Story County Hospital
Story County Hospital in Nevada, IA publishes cash prices for 299 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Iowa median for 206 of 296 procedures and above it for 86. By typical cash price it ranks #5 of 78 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
640 South 19th Street, Nevada, IA 50201 Collected Sep 27, 2026 Source price file (515) 382-2111
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161333 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Story County Hospital in Nevada, IA:
- Sep 18, 2025 Warning notice
- Dec 18, 2025 Case closed
Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems.
A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 HC ANKLE MIN 3 VIEWS | $224.00 | $280.00 | $170.00–$280.00 | at median | 20% |
| Ankle X-ray, complete, 3 or more views inpatient CPT 73610 HC ANKLE MIN 3 VIEWS | $224.00 | $280.00 | $193.00–$280.00 | — | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS | $520.00 | $650.00 | $396.00–$650.00 | 66% above | 20% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 HC UPR/L XTREMITY ART 2 LEVELS | $520.00 | $650.00 | $448.00–$650.00 | — | 20% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 HC ESOPHAGRAM SGL CONTRAST STUDY | $361.60 | $452.00 | $275.00–$452.00 | at median | 20% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 HC ESOPHAGRAM SGL CONTRAST STUDY | $361.60 | $452.00 | $311.00–$452.00 | — | 20% |
| Bone scan, whole body (nuclear medicine) CPT 78306 HC NM BONE IMAGING WHOLE BODY | $1,168.80 | $1,461.00 | $747.00–$1,417.00 | 3% below | 20% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 HC NM BONE IMAGING WHOLE BODY | $1,168.80 | $1,461.00 | $1,008.00–$1,461.00 | — | 20% |
| Breast ultrasound, complete, one breast CPT 76641 HC US BREAST COMPLETE | $662.40 | $828.00 | $505.00–$821.00 | 84% above | 20% |
| Breast ultrasound, complete, one breast inpatient CPT 76641 HC US BREAST COMPLETE | $662.40 | $828.00 | $571.00–$828.00 | — | 20% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 HC US BREAST LIMITED | $514.40 | $643.00 | $392.00–$643.00 | 44% above | 20% |
| Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 HC US BREAST LIMITED | $514.40 | $643.00 | $443.00–$643.00 | — | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT ANGIOGRAPHY CHEST W WO CONTRAST | $2,120.00 | $2,650.00 | $1,616.00–$1,828.00 | at median | 20% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 HC CT ANGIOGRAPHY CHEST W WO CONTRAST | $2,120.00 | $2,650.00 | $1,828.00–$2,650.00 | — | 20% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABD & PELVIS WO CONTRAST | $3,425.60 | $4,282.00 | $2,612.00–$2,954.00 | 28% above | 20% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 HC CT ABD & PELVIS WO CONTRAST | $3,425.60 | $4,282.00 | $2,954.00–$4,282.00 | — | 20% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST | $3,784.00 | $4,730.00 | $2,885.00–$3,263.00 | 18% above | 20% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT ABDOMEN & PELVIS W CONTRAST | $3,784.00 | $4,730.00 | $3,263.00–$4,730.00 | — | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABD & PELVIS W WO CONTR 1+ REG/SEC | $3,908.80 | $4,886.00 | $2,980.00–$4,739.00 | 12% above | 20% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 HC CT ABD & PELVIS W WO CONTR 1+ REG/SEC | $3,908.80 | $4,886.00 | $3,371.00–$4,886.00 | — | 20% |
| CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W CONTRAST | $1,895.20 | $2,369.00 | $821.00–$1,800.00 | 14% above | 20% |
| CT scan of the abdomen with contrast inpatient CPT 74160 HC CT ABDOMEN W CONTRAST | $1,895.20 | $2,369.00 | $1,634.00–$2,369.00 | — | 20% |
| CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN WO CONTRAST | $1,714.40 | $2,143.00 | $747.00–$2,078.00 | 30% above | 20% |
| CT scan of the abdomen without contrast inpatient CPT 74150 HC CT ABDOMEN WO CONTRAST | $1,714.40 | $2,143.00 | $1,478.00–$2,143.00 | — | 20% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $1,699.20 | $2,124.00 | $1,295.00–$2,060.00 | 32% above | 20% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 HC CT MAXILLOFACIAL WO CONTRAST | $1,699.20 | $2,124.00 | $1,465.00–$2,124.00 | — | 20% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT HEAD OR BRAIN WO CONTRAST | $1,582.40 | $1,978.00 | $1,206.00–$1,364.00 | 17% above | 20% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT HEAD OR BRAIN WO CONTRAST | $1,582.40 | $1,978.00 | $1,364.00–$1,978.00 | — | 20% |
| CT scan of the head with contrast CPT 70460 HC CT HEAD OR BRAIN W CONTRAST | $1,736.80 | $2,171.00 | $747.00–$2,105.00 | 15% above | 20% |
| CT scan of the head with contrast inpatient CPT 70460 HC CT HEAD OR BRAIN W CONTRAST | $1,736.80 | $2,171.00 | $1,497.00–$2,171.00 | — | 20% |
| CT scan of the head without and with contrast CPT 70470 HC CT HEAD OR BRAIN W WO CONTRAST | $1,840.00 | $2,300.00 | $747.00–$2,231.00 | 2% above | 20% |
| CT scan of the head without and with contrast inpatient CPT 70470 HC CT HEAD OR BRAIN W WO CONTRAST | $1,840.00 | $2,300.00 | $1,587.00–$2,300.00 | — | 20% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $1,628.00 | $2,035.00 | $1,241.00–$1,973.00 | 7% above | 20% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 HC CT LUMBAR SPINE WO CONTRAST | $1,628.00 | $2,035.00 | $1,404.00–$2,035.00 | — | 20% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE WO CONTRAST | $1,628.00 | $2,035.00 | $1,241.00–$1,973.00 | 8% above | 20% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 HC CT CERVICAL SPINE WO CONTRAST | $1,628.00 | $2,035.00 | $1,404.00–$2,035.00 | — | 20% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W CONTRAST | $1,895.20 | $2,369.00 | $1,445.00–$2,297.00 | 9% above | 20% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT PELVIS W CONTRAST | $1,895.20 | $2,369.00 | $1,634.00–$2,369.00 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC CAROTID DUPLEX SCAN; BILAT | $1,055.20 | $1,319.00 | $804.00–$1,279.00 | — | 20% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 HC CAROTID DUPLEX SCAN; BILAT | $1,055.20 | $1,319.00 | $910.00–$1,319.00 | — | 20% |
| Chest X-ray, 2 views CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $240.80 | $301.00 | $183.00–$207.00 | 18% above | 20% |
| Chest X-ray, 2 views inpatient CPT 71046 HC X-RAY EXAM CHEST 2 VIEWS | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| Chest X-ray, single view CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $212.00 | $265.00 | $161.00–$265.00 | 26% above | 20% |
| Chest X-ray, single view inpatient CPT 71045 HC X-RAY EXAM CHEST 1 VIEW | $212.00 | $265.00 | $182.00–$265.00 | — | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US EXAM RETROPERITONEAL COMPL | $706.40 | $883.00 | $538.00–$856.00 | 16% above | 20% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 HC US EXAM RETROPERITONEAL COMPL | $706.40 | $883.00 | $609.00–$883.00 | — | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 PR DEXA,BONE DENSITY,AXIAL SKELETON | $307.20 | $384.00 | $234.00–$372.00 | 21% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC DXA BONE DENSITY AXIAL | $354.40 | $443.00 | $270.00–$429.00 | 9% below | 20% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 PR DEXA,BONE DENSITY,AXIAL SKELETON | $307.20 | $384.00 | $264.00–$384.00 | — | 20% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 HC DXA BONE DENSITY AXIAL | $354.40 | $443.00 | $305.00–$443.00 | — | 20% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST WO CONTRAST DIAG | $1,628.00 | $2,035.00 | $1,241.00–$1,973.00 | 18% above | 20% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 HC CT CHEST WO CONTRAST DIAG | $1,628.00 | $2,035.00 | $1,404.00–$2,035.00 | — | 20% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W CONTRAST DIAG | $1,719.20 | $2,149.00 | $1,310.00–$2,084.00 | 4% below | 20% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 HC CT CHEST W CONTRAST DIAG | $1,719.20 | $2,149.00 | $1,482.00–$2,149.00 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC DUPLEX LE ART/BPG; BILAT | $1,337.60 | $1,672.00 | $747.00–$1,621.00 | — | 20% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 HC DUPLEX LE ART/BPG; BILAT | $1,337.60 | $1,672.00 | $1,153.00–$1,672.00 | — | 20% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC DUPLEX EXT VEINS; BILAT | $1,327.20 | $1,659.00 | $821.00–$1,609.00 | — | 20% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 HC DUPLEX EXT VEINS; BILAT | $1,327.20 | $1,659.00 | $1,144.00–$1,659.00 | — | 20% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC TTE W/ DOPPLER COMPLETE | $2,202.40 | $2,753.00 | $1,679.00–$1,899.00 | 45% above | 20% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 HC TTE W/ DOPPLER COMPLETE | $2,202.40 | $2,753.00 | $1,899.00–$2,753.00 | — | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING | $1,539.20 | $1,924.00 | $747.00–$1,866.00 | 32% above | 20% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HC NM HEPATOBILIARY SYSTEM IMAGING | $1,539.20 | $1,924.00 | $1,327.00–$1,924.00 | — | 20% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC SLEEP STUDY UNATT & RESP EFFT | $517.60 | $647.00 | $394.00–$647.00 | 6% below | 20% |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HC SLEEP STUDY UNATT & RESP EFFT | $517.60 | $647.00 | $446.00–$647.00 | — | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 HC PSS W 4/> PARAM W CPAP/BIPAP 6+ YRS | $5,209.60 | $6,512.00 | $747.00–$6,316.00 | 66% above | 20% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 HC PSS W 4/> PARAM W CPAP/BIPAP 6+ YRS | $5,209.60 | $6,512.00 | $3,614.00–$6,512.00 | — | 20% |
| Knee X-ray, 3 views CPT 73562 HC KNEE 3 VIEWS | $217.60 | $272.00 | $165.00–$272.00 | 1% above | 20% |
| Knee X-ray, 3 views inpatient CPT 73562 HC KNEE 3 VIEWS | $217.60 | $272.00 | $187.00–$272.00 | — | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US EXAM ABDOMEN LIMITED | $656.00 | $820.00 | $500.00–$565.00 | 34% above | 20% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 HC US EXAM ABDOMEN LIMITED | $656.00 | $820.00 | $565.00–$820.00 | — | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LUNG CANCER SCREEN | $512.80 | $641.00 | $391.00–$621.00 | 20% above | 20% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 HC CT THORAX LUNG CANCER SCREEN | $512.80 | $641.00 | $442.00–$641.00 | — | 20% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI LOW EXTR ANY JOINT WO CONTRAST | $1,487.20 | $1,859.00 | $747.00–$1,803.00 | 34% below | 20% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI LOW EXTR ANY JOINT WO CONTRAST | $1,487.20 | $1,859.00 | $1,282.00–$1,859.00 | — | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI LOW EXTR ANY JOINT W WO CONTR | $3,003.20 | $3,754.00 | $747.00–$3,641.00 | 5% below | 20% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI LOW EXTR ANY JOINT W WO CONTR | $3,003.20 | $3,754.00 | $2,590.00–$3,754.00 | — | 20% |
| MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN WO CONTRAST | $2,499.20 | $3,124.00 | $747.00–$3,030.00 | 21% above | 20% |
| MRI of the abdomen without contrast inpatient CPT 74181 HC MRI ABDOMEN WO CONTRAST | $2,499.20 | $3,124.00 | $2,155.00–$3,124.00 | — | 20% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W WO CONTRAST | $2,673.60 | $3,342.00 | $2,038.00–$3,241.00 | 20% below | 20% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 HC MRI ABDOMEN W WO CONTRAST | $2,673.60 | $3,342.00 | $2,305.00–$3,342.00 | — | 20% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN WO CONTRAST | $2,566.40 | $3,208.00 | $1,956.00–$3,111.00 | 18% above | 20% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI BRAIN WO CONTRAST | $2,566.40 | $3,208.00 | $2,213.00–$3,208.00 | — | 20% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W WO CONTRAST | $3,026.40 | $3,783.00 | $2,307.00–$2,610.00 | 14% below | 20% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI BRAIN W WO CONTRAST | $3,026.40 | $3,783.00 | $2,610.00–$3,783.00 | — | 20% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $2,891.20 | $3,614.00 | $2,204.00–$3,505.00 | 21% above | 20% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI SPINE LUMBAR WO CONTRAST | $2,891.20 | $3,614.00 | $2,493.00–$3,614.00 | — | 20% |
| MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI SPINE LUMBAR W WO CONTRAST | $3,243.20 | $4,054.00 | $2,472.00–$3,932.00 | 6% below | 20% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 HC MRI SPINE LUMBAR W WO CONTRAST | $3,243.20 | $4,054.00 | $2,797.00–$4,054.00 | — | 20% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI SPINE THORACIC WO CONTRAST | $2,840.00 | $3,550.00 | $747.00–$3,443.00 | 22% above | 20% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 HC MRI SPINE THORACIC WO CONTRAST | $2,840.00 | $3,550.00 | $2,449.00–$3,550.00 | — | 20% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI SPINE CERVICAL W WO CONTRAST | $3,010.40 | $3,763.00 | $2,295.00–$3,650.00 | 11% below | 20% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 HC MRI SPINE CERVICAL W WO CONTRAST | $3,010.40 | $3,763.00 | $2,596.00–$3,763.00 | — | 20% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST | $2,669.60 | $3,337.00 | $2,035.00–$3,236.00 | 18% above | 20% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 HC MRI SPINE CERVICAL WO CONTRAST | $2,669.60 | $3,337.00 | $2,302.00–$3,337.00 | — | 20% |
| MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W WO CONTRAST | $3,249.60 | $4,062.00 | $821.00–$3,940.00 | 1% above | 20% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 HC MRI PELVIS W WO CONTRAST | $3,249.60 | $4,062.00 | $2,802.00–$4,062.00 | — | 20% |
| MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS WO CONTRAST | $2,566.40 | $3,208.00 | $747.00–$3,111.00 | 24% above | 20% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 HC MRI PELVIS WO CONTRAST | $2,566.40 | $3,208.00 | $2,213.00–$3,208.00 | — | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 HC MRI UP EXTR ANY JOINT WO CONTRAST | $2,572.00 | $3,215.00 | $747.00–$3,118.00 | 15% above | 20% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 HC MRI UP EXTR ANY JOINT WO CONTRAST | $2,572.00 | $3,215.00 | $2,218.00–$3,215.00 | — | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HC NM HEART MUSCLE SPECT MULT | $2,309.60 | $2,887.00 | $747.00–$2,800.00 | 18% below | 20% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HC NM HEART MUSCLE SPECT MULT | $2,309.60 | $2,887.00 | $1,992.00–$2,887.00 | — | 20% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 HC NM PET IMAGE W CT SKULL THIGH | $4,061.60 | $5,077.00 | $747.00–$4,924.00 | 4% below | 20% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 HC NM PET IMAGE W CT SKULL THIGH | $4,061.60 | $5,077.00 | $3,503.00–$5,077.00 | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PR US,PELVIC (NONOBSTETRIC),REAL TIME,LIMITED | $63.20 | $79.00 | $48.00–$58.00 | 82% below | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US EXAM PELVIC LTD TRANSABDOMINAL | $848.80 | $1,061.00 | $647.00–$785.00 | 140% above | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PR US,PELVIC (NONOBSTETRIC),REAL TIME,LIMITED | $63.20 | $79.00 | $54.00–$79.00 | — | 20% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 HC US EXAM PELVIC LTD TRANSABDOMINAL | $848.80 | $1,061.00 | $732.00–$1,061.00 | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PR US,PELVIC (NONOBSTETRIC),REAL TIME,COMPLETE | $196.00 | $245.00 | $149.00–$169.00 | 63% below | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US EXAM PELVIC COMP TRANSABDOMINAL | $889.60 | $1,112.00 | $678.00–$767.00 | 68% above | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PR US,PELVIC (NONOBSTETRIC),REAL TIME,COMPLETE | $196.00 | $245.00 | $169.00–$245.00 | — | 20% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 HC US EXAM PELVIC COMP TRANSABDOMINAL | $889.60 | $1,112.00 | $767.00–$1,112.00 | — | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US, OB >/= 14 WKS, SNGL FETUS | $245.60 | $307.00 | $187.00–$307.00 | 55% below | 20% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB COMPLETE SNGL FETUS | $576.80 | $721.00 | $439.00–$721.00 | 5% above | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US, OB >/= 14 WKS, SNGL FETUS | $245.60 | $307.00 | $211.00–$307.00 | — | 20% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC US OB COMPLETE SNGL FETUS | $576.80 | $721.00 | $497.00–$721.00 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US, OB < 14 WKS, SINGLE FETUS | $196.00 | $245.00 | $149.00–$245.00 | 56% below | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB LESS THAN 14 WKS SNGL FETUS | $576.80 | $721.00 | $439.00–$721.00 | 29% above | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US, OB < 14 WKS, SINGLE FETUS | $196.00 | $245.00 | $169.00–$245.00 | — | 20% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 HC US OB LESS THAN 14 WKS SNGL FETUS | $576.80 | $721.00 | $497.00–$721.00 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 CHG US,PREGNANT UTERUS,LIMITED, 1/> FETUSES | $136.80 | $171.00 | $104.00–$171.00 | 59% below | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED FETUS(S) | $534.40 | $668.00 | $407.00–$668.00 | 59% above | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 CHG US,PREGNANT UTERUS,LIMITED, 1/> FETUSES | $136.80 | $171.00 | $117.00–$171.00 | — | 20% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 HC US OB LIMITED FETUS(S) | $534.40 | $668.00 | $460.00–$668.00 | — | 20% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 HC SHOULDER MIN 2 VIEWS | $217.60 | $272.00 | $165.00–$272.00 | 7% below | 20% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 HC SHOULDER MIN 2 VIEWS | $217.60 | $272.00 | $187.00–$272.00 | — | 20% |
| Sleep study in a lab (polysomnography) CPT 95810 HC PSS W 4/> PARAM W TECH 6+ YRS | $4,740.00 | $5,925.00 | $747.00–$5,747.00 | 65% above | 20% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 HC PSS W 4/> PARAM W TECH 6+ YRS | $4,740.00 | $5,925.00 | $3,614.00–$5,925.00 | — | 20% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC STRESS TTE COMPLETE | $208.80 | $261.00 | $159.00–$261.00 | 86% below | 20% |
| Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 HC STRESS TTE COMPLETE | $208.80 | $261.00 | $180.00–$261.00 | — | 20% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 HC SWALLOWING FUNCTION W CINE VIDEO | $492.80 | $616.00 | $375.00–$616.00 | 23% above | 20% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 HC SWALLOWING FUNCTION W CINE VIDEO | $492.80 | $616.00 | $425.00–$616.00 | — | 20% |
| Transvaginal pelvic ultrasound CPT 76830 PR ECHOGRAPHY,TRANSVAGINAL | $232.00 | $290.00 | $176.00–$220.00 | 56% below | 20% |
| Transvaginal pelvic ultrasound CPT 76830 HC US NON OB TRANSVAG | $866.40 | $1,083.00 | $660.00–$823.00 | 66% above | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 PR ECHOGRAPHY,TRANSVAGINAL | $232.00 | $290.00 | $200.00–$290.00 | — | 20% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US NON OB TRANSVAG | $866.40 | $1,083.00 | $747.00–$1,083.00 | — | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 PR US,PREGNANT UTERUS,TRANSVAGINAL | $158.40 | $198.00 | $120.00–$198.00 | 65% below | 20% |
| Transvaginal ultrasound during pregnancy CPT 76817 HC US OB TRANSVAGINAL | $817.60 | $1,022.00 | $623.00–$991.00 | 80% above | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 PR US,PREGNANT UTERUS,TRANSVAGINAL | $158.40 | $198.00 | $136.00–$198.00 | — | 20% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 HC US OB TRANSVAGINAL | $817.60 | $1,022.00 | $705.00–$1,022.00 | — | 20% |
| Ultrasound of the abdomen, complete CPT 76700 HC US EXAM ABDOMEN COMPLETE | $956.80 | $1,196.00 | $729.00–$908.00 | 38% above | 20% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US EXAM ABDOMEN COMPLETE | $956.80 | $1,196.00 | $825.00–$1,196.00 | — | 20% |
| Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM AND CONTENTS | $621.60 | $777.00 | $473.00–$574.00 | 15% above | 20% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 HC US SCROTUM AND CONTENTS | $621.60 | $777.00 | $536.00–$777.00 | — | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US EXAM OF HEAD AND NECK | $662.40 | $828.00 | $505.00–$571.00 | 43% above | 20% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HC US EXAM OF HEAD AND NECK | $662.40 | $828.00 | $571.00–$828.00 | — | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC DUPLEX EXT VEINS UNIL/LIMIT | $832.80 | $1,041.00 | $635.00–$1,009.00 | 29% above | 20% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 HC DUPLEX EXT VEINS UNIL/LIMIT | $832.80 | $1,041.00 | $718.00–$1,041.00 | — | 20% |
| Wrist X-ray, complete, 3 or more views CPT 73110 HC WRIST COMPL MIN 3 VIEWS | $230.40 | $288.00 | $175.00–$288.00 | 4% above | 20% |
| Wrist X-ray, complete, 3 or more views inpatient CPT 73110 HC WRIST COMPL MIN 3 VIEWS | $230.40 | $288.00 | $198.00–$288.00 | — | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS | $136.00 | $170.00 | $103.00–$170.00 | 29% below | 20% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 HC X-RAY EXAM HIP UNI 2-3 VIEWS | $136.00 | $170.00 | $117.00–$170.00 | — | 20% |
| X-ray of the abdomen, 1 view CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $206.40 | $258.00 | $157.00–$196.00 | 17% above | 20% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 HC X-RAY EXAM ABDOMEN 1 VIEW | $206.40 | $258.00 | $178.00–$258.00 | — | 20% |
| X-ray of the ankle, 2 views CPT 73600 HC ANKLE 2 VIEWS | $217.60 | $272.00 | $165.00–$272.00 | 26% above | 20% |
| X-ray of the ankle, 2 views inpatient CPT 73600 HC ANKLE 2 VIEWS | $217.60 | $272.00 | $187.00–$272.00 | — | 20% |
| X-ray of the finger(s), 2 or more views CPT 73140 HC FINGER OR FINGERS MIN 2 VIEWS | $167.20 | $209.00 | $127.00–$209.00 | at median | 20% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 HC FINGER OR FINGERS MIN 2 VIEWS | $167.20 | $209.00 | $144.00–$209.00 | — | 20% |
| X-ray of the foot, 2 views CPT 73620 HC FOOT 2 VIEWS | $212.00 | $265.00 | $161.00–$265.00 | 30% above | 20% |
| X-ray of the foot, 2 views inpatient CPT 73620 HC FOOT 2 VIEWS | $212.00 | $265.00 | $182.00–$265.00 | — | 20% |
| X-ray of the foot, complete, 3 or more views CPT 73630 HC FOOT MIN 3 VIEWS | $224.00 | $280.00 | $170.00–$280.00 | 2% above | 20% |
| X-ray of the foot, complete, 3 or more views inpatient CPT 73630 HC FOOT MIN 3 VIEWS | $224.00 | $280.00 | $193.00–$280.00 | — | 20% |
| X-ray of the hand, 3 or more views CPT 73130 HC HAND MIN 3 VIEWS | $230.40 | $288.00 | $175.00–$288.00 | 12% above | 20% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 HC HAND MIN 3 VIEWS | $230.40 | $288.00 | $198.00–$288.00 | — | 20% |
| X-ray of the knee, 1 or 2 views CPT 73560 HC KNEE 1 OR 2 VIEWS | $202.40 | $253.00 | $154.00–$253.00 | 2% above | 20% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 HC KNEE 1 OR 2 VIEWS | $202.40 | $253.00 | $174.00–$253.00 | — | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC LUMBOSACR SPINE 2 OR 3 VIEWS | $240.80 | $301.00 | $183.00–$207.00 | 16% below | 20% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 HC LUMBOSACR SPINE 2 OR 3 VIEWS | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| X-ray of the lower back, 4 or more views CPT 72110 HC LUMBOSACR SPINE MIN 4 VIEWS | $279.20 | $349.00 | $212.00–$338.00 | 21% below | 20% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC LUMBOSACR SPINE MIN 4 VIEWS | $279.20 | $349.00 | $240.00–$349.00 | — | 20% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC THORACIC SPINE 2 VIEWS | $252.80 | $316.00 | $192.00–$316.00 | at median | 20% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 HC THORACIC SPINE 2 VIEWS | $252.80 | $316.00 | $218.00–$316.00 | — | 20% |
