT INDICATED E/H $40.00 $51.00 $51.00 7% below 22%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS /B/E/F/G/J/N/O/T/U/V/Y/B1/C1/L1/P1/R1 $40.00 $51.00 $21.00–$47.00 7% below 22%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS /B/E/F/G/J/N/O/T/U/V/Y/B1/C1/L1/P1/R1 $37.00 $47.00 $19.00–$47.00 41% above 21%
Urinalysis without microscope exam, automated CPT 81003 UR MACROSCOPIC/REFLEX Y/QC/V/E/H/K/Q/R/S/C1/D/S1/B1/M1/N/C2/L1/W1/G1/V1/F1/M2/R1 $40.00 $51.00 $51.00 52% above 22%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE L/M/P/R/W/E/O/J/S1/L1/PL/G1/X $68.00 $86.00 $35.00–$80.00 16% above 21%
Urine microalbumin (albumin) test CPT 82043 UR MICROALB CREAT RATIO QC/A/E/F/G/T/N/P/Q/T/U/X/B/S/B1/W1/M1/G1/M2 $69.00 $87.00 $6.00–$85.00 26% above 21%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 QC/V/Z/Y/A/B/D/E/F/G/I/J/K/L/M/N/O/P/Q/R/S1/S1/L1/C2/P1/W1/R1/PL/G1/V1/F1/M2 $109.00 $137.00 $15.00–$132.00 26% above 20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D25 HYDROXY Q/QC/V/Z/Y/A/B/D/E/F/G/J/K/L1/N/H/C2/P1/W1/L/M/W/O/S/X/PL/G1/V1/M1/F1/M2 $242.00 $303.00 $54.00–$282.00 87% above 20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 125 DIHYDROXY MDHVD QC/Q/A/D/E/F/G/J/L/M/N/O/P/R/S/T/W/X/C1/S1/L1/W1/PL/G1/F1/C2/P1/V/Y/M2 $242.00 $303.00 $103.00–$266.00 36% above 20%
Zinc blood test CPT 84630 ZINC MZN_S QC/Q/D/E/J/L/M/N/O/P/R/S/T/W/X/C1/S1/L1/W1/PL/G1/F1/C2/P1/V/Y/M2 $49.00 $62.00 $23.00–$58.00 7% below 21%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 MS Quad UHL U14000-0 A/D/E/L/M/P/Q/R/S/W/C1/S1/N/L1/W1/PL/G1/F1 $33.00 $42.00 $42.00 63% below 21%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE /ALL $100.00 $125.00 $15.00–$116.00 12% above 20%

Surgery and procedures

ProcedureCash price List priceInsurers payvs IowaOff list
Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS $2,384.00 $2,980.00 $1,155.00–$2,861.00 267% above 20%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 KNEE ARTHROSCOPY/SURGERY $9,552.00 $11,940.00 $4,629.00–$11,462.00 289% above 20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION $459.00 $574.00 $155.00–$574.00 45% below 20%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY $3,403.00 $4,254.00 $1,957.00–$4,084.00 21% above 20%
Cataract surgery with lens implant CPT 66984 CATARACT SURG W/IOL 1 STAGE EXTRACAPSULAR $2,409.00 $3,012.00 $1,829.00–$3,012.00 43% below 20%
Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY $3,403.00 $4,254.00 $1,334.00–$4,084.00 138% above 20%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY $3,403.00 $4,254.00 $1.00–$4,220.00 124% above 20%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY $3,402.00 $4,253.00 $1,968.00–$4,253.00 196% above 20%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE $4,272.00 $5,340.00 $2,070.00–$5,126.00 1162% above 20%
Complex cataract surgery with lens implant CPT 66982 CATARACT SURGERY COMPLEX $3,505.00 $4,382.00 $1,699.00–$4,207.00 11% below 20%
Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 CREATE EARDRUM OPENING $2,140.00 $2,676.00 $1,037.00–$2,676.00 292% above 20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI $101.00 $127.00 $48.00–$118.00 48% above 20%
Earwax removal with instruments, one ear CPT 69210 REMOVAL IMPACTED CERUMEN (EARWAX) $172.00 $215.00 $94.00–$215.00 64% above 20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV $1,180.00 $1,475.00 $534.00–$1,475.00 9% below 20%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 Repair AA HRN 1ST < 3 NCR/STRN $5,596.00 $6,996.00 $2,712.00–$6,996.00 305% above 20%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 Repair AA HRN 1ST < 3 CM RDC $6,438.00 $8,048.00 $2,223.00–$8,048.00 448% above 20%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY $3,183.00 $3,979.00 $1.00–$3,820.00 313% above 20%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY $6,161.00 $7,702.00 $3,565.00–$7,702.00 192% above 20%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH $5,607.00 $7,009.00 $3,225.00–$7,009.00 177% above 20%
