Hospital Somerset, PA

Chan Soon-Shiong Medical Center at Windber

Chan Soon-Shiong Medical Center at Windber in Windber, PA publishes cash prices for 305 common procedures listed here, from its own machine-readable price file updated Feb 25, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Pennsylvania median for 219 of 291 procedures and above it for 69. By typical cash price it ranks #20 of 88 Pennsylvania hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

600 Somerset Ave, Windber, PA 15963 Collected Sep 27, 2026 Source price file (814) 467-3000

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 390112 · 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 3 actions for a hospital named Chan Soon-Shiong Medical Center at Windber in Windber, PA:

Oct 3, 2024 Warning notice
Jan 14, 2025 Corrective action plan requested
Feb 14, 2025 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. 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 Pennsylvania	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 ANKLE MIN 3 VIEWS BILAT	$229.50	$270.00	$16.89–$162.00	—	15%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 ANKLE MIN 3 VIEWS BILAT	$229.50	$270.00	—	—	15%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US PAS SINGLE LEVEL	$399.50	$470.00	$38.97–$282.00	at median	15%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US PAS SINGLE LEVEL	$399.50	$470.00	—	—	15%
Barium swallow (esophagus X-ray with contrast) CPT 74220 BA SWALLOW-SINGLE CONTRAST	$350.21	$412.01	$23.63–$247.21	18% below	15%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 BA SWALLOW-SINGLE CONTRAST	$350.21	$412.01	—	—	15%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$952.00	$1,120.00	$64.58–$672.00	23% below	15%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$952.00	$1,120.00	—	—	15%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST UNILAT COMPLETE	$191.25	$225.00	$56.10–$135.00	63% below	15%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST UNILAT COMPLETE	$191.25	$225.00	—	—	15%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST ENHANCED	$871.25	$1,025.00	$182.60–$729.98	39% below	15%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST-PE ENHANCED	$871.25	$1,025.00	$182.60–$729.98	39% below	15%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST-PE ENHANCED	$871.25	$1,025.00	—	—	15%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST ENHANCED	$871.25	$1,025.00	—	—	15%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT/ABD PELVIS UNENHANCED	$510.00	$600.00	$106.12–$360.00	67% below	15%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT/ABD PELVIS UNENHANCED	$510.00	$600.00	—	—	15%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS ENHANCED	$807.50	$950.00	$202.37–$570.00	66% below	15%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS ENHANCED	$807.50	$950.00	—	—	15%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS UNEN/ENHANCED	$1,105.00	$1,300.00	$267.44–$780.00	59% below	15%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS UNEN/ENHANCED	$1,105.00	$1,300.00	—	—	15%
CT scan of the abdomen with contrast CPT 74160 CT ABD ENHANCED	$807.50	$950.00	$94.50–$839.88	43% below	15%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD ENHANCED	$807.50	$950.00	—	—	15%
CT scan of the abdomen without contrast CPT 74150 CT ABD UNENHANCED	$580.55	$683.00	$81.38–$683.00	46% below	15%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD UNENHANCED	$580.55	$683.00	—	—	15%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLA-FACIAL UN	$479.26	$563.84	$81.38–$563.84	49% below	15%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLA-FACIAL UN	$479.26	$563.84	—	—	15%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD UNENHANCED	$463.27	$545.02	$81.38–$545.02	46% below	15%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD UNENHANCED	$463.27	$545.02	—	—	15%
CT scan of the head with contrast CPT 70460 CT HEAD ENHANCED	$558.65	$657.24	$84.00–$657.24	57% below	15%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD ENHANCED	$558.65	$657.24	—	—	15%
CT scan of the head without and with contrast CPT 70470 CT HEAD ENHA & UNENH	$672.42	$791.08	$105.00–$791.08	48% below	15%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD ENHA & UNENH	$672.42	$791.08	—	—	15%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE UNEN	$580.98	$683.50	$92.50–$683.50	43% below	15%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE UNEN	$580.98	$683.50	—	—	15%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE UNENHA	$580.65	$683.12	$87.25–$683.12	40% below	15%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE UNENHA	$580.65	$683.12	—	—	15%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS ENHANCED	$839.80	$988.00	$90.83–$823.89	41% below	15%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS ENHANCED	$839.80	$988.00	—	—	15%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US CAROTID DUPLEX BILAT	$634.10	$746.00	$90.06–$447.60	—	15%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US CAROTID DUPLEX BILAT	$634.10	$746.00	—	—	15%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS	$136.00	$160.00	$15.59–$96.00	41% below	15%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS	$136.00	$160.00	—	—	15%