| X-ray of the nasal bones, 3 or more views CPT 70160 HC NASAL BONES MIN 3 VIEWS | $180.80 | $226.00 | $137.00–$226.00 | 9% below | 20% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HC NASAL BONES MIN 3 VIEWS | $180.80 | $226.00 | $155.00–$226.00 | — | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC CERVICAL SPINE 2 OR 3 VIEWS | $260.00 | $325.00 | $198.00–$315.00 | 4% above | 20% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 HC CERVICAL SPINE 2 OR 3 VIEWS | $260.00 | $325.00 | $224.00–$325.00 | — | 20% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 HC PELVIS 1 OR 2 VIEWS | $176.80 | $221.00 | $134.00–$214.00 | 10% below | 20% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 HC PELVIS 1 OR 2 VIEWS | $176.80 | $221.00 | $152.00–$221.00 | — | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC SACRUM COCCYX MIN 2 VIEWS | $177.60 | $222.00 | $135.00–$222.00 | 19% below | 20% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 HC SACRUM COCCYX MIN 2 VIEWS | $177.60 | $222.00 | $153.00–$222.00 | — | 20% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT (SGPT) /ALL | $27.20 | $34.00 | $20.00–$23.00 | 36% below | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO (ALT) (SGPT) | $27.20 | $34.00 | $20.00–$23.00 | 36% below | 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 | $59.20 | $74.00 | $45.00–$51.00 | 40% above | 20% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 CHRONIC VIRAL HEP FIBROMETER Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/T/PL/G1/M2 | $60.80 | $76.00 | $46.00–$52.00 | 44% above | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO (ALT) (SGPT) | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT (SGPT) /ALL | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 LIVER FIBROSIS, NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 | $59.20 | $74.00 | $51.00–$74.00 | — | 20% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 CHRONIC VIRAL HEP FIBROMETER Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/T/PL/G1/M2 | $60.80 | $76.00 | $52.00–$76.00 | — | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE ASPARTATE AMINO (AST) (SGOT) | $27.20 | $34.00 | $20.00–$32.00 | 30% below | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST (SGOT) /ALL | $27.20 | $34.00 | $20.00–$32.00 | 30% below | 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 | $59.20 | $74.00 | $45.00–$71.00 | 52% above | 20% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 CHRONIC VIRAL HEP FIBROMETER Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/T/PL/G1/M2 | $60.80 | $76.00 | $46.00–$73.00 | 56% above | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST (SGOT) /ALL | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE ASPARTATE AMINO (AST) (SGOT) | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 LIVER FIBROSIS, NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 | $59.20 | $74.00 | $51.00–$74.00 | — | 20% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 CHRONIC VIRAL HEP FIBROMETER Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/T/PL/G1/M2 | $60.80 | $76.00 | $52.00–$76.00 | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 CHG HEPATITIS PANEL,ACUTE | $134.40 | $168.00 | $102.00–$168.00 | 41% below | 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 | $134.40 | $168.00 | $102.00–$168.00 | 41% below | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 CHG HEPATITIS PANEL,ACUTE | $134.40 | $168.00 | $115.00–$168.00 | — | 20% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS BATTERY E/J/L/M/O/P/R/T/W/C1/S1/L1/PL/G1/M2 | $134.40 | $168.00 | $115.00–$168.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPARAGUS ALLERGEN MASPAR QC/Q/D/S/T/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| 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 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MELON ALLERGEN MMELN L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEPPER ALLERGN MGPEP D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| 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 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHESTNUT SWEET ALLER MCNUT L/M/W/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RICE ALLERGEN MRICE QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW EPITH ALLERGEN MCOW QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| 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 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER SEED ALLER MAYO??/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 KIDNEY BEAN ALLERGEN MKIDBN D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| 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 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS ALLERG MJOHN QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HELMIN HALODES,IGE MHELM L/W/M/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE EPITH ALLERGEN MHORS QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/W1 | $8.00 | $10.00 | $6.00–$10.00 | 79% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE PROTEIN MMOUP D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $9.60 | $12.00 | $7.00–$12.00 | 75% below | 20% |
| 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 | $11.20 | $14.00 | $8.00–$14.00 | 71% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS F MOLD QC/V/Y/D/S/N/C2/P1/F1/M2 | $14.40 | $18.00 | $10.00–$18.00 | 63% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET ALLERG MYJV D/L/M/S/W/C1/S1/N/L1/O/PL/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WESTERN RAGWEED ALRG MWRW QC/Q/L/W/M/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE PINE ALLERGEN MWPIN QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WILLOW TREE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEY ALLERGEN MWHEY D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATO F DUST MITE QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WESTERN RAGWEED ALRG D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPER/COMMON WASP IgE | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH TREE ALLER QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY FEATHER ALRG D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLACKBERRY ALLERGEN MBLACK D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA FISH ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TREE ALLERGEN PANEL D/S/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS ALLERG V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE POTATO ALLERG D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE ALLERGEN D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWORDFISH ALLERGEN MSWORD D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP WOOL ALLERGEN MSHWL D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SUNFLOWER SEED ALLER D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STEMPHYLIUM ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CELERY ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET POTATO ALLERGN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHORT RAGWEED ALLERG QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SQUID ALLERGEN MSQUID QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SQUASH ALLERGEN MSQUA D/L/M/O/S/W/S1/N/L1/PL/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RED SORREL ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SOLE FISH ALLERGEN MSOLEF D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SARDINE ALLERGEN MSARD D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON FISH ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RUSSIAN THISTLE WEED QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Epithelium, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DERMATO P DUST MITE QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DUCK FEATHER ALLERG D/S/N/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003X2 PL | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG ALLEGEN W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lettuce, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RICE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RHIZOPUS ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RYE GRASS ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAT URINE PROTEIN MRTUP D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAT SERUM PROTEIN MRTSP D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RESP ALLERG PROFILE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Mugwort, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RABBIT EPI ALLERGEN D/S/N/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 DOG ALLERG W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Lentil, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY ALLERGEN MCHER L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SPINACH ALLERGEN MSPIN QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN POLLEN ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM N MOLD QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PLUM ALLERGEN MPLUM QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PLUM ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Penicillin G, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO NUT ALLERG D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET CHESTNUT ALLER D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINEAPPLE ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PIGWEED ALLERGEN MRRRP QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PHOMA BETAE ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V ALLERG | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G ALLERG | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| 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 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium chrysogenum, IgE | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEAR ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT ALLERGEN W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEACH ALLERGEN MPECH QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PEACH ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PARSLEY ALLERGEN MPSLY D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PAPRIKA ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Kidney Bean (Red), IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003X5 PL | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OYSTER ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS ALLERGEN MORCH QC/Q/M/L/W/C1/S1/L1/PL/O/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Penicillin V, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Pine Nut, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ELM TREE ALELRGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ONION ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ONION ALLERGEN MONIO QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OLIVE ALLERGEN MOLIVF QC/Q/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 T216 Profilin, Birch | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAK TREE ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TREE NUT COMPONENTS /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003X8 PL | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUE MUSSEL ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Tilapia IgE | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Trout, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR,IgE MMUC L/M/W/S1/L1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUCOR RACEMOSUS IGE D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRY ALLERGEN MBLUE D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Green String Bean, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MILK ALLERGEN W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| 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 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW MILK ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MELONS ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| 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 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO ALLERGEN MMANGO L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MANGO ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA NUT ALLERG MMACNT QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB'S QUARTER WEED D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Jacket Wasp,IgE L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LINSEED, IGE MLINS L/M/W/Z/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LIME ALLERGEN MLIME D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LETTUCE ALLERGEN MLETT QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMON ALLERGEN MLEM L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LEMON ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LAMB ALLERGEN MLAMB D/S/L/M/N/O/Q/QC/W/S1/L1/PL/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH ALLERGEN D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 KIWI ALLERGEN MKIWI QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 KIWI ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT ALLERG W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JUNE/KENT BLUE GRASS D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003X3 PL | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS ALLERG D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT TREE ALLERG D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT ALLERGEN QC/V/D/S/N/P1/F1/L/M/W/PL/M2/X | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 White Faced Hornet Venom, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE ALLERG W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HORSE EPI ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHO HAL MOLD D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HERRING ALLERGEN MHERR D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BETA LACTOGLOB ALLER D/N/S/V/P1/QC/Q/C/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAMSTER EPITH ALLERG MHEPI QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Faced Hornet Venom, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Garlic, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 PL | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRASS ALLERGEN PANEL D/S/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE ALLERGEN MGRAP QC/Q/Z/L/M/R/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GIANT RAGWEED ALLERG MGRW QC/Q/L/W/M/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GIANT RAGWEED ALLERG D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUINEA PIG EPITH ALR MGUIN QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GUINEA PIG EPI ALLER D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEA ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHER ALLERG MGOOS L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHER ALLERG D/S/N/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOAT EPITH ALLERGEN MGOAT D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN ALLERGEN MGLT QC/Q/J/L/M/W/S1/Z/L1/PL/O/C1/P/E/G1/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN ALLERGEN QC/V/Y/D/S/P1/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GOLDENROD ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT ALLERGEN MGRFR L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GERBIL EPITH ALLERGEN MGERB D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 GARLIC, IgE MGARL L/M/W/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FALSE RAGWEED ALELRG MFRW QC/Q/D/S/L/M/W/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAYFISH ALLERGEN MCRAY D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGEY PROFILE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BLUE MUSSEL ALELRGEN MMUSS QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EUCALYPTUS ALLERGEN MEUCL QC/D/S/L/M/W/Q/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOTRYTIS ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN AL D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM ALLERGEN MEPUR L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ANA O3 CASHEW NUT IGE D/N/S/V/Y/P1/QC/Q/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHER ALRG D/S/N/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ANCHOVY ALLERGEN MANCH D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHER ALRG MCHCK L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT ALLERGEN D/S/V/P1/Y/Q/QC/C2/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN SERUM PROT MCSPR D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BROCCOLI ALLERGEN D/S/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BURWEED MARSHELDER D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APRICOT ALLERGEN MAPR QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM H MOLD QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Honeybee Venom, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 A PULLULANS IGE D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Macadamia Nut, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE/COCOA ALRG D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ARA H1 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ARA H2 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CELERY ALLERGEN MCELY L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ARA H3 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND NUT ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CABBAGE ALLERGEN MCABB D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CLAM ALLERGEN QC/V/Y/D/S/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ARA H6 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ARA H8 PEANUT IGE D/N/S/V/P1/Y/QC/Q/Y | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMOXICILLIN ALLERGEN | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ARA H9 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRANBERRY ALLERGEN MCRANB D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CANDIDA ALB MOLD D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E226, RCAN F 5, DOG | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E102, RCAN F 2, DOG | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA T MOLD QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMOXICILLIN ALLERGEN MAMOXY D/L/M/N/S/W//S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E221, DOG SERUM ALBUMIN | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMPICILLIN ALLERGEN | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BANANA ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BANANA ALLERGEN MBANA QC/Q/L/M/O/W/S1/L1/PL/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY ALLERGEN MBRLY QC/Q/Z/L/M/R/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEEF ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEETS ALLERGEN MBEETS D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CARROT ALLERGEN MCROT QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AMPICILLIN ALLERGEN MAMP QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD TREE ALRG QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COW EPI ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BER E1 BRAZIL NUT IGE D/N/S/V/P1/Y/QC/Q/C2/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN ALLERGEN D/N/S/V/P1/QC/Q/C/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS ALLERG QC/V/Y/D/S/N/C2/P1/F1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA LACTOALB ALLER D/N/S/V/P1/QC/Q/C/C2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus niger, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RO214 CCD | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Cedar, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAT EPI ALLERGEN Q/QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Chick Pea, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E227 COMPONENT R EQU C HORSE | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E228 RFEL D 4 CAT | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CAULIFLOWER ALLERGEN MCALFL D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BOX ELDER/MAPLE TREE QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Curvularia lunata, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SILVER BIRCH TREE AL D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E94 RFEL D 1 CAT IMMUNOCAP | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E220 RFEL D2 CAT SERUM ALBUMIN | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 White Hickory, IgE | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Halibut, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHG ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN ALLERGEN QC/V/Y/D/S/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHILD ALLERG PROFILE /L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COD FISH ALLERGEN QC/V/Y/D/S/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 E101, RCAN F 1, DOG | $15.20 | $19.00 | $11.00–$19.00 | 61% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN,IGE MEGPL L/M/S/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $22.40 | $28.00 | $17.00–$28.00 | 43% below | 20% |
| 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 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| 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 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND ALLERGEN MALM QC/Q/Z/L/M/O/R/T/W/C1/S1/L1/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/T/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 YEL FACE HORNET VEN MYFHV L/M/W/L1/C1/O/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 WHITE FAC HORNET VEN MWFHV L/W/M/S1/L1/C1/O/PL/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TUNA ALLERGEN MTUNA QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TROUT ALLERGEN MTROT QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY ALLERGEN MSTRBY QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SALMON ALLERGEN MSALM QC/Q/L/M/O/W/C1/S1/L1/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| 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 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| 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 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RESP ALLERG PROFILE E/L/M/O/W/C1/S1/L1/PL/J/P/G1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SWEET POTATO ALLERGN MSPOT QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 POTATO ALLERGEN MPOTA QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PORK ALLERGEN MPORK QC/Q/L/M/O/W/C1/S1/L1/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO ALLERGEN MPISTA QC/Q/L/M/W/C1/S1/L1/P/PL/O/J/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINE NUT ALLERGEN MPINE D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN V ALLERGN MPENIV QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIN G ALLERGN MPBPO QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 PINEAPPLE ALLERGEN MPNAP QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE ALLERGEN MORNG QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK ALLERGEN MYOLK | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 OAT ALLERGEN MOATS L/M/Q/QC/S/W/Z/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| 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 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT,IGE MMUG QC/Q/L/W/N/M/S1/D/S/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/T/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE EPITH ALLERGEN MMOUS QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER ALLERGEN MLOB QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT FOOD ALLERG MNUTH | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HONEY BEE VENOM,IgE MHBV L/M/W/S1/L1/C1/PL/O/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HALIBUT ALLERGEN MHALI QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE E/J/L/M/O/W/C1/S1/L1/PL/P/G1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| 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 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 APPLE ALLERGEN MAPPL QC/Q/L/M/O/R/T/W/S1/L1/PL/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE/COCAL ALLG MCOCOA QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CHICK PEA, IGE MCHXP L/M/W/Z/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COCONUT ALLERGEN MCCNT QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 TRICHOSPOR PULLANS IGE MTRPU L/M/W/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 AVOCADO ALLERGEN MAVOC L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CORN POLLEN ALLERGEN MCRNP L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CEDAR TREE ALLERGEN MCEDR D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGEN MCRAB QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD TREE ALGR MCTWD QC/Q/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 SILVER BIRCH TREE AL MBIR QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 CURVULARIA LUNATA,IgE MCURL L/W/M/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$32.00 | 34% below | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS NIGER AL MASPG QC/Q/Z/D/S/L/M/W/X/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $41.60 | $52.00 | $31.00–$52.00 | 7% above | 20% |