Hammertoe correction surgery CPT 28285 REPAIR OF HAMMERTOE $5,790.00 $7,238.00 $2,453.00–$6,948.00 238% above 20%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ SALINE HYSTEROGRAM $368.00 $461.00 $461.00 5% above 20%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION $4,112.00 $5,140.00 $1,993.00–$5,140.00 13% above 20%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY $3,837.00 $4,797.00 $2,207.00–$4,797.00 4% above 20%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSC SMPL OR SGL $364.00 $455.00 $181.00–$424.00 42% above 20%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR $4,923.00 $6,154.00 $2,386.00–$6,154.00 233% above 20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JNT/BURSA $451.00 $564.00 $396.00–$564.00 31% above 20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA $382.00 $478.00 $478.00 22% above 20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT SM JNT/BURSA $413.00 $517.00 $517.00 50% above 20%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 KNEE ARTHROSCOPY/SURGERY $5,499.00 $6,874.00 $2,665.00–$6,599.00 167% above 20%
Knee arthroscopy with meniscus trim CPT 29881 KNEE ARTHROSCOPY/SURGERY $5,128.00 $6,411.00 $2,485.00–$6,155.00 112% above 20%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 KNEE ARTHROSCOPY/SURGERY $5,052.00 $6,316.00 $2,587.00–$6,063.00 127% above 20%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY $5,607.00 $7,009.00 $1,653.00–$7,009.00 222% above 20%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA $5,776.00 $7,220.00 $1.00–$7,220.00 241% above 20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT REP S/A/T/EX 2.5 CM/< $801.00 $1,002.00 $1.00 126% above 20%
Nail removal (partial or complete), one nail CPT 11730 SPL AVULSE NP SGL $355.00 $444.00 $444.00 73% above 20%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING $1,193.00 $1,492.00 $562.00–$1,492.00 8% above 20%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED $493.00 $617.00 $617.00 15% above 20%
Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION $3,952.00 $4,941.00 $1,916.00–$4,743.00 163% above 20%
Removal of a foreign object under the skin, simple CPT 10120 INC & REM FB SQ SMPL $461.00 $577.00 $134.00–$487.00 55% above 20%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLON CA SCRN NOT HI RSK IND $3,403.00 $4,254.00 $1,212.00–$4,084.00 225% above 20%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL SCRN; HI RISK IND $3,403.00 $4,254.00 $1,649.00–$4,084.00 183% above 20%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC $195.00 $244.00 $92.00–$228.00 11% above 20%
Short leg cast (below the knee) CPT 29405 APPLY SH LEG CAST $236.00 $296.00 $296.00 3% below 20%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT $212.00 $265.00 $81.00–$247.00 23% above 20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SREP S/N/A/G/TR/E 2.5 CM/< $287.00 $359.00 $62.00–$359.00 25% above 20%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION $569.00 $712.00 $480.00–$712.00 116% above 20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAG $564.00 $705.00 $606.00–$705.00 21% above 20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SREP S/N/A/G/TR/E 2.6-7.5 CM $344.00 $431.00 $75.00–$431.00 40% above 20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SREP F/E/N/L/MM 2.5 CM/< $344.00 $430.00 $181.00–$430.00 37% above 20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES $458.00 $573.00 $573.00 117% above 20%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING $949.00 $1,187.00 $447.00–$1,187.00 at median 20%
Tonsil and adenoid removal, age 12 or older CPT 42821 REMOVE TONSILS AND ADENOIDS $2,791.00 $3,489.00 $1,353.00–$3,489.00 219% above 20%