| 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 | $41.60 | $52.00 | $31.00–$52.00 | 7% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST PNL ALLER MHD1 D/S/X/S1/N/L1/PL/O/J/C1/P/E/G1/F1/F/G/PMP/A/T/QC/Q/W1 | $50.40 | $63.00 | $38.00–$63.00 | 29% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MOLD PANEL ALLERGEN MMOLD1 D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $50.40 | $63.00 | $38.00–$63.00 | 29% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 HAKE ALLERGEN MHAKE D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $68.00 | $85.00 | $51.00–$85.00 | 74% above | 20% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FUSARIUM OXYSPOR,IgE MFFOVE L/M/N/W/S1/S/D/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $122.40 | $153.00 | $93.00–$153.00 | 214% above | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPARAGUS ALLERGEN MASPAR QC/Q/D/S/T/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE EPITH ALLERGEN MHORS QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS ALLERG MJOHN QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN MWHT QC/Q/C1/E/L/M/O/W/L1/PL/J/P/G1/S1/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN MSOY QC/Q/C1/E/L/M/O/W/L1/W1/PL/J/P/G1/S1/F/G/PMP/A | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW EPITH ALLERGEN MCOW QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER SEED ALLER MAYO??/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEPPER ALLERGN MGPEP D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELON ALLERGEN MMELN L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHESTNUT SWEET ALLER MCNUT L/M/W/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMIN HALODES,IGE MHELM L/W/M/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE ALLERGEN MRICE QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIDNEY BEAN ALLERGEN MKIDBN D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE PROTEIN MMOUP D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $9.60 | $12.00 | $8.00–$12.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $11.20 | $14.00 | $9.00–$14.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS F MOLD QC/V/Y/D/S/N/C2/P1/F1/M2 | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E101, RCAN F 1, DOG | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHG ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET ALLERG MYJV D/L/M/S/W/C1/S1/N/L1/O/PL/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WESTERN RAGWEED ALRG MWRW QC/Q/L/W/M/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE PINE ALLERGEN MWPIN QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WILLOW TREE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEY ALLERGEN MWHEY D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WESTERN RAGWEED ALRG D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE BEAN ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER/COMMON WASP IgE | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH TREE ALLER QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT TREE ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY FEATHER ALRG D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA FISH ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE ALLERGEN PANEL D/S/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS ALLERG V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE POTATO ALLERG D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE ALLERGEN D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWORDFISH ALLERGEN MSWORD D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP WOOL ALLERGEN MSHWL D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SUNFLOWER SEED ALLER D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STEMPHYLIUM ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET POTATO ALLERGN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHORT RAGWEED ALLERG QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SQUID ALLERGEN MSQUID QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SQUASH ALLERGEN MSQUA D/L/M/O/S/W/S1/N/L1/PL/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RED SORREL ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOLE FISH ALLERGEN MSOLEF D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SARDINE ALLERGEN MSARD D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON FISH ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RUSSIAN THISTLE WEED QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RHIZOPUS ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RYE GRASS ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAT URINE PROTEIN MRTUP D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAT SERUM PROTEIN MRTSP D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESP ALLERG PROFILE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RABBIT EPI ALLERGEN D/S/N/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG ALLERG W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SPINACH ALLERGEN MSPIN QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN POLLEN ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM N MOLD QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PLUM ALLERGEN MPLUM QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PLUM ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO NUT ALLERG D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINEAPPLE ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PIGWEED ALLERGEN MRRRP QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PHOMA BETAE ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN V ALLERG | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN G ALLERG | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT ALLERGEN W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH ALLERGEN MPECH QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PARSLEY ALLERGEN MPSLY D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPRIKA ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003X5 PL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OYSTER ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS ALLERGEN MORCH QC/Q/M/L/W/C1/S1/L1/PL/O/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ONION ALLERGEN MONIO QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OLIVE ALLERGEN MOLIVF QC/Q/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK TREE ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TREE NUT COMPONENTS /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003X8 PL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUE MUSSEL ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR,IgE MMUC L/M/W/S1/L1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUCOR RACEMOSUS IGE D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK ALLERGEN W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW MILK ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MELONS ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO ALLERGEN MMANGO L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MANGO ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA NUT ALLERG MMACNT QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB'S QUARTER WEED D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LINSEED, IGE MLINS L/M/W/Z/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIME ALLERGEN MLIME D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LETTUCE ALLERGEN MLETT QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON ALLERGEN MLEM L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX ALLERGEN QC/V/Y/D/S/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB ALLERGEN MLAMB D/S/L/M/N/O/Q/QC/W/S1/L1/PL/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH ALLERGEN D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI ALLERGEN MKIWI QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIWI ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT ALLERG W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE/KENT BLUE GRASS D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003X3 PL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS ALLERG D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT TREE ALLERG D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT ALLERGEN QC/V/D/S/N/P1/F1/L/M/W/PL/M2/X | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE ALLERG W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HORSE EPI ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHO HAL MOLD D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HERRING ALLERGEN MHERR D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAMSTER EPITH ALLERG MHEPI QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 PL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRASS ALLERGEN PANEL D/S/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE ALLERGEN MGRAP QC/Q/Z/L/M/R/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GIANT RAGWEED ALLERG MGRW QC/Q/L/W/M/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GIANT RAGWEED ALLERG D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUINEA PIG EPITH ALR MGUIN QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GUINEA PIG EPI ALLER D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEA ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHER ALLERG MGOOS L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHER ALLERG D/S/N/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOAT EPITH ALLERGEN MGOAT D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN ALLERGEN MGLT QC/Q/J/L/M/W/S1/Z/L1/PL/O/C1/P/E/G1/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN ALLERGEN QC/V/Y/D/S/P1/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOLDENROD ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT ALLERGEN MGRFR L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GERBIL EPITH ALLERGEN MGERB D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GARLIC, IgE MGARL L/M/W/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FALSE RAGWEED ALELRG MFRW QC/Q/D/S/L/M/W/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGEY PROFILE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EUCALYPTUS ALLERGEN MEUCL QC/D/S/L/M/W/Q/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN AL D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM ALLERGEN MEPUR L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM TREE ALELRGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG ALLEGEN W REFLEX /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003X2 PL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK FEATHER ALLERG D/S/N/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATO P DUST MITE QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER ALLERGEN QC/V/Y/D/S/N/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATO F DUST MITE QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAYFISH ALLERGEN MCRAY D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRANBERRY ALLERGEN MCRANB D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COW EPI ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD TREE ALRG QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN ALLERGEN QC/V/Y/D/S/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COD FISH ALLERGEN QC/V/Y/D/S/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM ALLERGEN QC/V/Y/D/S/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHOCOLATE/COCOA ALRG D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM H MOLD QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN SERUM PROT MCSPR D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHER ALRG MCHCK L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHER ALRG D/S/N/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET CHESTNUT ALLER D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY ALLERGEN MCHER L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY ALLERGEN MCELY L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAULIFLOWER ALLERGEN MCALFL D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT EPI ALLERGEN Q/QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN ALLERGEN D/N/S/V/P1/QC/Q/C/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT ALLERGEN MCROT QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILD ALLERG PROFILE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CANDIDA ALB MOLD D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CABBAGE ALLERGEN MCABB D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BURWEED MARSHELDER D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BROCCOLI ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT ALLERGEN D/S/V/P1/Y/Q/QC/C2/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOX ELDER/MAPLE TREE QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BOTRYTIS ALLERGEN D/S/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUE MUSSEL ALELRGEN MMUSS QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEBERRY ALLERGEN MBLUE D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACKBERRY ALLERGEN MBLACK D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BETA LACTOGLOB ALLER D/N/S/V/P1/QC/Q/C/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SILVER BIRCH TREE AL D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS ALLERG QC/V/Y/D/S/N/C2/P1/F1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BER E1 BRAZIL NUT IGE D/N/S/V/P1/Y/QC/Q/C2/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEETS ALLERGEN MBEETS D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY ALLERGEN MBRLY QC/Q/Z/L/M/R/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA ALLERGEN MBANA QC/Q/L/M/O/W/S1/L1/PL/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA T MOLD QC/V/Y/D/S/N/C2/P1/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ARA H9 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ARA H8 PEANUT IGE D/N/S/V/P1/Y/QC/Q/Y | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ARA H6 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ARA H3 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ARA H2 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ARA H1 PEANUT IGE D/N/S/V/P1/Y/QC/Q/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 A PULLULANS IGE D/N/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE ALLERGEN D/S/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APRICOT ALLERGEN MAPR QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ANCHOVY ALLERGEN MANCH D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ANA O3 CASHEW NUT IGE D/N/S/V/Y/P1/QC/Q/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMPICILLIN ALLERGEN MAMP QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMPICILLIN ALLERGEN | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMOXICILLIN ALLERGEN MAMOXY D/L/M/N/S/W//S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AMOXICILLIN ALLERGEN | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND NUT ALLERGEN D/S/N/F1/L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Faced Hornet Venom, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Faced Hornet Venom, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Yellow Jacket Wasp,IgE L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Trout, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Tilapia IgE | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 T216 Profilin, Birch | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pine Nut, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillin V, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillium chrysogenum, IgE | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillin G, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mugwort, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mouse Epithelium, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Macadamia Nut, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lettuce, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Lentil, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Kidney Bean (Red), IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Honeybee Venom, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 White Hickory, IgE | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Halibut, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Green String Bean, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Garlic, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E226, RCAN F 5, DOG | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E102, RCAN F 2, DOG | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E221, DOG SERUM ALBUMIN | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E227 COMPONENT R EQU C HORSE | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E228 RFEL D 4 CAT | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E220 RFEL D2 CAT SERUM ALBUMIN | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E94 RFEL D 1 CAT IMMUNOCAP | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Curvularia lunata, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Chick Pea, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cedar, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RO214 CCD | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus niger, IgE /L/M/W/PL/M2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA LACTOALB ALLER D/N/S/V/P1/QC/Q/C/C2 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN,IGE MEGPL L/M/S/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $22.40 | $28.00 | $19.00–$28.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND ALLERGEN MALM QC/Q/Z/L/M/O/R/T/W/C1/S1/L1/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/T/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE ALLERGEN MAPPL QC/Q/L/M/O/R/T/W/S1/L1/PL/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TRICHOSPOR PULLANS IGE MTRPU L/M/W/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 AVOCADO ALLERGEN MAVOC L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SILVER BIRCH TREE AL MBIR QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CEDAR TREE ALLERGEN MCEDR D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHOCOLATE/COCAL ALLG MCOCOA QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICK PEA, IGE MCHXP L/M/W/Z/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCONUT ALLERGEN MCCNT QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN POLLEN ALLERGEN MCRNP L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGEN MCRAB QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD TREE ALGR MCTWD QC/Q/E/L/M/O/W/X/C1/S1/L1/PL/J/P/G1/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CURVULARIA LUNATA,IgE MCURL L/W/M/S1/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK ALLERGEN MYOLK | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE E/J/L/M/O/W/C1/S1/L1/PL/P/G1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HALIBUT ALLERGEN MHALI QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEY BEE VENOM,IgE MHBV L/M/W/S1/L1/C1/PL/O/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT FOOD ALLERG MNUTH | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER ALLERGEN MLOB QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE EPITH ALLERGEN MMOUS QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUGWORT,IGE MMUG QC/Q/L/W/N/M/S1/D/S/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/T/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT ALLERGEN MOATS L/M/Q/QC/S/W/Z/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE ALLERGEN MORNG QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINEAPPLE ALLERGEN MPNAP QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/T/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN G ALLERGN MPBPO QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIN V ALLERGN MPENIV QC/Q/D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINE NUT ALLERGEN MPINE D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO ALLERGEN MPISTA QC/Q/L/M/W/C1/S1/L1/P/PL/O/J/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK ALLERGEN MPORK QC/Q/L/M/O/W/C1/S1/L1/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO ALLERGEN MPOTA QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET POTATO ALLERGN MSPOT QC/Q/L/M/W/S1/L1/PL/O/J/C1/P/E/G1/C2/P1/V/Y/F/G/PMP/A/X/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RESP ALLERG PROFILE E/L/M/O/W/C1/S1/L1/PL/J/P/G1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON ALLERGEN MSALM QC/Q/L/M/O/W/C1/S1/L1/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY ALLERGEN MSTRBY QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TROUT ALLERGEN MTROT QC/Q/D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA ALLERGEN MTUNA QC/Q/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE FAC HORNET VEN MWFHV L/W/M/S1/L1/C1/O/PL/J/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEL FACE HORNET VEN MYFHV L/M/W/L1/C1/O/PL/J/P/E/G1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS NIGER AL MASPG QC/Q/Z/D/S/L/M/W/X/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/W1 | $41.60 | $52.00 | $35.00–$52.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient 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 | $41.60 | $52.00 | $35.00–$52.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST PNL ALLER MHD1 D/S/X/S1/N/L1/PL/O/J/C1/P/E/G1/F1/F/G/PMP/A/T/QC/Q/W1 | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOLD PANEL ALLERGEN MMOLD1 D/L/M/S/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAKE ALLERGEN MHAKE D/S/L/M/W/S1/N/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/T/QC/Q/W1 | $68.00 | $85.00 | $58.00–$85.00 | — | 20% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FUSARIUM OXYSPOR,IgE MFFOVE L/M/N/W/S1/S/D/L1/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/F/G/PMP/A/X/QC/Q/W1 | $122.40 | $153.00 | $105.00–$153.00 | — | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODIES MAYO MCCP E/J/L/M/O/P/R/W/C1/S1/W1/PL | $21.60 | $27.00 | $16.00–$27.00 | 69% 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 | $34.40 | $43.00 | $26.00–$43.00 | 51% below | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODIES MAYO MCCP E/J/L/M/O/P/R/W/C1/S1/W1/PL | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient 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 | $34.40 | $43.00 | $29.00–$43.00 | — | 20% |
| 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 | $9.60 | $12.00 | $7.00–$8.00 | 87% below | 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 | $37.60 | $47.00 | $28.00–$32.00 | 48% below | 20% |
| 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 | $37.60 | $47.00 | $28.00–$32.00 | 48% below | 20% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 CHG ANTINUCLEAR ANTIBODIES | $38.40 | $48.00 | $29.00–$33.00 | 47% below | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA C1/E/J/L/L1/M/O/P/R/W/S1/PL/G1/M2 | $9.60 | $12.00 | $8.00–$12.00 | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA BY IFA W REFLEX C1/E/J/L/M/O/P/R/W/S1/X/PL/G1/M2 | $37.60 | $47.00 | $32.00–$47.00 | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA 10 PANEL L/M/O/T/W/S1/R/P/J/E/L1/PL/G1/M2 | $37.60 | $47.00 | $32.00–$47.00 | — | 20% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CHG ANTINUCLEAR ANTIBODIES | $38.40 | $48.00 | $33.00–$48.00 | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 CHG NATRIURETIC PEPTIDE | $103.20 | $129.00 | $78.00–$125.00 | 34% below | 20% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP A/F/G/H/K/L/M/P/R/T/U/W/C1/M1/S1/W1/R1/V1/F1 | $103.20 | $129.00 | $78.00–$125.00 | 34% below | 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 | $112.00 | $140.00 | $85.00–$135.00 | 29% below | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 CHG NATRIURETIC PEPTIDE | $103.20 | $129.00 | $89.00–$129.00 | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP A/F/G/H/K/L/M/P/R/T/U/W/C1/M1/S1/W1/R1/V1/F1 | $103.20 | $129.00 | $89.00–$129.00 | — | 20% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient 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 | $112.00 | $140.00 | $96.00–$140.00 | — | 20% |
| Basic metabolic panel (blood test) CPT 80048 HC METABOLIC PANEL TOTAL CA | $27.20 | $34.00 | $23.00 | 67% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL | $27.20 | $34.00 | $23.00 | 67% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 CHEM PANEL 8 ISTAT /S1 | $27.20 | $34.00 | $23.00 | 67% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC FASTING PNL /ALL | $27.20 | $34.00 | $23.00 | 67% below | 20% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PROFILE /ALL | $27.20 | $34.00 | $23.00 | 67% below | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHG BASIC METABOLIC PANEL CALCIUM TOTAL | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC METABOLIC PANEL TOTAL CA | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PROFILE /ALL | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC FASTING PNL /ALL | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHEM PANEL 8 ISTAT /S1 | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC SURG PATH, LEVEL-IV | $240.80 | $301.00 | $183.00–$301.00 | 35% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 CHG SURG PATH,LEVEL IV | $240.80 | $301.00 | $183.00–$301.00 | 35% above | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CHG SURG PATH,LEVEL IV | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 HC SURG PATH, LEVEL-IV | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| Blood culture for bacteria CPT 87040 CHG BLOOD CULTURE FOR BACTERIA | $27.20 | $34.00 | $20.00–$34.00 | 69% below | 20% |
| Blood culture for bacteria CPT 87040 CULT BLOOD ROUTINE M/L/P/R/W/E/O/J/S1/L1/PL/G1 | $27.20 | $34.00 | $20.00–$34.00 | 69% below | 20% |
| Blood culture for bacteria inpatient CPT 87040 CULT BLOOD ROUTINE M/L/P/R/W/E/O/J/S1/L1/PL/G1 | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Blood culture for bacteria inpatient CPT 87040 CHG BLOOD CULTURE FOR BACTERIA | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 SCN VENIPUNCTURE (S1VP) | $11.20 | $14.00 | $9.00 | 43% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PBB ROUTINE VENIPUNCTURE | $14.40 | $18.00 | $12.00 | 27% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 PR COLLECTION VENOUS BLOOD,VENIPUNCTURE | $14.40 | $18.00 | $12.00 | 27% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ROUTINE VENIPUNCTURE | $14.40 | $18.00 | $12.00 | 27% below | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SCN VENIPUNCTURE (S1VP) | $11.20 | $14.00 | $9.00–$14.00 | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 HC ROUTINE VENIPUNCTURE | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PBB ROUTINE VENIPUNCTURE | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 PR COLLECTION VENOUS BLOOD,VENIPUNCTURE | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE FASTING /ALL | $7.20 | $9.00 | $5.00–$8.00 | 79% below | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE /ALL | $8.00 | $10.00 | $6.00–$9.00 | 76% below | 20% |
| Blood glucose (sugar) test CPT 82947 GEST GLU TOLERANCE QC/V/Z/Y/K/N/Q/X/S1/B1/P1/R1 | $18.40 | $23.00 | $14.00–$22.00 | 45% below | 20% |
| Blood glucose (sugar) test CPT 82947 ASSAY QUANTITATIVE,BLOOD GLUCOSE | $18.40 | $23.00 | $14.00–$22.00 | 45% below | 20% |
| 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 | $59.20 | $74.00 | $45.00–$71.00 | 76% above | 20% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE TOLERANCE /S1 | $71.20 | $89.00 | $54.00–$86.00 | 112% above | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE FASTING /ALL | $7.20 | $9.00 | $6.00–$9.00 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE /ALL | $8.00 | $10.00 | $6.00–$10.00 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GEST GLU TOLERANCE QC/V/Z/Y/K/N/Q/X/S1/B1/P1/R1 | $18.40 | $23.00 | $15.00–$23.00 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 ASSAY QUANTITATIVE,BLOOD GLUCOSE | $18.40 | $23.00 | $15.00–$23.00 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 LIVER FIBROSIS, NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 | $59.20 | $74.00 | $51.00–$74.00 | — | 20% |
| Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE TOLERANCE /S1 | $71.20 | $89.00 | $61.00–$89.00 | — | 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 | $12.00 | $15.00 | $9.00–$11.00 | 77% below | 20% |
| Blood lead test CPT 83655 HEAVY METAL/CREAT W/REFLX MHMUCR QC/Q/Z/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/W1 | $20.00 | $25.00 | $15.00–$19.00 | 62% below | 20% |
| Blood lead test CPT 83655 LEAD CAP W/DEMO MPBDC Q/QC/Z/F1/C2/P1/V/Y/D/S/SA/N | $23.20 | $29.00 | $17.00–$22.00 | 56% 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 | $23.20 | $29.00 | $17.00–$22.00 | 56% below | 20% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $23.20 | $29.00 | $17.00–$22.00 | 56% below | 20% |
| Blood lead test CPT 83655 LEAD L/M/R/W/X/C1/S1/L1/PL/G1/M2 | $23.20 | $29.00 | $17.00–$22.00 | 56% below | 20% |
| Blood lead test inpatient 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 | $12.00 | $15.00 | $10.00–$15.00 | — | 20% |
| Blood lead test inpatient CPT 83655 HEAVY METAL/CREAT W/REFLX MHMUCR QC/Q/Z/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/W1 | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD CAP W/DEMO MPBDC Q/QC/Z/F1/C2/P1/V/Y/D/S/SA/N | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Blood lead test inpatient CPT 83655 LEAD L/M/R/W/X/C1/S1/L1/PL/G1/M2 | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Blood lead test inpatient 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 | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Blood lead test inpatient CPT 83655 ASSAY OF LEAD | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG SCREEN ??? /ALL EXCEPT/B/H/J/V/L1/P1 | $36.00 | $45.00 | $27.00–$45.00 | 42% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN, QUAL | $36.80 | $46.00 | $28.00–$46.00 | 40% below | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG SCREEN ??? /ALL EXCEPT/B/H/J/V/L1/P1 | $36.00 | $45.00 | $31.00–$45.00 | — | 20% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN, QUAL | $36.80 | $46.00 | $31.00–$46.00 | — | 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 | $84.80 | $106.00 | $64.00–$106.00 | 48% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 TYPE AND SCREEN F/G/H/P/R/T/U/O/B/K/S1/B1/V1 | $84.80 | $106.00 | $64.00–$106.00 | 48% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 CHG BLOOD TYPING SEROLOGIC ABO | $85.60 | $107.00 | $65.00–$107.00 | 50% above | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 TYPE AND SCREEN F/G/H/P/R/T/U/O/B/K/S1/B1/V1 | $84.80 | $106.00 | $73.00–$106.00 | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient 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 | $84.80 | $106.00 | $73.00–$106.00 | — | 20% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 CHG BLOOD TYPING SEROLOGIC ABO | $85.60 | $107.00 | $73.00–$107.00 | — | 20% |
| 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 | $16.00 | $20.00 | $12.00–$13.00 | 72% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CHG C-REACTIVE PROTEIN | $16.00 | $20.00 | $12.00–$13.00 | 72% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 BODY FLUID CRP G1/M2 | $24.00 | $30.00 | $18.00–$20.00 | 58% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 IBD sgi DIAGNOSTIC H/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/M2 | $37.60 | $47.00 | $28.00–$32.00 | 35% below | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient 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 | $16.00 | $20.00 | $13.00–$20.00 | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CHG C-REACTIVE PROTEIN | $16.00 | $20.00 | $13.00–$20.00 | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 BODY FLUID CRP G1/M2 | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 IBD sgi DIAGNOSTIC H/L/M/W/C1/S1/L1/PL/O/J/P/E/G1/M2 | $37.60 | $47.00 | $32.00–$47.00 | — | 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 | $50.40 | $63.00 | $38.00–$61.00 | 53% below | 20% |
| C. difficile toxin gene test (stool PCR) CPT 87493 CHG CYTOMED, DNA, AMP PROBE | $50.40 | $63.00 | $38.00–$61.00 | 53% below | 20% |
| C. difficile toxin gene test (stool PCR) inpatient 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 | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CHG CYTOMED, DNA, AMP PROBE | $50.40 | $63.00 | $43.00–$63.00 | — | 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 | $67.20 | $84.00 | $51.00–$84.00 | 30% below | 20% |
| CA 19-9 blood test (tumor marker) inpatient 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 | $67.20 | $84.00 | $57.00–$84.00 | — | 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 | $48.80 | $61.00 | $37.00–$61.00 | 57% below | 20% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CHG IMMUNOASSAY, TUMOR ANTIGEN, CA 125 | $48.80 | $61.00 | $37.00–$61.00 | 57% below | 20% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CHG IMMUNOASSAY, TUMOR ANTIGEN, CA 125 | $48.80 | $61.00 | $42.00–$61.00 | — | 20% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 D/L/M/N/O/P/R/S/X/W/E/J/C1/S1/L1/R1/PL/G1/F1 | $48.80 | $61.00 | $42.00–$61.00 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID-19 LAB TEST NON-CDC AMP PRB | $78.40 | $98.00 | $59.00–$98.00 | 32% below | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV 2 MOLECULAR Z/W/L/M/PL/G1/J/T/R/S1/O/C1/P/L1/E/S/SA/D/N/QC/Q/V/Y/P1/W1/A/G/F/H/V1/F1/K/B1/M2/B | $78.40 | $98.00 | $59.00–$98.00 | 32% below | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ | $78.40 | $98.00 | $59.00–$98.00 | 32% below | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 87635 | $89.60 | $112.00 | $68.00–$112.00 | 22% below | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV 2 MOLECULAR Z/W/L/M/PL/G1/J/T/R/S1/O/C1/P/L1/E/S/SA/D/N/QC/Q/V/Y/P1/W1/A/G/F/H/V1/F1/K/B1/M2/B | $78.40 | $98.00 | $67.00–$98.00 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 HC COVID-19 LAB TEST NON-CDC AMP PRB | $78.40 | $98.00 | $67.00–$98.00 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ | $78.40 | $98.00 | $67.00–$98.00 | — | 20% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 87635 | $89.60 | $112.00 | $77.00–$112.00 | — | 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 | $31.20 | $39.00 | $23.00–$37.00 | 69% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHG CHYLMD TRACH, DNA, AMP PROBE | $32.00 | $40.00 | $24.00–$38.00 | 68% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY NAA OTHER L/W/M/J/S1/L1/PL/O/C1/P/E/G1/M2 | $45.60 | $57.00 | $34.00–$55.00 | 54% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C.TRACHOMATIS BY PCR /R1/Z)AP ONLY) | $64.00 | $80.00 | $48.00–$77.00 | 36% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1 | $64.00 | $80.00 | $48.00–$77.00 | 36% below | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA URINE L/M/O/P/W/J/S1/L1/PL/G1/M2 | $31.20 | $39.00 | $26.00–$39.00 | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHG CHYLMD TRACH, DNA, AMP PROBE | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY NAA OTHER L/W/M/J/S1/L1/PL/O/C1/P/E/G1/M2 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C.TRACHOMATIS BY PCR /R1/Z)AP ONLY) | $64.00 | $80.00 | $55.00–$80.00 | — | 20% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1 | $64.00 | $80.00 | $55.00–$80.00 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL D/S | $14.40 | $18.00 | $12.00 | 83% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPOPROTEIN METABOLISM PROFILE LMPP Z/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/QC/Q/W1 | $41.60 | $52.00 | $35.00 | 51% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID SCREEN Z/X/S1/M1/L1 | $44.00 | $55.00 | $37.00 | 48% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL | $44.00 | $55.00 | $37.00 | 48% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 CHG LIPID PANEL | $44.00 | $55.00 | $37.00 | 48% below | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL D/S | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPOPROTEIN METABOLISM PROFILE LMPP Z/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/QC/Q/W1 | $41.60 | $52.00 | $35.00–$52.00 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC LIPID PANEL | $44.00 | $55.00 | $37.00–$55.00 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID SCREEN Z/X/S1/M1/L1 | $44.00 | $55.00 | $37.00–$55.00 | — | 20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 CHG LIPID PANEL | $44.00 | $55.00 | $37.00–$55.00 | — | 20% |
| Complete blood count (CBC) with differential CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF | $25.60 | $32.00 | $22.00 | 59% below | 20% |
| Complete blood count (CBC) with differential CPT 85025 CBC W DIFF Z/P1/B1/C1/C2/H/L1/M1/QC/S1/X/W1/A/S/D/N/E/T/R1/J/N/O/P/Q/R/U/PL/G1/V1/F1/M2 | $25.60 | $32.00 | $22.00 | 59% below | 20% |
| Complete blood count (CBC) with differential CPT 85025 CHG COMPLETE CBC & AUTO DIFF WBC | $25.60 | $32.00 | $22.00 | 59% below | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC W DIFF Z/P1/B1/C1/C2/H/L1/M1/QC/S1/X/W1/A/S/D/N/E/T/R1/J/N/O/P/Q/R/U/PL/G1/V1/F1/M2 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CHG COMPLETE CBC & AUTO DIFF WBC | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC COMPL CBC W PLT W AUTOM DIFF | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Complete blood count (CBC), no differential CPT 85027 MANUAL DIFFERENTIAL BILL | $21.60 | $27.00 | $16.00–$26.00 | 52% below | 20% |
| Complete blood count (CBC), no differential CPT 85027 CHG COMPLETE CBC | $21.60 | $27.00 | $16.00–$26.00 | 52% below | 20% |
| 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 | $21.60 | $27.00 | $16.00–$26.00 | 52% below | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CHG COMPLETE CBC | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Complete blood count (CBC), no differential inpatient CPT 85027 MANUAL DIFFERENTIAL BILL | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Complete blood count (CBC), no differential inpatient 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 | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP FASTING PNL /ALL | $32.80 | $41.00 | $25.00–$28.00 | 72% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL /ALL | $32.80 | $41.00 | $25.00–$28.00 | 72% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 CHG METABOLIC PANEL,COMPREHENSIVE | $33.60 | $42.00 | $25.00–$28.00 | 72% below | 20% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHEN METABOLIC PANEL | $33.60 | $42.00 | $25.00–$28.00 | 72% below | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP FASTING PNL /ALL | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL /ALL | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CHG METABOLIC PANEL,COMPREHENSIVE | $33.60 | $42.00 | $28.00–$42.00 | — | 20% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC COMPREHEN METABOLIC PANEL | $33.60 | $42.00 | $28.00–$42.00 | — | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 D-DIMER SENS QUANT Z/L/M/O/P/W/PL/G1/R/SME | $35.20 | $44.00 | $26.00–$44.00 | 58% below | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT | $36.00 | $45.00 | $27.00–$45.00 | 57% below | 20% |
| D-dimer blood test (blood clot marker) CPT 85379 THROMBOPHILIA PROFILE MAATHR /F1/F1/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1/PL/W/L/M | $45.60 | $57.00 | $34.00–$57.00 | 46% below | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER SENS QUANT Z/L/M/O/P/W/PL/G1/R/SME | $35.20 | $44.00 | $30.00–$44.00 | — | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADPRODUCTS,D-DIMER, QUANT | $36.00 | $45.00 | $31.00–$45.00 | — | 20% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 THROMBOPHILIA PROFILE MAATHR /F1/F1/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1/PL/W/L/M | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 CHG DEHYDROEPIANDROSTERONE-SULFATE | $45.60 | $57.00 | $34.00–$55.00 | 59% below | 20% |
| 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 | $45.60 | $57.00 | $34.00–$55.00 | 59% below | 20% |
| DHEA sulfate (DHEA-S) blood test inpatient 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 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 CHG DEHYDROEPIANDROSTERONE-SULFATE | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| 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 | $52.80 | $66.00 | $40.00–$45.00 | 59% below | 20% |
| 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 | $63.20 | $79.00 | $48.00–$54.00 | 51% below | 20% |
| Estradiol blood test CPT 82670 CHG ASSAY OF TOTAL ESTRADIOL | $64.00 | $80.00 | $48.00–$55.00 | 51% below | 20% |
| Estradiol blood test CPT 82670 BASELINE PED ESTRADI ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $183.00–$207.00 | 85% above | 20% |
| Estradiol blood test CPT 82670 PEDS ESTRADIOL ESOTERIX /H/L/M/W/O/S1/J/L1/C1/PL/P/E/G1/M2 | $240.00 | $300.00 | $183.00–$207.00 | 85% above | 20% |
| Estradiol blood test CPT 82670 24HOUR PED ESTRADIOL ESOTERIX/L/W/W/S1/H/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $183.00–$207.00 | 85% above | 20% |
| Estradiol blood test CPT 82670 60MIN PED ESTRADIOL ESOTERIX/L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $183.00–$207.00 | 85% above | 20% |
| Estradiol blood test CPT 82670 120MIN PED ESTRADIOL ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $183.00–$207.00 | 85% above | 20% |
| Estradiol blood test inpatient 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 | $52.80 | $66.00 | $45.00–$66.00 | — | 20% |
| Estradiol blood test inpatient 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 | $63.20 | $79.00 | $54.00–$79.00 | — | 20% |
| Estradiol blood test inpatient CPT 82670 CHG ASSAY OF TOTAL ESTRADIOL | $64.00 | $80.00 | $55.00–$80.00 | — | 20% |
| Estradiol blood test inpatient CPT 82670 120MIN PED ESTRADIOL ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $207.00–$300.00 | — | 20% |
| Estradiol blood test inpatient CPT 82670 PEDS ESTRADIOL ESOTERIX /H/L/M/W/O/S1/J/L1/C1/PL/P/E/G1/M2 | $240.00 | $300.00 | $207.00–$300.00 | — | 20% |
| Estradiol blood test inpatient CPT 82670 BASELINE PED ESTRADI ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $207.00–$300.00 | — | 20% |
| Estradiol blood test inpatient CPT 82670 24HOUR PED ESTRADIOL ESOTERIX/L/W/W/S1/H/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $207.00–$300.00 | — | 20% |
| Estradiol blood test inpatient CPT 82670 60MIN PED ESTRADIOL ESOTERIX/L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $240.00 | $300.00 | $207.00–$300.00 | — | 20% |
| 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 | $23.20 | $29.00 | $17.00–$20.00 | 75% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 CHG GONADOTROPIN (FSH) | $23.20 | $29.00 | $17.00–$20.00 | 75% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 BASELINE PED FSH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $35.00–$40.00 | 50% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 24HOUR PED FSH ESOTERIX/L/M/W/H/L1/PL/O/J/C1/R/P/E/G1/M2 | $67.20 | $84.00 | $51.00–$57.00 | 27% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 60MIN PED FSH ESOTERIX/L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $67.20 | $84.00 | $51.00–$57.00 | 27% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 120MIN PED FSH ESOTERIX/L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $67.20 | $84.00 | $51.00–$57.00 | 27% below | 20% |
| FSH (follicle-stimulating hormone) test CPT 83001 PEDS FSH ESOTERIX /M/H/O/J/L1/P/C1/PL/E/G1/M2 | $67.20 | $84.00 | $51.00–$57.00 | 27% below | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 CHG GONADOTROPIN (FSH) | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient 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 | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 BASELINE PED FSH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 24HOUR PED FSH ESOTERIX/L/M/W/H/L1/PL/O/J/C1/R/P/E/G1/M2 | $67.20 | $84.00 | $57.00–$84.00 | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 120MIN PED FSH ESOTERIX/L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $67.20 | $84.00 | $57.00–$84.00 | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 PEDS FSH ESOTERIX /M/H/O/J/L1/P/C1/PL/E/G1/M2 | $67.20 | $84.00 | $57.00–$84.00 | — | 20% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 60MIN PED FSH ESOTERIX/L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $67.20 | $84.00 | $57.00–$84.00 | — | 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 | $150.40 | $188.00 | $114.00–$182.00 | 6% below | 20% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, F MCALPR Q/Z/X/W1/A/S/D/N/L/M/W/PL/F1/C2/P1/V/Y/M2 | $150.40 | $188.00 | $129.00–$188.00 | — | 20% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $43.20 | $54.00 | $32.00–$37.00 | 49% below | 20% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN /ALL | $43.20 | $54.00 | $32.00–$37.00 | 49% below | 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 | $59.20 | $74.00 | $45.00–$51.00 | 31% below | 20% |
| Ferritin blood test (iron stores) CPT 82728 THAL AND HEMOGL EVAL MTHEV1 D/L/L1/M/N/Q/S/S1/W/W1/Z/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/T/QC | $84.80 | $106.00 | $64.00–$73.00 | 1% below | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN | $43.20 | $54.00 | $37.00–$54.00 | — | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN /ALL | $43.20 | $54.00 | $37.00–$54.00 | — | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 LIVER FIBROSIS, NON-ALCOHOLIC Y/V/P1/L/M/W/E/J/L1/O/S1/P/R/C1/PL/G1/M2 | $59.20 | $74.00 | $51.00–$74.00 | — | 20% |
| Ferritin blood test (iron stores) inpatient CPT 82728 THAL AND HEMOGL EVAL MTHEV1 D/L/L1/M/N/Q/S/S1/W/W1/Z/PL/O/J/C1/P/E/G1/F1/C2/P1/V/Y/M2/F/G/PMP/A/X/T/QC | $84.80 | $106.00 | $73.00–$106.00 | — | 20% |
| Folate (folic acid) blood test CPT 82746 FOLATE /ALL EXCEPT/H/T/U/ | $28.00 | $35.00 | $21.00–$24.00 | 68% below | 20% |
| Folate (folic acid) blood test CPT 82746 CHG BLOOD FOLIC ACID SERUM | $28.80 | $36.00 | $21.00–$24.00 | 67% below | 20% |
| Folate (folic acid) blood test CPT 82746 VIT B12 AND FOLATE Q/QC/Z/A/F/G/I/L/M/W/S1/L1/C2/W1/R1/PL/O/J/C1/P/E/G1/B | $45.60 | $57.00 | $34.00–$39.00 | 49% below | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLATE /ALL EXCEPT/H/T/U/ | $28.00 | $35.00 | $24.00–$35.00 | — | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 CHG BLOOD FOLIC ACID SERUM | $28.80 | $36.00 | $24.00–$36.00 | — | 20% |
| Folate (folic acid) blood test inpatient CPT 82746 VIT B12 AND FOLATE Q/QC/Z/A/F/G/I/L/M/W/S1/L1/C2/W1/R1/PL/O/J/C1/P/E/G1/B | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Free T3 thyroid hormone test CPT 84481 CHG TRIIODOTHYRONINE FREE ASSAY (FT-3) | $27.20 | $34.00 | $20.00–$23.00 | 73% below | 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 | $27.20 | $34.00 | $20.00–$23.00 | 73% below | 20% |
| Free T3 thyroid hormone test inpatient 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 | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Free T3 thyroid hormone test inpatient CPT 84481 CHG TRIIODOTHYRONINE FREE ASSAY (FT-3) | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $25.60 | $32.00 | $19.00–$22.00 | 60% below | 20% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE QC/A/B/D/F/G/I/J/K/L/M/P/Q/R/S/T/W/X/S1/B1/L1/W1/PL/G1/V1/M2 | $25.60 | $32.00 | $19.00–$22.00 | 60% below | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE QC/A/B/D/F/G/I/J/K/L/M/P/Q/R/S/T/W/X/S1/B1/L1/W1/PL/G1/V1/M2 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| 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 | $12.80 | $16.00 | $9.00–$15.00 | 88% below | 20% |
| Free testosterone test CPT 84402 TESTOS,BIOAVAIL W/SHBG A70102 V/Y/P1/C2/Z/L/M/W | $14.40 | $18.00 | $10.00–$17.00 | 86% below | 20% |
| Free testosterone test CPT 84402 TESTOS BIO W/SHBG 0081057 Z/M/L/W | $22.40 | $28.00 | $17.00–$27.00 | 79% below | 20% |
| Free testosterone test CPT 84402 TESTOSTERONE FR,MALE C1/E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2 | $52.00 | $65.00 | $39.00–$63.00 | 51% below | 20% |
| Free testosterone test CPT 84402 ASSAY OF TESTOSTERONE | $52.00 | $65.00 | $39.00–$63.00 | 51% below | 20% |
| Free testosterone test CPT 84402 TESTOS BY DIALYSIS A2003246 L/M/W | $96.80 | $121.00 | $73.00–$117.00 | 9% below | 20% |
| Free testosterone test CPT 84402 TEST FR,FEMALE/CHILD C1/E/J/L/M/O/P/R/T/W/S1/L1/PL/G1/M2 | $119.20 | $149.00 | $90.00–$144.00 | 12% above | 20% |
| Free testosterone test inpatient 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 | $12.80 | $16.00 | $11.00–$16.00 | — | 20% |
| Free testosterone test inpatient CPT 84402 TESTOS,BIOAVAIL W/SHBG A70102 V/Y/P1/C2/Z/L/M/W | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Free testosterone test inpatient CPT 84402 TESTOS BIO W/SHBG 0081057 Z/M/L/W | $22.40 | $28.00 | $19.00–$28.00 | — | 20% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE FR,MALE C1/E/J/L/M/O/P/R/W/S1/L1/PL/G1/M2 | $52.00 | $65.00 | $44.00–$65.00 | — | 20% |
| Free testosterone test inpatient CPT 84402 ASSAY OF TESTOSTERONE | $52.00 | $65.00 | $44.00–$65.00 | — | 20% |