Tonsil and adenoid removal, child under 12 CPT 42820 REMOVE TONSILS AND ADENOIDS $2,398.00 $2,998.00 $1,162.00–$2,998.00 136% above 20%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY $10,380.00 $12,976.00 $5,031.00–$12,976.00 86% above 20%
Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY $8,875.00 $11,094.00 $4,301.00–$11,094.00 106% above 20%
Total shoulder replacement CPT 23472 RECONSTRUCT SHOULDER JOINT $9,552.00 $11,940.00 $4,629.00–$11,462.00 169% above 20%
Trigger finger release surgery CPT 26055 INCISE FINGER TENDON SHEATH $2,398.00 $2,998.00 $1,162.00–$2,878.00 33% above 20%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL $364.00 $456.00 $38.00–$456.00 21% above 20%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY $5,607.00 $7,009.00 $2,717.00–$7,009.00 410% above 20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG $1,752.00 $2,191.00 $2,191.00 16% below 20%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY BIOPSY $3,401.00 $4,252.00 $1.00–$4,252.00 161% above 20%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UPPR GI SCOPE W/SUBMUC INJ $3,756.00 $4,696.00 $1,120.00–$4,508.00 282% above 20%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 OPERATIVE UPPER GI ENDOSCOPY $3,837.00 $4,797.00 $1,860.00–$4,605.00 289% above 20%
Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY DIAGNOSIS $3,403.00 $4,254.00 $1,127.00–$4,084.00 261% above 20%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT(S) $2,841.00 $3,552.00 $1,377.00–$3,410.00 208% above 20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN TO SQ TISSUE $581.00 $727.00 $132.00–$727.00 36% above 20%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs IowaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR COMPONENT PER UNIT $816.00 $1,020.00 $66.00–$1,020.00 40% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT INITIAL $187.00 $234.00 $78.00–$234.00 61% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI AIRWAY INHALATION TX INITIAL $187.00 $234.00 $234.00 61% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT SUBQ $187.00 $234.00 $234.00 61% above 20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI AIRWAY INHALATION TX SUBQ $187.00 $234.00 $234.00 61% above 20%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO, IV INFUSION, 1 HR $573.00 $717.00 $255.00–$652.00 5% above 20%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 30-74 MIN $1,572.00 $1,965.00 $442.00–$1,933.00 57% above 20%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE & DROWSY $589.00 $737.00 $737.00 9% below 20%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 12 LEAD EKG; GLOBAL $212.00 $265.00 $265.00 118% above 20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG; TRACING ONLY $157.00 $197.00 $66.00–$183.00 1% below 20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED LEVEL 1 VISIT $182.00 $228.00 $23.00–$228.00 18% above 20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED LEVEL 2 VISIT $304.00 $381.00 $45.00–$381.00 16% above 20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED LEVEL 3 VISIT $486.00 $608.00 $77.00–$608.00 17% above 20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED LEVEL 4 VISIT $776.00 $970.00 $424.00–$961.00 20% above 20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED LEVEL 5 VISIT $1,150.00 $1,438.00 $628.00–$1,420.00 17% above 20%
Exercise stress test, tracing only, the hospital charge CPT 93017 CVSLR STRESS TEST; TRACING $612.00 $766.00 $766.00 9% below 20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT 31-60 MIN $272.00 $340.00 $148.00–$340.00 3% below 20%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DX IV INF INIT UP TO 1HR $438.00 $548.00 $232.00–$548.00 39% above 20%
IV push of a medicine, first drug CPT 96374 THER/PRO/DX INJ IV PUSH $148.00 $185.00 $81.00–$179.00 22% below 20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM $107.00 $134.00 $36.00–$134.00 17% above 20%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CONDUCT TST 7-8 STUDIES $413.00 $517.00 $517.00 25% below 20%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCLE RE-EDUC EA 15M $116.00 $145.00 $61.00–$145.00 27% above 20%