| Free testosterone test inpatient CPT 84402 TESTOS BY DIALYSIS A2003246 L/M/W | $96.80 | $121.00 | $83.00–$121.00 | — | 20% |
| Free testosterone test inpatient CPT 84402 TEST FR,FEMALE/CHILD C1/E/J/L/M/O/P/R/T/W/S1/L1/PL/G1/M2 | $119.20 | $149.00 | $102.00–$149.00 | — | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR PP QC/Z/A/B/F/G/H/I/L/PL/Q/T/B1/L1/R1/PL/F1/V/P1/Y | $9.60 | $12.00 | $7.00–$12.00 | 73% below | 20% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR PP QC/Z/A/B/F/G/H/I/L/PL/Q/T/B1/L1/R1/PL/F1/V/P1/Y | $9.60 | $12.00 | $8.00–$12.00 | — | 20% |
| Glucose tolerance test, 3 samples CPT 82951 GLU TOLERANCE GEST QC/I/L/M/Q/W/B/D/S/M1/P1/PL/G1/P | $30.40 | $38.00 | $23.00–$38.00 | 64% below | 20% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLU TOLERANCE GEST QC/I/L/M/Q/W/B/D/S/M1/P1/PL/G1/P | $30.40 | $38.00 | $26.00–$38.00 | — | 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 | $27.20 | $34.00 | $20.00–$32.00 | 70% below | 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 | $32.00 | $40.00 | $24.00–$38.00 | 65% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC BY NAA OTHER R/S1/L1/PL/O/J/C1/P/E/G1/M2 | $32.00 | $40.00 | $24.00–$38.00 | 65% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CHG N.GONORRHOEAE, DNA, AMP PROB | $32.80 | $41.00 | $25.00–$39.00 | 64% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1 | $64.00 | $80.00 | $48.00–$77.00 | 30% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE BY PCR /R1 | $64.00 | $80.00 | $48.00–$77.00 | 30% below | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY NAA E/L/M/W/J/S1/L1/PL/O/C1/P/G1/M2 | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC BY NAA OTHER R/S1/L1/PL/O/J/C1/P/E/G1/M2 | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GONORRHEA URINE L/M/P/E/J/O/W/S1/L1/PL/C1/G1/M2 | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CHG N.GONORRHOEAE, DNA, AMP PROB | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHOEAE BY PCR /R1 | $64.00 | $80.00 | $55.00–$80.00 | — | 20% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 CT AND NG PCR C2/R1/X/Z(AP ONLY)/F1 | $64.00 | $80.00 | $55.00–$80.00 | — | 20% |
| H. pylori antibody blood test CPT 86677 CHG HELICOBACTER PYLORI | $63.20 | $79.00 | $48.00–$79.00 | 21% below | 20% |
| H. pylori antibody blood test inpatient CPT 86677 CHG HELICOBACTER PYLORI | $63.20 | $79.00 | $54.00–$79.00 | — | 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 | $112.00 | $140.00 | $85.00–$135.00 | at median | 20% |
| H. pylori stool antigen test CPT 87338 CHG IAAD IA HPYLORI STOOL | $112.80 | $141.00 | $86.00–$136.00 | 1% above | 20% |
| H. pylori stool antigen test inpatient 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 | $112.00 | $140.00 | $96.00–$140.00 | — | 20% |
| H. pylori stool antigen test inpatient CPT 87338 CHG IAAD IA HPYLORI STOOL | $112.80 | $141.00 | $97.00–$141.00 | — | 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 | $120.80 | $151.00 | $92.00–$146.00 | 55% below | 20% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV1 ULTRASENSITIVE VIRAL LOAD L/M/W/E/J/C1/L1/S/D/N/PL/O//G1/F1/M2 | $120.80 | $151.00 | $104.00–$151.00 | — | 20% |
| HIV-1 and HIV-2 antibody test CPT 86703 PR ANTIBODY HIV-1&HIV-2 SINGLE RESULT | $65.60 | $82.00 | $50.00–$82.00 | 35% above | 20% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 PR ANTIBODY HIV-1&HIV-2 SINGLE RESULT | $65.60 | $82.00 | $56.00–$82.00 | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 4TH GEN V/Q/Z/QC/E/J/L/M/N/O/P/R/W/C1/D/S/L1/S1/PL/Y/P1/F1/M2 | $31.20 | $39.00 | $23.00–$37.00 | 58% below | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV-1 AG W/ HIV-1 & HIV-2 AB | $32.00 | $40.00 | $24.00–$38.00 | 57% below | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 CHG IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | $32.00 | $40.00 | $24.00–$38.00 | 57% below | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 4TH GEN V/Q/Z/QC/E/J/L/M/N/O/P/R/W/C1/D/S/L1/S1/PL/Y/P1/F1/M2 | $31.20 | $39.00 | $26.00–$39.00 | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HC HIV-1 AG W/ HIV-1 & HIV-2 AB | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 CHG IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C W/eAG QC/V/Z/Y/B/D/F/J/K/N/Q/S/U/S1/L1/P1/V1/F1 | $31.20 | $39.00 | $23.00–$26.00 | 49% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN GLYCOSYLATED TEST (A1C) | $32.00 | $40.00 | $24.00–$27.00 | 47% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 PR GLYCOSYLATED HEMOGLOBIN TEST | $32.00 | $40.00 | $24.00–$27.00 | 47% below | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C W/eAG QC/V/Z/Y/B/D/F/J/K/N/Q/S/U/S1/L1/P1/V1/F1 | $31.20 | $39.00 | $26.00–$39.00 | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 PR GLYCOSYLATED HEMOGLOBIN TEST | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HC HEMOGLOBIN GLYCOSYLATED TEST (A1C) | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| 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 | $29.60 | $37.00 | $22.00–$27.00 | 56% below | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 CHG HEPATITIS B SURFACE AB TEST | $30.40 | $38.00 | $23.00–$28.00 | 55% below | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC AB: HBSAB | $46.40 | $58.00 | $35.00–$42.00 | 32% below | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SUR AB L/M/N/P/W/C1 | $47.20 | $59.00 | $35.00–$43.00 | 30% below | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient 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 | $29.60 | $37.00 | $25.00–$37.00 | — | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 CHG HEPATITIS B SURFACE AB TEST | $30.40 | $38.00 | $26.00–$38.00 | — | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HC AB: HBSAB | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SUR AB L/M/N/P/W/C1 | $47.20 | $59.00 | $40.00–$59.00 | — | 20% |
| 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 | $24.00 | $30.00 | $18.00–$22.00 | 63% below | 20% |
| 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 | $45.60 | $57.00 | $34.00–$42.00 | 30% below | 20% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 CHG IAAD IA HEPATITIS B SURFACE ANTIGEN | $45.60 | $57.00 | $34.00–$42.00 | 30% below | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient 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 | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURF AG E/J/L/M/O/P/R/W/C1/S1/L1/PL/G1/M2 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 CHG IAAD IA HEPATITIS B SURFACE ANTIGEN | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| 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 | $59.20 | $74.00 | $45.00–$71.00 | 24% below | 20% |
| Hepatitis C antibody blood test (screening) CPT 86803 CHG HEPATITIS C AB TEST | $60.00 | $75.00 | $45.00–$72.00 | 23% below | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB E/J/L/M/O/P/T/W/C1/S1/L1/PL/G1/M2 | $59.20 | $74.00 | $51.00–$74.00 | — | 20% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 CHG HEPATITIS C AB TEST | $60.00 | $75.00 | $51.00–$75.00 | — | 20% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 CHG HEPATITIS C, RNA, QUANT | $179.20 | $224.00 | $136.00–$217.00 | 31% below | 20% |
| 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 | $179.20 | $224.00 | $136.00–$217.00 | 31% below | 20% |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HEPATITIS C RT PCR MHCVQN QC/Q/S1/W1/C2/P1/V/Y | $220.00 | $275.00 | $167.00–$266.00 | 15% below | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 CHG HEPATITIS C, RNA, QUANT | $179.20 | $224.00 | $154.00–$224.00 | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient 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 | $179.20 | $224.00 | $154.00–$224.00 | — | 20% |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HEPATITIS C RT PCR MHCVQN QC/Q/S1/W1/C2/P1/V/Y | $220.00 | $275.00 | $189.00–$275.00 | — | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1,2 IGG QC/Y/V/P1/L/M/W/PL/M2 | $17.60 | $22.00 | $13.00–$22.00 | 74% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 CHG HERPES SIMPLEX TEST | $17.60 | $22.00 | $13.00–$22.00 | 74% below | 20% |
| Herpes blood test, HSV-1 antibody CPT 86695 TORCH PROFILE IgG | $17.60 | $22.00 | $13.00–$22.00 | 74% 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 | $24.00 | $30.00 | $18.00–$30.00 | 64% below | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1,2 IGG QC/Y/V/P1/L/M/W/PL/M2 | $17.60 | $22.00 | $15.00–$22.00 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 TORCH PROFILE IgG | $17.60 | $22.00 | $15.00–$22.00 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 CHG HERPES SIMPLEX TEST | $17.60 | $22.00 | $15.00–$22.00 | — | 20% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 AB, IGG MHSVG D/N/S/Z/W1/X/E/F1/M2 | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 TORCH PROFILE IgG | $17.60 | $22.00 | $13.00–$22.00 | 70% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 1,2 IGG QC/Y/V/P1/L/M/W/PL/M2 | $17.60 | $22.00 | $13.00–$22.00 | 70% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 CHG HERPES SIMPLEX TEST, TYPE 2 | $24.00 | $30.00 | $18.00–$30.00 | 59% below | 20% |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 1/2 AB, IGG MHSVG D/N/S/Z/W1/X/E/F1/M2 | $24.00 | $30.00 | $18.00–$30.00 | 59% below | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 TORCH PROFILE IgG | $17.60 | $22.00 | $15.00–$22.00 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1,2 IGG QC/Y/V/P1/L/M/W/PL/M2 | $17.60 | $22.00 | $15.00–$22.00 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1/2 AB, IGG MHSVG D/N/S/Z/W1/X/E/F1/M2 | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 CHG HERPES SIMPLEX TEST, TYPE 2 | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| 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 | $24.80 | $31.00 | $18.00–$30.00 | 68% below | 20% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CHG C-REACTIVE PROTEIN,HIGH SENSITIVITY | $24.80 | $31.00 | $18.00–$30.00 | 68% below | 20% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CHG C-REACTIVE PROTEIN,HIGH SENSITIVITY | $24.80 | $31.00 | $21.00–$31.00 | — | 20% |
| High-sensitivity CRP (hs-CRP) test inpatient 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 | $24.80 | $31.00 | $21.00–$31.00 | — | 20% |
| 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 | $69.60 | $87.00 | $53.00–$87.00 | 27% below | 20% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE | $69.60 | $87.00 | $53.00–$87.00 | 27% below | 20% |
| Homocysteine blood test inpatient 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 | $69.60 | $87.00 | $60.00–$87.00 | — | 20% |
| Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE | $69.60 | $87.00 | $60.00–$87.00 | — | 20% |
| Insulin blood test CPT 83525 CHG ASSAY OF INSULIN,TOTAL | $15.20 | $19.00 | $11.00–$14.00 | 80% below | 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 | $15.20 | $19.00 | $11.00–$14.00 | 80% below | 20% |
| Insulin blood test CPT 83525 INSULIN,FREE & TOTAL MINSFT F1/C2/P1/V/Y/X/D/S/N/QC/Q/W1 | $25.60 | $32.00 | $19.00–$24.00 | 67% below | 20% |
| Insulin blood test inpatient CPT 83525 CHG ASSAY OF INSULIN,TOTAL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Insulin blood test inpatient 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 | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Insulin blood test inpatient CPT 83525 INSULIN,FREE & TOTAL MINSFT F1/C2/P1/V/Y/X/D/S/N/QC/Q/W1 | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Iron blood test (serum iron) CPT 83540 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1 | $21.60 | $27.00 | $16.00–$18.00 | 46% below | 20% |
| Iron blood test (serum iron) CPT 83540 IRON /ALL EXCEPT/H/T/U | $21.60 | $27.00 | $16.00–$18.00 | 46% below | 20% |
| Iron blood test (serum iron) CPT 83540 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1 | $21.60 | $27.00 | $16.00–$18.00 | 46% below | 20% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $21.60 | $27.00 | $16.00–$18.00 | 46% below | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON /ALL EXCEPT/H/T/U | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1 | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Iron blood test (serum iron) inpatient CPT 83540 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1 | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1 | $21.60 | $27.00 | $16.00–$18.00 | 55% below | 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 | $40.00 | $50.00 | $30.00–$34.00 | 17% below | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 CHG IRON BINDING TEST | $40.80 | $51.00 | $31.00–$35.00 | 16% below | 20% |
| Iron-binding capacity (TIBC) test CPT 83550 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1 | $41.60 | $52.00 | $31.00–$35.00 | 14% below | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON & IRON BINDING I/L/M/P/W/PL/G1/F1 | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Iron-binding capacity (TIBC) test inpatient 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 | $40.00 | $50.00 | $34.00–$50.00 | — | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 CHG IRON BINDING TEST | $40.80 | $51.00 | $35.00–$51.00 | — | 20% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON/IRON BIND QC/V/Y/A/B/E/F/G/O/Q/T/U/S1/C2/P1/W1/R1/J/N1 | $41.60 | $52.00 | $35.00–$52.00 | — | 20% |
| Kidney function blood test panel CPT 80069 RENAL FASTING PNL /ALL | $99.20 | $124.00 | $75.00–$91.00 | 13% above | 20% |
| Kidney function blood test panel CPT 80069 CHG RENAL FUNCTION PANEL | $99.20 | $124.00 | $75.00–$91.00 | 13% above | 20% |
| 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 | $99.20 | $124.00 | $75.00–$91.00 | 13% above | 20% |
| Kidney function blood test panel inpatient CPT 80069 CHG RENAL FUNCTION PANEL | $99.20 | $124.00 | $85.00–$124.00 | — | 20% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FASTING PNL /ALL | $99.20 | $124.00 | $85.00–$124.00 | — | 20% |
| Kidney function blood test panel inpatient 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 | $99.20 | $124.00 | $85.00–$124.00 | — | 20% |
| LH (luteinizing hormone) test CPT 83002 CHG GONADOTROPIN (LH) | $23.20 | $29.00 | $17.00–$28.00 | 75% 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 | $23.20 | $29.00 | $17.00–$28.00 | 75% below | 20% |
| LH (luteinizing hormone) test CPT 83002 BASELINE PED LH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $35.00–$56.00 | 50% below | 20% |
| LH (luteinizing hormone) test CPT 83002 24HOUR PED LH ESOTERIX/L/M/W/H/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $35.00–$56.00 | 50% below | 20% |
| LH (luteinizing hormone) test CPT 83002 120MIN PED LH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $35.00–$56.00 | 50% below | 20% |
| LH (luteinizing hormone) test CPT 83002 60MIN PED LH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $35.00–$56.00 | 50% below | 20% |
| LH (luteinizing hormone) test CPT 83002 PEDS LH ESOTERIX /M/H/J/L1/P/C1/PL/E/G1/M2 | $46.40 | $58.00 | $35.00–$56.00 | 50% below | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 CHG GONADOTROPIN (LH) | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| LH (luteinizing hormone) test inpatient 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 | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 120MIN PED LH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 60MIN PED LH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 PEDS LH ESOTERIX /M/H/J/L1/P/C1/PL/E/G1/M2 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 24HOUR PED LH ESOTERIX/L/M/W/H/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| LH (luteinizing hormone) test inpatient CPT 83002 BASELINE PED LH ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE /ALL | $23.20 | $29.00 | $17.00–$20.00 | 63% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $23.20 | $29.00 | $17.00–$20.00 | 63% below | 20% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE, FLUID V/I/J/L/M/Q/D/L1/O/P1/PL/C1/R/P/E/G1/M2 | $24.00 | $30.00 | $18.00–$20.00 | 62% below | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE /ALL | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE, FLUID V/I/J/L/M/Q/D/L1/O/P1/PL/C1/R/P/E/G1/M2 | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| Liver function blood test panel CPT 80076 HEPATIC FUNC PANEL /ALL EXCEPT M/L/W/PL/G1 | $26.40 | $33.00 | $20.00–$22.00 | 69% below | 20% |
| Liver function blood test panel CPT 80076 CHG HEPATIC FUNCTION PANEL | $26.40 | $33.00 | $20.00–$22.00 | 69% below | 20% |
| Liver function blood test panel inpatient CPT 80076 CHG HEPATIC FUNCTION PANEL | $26.40 | $33.00 | $22.00–$33.00 | — | 20% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNC PANEL /ALL EXCEPT M/L/W/PL/G1 | $26.40 | $33.00 | $22.00–$33.00 | — | 20% |
| Lyme disease antibody test CPT 86618 LYME DISEASE AB A/D/F/G/S/N/F1/PL | $26.40 | $33.00 | $20.00–$33.00 | 70% below | 20% |
| Lyme disease antibody test CPT 86618 LYME AB IGM J/L/M/P/W/L1/PL/O/C1/G1/T/M2 | $30.40 | $38.00 | $23.00–$38.00 | 66% 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/G1/M2 | $30.40 | $38.00 | $23.00–$38.00 | 66% below | 20% |
| Lyme disease antibody test CPT 86618 LYME AB IGG J/L/M/P/W/L1/PL/O/C1/E/G1/M2 | $30.40 | $38.00 | $23.00–$38.00 | 66% below | 20% |
| Lyme disease antibody test CPT 86618 CHG LYME DISEASE ANTIBODY | $31.20 | $39.00 | $23.00–$39.00 | 65% below | 20% |
| Lyme disease antibody test CPT 86618 TICK-BORNE AB PANEL, S TICKS Z/W1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/QC/Q | $55.20 | $69.00 | $42.00–$69.00 | 38% below | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB A/D/F/G/S/N/F1/PL | $26.40 | $33.00 | $22.00–$33.00 | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYME AB IGG J/L/M/P/W/L1/PL/O/C1/E/G1/M2 | $30.40 | $38.00 | $26.00–$38.00 | — | 20% |
| Lyme disease antibody test inpatient 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/G1/M2 | $30.40 | $38.00 | $26.00–$38.00 | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 LYME AB IGM J/L/M/P/W/L1/PL/O/C1/G1/T/M2 | $30.40 | $38.00 | $26.00–$38.00 | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 CHG LYME DISEASE ANTIBODY | $31.20 | $39.00 | $26.00–$39.00 | — | 20% |
| Lyme disease antibody test inpatient CPT 86618 TICK-BORNE AB PANEL, S TICKS Z/W1/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/QC/Q | $55.20 | $69.00 | $47.00–$69.00 | — | 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 | $20.80 | $26.00 | $15.00–$17.00 | 57% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE L/M/W/PL/O/J/R/P/G1/M2 | $20.80 | $26.00 | $15.00–$17.00 | 57% below | 20% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $21.60 | $27.00 | $16.00–$18.00 | 55% below | 20% |
| Magnesium blood test CPT 83735 MAGNESIUM /ALL | $21.60 | $27.00 | $16.00–$18.00 | 55% below | 20% |
| Magnesium blood test CPT 83735 LYTES AND OSMOL PANEL, F EFPO Z/W1/R/T/L/M/W/E/J/L1/O/P/W1/PL/E/G1/F1/C2/P1/V/Y/M2/X/D/S/SA/N/T/QC/Q | $184.00 | $230.00 | $140.00–$158.00 | 280% above | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE L/M/W/PL/O/J/R/P/G1/M2 | $20.80 | $26.00 | $17.00–$26.00 | — | 20% |
| Magnesium blood test inpatient 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 | $20.80 | $26.00 | $17.00–$26.00 | — | 20% |
| Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM /ALL | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Magnesium blood test inpatient CPT 83735 LYTES AND OSMOL PANEL, F EFPO Z/W1/R/T/L/M/W/E/J/L1/O/P/W1/PL/E/G1/F1/C2/P1/V/Y/M2/X/D/S/SA/N/T/QC/Q | $184.00 | $230.00 | $158.00–$230.00 | — | 20% |
| Measles (rubeola) antibody test CPT 86765 CHG RUBEOLA | $20.80 | $26.00 | $15.00–$26.00 | 62% below | 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 | $20.80 | $26.00 | $15.00–$26.00 | 62% below | 20% |
| 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 | $21.60 | $27.00 | $16.00–$27.00 | 61% below | 20% |
| Measles (rubeola) antibody test CPT 86765 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 | $28.00 | $35.00 | $21.00–$35.00 | 49% below | 20% |
| Measles (rubeola) antibody test CPT 86765 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 | $28.00 | $35.00 | $21.00–$35.00 | 49% below | 20% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA AB IGG/IGM MROGM QC/Q/D/S/X/L/M/P/W/S1/N/L1/W1/PL/O/C1/E/G1/F1/C2/P1/V/Y/M2 | $31.20 | $39.00 | $23.00–$39.00 | 43% below | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IgG QC/Y/V/C1/E/J/L/M/P/W/S1/L1/P1/X/R1/PL/R/G1/M2 | $20.80 | $26.00 | $17.00–$26.00 | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 CHG RUBEOLA | $20.80 | $26.00 | $17.00–$26.00 | — | 20% |
| Measles (rubeola) antibody test inpatient 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 | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 | $28.00 | $35.00 | $24.00–$35.00 | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 | $28.00 | $35.00 | $24.00–$35.00 | — | 20% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB IGG/IGM MROGM QC/Q/D/S/X/L/M/P/W/S1/N/L1/W1/PL/O/C1/E/G1/F1/C2/P1/V/Y/M2 | $31.20 | $39.00 | $26.00–$39.00 | — | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 INFECTIOUS MONO SCRN /ALL | $16.80 | $21.00 | $12.00–$21.00 | 65% below | 20% |
| Mono test (heterophile antibody, Monospot) CPT 86308 CHG HETEROPHILE ANTIBODIES,SCREEN | $16.80 | $21.00 | $12.00–$21.00 | 65% below | 20% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 INFECTIOUS MONO SCRN /ALL | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 CHG HETEROPHILE ANTIBODIES,SCREEN | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1 | $20.00 | $25.00 | $15.00–$25.00 | 79% below | 20% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1 | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 CHG PROSTATE SPECIFIC ANTIGEN,TOTAL | $20.00 | $25.00 | $15.00–$25.00 | 79% below | 20% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1 | $20.00 | $25.00 | $15.00–$25.00 | 79% below | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CHG PROSTATE SPECIFIC ANTIGEN,TOTAL | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL,FREE MPSAFT L/M/P/R/W/X/O/J/D/S/C1/E/S1/N/L1/W1/PL/G1/F1 | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PR CYTOPAT,CER/VAG,THIN LAYER,MAN RES,INTER | $112.00 | $140.00 | $85.00–$140.00 | 44% above | 20% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PR CYTOPAT,CER/VAG,THIN LAYER,MAN RES,INTER | $112.00 | $140.00 | $96.00–$140.00 | — | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT W CALCIUM QC/Z//L/M/R/PATHLAB/S1/L1//PL/J/P/E | $72.00 | $90.00 | $54.00–$66.00 | 59% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT /ALL EXCEPT/H/U/G1 | $89.60 | $112.00 | $68.00–$82.00 | 49% below | 20% |
| Parathyroid hormone (PTH) blood test CPT 83970 CHG ASSAY OF PARATHORMONE | $90.40 | $113.00 | $68.00–$83.00 | 49% below | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT W CALCIUM QC/Z//L/M/R/PATHLAB/S1/L1//PL/J/P/E | $72.00 | $90.00 | $62.00–$90.00 | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT /ALL EXCEPT/H/U/G1 | $89.60 | $112.00 | $77.00–$112.00 | — | 20% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 CHG ASSAY OF PARATHORMONE | $90.40 | $113.00 | $77.00–$113.00 | — | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT /ALL | $16.80 | $21.00 | $12.00–$21.00 | 63% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 CHG THROMBOPLAS TIME PARTIAL | $16.80 | $21.00 | $12.00–$21.00 | 63% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 UPC PTT CLINIC ONLY M/S1 | $18.40 | $23.00 | $14.00–$23.00 | 59% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAGULANT E/J/L/M/O/P/W/C1/S1/L1/PL/G1/M2 | $22.40 | $28.00 | $17.00–$28.00 | 50% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPHILIA PROFILE MAATHR /F1/F1/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1/PL/W/L/M | $27.20 | $34.00 | $20.00–$34.00 | 40% below | 20% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 LUPUS ANTICOAGULANT MALUPP QC/Q/T/W/X/S/D/S1/N/W1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q | $34.40 | $43.00 | $26.00–$43.00 | 24% below | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 CHG THROMBOPLAS TIME PARTIAL | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT /ALL | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 UPC PTT CLINIC ONLY M/S1 | $18.40 | $23.00 | $15.00–$23.00 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAGULANT E/J/L/M/O/P/W/C1/S1/L1/PL/G1/M2 | $22.40 | $28.00 | $19.00–$28.00 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPHILIA PROFILE MAATHR /F1/F1/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1/PL/W/L/M | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LUPUS ANTICOAGULANT MALUPP QC/Q/T/W/X/S/D/S1/N/W1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q | $34.40 | $43.00 | $29.00–$43.00 | — | 20% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $51.20 | $64.00 | $39.00–$62.00 | 47% below | 20% |
| 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 | $51.20 | $64.00 | $39.00–$62.00 | 47% below | 20% |
| Progesterone blood test CPT 84144 CAH PROFILE 6 ENDO SC IMC/S1/L1/C1/PL/O/J/P/E/G1/M2 | $114.40 | $143.00 | $87.00–$138.00 | 17% above | 20% |
| Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE | $51.20 | $64.00 | $44.00–$64.00 | — | 20% |
| Progesterone blood test inpatient 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 | $51.20 | $64.00 | $44.00–$64.00 | — | 20% |
| Progesterone blood test inpatient CPT 84144 CAH PROFILE 6 ENDO SC IMC/S1/L1/C1/PL/O/J/P/E/G1/M2 | $114.40 | $143.00 | $98.00–$143.00 | — | 20% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $51.20 | $64.00 | $39.00–$64.00 | 49% below | 20% |
| Prolactin blood test CPT 84146 PROLACTIN ALL EXCEPT B/B1/H/K/M1/T/U | $51.20 | $64.00 | $39.00–$64.00 | 49% below | 20% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN ALL EXCEPT B/B1/H/K/M1/T/U | $51.20 | $64.00 | $44.00–$64.00 | — | 20% |
| Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN | $51.20 | $64.00 | $44.00–$64.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CHG PROTHROMBIN TIME | $14.40 | $18.00 | $10.00–$12.00 | 56% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTHROMBIN TIME | $14.40 | $18.00 | $10.00–$12.00 | 56% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PBB PROTHROMBIN TIME | $14.40 | $18.00 | $10.00–$12.00 | 56% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME /ALL | $14.40 | $18.00 | $10.00–$12.00 | 56% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 UPC PT CLINIC ONLY /M | $15.20 | $19.00 | $11.00–$13.00 | 54% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 THROMBOPHILIA PROFILE MAATHR /F1/F1/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1/PL/W/L/M | $20.00 | $25.00 | $15.00–$17.00 | 39% below | 20% |
| Prothrombin time (PT/INR) clotting test CPT 85610 LUPUS ANTICOAGULANT MALUPP QC/Q/T/W/X/S/D/S1/N/W1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q | $20.00 | $25.00 | $15.00–$17.00 | 39% below | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PBB PROTHROMBIN TIME | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC PROTHROMBIN TIME | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME /ALL | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CHG PROTHROMBIN TIME | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 UPC PT CLINIC ONLY /M | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LUPUS ANTICOAGULANT MALUPP QC/Q/T/W/X/S/D/S1/N/W1/F1/C2/P1/V/Y/F/G/PMP/A/D/S/SA/N/QC/Q | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 THROMBOPHILIA PROFILE MAATHR /F1/F1/F/G/PMP/A/X/D/S/SA/N/T/QC/Q/W1/PL/W/L/M | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 5 PANEL UDS /S1 | $36.00 | $45.00 | $27.00–$45.00 | 50% below | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUGS OF ABUSE 9 S1 | $39.20 | $49.00 | $29.00–$49.00 | 46% below | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 URINE DRUG SCR J/S1/R1/G1 | $41.60 | $52.00 | $31.00–$52.00 | 42% below | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 MEDICAL DRG SCRN /S1/M2 | $216.00 | $270.00 | $164.00–$270.00 | 199% above | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 5 PANEL UDS /S1 | $36.00 | $45.00 | $31.00–$45.00 | — | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUGS OF ABUSE 9 S1 | $39.20 | $49.00 | $33.00–$49.00 | — | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCR J/S1/R1/G1 | $41.60 | $52.00 | $35.00–$52.00 | — | 20% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 MEDICAL DRG SCRN /S1/M2 | $216.00 | $270.00 | $186.00–$270.00 | — | 20% |
| Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA IA W DO | $48.80 | $61.00 | $37.00–$61.00 | 5% above | 20% |
| Rapid flu test (influenza antigen) CPT 87804 CHG IAADIADOO INFLUENZA | $53.60 | $67.00 | $40.00–$67.00 | 16% above | 20% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 HC INFLUENZA IA W DO | $48.80 | $61.00 | $42.00–$61.00 | — | 20% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 CHG IAADIADOO INFLUENZA | $53.60 | $67.00 | $46.00–$67.00 | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC STREP A ASSAY W/OPTIC | $36.80 | $46.00 | $28.00–$46.00 | 26% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 PBB STREP A ASSAY W/OPTIC | $36.80 | $46.00 | $28.00–$46.00 | 26% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP GP A ANTIGEN ALL EXCEPT B1/C2/L1 | $41.60 | $52.00 | $31.00–$52.00 | 17% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 CHG IAADIADOO STREPTOCOCCUS GROUP A | $41.60 | $52.00 | $31.00–$52.00 | 17% below | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 HC STREP A ASSAY W/OPTIC | $36.80 | $46.00 | $31.00–$46.00 | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 PBB STREP A ASSAY W/OPTIC | $36.80 | $46.00 | $31.00–$46.00 | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP GP A ANTIGEN ALL EXCEPT B1/C2/L1 | $41.60 | $52.00 | $35.00–$52.00 | — | 20% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CHG IAADIADOO STREPTOCOCCUS GROUP A | $41.60 | $52.00 | $35.00–$52.00 | — | 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 | $9.60 | $12.00 | $7.00–$11.00 | 80% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 CHG RHEUMATOID FACTOR, QUANT | $10.40 | $13.00 | $7.00–$12.00 | 79% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 FLUID RHEUMATOID FCT L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $11.20 | $14.00 | $8.00–$13.00 | 77% below | 20% |
| Rheumatoid factor (RF) test CPT 86431 RA TITER M9060 M/L/W//S1/F/G/PMP/A/X/N/QC/Q/W1 | $1,681.60 | $2,102.00 | $1,282.00–$2,038.00 | 3362% above | 20% |
| Rheumatoid factor (RF) test inpatient 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 | $9.60 | $12.00 | $8.00–$12.00 | — | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 CHG RHEUMATOID FACTOR, QUANT | $10.40 | $13.00 | $8.00–$13.00 | — | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 FLUID RHEUMATOID FCT L/M/W/L1/PL/O/J/C1/R/P/E/G1/M2 | $11.20 | $14.00 | $9.00–$14.00 | — | 20% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER M9060 M/L/W//S1/F/G/PMP/A/X/N/QC/Q/W1 | $1,681.60 | $2,102.00 | $1,450.00–$2,102.00 | — | 20% |
| Rubella antibody test (immunity check) CPT 86762 TORCH PROFILE IgG | $17.60 | $22.00 | $13.00–$21.00 | 70% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG QC/Y/V/J/L/M/O/P/R/W/S1/L1/P1/PL/G1/T/M2 | $27.20 | $34.00 | $20.00–$32.00 | 54% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 | $32.00 | $40.00 | $24.00–$38.00 | 46% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 | $32.00 | $40.00 | $24.00–$38.00 | 46% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 CHG RUBELLA | $32.80 | $41.00 | $25.00–$39.00 | 44% below | 20% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM L/M/P/S1/L1/PL/O/J/C1/E/G1/M2 | $37.60 | $47.00 | $28.00–$45.00 | 36% below | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 TORCH PROFILE IgG | $17.60 | $22.00 | $15.00–$22.00 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG QC/Y/V/J/L/M/O/P/R/W/S1/L1/P1/PL/G1/T/M2 | $27.20 | $34.00 | $23.00–$34.00 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 MMRV PANEL L/M/W/E/J/S1/L1/C1/X/PL/O/P/G1/M2 | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 MMR PANEL E/L/M/W/S1/L1/PL/O/J/C1/P/G1/M2 | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 CHG RUBELLA | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM L/M/P/S1/L1/PL/O/J/C1/E/G1/M2 | $37.60 | $47.00 | $32.00–$47.00 | — | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR /ALL | $9.60 | $12.00 | $7.00–$8.00 | 71% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 CHG RBC SED RATE, AUTO | $10.40 | $13.00 | $7.00–$8.00 | 69% below | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR /ALL | $9.60 | $12.00 | $8.00–$12.00 | — | 20% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 CHG RBC SED RATE, AUTO | $10.40 | $13.00 | $8.00–$13.00 | — | 20% |
| Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS M/P/R/S1/L1/O/J/E/M2 | $116.00 | $145.00 | $88.00–$145.00 | 106% above | 20% |
| Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS M/P/R/S1/L1/O/J/E/M2 | $116.00 | $145.00 | $100.00–$145.00 | — | 20% |
| Stool ova and parasites exam CPT 87177 PARASITIC EXAMINATION MOPE QC/Q/W1/C2/P1/V/Y/X/D/S/SA/N | $13.60 | $17.00 | $10.00–$17.00 | 71% below | 20% |
| Stool ova and parasites exam CPT 87177 CHG OVA AND PARASITES SMEARS | $16.80 | $21.00 | $12.00–$21.00 | 64% below | 20% |
| 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 | $15.00–$25.00 | 57% below | 20% |
| Stool ova and parasites exam inpatient CPT 87177 PARASITIC EXAMINATION MOPE QC/Q/W1/C2/P1/V/Y/X/D/S/SA/N | $13.60 | $17.00 | $11.00–$17.00 | — | 20% |
| Stool ova and parasites exam inpatient CPT 87177 CHG OVA AND PARASITES SMEARS | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| Stool ova and parasites exam inpatient CPT 87177 Expanded O&P (UHL) E/J/L/M/O/P/R/W/C1/L1/S1/PL/G1/M2 | $20.00 | $25.00 | $17.00–$25.00 | — | 20% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN | $21.60 | $27.00 | $16.00–$27.00 | 34% below | 20% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT,BY PEROXID,FECES,SINGLE, COLORECTAL SCREEN | $21.60 | $27.00 | $18.00–$27.00 | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCC BLD IMMUNO DIAG Z/H/K/O/P/S1/C1/L/M/W/T/C2/S/D/N/PL/F1/E | $50.40 | $63.00 | $38.00–$63.00 | 12% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC OCCULT BLD FHG, QUAL, 1-3 | $50.40 | $63.00 | $38.00–$63.00 | 12% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 PBB OCCULT BLD FHG QUAL 1-3 | $50.40 | $63.00 | $38.00–$63.00 | 12% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 CHG BLOOD,OCCULT,FECAL HGB,FECES,1-3 SIMULT | $50.40 | $63.00 | $38.00–$63.00 | 12% below | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCC BLD IMMUNO DIAG Z/H/K/O/P/S1/C1/L/M/W/T/C2/S/D/N/PL/F1/E | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CHG BLOOD,OCCULT,FECAL HGB,FECES,1-3 SIMULT | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 PBB OCCULT BLD FHG QUAL 1-3 | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 HC OCCULT BLD FHG, QUAL, 1-3 | $50.40 | $63.00 | $43.00–$63.00 | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF L/M/W/C1/PL/O/J/R/P/E/G1/M2 | $18.40 | $23.00 | $14.00–$23.00 | 62% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR CONFIRM L/M/W/L1/A/PL/E/G1/M2 | $45.60 | $57.00 | $34.00–$57.00 | 6% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, RESP TO THERAPY L/M/W/L1/J/O/P/S1/T/R/PL/C1/E/G1/M2 | $45.60 | $57.00 | $34.00–$57.00 | 6% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CHG SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL | $45.60 | $57.00 | $34.00–$57.00 | 6% below | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF L/M/W/C1/PL/O/J/R/P/E/G1/M2 | $18.40 | $23.00 | $15.00–$23.00 | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, RESP TO THERAPY L/M/W/L1/J/O/P/S1/T/R/PL/C1/E/G1/M2 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR CONFIRM L/M/W/L1/A/PL/E/G1/M2 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CHG SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QFT PANEL S/D/N/F1 | $124.00 | $155.00 | $94.00–$150.00 | 21% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD E/J/L/M/O/P/R/W/T/S1/C1/L1 | $134.40 | $168.00 | $102.00–$162.00 | 15% below | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QFT PANEL S/D/N/F1 | $124.00 | $155.00 | $106.00–$155.00 | — | 20% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD E/J/L/M/O/P/R/W/T/S1/C1/L1 | $134.40 | $168.00 | $115.00–$168.00 | — | 20% |
| 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 | $12.80 | $16.00 | $9.00–$11.00 | 88% 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 | $12.80 | $16.00 | $9.00–$11.00 | 88% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $14.40 | $18.00 | $10.00–$12.00 | 86% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOS,BIOAVAIL W/SHBG A70102 V/Y/P1/C2/Z/L/M/W | $14.40 | $18.00 | $10.00–$12.00 | 86% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE,TOTAL 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 | $14.40 | $18.00 | $10.00–$12.00 | 86% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOS BIO W/SHBG 0081057 Z/M/L/W | $22.40 | $28.00 | $17.00–$19.00 | 78% below | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 CAH PROFILE 6 ENDO SC IMC/S1/L1/C1/PL/O/J/P/E/G1/M2 | $114.40 | $143.00 | $87.00–$98.00 | 11% above | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 CAH PROFILE 7 ENDO SC IMC/S1/J/T/L1/PL/O/C1/P/E/G1/M2 | $136.80 | $171.00 | $104.00–$117.00 | 33% above | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 24HOUR PED TESTOSTER ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $272.00 | $340.00 | $207.00–$234.00 | 164% above | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 BASELINE PED TESTOST ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $272.00 | $340.00 | $207.00–$234.00 | 164% above | 20% |
| Testosterone blood test, total (not free testosterone) CPT 84403 PEDIATRIC TESTOSTERONE ESOTERIX /M/H/S1/L1/PL/O/J/C1/P/E/G1/M2 | $272.00 | $340.00 | $207.00–$234.00 | 164% above | 20% |
| Testosterone blood test, total (not free testosterone) inpatient 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 | $12.80 | $16.00 | $11.00–$16.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient 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 | $12.80 | $16.00 | $11.00–$16.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOS,BIOAVAIL W/SHBG A70102 V/Y/P1/C2/Z/L/M/W | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE,TOTAL 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 | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $14.40 | $18.00 | $12.00–$18.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOS BIO W/SHBG 0081057 Z/M/L/W | $22.40 | $28.00 | $19.00–$28.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAH PROFILE 6 ENDO SC IMC/S1/L1/C1/PL/O/J/P/E/G1/M2 | $114.40 | $143.00 | $98.00–$143.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 CAH PROFILE 7 ENDO SC IMC/S1/J/T/L1/PL/O/C1/P/E/G1/M2 | $136.80 | $171.00 | $117.00–$171.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 24HOUR PED TESTOSTER ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $272.00 | $340.00 | $234.00–$340.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 BASELINE PED TESTOST ESOTERIX/L/M/W/S1/L1/PL/O/J/C1/R/P/E/G1/M2 | $272.00 | $340.00 | $234.00–$340.00 | — | 20% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 PEDIATRIC TESTOSTERONE ESOTERIX /M/H/S1/L1/PL/O/J/C1/P/E/G1/M2 | $272.00 | $340.00 | $234.00–$340.00 | — | 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 | $32.00 | $40.00 | $24.00–$40.00 | 58% below | 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 | $32.80 | $41.00 | $25.00–$41.00 | 57% below | 20% |
| 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 | $68.00 | $85.00 | $51.00–$85.00 | 10% below | 20% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 CHG MICROSOMAL ANTIBODY | $68.80 | $86.00 | $52.00–$86.00 | 9% below | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID AB GROUP J/L/M/O/P/R/W/C1/S1/L1/X/PL/G1/M2 | $32.00 | $40.00 | $27.00–$40.00 | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient 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 | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient 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 | $68.00 | $85.00 | $58.00–$85.00 | — | 20% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 CHG MICROSOMAL ANTIBODY | $68.80 | $86.00 | $59.00–$86.00 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 CHG ASSAY THYROID STIM HORMONE | $51.20 | $64.00 | $39.00–$44.00 | 47% 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 | $51.20 | $64.00 | $39.00–$44.00 | 47% below | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEONATAL SCREEN UHL U80001 | $300.80 | $376.00 | $229.00–$259.00 | 210% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 NEONATAL SCREEN UHL QC/A/D/L/M/Q/S/T/U/X/W/S1/N/L1/W1/PL/P/G1/F1/M2 | $300.80 | $376.00 | $229.00–$259.00 | 210% above | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CHG ASSAY THYROID STIM HORMONE | $51.20 | $64.00 | $44.00–$64.00 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM HORMONE /ALL EXCEPT /K/L/M/W/P/U/B1/P1/Y/V/PL/G1/L1 | $51.20 | $64.00 | $44.00–$64.00 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NEONATAL SCREEN UHL U80001 | $300.80 | $376.00 | $259.00–$376.00 | — | 20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 NEONATAL SCREEN UHL QC/A/D/L/M/Q/S/T/U/X/W/S1/N/L1/W1/PL/P/G1/F1/M2 | $300.80 | $376.00 | $259.00–$376.00 | — | 20% |
| Trichomonas test (NAAT) CPT 87661 Vaginitis NuSwab MFNSVG | $58.40 | $73.00 | $44.00–$73.00 | 37% below | 20% |
| Trichomonas test (NAAT) CPT 87661 TRICH VAGINALIS DNA F1/PL | $66.40 | $83.00 | $50.00–$83.00 | 28% below | 20% |
| Trichomonas test (NAAT) CPT 87661 CHG IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH | $67.20 | $84.00 | $51.00–$84.00 | 27% below | 20% |
| Trichomonas test (NAAT) CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIF | $350.40 | $438.00 | $267.00–$438.00 | 279% above | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 Vaginitis NuSwab MFNSVG | $58.40 | $73.00 | $50.00–$73.00 | — | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICH VAGINALIS DNA F1/PL | $66.40 | $83.00 | $57.00–$83.00 | — | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 CHG IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH | $67.20 | $84.00 | $57.00–$84.00 | — | 20% |
| Trichomonas test (NAAT) inpatient CPT 87661 HC TRICHOMONAS VAGINALIS AMPLIF | $350.40 | $438.00 | $302.00–$438.00 | — | 20% |
| Uric acid blood test CPT 84550 ASSAY OF URIC ACID, BLOOD | $15.20 | $19.00 | $11.00–$18.00 | 57% below | 20% |
| Uric acid blood test CPT 84550 URIC ACID /ALL | $15.20 | $19.00 | $11.00–$18.00 | 57% below | 20% |
| Uric acid blood test inpatient CPT 84550 URIC ACID /ALL | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Uric acid blood test inpatient CPT 84550 ASSAY OF URIC ACID, BLOOD | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Urinalysis with microscope exam, automated CPT 81001 URINE MICROSCOPIC S/D/S1/V/M1/W1/QC/G1/V1/F1/M2/C1 | $16.80 | $21.00 | $12.00–$14.00 | 60% below | 20% |
| Urinalysis with microscope exam, automated CPT 81001 CHG URINALYSIS, AUTO, W/SCOPE | $16.80 | $21.00 | $12.00–$14.00 | 60% below | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINE MICROSCOPIC S/D/S1/V/M1/W1/QC/G1/V1/F1/M2/C1 | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 CHG URINALYSIS, AUTO, W/SCOPE | $16.80 | $21.00 | $14.00–$21.00 | — | 20% |
| Urinalysis with microscope exam, manual CPT 81000 CHG URINALYSIS, NONAUTO, W/SCOPE | $16.00 | $20.00 | $12.00–$20.00 | 38% below | 20% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 CHG URINALYSIS, NONAUTO, W/SCOPE | $16.00 | $20.00 | $13.00–$20.00 | — | 20% |
| Urinalysis without microscope exam, automated CPT 81003 CHG URINALYSIS, AUTO, W/O SCOPE | $4.80 | $6.00 | $3.00–$4.00 | 81% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 HC AUTOM URINALYSIS WO MICRO | $4.80 | $6.00 | $3.00–$4.00 | 81% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 PBB AUTOM URINALYSIS WO MICRO | $4.80 | $6.00 | $3.00–$4.00 | 81% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 KETONES,URINE QC/V/Y/A/D/K/L/M/S/T/U/O/E/S1/B1/L1/P1/W1/PL/G1/F1 | $8.80 | $11.00 | $6.00–$7.00 | 66% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE CHEMISTRY BILL /X | $8.80 | $11.00 | $6.00–$7.00 | 66% below | 20% |
| Urinalysis without microscope exam, automated CPT 81003 URINE MACROSCOPIC BILL | $8.80 | $11.00 | $6.00–$7.00 | 66% below | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 PBB AUTOM URINALYSIS WO MICRO | $4.80 | $6.00 | $4.00–$6.00 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 CHG URINALYSIS, AUTO, W/O SCOPE | $4.80 | $6.00 | $4.00–$6.00 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC AUTOM URINALYSIS WO MICRO | $4.80 | $6.00 | $4.00–$6.00 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 KETONES,URINE QC/V/Y/A/D/K/L/M/S/T/U/O/E/S1/B1/L1/P1/W1/PL/G1/F1 | $8.80 | $11.00 | $7.00–$11.00 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE CHEMISTRY BILL /X | $8.80 | $11.00 | $7.00–$11.00 | — | 20% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINE MACROSCOPIC BILL | $8.80 | $11.00 | $7.00–$11.00 | — | 20% |
| Urinalysis without microscope exam, manual CPT 81002 CHG URINALYSIS NONAUTO W/O SCOPE | $16.00 | $20.00 | $12.00–$20.00 | 31% below | 20% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 CHG URINALYSIS NONAUTO W/O SCOPE | $16.00 | $20.00 | $13.00–$20.00 | — | 20% |
| Urine culture for bacteria, with colony count CPT 87086 CULT URINE L/M/P/R/W/E/O/J/S1/L1/PL/G1/X | $15.20 | $19.00 | $11.00–$13.00 | 74% below | 20% |
| Urine culture for bacteria, with colony count CPT 87086 CHG URINE CULTURE, COLONY COUNT | $15.20 | $19.00 | $11.00–$13.00 | 74% below | 20% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CHG URINE CULTURE, COLONY COUNT | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE L/M/P/R/W/E/O/J/S1/L1/PL/G1/X | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Urine pregnancy test, read by color change CPT 81025 HCG SCREEN URINE /ALL EXCEPT/J | $36.00 | $45.00 | $27.00–$31.00 | 14% below | 20% |
| Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY, VISUAL COLOR | $36.80 | $46.00 | $28.00–$31.00 | 12% below | 20% |
| Urine pregnancy test, read by color change CPT 81025 CHG URINE PREGNANCY TEST | $36.80 | $46.00 | $28.00–$31.00 | 12% below | 20% |
| Urine pregnancy test, read by color change CPT 81025 PBB URINE PREGNANCY, VISUAL COLOR | $36.80 | $46.00 | $28.00–$31.00 | 12% below | 20% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HCG SCREEN URINE /ALL EXCEPT/J | $36.00 | $45.00 | $31.00–$45.00 | — | 20% |
| Urine pregnancy test, read by color change inpatient CPT 81025 CHG URINE PREGNANCY TEST | $36.80 | $46.00 | $31.00–$46.00 | — | 20% |
| Urine pregnancy test, read by color change inpatient CPT 81025 PBB URINE PREGNANCY, VISUAL COLOR | $36.80 | $46.00 | $31.00–$46.00 | — | 20% |
| Urine pregnancy test, read by color change inpatient CPT 81025 HC URINE PREGNANCY, VISUAL COLOR | $36.80 | $46.00 | $31.00–$46.00 | — | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 PERNICIOUS ANEMIA MACASM Z/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/QC/Q/W1 | $31.20 | $39.00 | $23.00–$26.00 | 63% below | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CHG VITAMIN B-12 | $45.60 | $57.00 | $34.00–$39.00 | 45% below | 20% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VIT B12 AND FOLATE Q/QC/Z/A/F/G/I/L/M/W/S1/L1/C2/W1/R1/PL/O/J/C1/P/E/G1/B | $45.60 | $57.00 | $34.00–$39.00 | 45% below | 20% |
| 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 | $46.40 | $58.00 | $35.00–$40.00 | 44% below | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 PERNICIOUS ANEMIA MACASM Z/F1/C2/P1/V/Y/F/G/PMP/A/X/D/S/SA/N/QC/Q/W1 | $31.20 | $39.00 | $26.00–$39.00 | — | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VIT B12 AND FOLATE Q/QC/Z/A/F/G/I/L/M/W/S1/L1/C2/W1/R1/PL/O/J/C1/P/E/G1/B | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CHG VITAMIN B-12 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Vitamin B12 (cobalamin) blood test inpatient 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 | $46.40 | $58.00 | $40.00–$58.00 | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 OH VIT D2/D3 M25HDN Z/A/F/G/X/W1/P1/V/Y/M2/D/S/SA/N/QC/Q | $12.00 | $15.00 | $9.00–$10.00 | 90% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CHG ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED | $24.00 | $30.00 | $18.00–$20.00 | 81% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25 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 | $24.00 | $30.00 | $18.00–$20.00 | 81% below | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 OH VIT D2/D3 M25HDN Z/A/F/G/X/W1/P1/V/Y/M2/D/S/SA/N/QC/Q | $12.00 | $15.00 | $10.00–$15.00 | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CHG ASSAY OF VIT D,CALCIFEDIOL W FRACTIONS, IF PERFORMED | $24.00 | $30.00 | $20.00–$30.00 | — | 20% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,25 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 | $24.00 | $30.00 | $20.00–$30.00 | — | 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 | $32.80 | $41.00 | $25.00–$41.00 | 38% below | 20% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $33.60 | $42.00 | $25.00–$42.00 | 36% below | 20% |