New patient office visit, about 30 minutes CPT 99203 O/P VISIT NEW LEVEL 3 $240.00 $300.00 $300.00 47% above 20%
New patient office visit, about 45 minutes CPT 99204 O/P VISIT NEW LEVEL 4 $391.00 $489.00 $489.00 59% above 20%
New patient office visit, about 60 minutes CPT 99205 O/P VISIT NEW LEVEL 5 $474.00 $593.00 $593.00 49% above 20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 O/P VISIT NEW LEVEL 2 $184.00 $231.00 $231.00 76% above 20%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT NUTRITION THERAPY; EACH 15M $77.00 $97.00 $97.00 74% above 21%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX $240.00 $300.00 $90.00–$279.00 34% above 20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX $240.00 $300.00 $134.00–$279.00 12% above 20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX $240.00 $300.00 $127.00–$279.00 23% above 20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX $240.00 $300.00 $127.00–$279.00 21% above 20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY EA 15M $103.00 $129.00 $54.00–$129.00 6% above 20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAP EXERCISE ROM EA 15M $111.00 $139.00 $59.00–$134.00 22% above 20%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKE/TOBACCO COUNSELING 3-10 MIN $35.00 $44.00 $44.00 5% below 20%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 O/P VISIT EST LEVEL 5 (40-54 MIN) $424.00 $530.00 $153.00–$473.00 80% above 20%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 O/P VISIT EST LEVEL 3 (20-29 MIN) $231.00 $289.00 $63.00–$264.00 95% above 20%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 O/P VISIT EST LEVEL 4 (30-39 MIN) $327.00 $409.00 $93.00–$373.00 97% above 20%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 O/P VISIT EST LEVEL 2 (10-19 MIN) $181.00 $227.00 $38.00–$119.00 123% above 20%
Speech and language evaluation CPT 92523 EVAL SPEECH SOUND LANG COMPREHEN $545.00 $682.00 $192.00–$636.00 81% above 20%
Speech therapy session, individual CPT 92507 SPEECH/HEARING THERAPY $229.00 $287.00 $120.00–$268.00 5% above 20%
Spirometry (breathing test) CPT 94010 SPIROMETRY $207.00 $259.00 $259.00 6% above 20%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM PRE & POST BD $360.00 $451.00 $191.00–$451.00 8% below 20%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY DIR EA 15M $110.00 $138.00 $60.00–$138.00 8% above 20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY B/E/H/J/N/P/S1/R/G1/M2 $41.00 $52.00 $20.00–$52.00 79% below 21%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY, THERAPEUTIC $250.00 $313.00 $313.00 30% above 20%

Vaccines

ProcedureCash price List priceInsurers payvs IowaOff list
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HPV VIRUS VACCINE 9 VAL IM $243.00 $304.00 $304.00 22% below 20%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV no prsv increased ag im $52.00 $65.00 $25.00–$63.00 33% below 20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pcv20 vaccine im $476.00 $595.00 $231.00–$572.00 4% below 20%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM $676.00 $846.00 $294.00–$812.00 5% below 20%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV >/= 7 IM $131.00 $164.00 $64.00–$158.00 119% above 20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >7 IM $141.00 $177.00 $38.00–$170.00 66% above 20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VIRUS VACCINE $50.00 $63.00 $63.00 43% above 21%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN PNEUMONIA VACCINE $50.00 $63.00 $63.00 43% above 21%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM 1 VACCINE $79.00 $99.00 $37.00–$92.00 126% above 20%

Source file: https://www.stewartmemorial.org/wp-content/uploads/2025/12/420860039_Stewart-Memorial-Community-Hospital_StandardCharges.csv