| Zinc blood test inpatient 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 | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| Zinc blood test inpatient CPT 84630 ASSAY OF ZINC | $33.60 | $42.00 | $28.00–$42.00 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG TUMOR MARKER L/M/W/S1/O/P/L1/PL/C1/E/G1/M2 | $32.80 | $41.00 | $25.00–$41.00 | 63% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE /ALL | $47.20 | $59.00 | $35.00–$59.00 | 47% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN, QUANT | $47.20 | $59.00 | $35.00–$59.00 | 47% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 MS Integrated Samp 2 UHL U5557-7 A/D/M/Q/S/T/S1/N/L1/W1/PL/O/J/C1/P/E/G1/F1 | $60.80 | $76.00 | $46.00–$76.00 | 31% below | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 MS First Trimester UHL U5555-5 A/Q/S1/PL/O/J/C1/P/E/G1/F1 | $104.80 | $131.00 | $79.00–$131.00 | 18% above | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TUMOR MARKER L/M/W/S1/O/P/L1/PL/C1/E/G1/M2 | $32.80 | $41.00 | $28.00–$41.00 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE /ALL | $47.20 | $59.00 | $40.00–$59.00 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN, QUANT | $47.20 | $59.00 | $40.00–$59.00 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 MS Integrated Samp 2 UHL U5557-7 A/D/M/Q/S/T/S1/N/L1/W1/PL/O/J/C1/P/E/G1/F1 | $60.80 | $76.00 | $52.00–$76.00 | — | 20% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 MS First Trimester UHL U5555-5 A/Q/S1/PL/O/J/C1/P/E/G1/F1 | $104.80 | $131.00 | $90.00–$131.00 | — | 20% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC CL TX DSTL FIB FX WO MANIP | $167.20 | $209.00 | $127.00–$209.00 | 61% below | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 PR CLOSED RX DIST FIBULA FX | $786.40 | $983.00 | $599.00–$953.00 | 82% above | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 HC CL TX DSTL FIB FX WO MANIP | $167.20 | $209.00 | $144.00–$209.00 | — | 20% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 PR CLOSED RX DIST FIBULA FX | $786.40 | $983.00 | $678.00–$983.00 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC CL TX METATARSAL FX WO MANIP | $160.80 | $201.00 | $122.00–$201.00 | 57% below | 20% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 PR CLOSED RX METATARSAL FX | $614.40 | $768.00 | $468.00–$768.00 | 65% above | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 HC CL TX METATARSAL FX WO MANIP | $160.80 | $201.00 | $138.00–$201.00 | — | 20% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 PR CLOSED RX METATARSAL FX | $614.40 | $768.00 | $529.00–$768.00 | — | 20% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 PR CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT | $1,324.00 | $1,655.00 | $747.00–$1,605.00 | 27% below | 20% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 PR CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT | $1,324.00 | $1,655.00 | $1,141.00–$1,655.00 | — | 20% |
| Bunion correction with removal of part of the big toe joint CPT 28292 PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE | $1,940.80 | $2,426.00 | $747.00–$2,353.00 | 12% above | 20% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE | $1,940.80 | $2,426.00 | $1,673.00–$2,426.00 | — | 20% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $331.20 | $414.00 | $252.00–$414.00 | 59% below | 20% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 PR CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL | $331.20 | $414.00 | $285.00–$414.00 | — | 20% |
| Cervical biopsy CPT 57500 PR BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION | $301.60 | $377.00 | $229.00–$377.00 | 17% below | 20% |
| Cervical biopsy inpatient CPT 57500 PR BIOPSY CERVIX, 1 OR MORE, OR EXCISION OF LESION | $301.60 | $377.00 | $260.00–$377.00 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC TX FRACTURE D RADIUS/ULNA WO MANIP | $154.40 | $193.00 | $117.00–$193.00 | 64% below | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 PR CLOSED RX DIST RAD/ULNA FX | $729.60 | $912.00 | $556.00–$884.00 | 72% above | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 HC TX FRACTURE D RADIUS/ULNA WO MANIP | $154.40 | $193.00 | $133.00–$193.00 | — | 20% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 PR CLOSED RX DIST RAD/ULNA FX | $729.60 | $912.00 | $629.00–$912.00 | — | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 PR COLPOSCOPY,CERVIX W/ADJ VAG,W/LOOP BX | $740.80 | $926.00 | $564.00–$898.00 | 2% below | 20% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 PR COLPOSCOPY,CERVIX W/ADJ VAG,W/LOOP BX | $740.80 | $926.00 | $638.00–$926.00 | — | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 HC COLPOSCOPY CERVIX W BX & EC CURETT | $68.00 | $85.00 | $51.00–$85.00 | 81% below | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 PR COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAG | $403.20 | $504.00 | $307.00–$504.00 | 12% above | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 HC COLPOSCOPY CERVIX W BX & EC CURETT | $68.00 | $85.00 | $58.00–$85.00 | — | 20% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 PR COLPOSC,CERVIX W/ADJ VAG,W/BX & CURRETAG | $403.20 | $504.00 | $347.00–$504.00 | — | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 PR CYSTOURETHROSCOPY | $539.20 | $674.00 | $411.00–$674.00 | 33% below | 20% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 PR CYSTOURETHROSCOPY | $539.20 | $674.00 | $465.00–$674.00 | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 HC DESTRUCT PREMALIG LESION | $40.80 | $51.00 | $31.00–$51.00 | 72% below | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 PR DESTRUC PREMALIGNANT, FIRST LESION | $182.40 | $228.00 | $139.00–$228.00 | 23% above | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 HC DESTRUCT PREMALIG LESION | $40.80 | $51.00 | $35.00–$51.00 | — | 20% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 PR DESTRUC PREMALIGNANT, FIRST LESION | $182.40 | $228.00 | $157.00–$228.00 | — | 20% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 HC REMOVE IMPACTED EAR WAX UNI | $10.40 | $13.00 | $7.00–$13.00 | 85% below | 20% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 HC REMOVE IMPACTED EAR WAX UNI | $10.40 | $13.00 | $8.00–$13.00 | — | 20% |
| Earwax removal with instruments, one ear CPT 69210 HC REMOVAL IMPACTED CERUMEN (EARWAX) | $65.60 | $82.00 | $50.00–$82.00 | 37% below | 20% |
| Earwax removal with instruments, one ear CPT 69210 PR REMOVE IMPACTED EAR WAX | $284.80 | $356.00 | $217.00–$356.00 | 175% above | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 HC REMOVAL IMPACTED CERUMEN (EARWAX) | $65.60 | $82.00 | $56.00–$82.00 | — | 20% |
| Earwax removal with instruments, one ear inpatient CPT 69210 PR REMOVE IMPACTED EAR WAX | $284.80 | $356.00 | $245.00–$356.00 | — | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 PR BIOPSY OF UTERUS LINING | $289.60 | $362.00 | $220.00–$362.00 | 14% above | 20% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 PR BIOPSY OF UTERUS LINING | $289.60 | $362.00 | $249.00–$362.00 | — | 20% |
| Hammertoe correction surgery CPT 28285 PR REPAIR OF HAMMERTOE,ONE | $1,004.00 | $1,255.00 | $747.00–$1,217.00 | 44% below | 20% |
| Hammertoe correction surgery inpatient CPT 28285 PR REPAIR OF HAMMERTOE,ONE | $1,004.00 | $1,255.00 | $865.00–$1,255.00 | — | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HC INJ SALINE HYSTEROGRAM | $146.40 | $183.00 | $111.00–$183.00 | 56% below | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 PR CATH/INJECT HYSTEROSALPINGOGRAM | $301.60 | $377.00 | $229.00–$377.00 | 10% below | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HC INJ SALINE HYSTEROGRAM | $146.40 | $183.00 | $126.00–$183.00 | — | 20% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 PR CATH/INJECT HYSTEROSALPINGOGRAM | $301.60 | $377.00 | $260.00–$377.00 | — | 20% |
| Hysteroscopy with endometrial ablation CPT 58563 PR HYSTEROSCOPY,W/ENDOMETRIAL ABLATION | $4,335.20 | $5,419.00 | $747.00–$5,256.00 | 9% above | 20% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 PR HYSTEROSCOPY,W/ENDOMETRIAL ABLATION | $4,335.20 | $5,419.00 | $3,614.00–$5,419.00 | — | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 PR HYSTEROSCOPY,W/ENDO BX | $1,040.80 | $1,301.00 | $793.00–$1,261.00 | 69% below | 20% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 PR HYSTEROSCOPY,W/ENDO BX | $1,040.80 | $1,301.00 | $897.00–$1,301.00 | — | 20% |
| IUD insertion (the device itself billed separately) CPT 58300 PR INSERT INTRAUTERINE DEVICE | $205.60 | $257.00 | $156.00–$257.00 | 21% below | 20% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 PR INSERT INTRAUTERINE DEVICE | $205.60 | $257.00 | $177.00–$257.00 | — | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 HC I&D ABSC SMPL OR SGL | $60.00 | $75.00 | $45.00–$75.00 | 75% below | 20% |
| Incision and drainage of a simple or single skin abscess CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $278.40 | $348.00 | $212.00–$348.00 | 15% above | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 HC I&D ABSC SMPL OR SGL | $60.00 | $75.00 | $51.00–$75.00 | — | 20% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | $278.40 | $348.00 | $240.00–$348.00 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT | $36.80 | $46.00 | $28.00–$46.00 | 85% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $169.60 | $212.00 | $129.00–$212.00 | 29% below | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 HC INJ SGL TENDON SHTH OR LIGAMENT | $36.80 | $46.00 | $31.00–$46.00 | — | 20% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS | $169.60 | $212.00 | $146.00–$212.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN/INJ MAJOR JNT/BURSA | $47.20 | $59.00 | $35.00–$59.00 | 86% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 PR DRAIN/INJECT LARGE JOINT/BURSA | $216.00 | $270.00 | $164.00–$270.00 | 37% below | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 HC DRAIN/INJ MAJOR JNT/BURSA | $47.20 | $59.00 | $40.00–$59.00 | — | 20% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 PR DRAIN/INJECT LARGE JOINT/BURSA | $216.00 | $270.00 | $186.00–$270.00 | — | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 PR INSERTION DRUG DELIVERY IMPLANT | $365.60 | $457.00 | $278.00–$457.00 | 32% above | 20% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 PR INSERTION DRUG DELIVERY IMPLANT | $365.60 | $457.00 | $315.00–$457.00 | — | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $140.80 | $176.00 | $107.00–$176.00 | 51% below | 20% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US | $140.80 | $176.00 | $121.00–$176.00 | — | 20% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $210.40 | $263.00 | $160.00–$263.00 | 23% below | 20% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US | $210.40 | $263.00 | $181.00–$263.00 | — | 20% |
| Knee arthroscopy with meniscus trim CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $1,556.00 | $1,945.00 | $747.00–$1,886.00 | 36% below | 20% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 PR ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $1,556.00 | $1,945.00 | $1,342.00–$1,945.00 | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC INT REP S/A/T/EX 2.5 CM/< | $263.20 | $329.00 | $200.00–$329.00 | 26% below | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 PR LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $362.40 | $453.00 | $276.00–$453.00 | 2% above | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 HC INT REP S/A/T/EX 2.5 CM/< | $263.20 | $329.00 | $227.00–$329.00 | — | 20% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 PR LAYR CLOS WND TRUNK,ARM,LEG <2.5 CM | $362.40 | $453.00 | $312.00–$453.00 | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/< | $56.80 | $71.00 | $43.00–$71.00 | 80% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 PR EXC SKIN BENIG <5MM TRUNK,ARM,LEG | $262.40 | $328.00 | $200.00–$328.00 | 5% below | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 HC EXC TR-EXT B9+MARG 0.5 CM/< | $56.80 | $71.00 | $48.00–$71.00 | — | 20% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 PR EXC SKIN BENIG <5MM TRUNK,ARM,LEG | $262.40 | $328.00 | $226.00–$328.00 | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 HC EXC FACE-MM B9+MARG 0.5 < CM | $65.60 | $82.00 | $50.00–$82.00 | 85% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 PR EXC SKIN BENIG <5MM FACE,FACIAL | $296.00 | $370.00 | $225.00–$370.00 | 33% below | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 HC EXC FACE-MM B9+MARG 0.5 < CM | $65.60 | $82.00 | $56.00–$82.00 | — | 20% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 PR EXC SKIN BENIG <5MM FACE,FACIAL | $296.00 | $370.00 | $255.00–$370.00 | — | 20% |
| Nail removal (partial or complete), one nail CPT 11730 HC SPL AVULSE NP SGL | $56.80 | $71.00 | $43.00–$71.00 | 73% below | 20% |
| Nail removal (partial or complete), one nail CPT 11730 PR REMOVAL OF NAIL PLATE | $260.80 | $326.00 | $198.00–$326.00 | 22% above | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 HC SPL AVULSE NP SGL | $56.80 | $71.00 | $48.00–$71.00 | — | 20% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 PR REMOVAL OF NAIL PLATE | $260.80 | $326.00 | $224.00–$326.00 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 HC REMOVAL OF NAIL BED | $104.00 | $130.00 | $79.00–$130.00 | 76% below | 20% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 PR REMOVAL OF NAIL BED | $543.20 | $679.00 | $414.00–$679.00 | 27% above | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 HC REMOVAL OF NAIL BED | $104.00 | $130.00 | $89.00–$130.00 | — | 20% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 PR REMOVAL OF NAIL BED | $543.20 | $679.00 | $468.00–$679.00 | — | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 HC DESTROY LUMB/SAC FACET JNT UNIL | $284.80 | $356.00 | $217.00–$356.00 | 86% below | 20% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 HC DESTROY LUMB/SAC FACET JNT UNIL | $284.80 | $356.00 | $245.00–$356.00 | — | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 HC INC & REM FB SQ SMPL | $69.60 | $87.00 | $53.00–$87.00 | 77% below | 20% |
| Removal of a foreign object under the skin, simple CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $413.60 | $517.00 | $315.00–$517.00 | 39% above | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 HC INC & REM FB SQ SMPL | $69.60 | $87.00 | $60.00–$87.00 | — | 20% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 PR INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | $413.60 | $517.00 | $356.00–$517.00 | — | 20% |
| Short arm cast (elbow to hand) CPT 29075 HC APPLY SHORT ARM CAST | $98.40 | $123.00 | $75.00–$123.00 | 57% below | 20% |
| Short arm cast (elbow to hand) CPT 29075 PR APPLY FOREARM CAST | $473.60 | $592.00 | $361.00–$592.00 | 109% above | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 HC APPLY SHORT ARM CAST | $98.40 | $123.00 | $84.00–$123.00 | — | 20% |
| Short arm cast (elbow to hand) inpatient CPT 29075 PR APPLY FOREARM CAST | $473.60 | $592.00 | $408.00–$592.00 | — | 20% |
| Short arm splint (forearm and hand) CPT 29125 HC APPLY SHORT ARM SPLINT STATIC | $109.60 | $137.00 | $83.00–$137.00 | 38% below | 20% |
| Short arm splint (forearm and hand) CPT 29125 PR APPLY FOREARM SPLINT,STATIC | $164.80 | $206.00 | $125.00–$206.00 | 6% below | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 HC APPLY SHORT ARM SPLINT STATIC | $109.60 | $137.00 | $94.00–$137.00 | — | 20% |
| Short arm splint (forearm and hand) inpatient CPT 29125 PR APPLY FOREARM SPLINT,STATIC | $164.80 | $206.00 | $142.00–$206.00 | — | 20% |
| Short leg cast (below the knee) CPT 29405 PR APPLY SHORT LEG CAST | $240.80 | $301.00 | $183.00–$301.00 | at median | 20% |
| Short leg cast (below the knee) inpatient CPT 29405 PR APPLY SHORT LEG CAST | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| Short leg splint (calf to foot) CPT 29515 HC APPLY SHORT LEG SPLINT | $30.40 | $38.00 | $23.00–$38.00 | 82% below | 20% |
| Short leg splint (calf to foot) CPT 29515 PR APPLY LOWER LEG SPLINT | $175.20 | $219.00 | $133.00–$219.00 | 6% above | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 HC APPLY SHORT LEG SPLINT | $30.40 | $38.00 | $26.00–$38.00 | — | 20% |
| Short leg splint (calf to foot) inpatient CPT 29515 PR APPLY LOWER LEG SPLINT | $175.20 | $219.00 | $151.00–$219.00 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC SREP S/N/A/G/TR/E 2.5 CM/< | $52.80 | $66.00 | $40.00–$45.00 | 76% below | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 PR REPR SUPERF WND BODY <2.5CM | $252.00 | $315.00 | $192.00–$217.00 | 13% above | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 HC SREP S/N/A/G/TR/E 2.5 CM/< | $52.80 | $66.00 | $45.00–$66.00 | — | 20% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 PR REPR SUPERF WND BODY <2.5CM | $252.00 | $315.00 | $217.00–$315.00 | — | 20% |
| Skin biopsy, punch, one lesion CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION | $170.40 | $213.00 | $129.00–$213.00 | 34% below | 20% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PR PUNCH BIOPSY SKIN SINGLE LESION | $170.40 | $213.00 | $146.00–$213.00 | — | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 PR EXC SKIN MALIG <5MM TRUNK,ARM,LEG | $452.00 | $565.00 | $344.00–$565.00 | 12% above | 20% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 PR EXC SKIN MALIG <5MM TRUNK,ARM,LEG | $452.00 | $565.00 | $389.00–$565.00 | — | 20% |
| Skin tag removal, up to 15 tags CPT 11200 HC REM SKIN TAGS TO 15 | $43.20 | $54.00 | $32.00–$54.00 | 75% below | 20% |
| Skin tag removal, up to 15 tags CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15 | $240.80 | $301.00 | $183.00–$301.00 | 40% above | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 HC REM SKIN TAGS TO 15 | $43.20 | $54.00 | $37.00–$54.00 | — | 20% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15 | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC SREP S/N/A/G/TR/E 2.6-7.5 CM | $88.80 | $111.00 | $67.00–$82.00 | 63% below | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PR REPR SUP NPTERF WND BODY 2.6-7.5 | $419.20 | $524.00 | $319.00–$387.00 | 72% above | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 HC SREP S/N/A/G/TR/E 2.6-7.5 CM | $88.80 | $111.00 | $76.00–$111.00 | — | 20% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PR REPR SUP NPTERF WND BODY 2.6-7.5 | $419.20 | $524.00 | $361.00–$524.00 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC SREP F/E/N/L/MM 2.5 CM/< | $73.60 | $92.00 | $56.00–$63.00 | 70% below | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 PR REPR SUPERF WND FACE <2.5CM | $344.80 | $431.00 | $262.00–$297.00 | 39% above | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 HC SREP F/E/N/L/MM 2.5 CM/< | $73.60 | $92.00 | $63.00–$92.00 | — | 20% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 PR REPR SUPERF WND FACE <2.5CM | $344.80 | $431.00 | $297.00–$431.00 | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 PR TANGENTIAL BIOPSY SKIN SINGLE LESION | $278.40 | $348.00 | $212.00–$348.00 | 45% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC TANGNTL BX SKIN SINGLE LES | $294.40 | $368.00 | $224.00–$368.00 | 54% above | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 PR TANGENTIAL BIOPSY SKIN SINGLE LESION | $278.40 | $348.00 | $240.00–$348.00 | — | 20% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 HC TANGNTL BX SKIN SINGLE LES | $294.40 | $368.00 | $253.00–$368.00 | — | 20% |
| Total knee replacement CPT 27447 PR TOTAL KNEE ARTHROPLASTY | $484.80 | $606.00 | $369.00–$606.00 | 88% below | 20% |
| Total knee replacement inpatient CPT 27447 PR TOTAL KNEE ARTHROPLASTY | $484.80 | $606.00 | $418.00–$606.00 | — | 20% |
| Trigger point injections, 1 or 2 muscles CPT 20552 PR INJECT TRIGGER POINT, 1 OR 2 | $131.20 | $164.00 | $100.00–$164.00 | 46% below | 20% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 PR INJECT TRIGGER POINT, 1 OR 2 | $131.20 | $164.00 | $113.00–$164.00 | — | 20% |
| Wart removal, up to 14 warts CPT 17110 HC DESTRUCT B9 LESION 1-14 | $45.60 | $57.00 | $34.00–$57.00 | 78% below | 20% |
| Wart removal, up to 14 warts CPT 17110 PR DESTRUCTION BENIGN LESIONS UP TO 14 | $292.00 | $365.00 | $222.00–$365.00 | 44% above | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 HC DESTRUCT B9 LESION 1-14 | $45.60 | $57.00 | $39.00–$57.00 | — | 20% |
| Wart removal, up to 14 warts inpatient CPT 17110 PR DESTRUCTION BENIGN LESIONS UP TO 14 | $292.00 | $365.00 | $251.00–$365.00 | — | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/< | $332.00 | $415.00 | $253.00–$415.00 | 21% below | 20% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 PR DEBRIDEMENT SUBCUTANEOUS TISSUE 1ST 20 SQ CM/< | $332.00 | $415.00 | $286.00–$415.00 | — | 20% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 PR TRANSFUSION BLOOD/BLOOD COMPONENTS | $95.20 | $119.00 | $72.00–$115.00 | 83% below | 20% |
| Blood transfusion (giving blood or blood components) CPT 36430 HC TRANSFUSION BLOOD OR COMPONENT PER UNIT | $818.40 | $1,023.00 | $624.00–$992.00 | 50% above | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 PR TRANSFUSION BLOOD/BLOOD COMPONENTS | $95.20 | $119.00 | $82.00–$119.00 | — | 20% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 HC TRANSFUSION BLOOD OR COMPONENT PER UNIT | $818.40 | $1,023.00 | $705.00–$1,023.00 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $47.20 | $59.00 | $35.00–$59.00 | 57% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI AIRWAY INHALATION TX SUBQ | $60.00 | $75.00 | $45.00–$75.00 | 46% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC MDI AIRWAY INHALATION TX INITIAL | $69.60 | $87.00 | $53.00–$87.00 | 37% below | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT SUBQ | $129.60 | $162.00 | $98.00–$162.00 | 17% above | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $47.20 | $59.00 | $40.00–$59.00 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI AIRWAY INHALATION TX SUBQ | $60.00 | $75.00 | $51.00–$75.00 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC MDI AIRWAY INHALATION TX INITIAL | $69.60 | $87.00 | $60.00–$87.00 | — | 20% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HC AIRWAY INHALATION TREATMENT SUBQ | $129.60 | $162.00 | $111.00–$162.00 | — | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 PR CRITICAL CARE, E/M 30-74 MINUTES | $535.20 | $669.00 | $408.00–$669.00 | 39% below | 20% |
| Critical care, first 30 to 74 minutes CPT 99291 HC CRITICAL CARE 30-74 MIN | $1,084.80 | $1,356.00 | $747.00–$1,315.00 | 24% above | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 PR CRITICAL CARE, E/M 30-74 MINUTES | $535.20 | $669.00 | $461.00–$669.00 | — | 20% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 HC CRITICAL CARE 30-74 MIN | $1,084.80 | $1,356.00 | $935.00–$1,356.00 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC 12 LEAD EKG; TRACING ONLY | $23.20 | $29.00 | $17.00–$20.00 | 85% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PR ELECTROCARDIOGRAM, TRACING | $90.40 | $113.00 | $68.00–$77.00 | 43% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 PBB 12 LEAD EKG; TRACING ONLY | $95.20 | $119.00 | $72.00–$82.00 | 40% below | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 HC 12 LEAD EKG; TRACING ONLY | $23.20 | $29.00 | $20.00–$29.00 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PR ELECTROCARDIOGRAM, TRACING | $90.40 | $113.00 | $77.00–$113.00 | — | 20% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 PBB 12 LEAD EKG; TRACING ONLY | $95.20 | $119.00 | $82.00–$119.00 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL 1 INIT ASSESS | $36.00 | $45.00 | $27.00–$43.00 | 47% below | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ED LEVEL 1 VISIT | $202.40 | $253.00 | $154.00–$245.00 | 200% above | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL 1 INIT ASSESS | $36.00 | $45.00 | $31.00–$45.00 | — | 20% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 HC ED LEVEL 1 VISIT | $202.40 | $253.00 | $174.00–$253.00 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL 2 INIT ASSESS | $60.00 | $75.00 | $45.00–$51.00 | 58% below | 20% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ED LEVEL 2 VISIT | $263.20 | $329.00 | $200.00–$227.00 | 84% above | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL 2 INIT ASSESS | $60.00 | $75.00 | $51.00–$75.00 | — | 20% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 HC ED LEVEL 2 VISIT | $263.20 | $329.00 | $227.00–$329.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL 3 INIT ASSESS | $88.00 | $110.00 | $67.00–$75.00 | 68% below | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ED LEVEL 3 VISIT | $413.60 | $517.00 | $315.00–$356.00 | 48% above | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL 3 INIT ASSESS | $88.00 | $110.00 | $75.00–$110.00 | — | 20% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 HC ED LEVEL 3 VISIT | $413.60 | $517.00 | $356.00–$517.00 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL 4 INIT ASSESS | $116.80 | $146.00 | $89.00–$100.00 | 78% below | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ED LEVEL 4 VISIT | $550.40 | $688.00 | $419.00–$474.00 | 5% above | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL 4 INIT ASSESS | $116.80 | $146.00 | $100.00–$146.00 | — | 20% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 HC ED LEVEL 4 VISIT | $550.40 | $688.00 | $474.00–$688.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL 5 INIT ASSESS | $145.60 | $182.00 | $111.00–$182.00 | 81% below | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ED LEVEL 5 VISIT | $808.00 | $1,010.00 | $616.00–$979.00 | 6% above | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL 5 INIT ASSESS | $145.60 | $182.00 | $125.00–$182.00 | — | 20% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 HC ED LEVEL 5 VISIT | $808.00 | $1,010.00 | $696.00–$1,010.00 | — | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 PBB CVSLR STRESS TEST; TRACING | $553.60 | $692.00 | $422.00–$692.00 | 18% below | 20% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 HC CVSLR STRESS TEST; TRACING | $692.00 | $865.00 | $527.00–$839.00 | 3% above | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 PBB CVSLR STRESS TEST; TRACING | $553.60 | $692.00 | $477.00–$692.00 | — | 20% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 HC CVSLR STRESS TEST; TRACING | $692.00 | $865.00 | $596.00–$865.00 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PR IV INFUSION, HYDRATION, 31-60 MIN | $136.80 | $171.00 | $104.00–$117.00 | 51% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC HYDRATION IV INFUSION INIT 31-60 MIN | $145.60 | $182.00 | $111.00–$125.00 | 48% below | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PR IV INFUSION, HYDRATION, 31-60 MIN | $136.80 | $171.00 | $117.00–$171.00 | — | 20% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HC HYDRATION IV INFUSION INIT 31-60 MIN | $145.60 | $182.00 | $125.00–$182.00 | — | 20% |
| IV infusion of a medicine, first hour CPT 96365 HC THER/PROPH/DX IV INF INIT UP TO 1HR | $242.40 | $303.00 | $184.00–$209.00 | 23% below | 20% |
| IV infusion of a medicine, first hour inpatient CPT 96365 HC THER/PROPH/DX IV INF INIT UP TO 1HR | $242.40 | $303.00 | $209.00–$303.00 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC THER/PROPH/DIAG INJ SC/IM | $60.00 | $75.00 | $45.00–$51.00 | 30% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PR INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $78.40 | $98.00 | $59.00–$67.00 | 8% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 PBB THER/PROPH/DIAG INJ SC/IM | $81.60 | $102.00 | $62.00–$70.00 | 4% below | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 HC THER/PROPH/DIAG INJ SC/IM | $60.00 | $75.00 | $51.00–$75.00 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PR INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT | $78.40 | $98.00 | $67.00–$98.00 | — | 20% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PBB THER/PROPH/DIAG INJ SC/IM | $81.60 | $102.00 | $70.00–$102.00 | — | 20% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION | $185.60 | $232.00 | $141.00–$232.00 | 27% below | 20% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PR PSYCHIATRIC DIAGNOSTIC EVALUATION | $185.60 | $232.00 | $160.00–$232.00 | — | 20% |
| Neuromuscular re-education, 15 minutes CPT 97112 HC NEUROMUSCLE RE-EDUC EA 15M | $76.80 | $96.00 | $58.00–$96.00 | 16% below | 20% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 HC NEUROMUSCLE RE-EDUC EA 15M | $76.80 | $96.00 | $66.00–$96.00 | — | 20% |
| New patient office visit, about 30 minutes CPT 99203 HC O/P VISIT NEW LEVEL 3 | $37.60 | $47.00 | $28.00–$47.00 | 77% below | 20% |
| New patient office visit, about 30 minutes CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $203.20 | $254.00 | $154.00–$254.00 | 24% above | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC O/P VISIT NEW LEVEL 3 | $37.60 | $47.00 | $32.00–$47.00 | — | 20% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $203.20 | $254.00 | $175.00–$254.00 | — | 20% |
| New patient office visit, about 45 minutes CPT 99204 HC O/P VISIT NEW LEVEL 4 | $58.40 | $73.00 | $44.00–$73.00 | 76% below | 20% |
| New patient office visit, about 45 minutes CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $260.00 | $325.00 | $198.00–$325.00 | 6% above | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC O/P VISIT NEW LEVEL 4 | $58.40 | $73.00 | $50.00–$73.00 | — | 20% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $260.00 | $325.00 | $224.00–$325.00 | — | 20% |
| New patient office visit, about 60 minutes CPT 99205 HC O/P VISIT NEW LEVEL 5 | $70.40 | $88.00 | $53.00–$88.00 | 78% below | 20% |
| New patient office visit, about 60 minutes CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $313.60 | $392.00 | $239.00–$392.00 | 2% below | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC O/P VISIT NEW LEVEL 5 | $70.40 | $88.00 | $60.00–$88.00 | — | 20% |
| New patient office visit, about 60 minutes inpatient CPT 99205 PR OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $313.60 | $392.00 | $270.00–$392.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC O/P VISIT NEW LEVEL 2 | $26.40 | $33.00 | $20.00–$33.00 | 74% below | 20% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | $146.40 | $183.00 | $111.00–$183.00 | 45% above | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 HC O/P VISIT NEW LEVEL 2 | $26.40 | $33.00 | $22.00–$33.00 | — | 20% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PR OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES | $146.40 | $183.00 | $126.00–$183.00 | — | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 HC INIT NUTRITION THERAPY; EACH 15M | $52.00 | $65.00 | $39.00–$65.00 | 22% above | 20% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 HC INIT NUTRITION THERAPY; EACH 15M | $52.00 | $65.00 | $44.00–$65.00 | — | 20% |
| Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX | $121.60 | $152.00 | $92.00–$152.00 | 32% below | 20% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 HC OT EVAL LOW COMPLEX | $121.60 | $152.00 | $104.00–$152.00 | — | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX | $117.60 | $147.00 | $89.00–$147.00 | 45% below | 20% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 HC PT EVAL HIGH COMPLEX | $117.60 | $147.00 | $101.00–$147.00 | — | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX | $117.60 | $147.00 | $89.00–$147.00 | 40% below | 20% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 HC PT EVAL LOW COMPLEX | $117.60 | $147.00 | $101.00–$147.00 | — | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX | $117.60 | $147.00 | $89.00–$147.00 | 41% below | 20% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 HC PT EVAL MOD COMPLEX | $117.60 | $147.00 | $101.00–$147.00 | — | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC MANUAL THERAPY EA 15M | $88.00 | $110.00 | $67.00–$110.00 | 9% below | 20% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 HC MANUAL THERAPY EA 15M | $88.00 | $110.00 | $75.00–$110.00 | — | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC THERAP EXERCISE ROM EA 15M | $73.60 | $92.00 | $56.00–$92.00 | 19% below | 20% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC THERAP EXERCISE ROM EA 15M | $73.60 | $92.00 | $63.00–$92.00 | — | 20% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PR PREVENTIVE VISIT,NEW,18-39 | $235.20 | $294.00 | $179.00–$294.00 | 20% above | 20% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PR PREVENTIVE VISIT,NEW,18-39 | $235.20 | $294.00 | $202.00–$294.00 | — | 20% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PR PREVENTIVE VISIT,NEW,40-64 | $276.80 | $346.00 | $211.00–$346.00 | 34% above | 20% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PR PREVENTIVE VISIT,NEW,40-64 | $276.80 | $346.00 | $238.00–$346.00 | — | 20% |
| Preventive checkup, new patient aged 65 or older CPT 99387 PR PREVENTIVE VISIT,NEW,65 & OVER | $299.20 | $374.00 | $228.00–$374.00 | 21% above | 20% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PR PREVENTIVE VISIT,NEW,65 & OVER | $299.20 | $374.00 | $258.00–$374.00 | — | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 HC PREV REEVAL EST AGE 18-39 YRS | $42.40 | $53.00 | $32.00–$53.00 | 74% below | 20% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PR PREVENTIVE VISIT,EST,18-39 | $200.80 | $251.00 | $153.00–$251.00 | 22% above | 20% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 HC PREV REEVAL EST AGE 18-39 YRS | $42.40 | $53.00 | $36.00–$53.00 | — | 20% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PR PREVENTIVE VISIT,EST,18-39 | $200.80 | $251.00 | $173.00–$251.00 | — | 20% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PR PREVENTIVE VISIT,EST,40-64 | $210.40 | $263.00 | $160.00–$263.00 | 13% above | 20% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PR PREVENTIVE VISIT,EST,40-64 | $210.40 | $263.00 | $181.00–$263.00 | — | 20% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PR PREVENTIVE VISIT,EST,65 & OVER | $224.00 | $280.00 | $170.00–$280.00 | 5% above | 20% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PR PREVENTIVE VISIT,EST,65 & OVER | $224.00 | $280.00 | $193.00–$280.00 | — | 20% |
| Psychiatric evaluation with medical services CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $257.60 | $322.00 | $196.00–$322.00 | 10% above | 20% |
| Psychiatric evaluation with medical services inpatient CPT 90792 PR PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES | $257.60 | $322.00 | $222.00–$322.00 | — | 20% |
| Psychotherapy session, 30 minutes CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $128.00 | $160.00 | $97.00–$160.00 | 25% below | 20% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PR PSYCHOTHERAPY W/PATIENT 30 MINUTES | $128.00 | $160.00 | $110.00–$160.00 | — | 20% |
| Psychotherapy session, 45 minutes CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $140.80 | $176.00 | $107.00–$176.00 | 37% below | 20% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PR PSYCHOTHERAPY W/PATIENT 45 MINUTES | $140.80 | $176.00 | $121.00–$176.00 | — | 20% |
| Psychotherapy session, 60 minutes CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $156.80 | $196.00 | $119.00–$196.00 | 45% below | 20% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PR PSYCHOTHERAPY W/PATIENT 60 MINUTES | $156.80 | $196.00 | $135.00–$196.00 | — | 20% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $69.60 | $87.00 | $53.00–$87.00 | 89% above | 20% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES | $69.60 | $87.00 | $60.00–$87.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 HC O/P VISIT EST LEVEL 5 (40-54 MIN) | $53.60 | $67.00 | $40.00–$67.00 | 77% below | 20% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $252.00 | $315.00 | $192.00–$315.00 | 7% above | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 HC O/P VISIT EST LEVEL 5 (40-54 MIN) | $53.60 | $67.00 | $46.00–$67.00 | — | 20% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PR OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN | $252.00 | $315.00 | $217.00–$315.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 HC O/P VISIT EST LEVEL 3 (20-29 MIN) | $25.60 | $32.00 | $19.00–$32.00 | 78% below | 20% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $140.80 | $176.00 | $107.00–$176.00 | 19% above | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 HC O/P VISIT EST LEVEL 3 (20-29 MIN) | $25.60 | $32.00 | $22.00–$32.00 | — | 20% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN | $140.80 | $176.00 | $121.00–$176.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 HC O/P VISIT EST LEVEL 4 (30-39 MIN) | $40.80 | $51.00 | $31.00–$51.00 | 75% below | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $194.40 | $243.00 | $148.00–$243.00 | 17% above | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 HC O/P VISIT EST LEVEL 4 (30-39 MIN) | $40.80 | $51.00 | $35.00–$51.00 | — | 20% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN | $194.40 | $243.00 | $167.00–$243.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 HC O/P VISIT EST LEVEL 2 (10-19 MIN) | $15.20 | $19.00 | $11.00–$19.00 | 81% below | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN | $88.80 | $111.00 | $67.00–$111.00 | 11% above | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 HC O/P VISIT EST LEVEL 2 (10-19 MIN) | $15.20 | $19.00 | $13.00–$19.00 | — | 20% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PR OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN | $88.80 | $111.00 | $76.00–$111.00 | — | 20% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $240.80 | $301.00 | $183.00–$301.00 | 19% above | 20% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PR OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $240.80 | $301.00 | $207.00–$301.00 | — | 20% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $353.60 | $442.00 | $269.00–$442.00 | 24% above | 20% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PR OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $353.60 | $442.00 | $304.00–$442.00 | — | 20% |
| Speech and language evaluation CPT 92523 HC EVAL SPEECH SOUND LANG COMPREHEN | $274.40 | $343.00 | $209.00–$343.00 | 10% below | 20% |
| Speech and language evaluation inpatient CPT 92523 HC EVAL SPEECH SOUND LANG COMPREHEN | $274.40 | $343.00 | $236.00–$343.00 | — | 20% |
| Speech therapy session, individual CPT 92507 HC SPEECH/HEARING THERAPY | $192.00 | $240.00 | $146.00–$240.00 | 12% below | 20% |
| Speech therapy session, individual inpatient CPT 92507 HC SPEECH/HEARING THERAPY | $192.00 | $240.00 | $165.00–$240.00 | — | 20% |
| Spirometry (breathing test) CPT 94010 HC SPIROMETRY | $94.40 | $118.00 | $71.00–$118.00 | 49% below | 20% |
| Spirometry (breathing test) CPT 94010 PR BREATHING CAPACITY TEST | $97.60 | $122.00 | $74.00–$122.00 | 47% below | 20% |
| Spirometry (breathing test) inpatient CPT 94010 HC SPIROMETRY | $94.40 | $118.00 | $81.00–$118.00 | — | 20% |
| Spirometry (breathing test) inpatient CPT 94010 PR BREATHING CAPACITY TEST | $97.60 | $122.00 | $84.00–$122.00 | — | 20% |
| Spirometry before and after a bronchodilator CPT 94060 PR EVAL OF BRONCHOSPASM | $140.80 | $176.00 | $107.00–$170.00 | 64% below | 20% |
| Spirometry before and after a bronchodilator CPT 94060 HC BRONCHOSPASM PRE & POST BD | $148.00 | $185.00 | $112.00–$179.00 | 62% below | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 PR EVAL OF BRONCHOSPASM | $140.80 | $176.00 | $121.00–$176.00 | — | 20% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 HC BRONCHOSPASM PRE & POST BD | $148.00 | $185.00 | $127.00–$185.00 | — | 20% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 HC THERAPEUTIC ACTIVITY DIR EA 15M | $70.40 | $88.00 | $53.00–$88.00 | 31% below | 20% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 HC THERAPEUTIC ACTIVITY DIR EA 15M | $70.40 | $88.00 | $60.00–$88.00 | — | 20% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY B/E/H/J/N/P/S1/R/G1/M2 | $301.60 | $377.00 | $229.00–$377.00 | 53% above | 20% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY B/E/H/J/N/P/S1/R/G1/M2 | $301.60 | $377.00 | $260.00–$377.00 | — | 20% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Iowa | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 PR IM INJ SARS-COV2 COVID VAC,MRNA-LNP, SPIKE PROTEIN, 30 MCG/0.3 ML DOSE | $128.00 | $160.00 | $97.00–$155.00 | 10% below | 20% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 PR IM INJ SARS-COV2 COVID VAC,MRNA-LNP, SPIKE PROTEIN, 30 MCG/0.3 ML DOSE | $128.00 | $160.00 | $110.00–$160.00 | — | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE | $158.40 | $198.00 | $120.00–$192.00 | 1% below | 20% |
| Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE | $158.40 | $198.00 | $136.00–$198.00 | — | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $39.20 | $49.00 | $29.00–$37.00 | 81% above | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY | $127.00 | $127.00 | $77.00–$96.00 | 486% above | — |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE | $39.20 | $49.00 | $33.00–$49.00 | — | 20% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY | $127.00 | $127.00 | $87.00–$127.00 | — | — |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE | $372.00 | $465.00 | $283.00–$451.00 | 27% above | 20% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PR 9VHPV VACC 2/3 DOSE SCHED IM USE | $372.00 | $465.00 | $320.00–$465.00 | — | 20% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HC IM ADULT HEPA-HEPB | $224.00 | $280.00 | $170.00–$271.00 | 79% above | 20% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 HC IM ADULT HEPA-HEPB | $224.00 | $280.00 | $193.00–$280.00 | — | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE | $397.60 | $497.00 | $303.00–$482.00 | 210% above | 20% |
| Hepatitis A vaccine, adult dose CPT 90632 PBB HEPA VACCINE ADULT IM | $416.80 | $521.00 | $317.00–$505.00 | 225% above | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE | $397.60 | $497.00 | $342.00–$497.00 | — | 20% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 PBB HEPA VACCINE ADULT IM | $416.80 | $521.00 | $359.00–$521.00 | — | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | $149.60 | $187.00 | $114.00–$181.00 | 35% above | 20% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE | $149.60 | $187.00 | $129.00–$187.00 | — | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PBB IIV NO PRSV INCREASED AG IM | $52.00 | $65.00 | $39.00–$63.00 | 35% below | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY | $73.40 | $73.40 | $44.00–$71.00 | 8% below | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG COUNT IM | $198.40 | $248.00 | $151.00–$240.00 | 149% above | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PBB IIV NO PRSV INCREASED AG IM | $52.00 | $65.00 | $44.00–$65.00 | — | 20% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY | $73.40 | $73.40 | $50.00–$73.00 | — | — |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 PR IIV VACCINE PRESERV FREE INCREASED AG COUNT IM | $198.40 | $248.00 | $171.00–$248.00 | — | 20% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 PR MMR VIRUS IMMUNIZATION, SUBCUT | $348.80 | $436.00 | $265.00–$422.00 | 233% above | 20% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PR MMR VIRUS IMMUNIZATION, SUBCUT | $348.80 | $436.00 | $300.00–$436.00 | — | 20% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE | $186.40 | $233.00 | $142.00–$226.00 | 20% below | 20% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE | $186.40 | $233.00 | $160.00–$233.00 | — | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM | $228.00 | $285.00 | $173.00–$276.00 | 7% below | 20% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM | $228.00 | $285.00 | $196.00–$285.00 | — | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE | $506.40 | $633.00 | $386.00–$614.00 | 1% above | 20% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PR PCV20 VACCINE FOR INTRAMUSCULAR USE | $506.40 | $633.00 | $436.00–$633.00 | — | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PBB PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ/IM | $122.40 | $153.00 | $93.00–$148.00 | 44% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE | $122.40 | $153.00 | $93.00–$148.00 | 44% below | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PBB PNEUMOCOCCAL VACCINE 23 VALENT >2 YRS SQ/IM | $122.40 | $153.00 | $105.00–$153.00 | — | 20% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE | $122.40 | $153.00 | $105.00–$153.00 | — | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $579.20 | $724.00 | $441.00–$702.00 | 16% below | 20% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 PR RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE | $579.20 | $724.00 | $499.00–$724.00 | — | 20% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $305.60 | $382.00 | $233.00–$370.00 | 2% above | 20% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 PR RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE | $305.60 | $382.00 | $263.00–$382.00 | — | 20% |
| Rabies vaccine, one dose CPT 90675 PR RABIES VACCINE, IM | $418.40 | $523.00 | $319.00–$507.00 | 40% below | 20% |
| Rabies vaccine, one dose inpatient CPT 90675 PR RABIES VACCINE, IM | $418.40 | $523.00 | $360.00–$523.00 | — | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX | $255.20 | $319.00 | $194.00–$309.00 | 8% above | 20% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX | $255.20 | $319.00 | $220.00–$319.00 | — | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE | $128.00 | $160.00 | $97.00–$155.00 | 114% above | 20% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PR TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE | $128.00 | $160.00 | $110.00–$160.00 | — | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PR TDAP VACCINE >7 YO, IM | $136.80 | $171.00 | $104.00–$117.00 | 63% above | 20% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PR TDAP VACCINE >7 YO, IM | $136.80 | $171.00 | $117.00–$171.00 | — | 20% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PR TYPHOID VACCINE, IM | $127.20 | $159.00 | $96.00–$154.00 | 6% above | 20% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PR TYPHOID VACCINE, IM | $127.20 | $159.00 | $109.00–$159.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $80.00 | $100.00 | $61.00–$100.00 | 129% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMMUNIZATION ADM 1 VACCINE | $80.00 | $100.00 | $61.00–$100.00 | 129% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PBB IMMUNIZATION ADM 1 VACCINE | $84.00 | $105.00 | $64.00–$105.00 | 140% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN INFLUENZA VIRUS VACCINE | $84.00 | $105.00 | $64.00–$105.00 | 140% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC ADMIN PNEUMONIA VACCINE | $84.00 | $105.00 | $64.00–$105.00 | 140% above | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY | $97.00 | $97.00 | $59.00–$97.00 | 177% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY | $101.00 | $101.00 | $61.00–$101.00 | 189% above | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID | $80.00 | $100.00 | $69.00–$100.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC IMMUNIZATION ADM 1 VACCINE | $80.00 | $100.00 | $69.00–$100.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PBB IMMUNIZATION ADM 1 VACCINE | $84.00 | $105.00 | $72.00–$105.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN PNEUMONIA VACCINE | $84.00 | $105.00 | $72.00–$105.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HC ADMIN INFLUENZA VIRUS VACCINE | $84.00 | $105.00 | $72.00–$105.00 | — | 20% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA VIRUS VACC SPLIT PF 0.5 ML IM SUSY | $97.00 | $97.00 | $66.00–$97.00 | — | — |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA VAC SPLIT HIGH-DOSE 0.5 ML IM SUSY | $101.00 | $101.00 | $69.00–$101.00 | — | — |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PR IMMUNIZ,ADMIN,EACH ADDL | $40.80 | $51.00 | $31.00–$51.00 | 42% above | 20% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PR IMMUNIZ,ADMIN,EACH ADDL | $40.80 | $51.00 | $35.00–$51.00 | — | 20% |
Source file: https://www.storymedical.org/filesimages/charge-masters/426037754_Story-County-Hospital_StandardCharges.csv