Chest X-ray, single view CPT 71045 CHEST 1 VIEW	$125.80	$148.00	$8.52–$88.80	19% below	15%
Chest X-ray, single view inpatient CPT 71045 CHEST 1 VIEW	$125.80	$148.00	—	—	15%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERI COMPL	$309.40	$364.00	$51.45–$298.91	54% below	15%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERI COMPL	$309.40	$364.00	—	—	15%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA AXIAL SKELETON	$365.50	$430.00	$54.54–$258.00	39% above	15%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA AXIAL SKELETON	$365.50	$430.00	—	—	15%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST UNENHANCED	$581.66	$684.31	$87.25–$684.31	45% below	15%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST UNENHANCED	$581.66	$684.31	—	—	15%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST ENHANCED	$667.83	$785.68	$91.88–$785.68	49% below	15%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST ENHANCED	$667.83	$785.68	—	—	15%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAG BILAT W/WO CAD	$340.00	$400.00	$87.74–$240.00	—	15%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAG BILAT W/WO CAD	$340.00	$400.00	—	—	15%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US DUP LOW EXT ART BIL	$561.00	$660.00	$77.26–$396.00	32% below	15%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US DUP LOW EXT ART BIL	$561.00	$660.00	—	—	15%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DUPLEX BILAT	$595.85	$701.00	$85.58–$420.60	—	15%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DUPLEX BILAT	$595.85	$701.00	—	—	15%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO COMP W/DOPP, COLOR FLO	$1,320.05	$1,553.00	$103.05–$931.80	29% below	15%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO COMP W/DOPP, COLOR FLO	$1,320.05	$1,553.00	—	—	15%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HIDA NON RX	$1,138.15	$1,339.00	$225.19–$803.40	7% below	15%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HIDA NON RX	$1,138.15	$1,339.00	—	—	15%
Knee X-ray, 3 views both sides CPT 73562 KNEES 3 VIEWS BILATERAL	$229.50	$270.00	$17.32–$162.00	—	15%
Knee X-ray, 3 views inpatient both sides CPT 73562 KNEES 3 VIEWS BILATERAL	$229.50	$270.00	—	—	15%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED	$174.46	$205.25	$39.38–$205.25	68% below	15%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED	$174.46	$205.25	—	—	15%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG CA SCREENING	$697.85	$821.00	$77.05–$492.60	176% above	15%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE LUNG CA SCREENING	$697.85	$821.00	—	—	15%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BREAST BILAT W/WO	$1,530.00	$1,800.00	$226.66–$1,080.00	—	15%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BREAST BILAT W/WO	$1,530.00	$1,800.00	—	—	15%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/0	$1,030.96	$1,212.89	$237.03–$1,212.89	39% below	15%
MRI of the abdomen without contrast CPT 74181 MRCP	$1,031.05	$1,213.00	$237.03–$1,213.00	39% below	15%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/0	$1,030.96	$1,212.89	—	—	15%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP	$1,031.05	$1,213.00	—	—	15%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRCP W AND W/O CONTRAST	$1,098.66	$1,292.54	$367.30–$1,292.54	60% below	15%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO	$1,213.80	$1,428.00	$367.30–$1,428.00	55% below	15%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRCP W AND W/O CONTRAST	$1,098.66	$1,292.54	—	—	15%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO	$1,213.80	$1,428.00	—	—	15%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O	$1,016.62	$1,196.02	$237.03–$1,196.02	24% below	15%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O	$1,016.62	$1,196.02	—	—	15%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO	$2,151.68	$2,531.39	$282.45–$2,531.39	20% below	15%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO	$2,151.68	$2,531.39	—	—	15%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR W/O	$1,099.96	$1,294.07	$196.56–$1,294.07	35% below	15%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR W/O	$1,099.96	$1,294.07	—	—	15%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR W/WO	$2,141.82	$2,519.79	$282.45–$2,519.79	21% below	15%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR W/WO	$2,141.82	$2,519.79	—	—	15%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC W/O	$1,113.77	$1,310.32	$196.56–$1,310.32	36% below	15%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC W/O	$1,113.77	$1,310.32	—	—	15%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL W/WO	$2,164.13	$2,546.04	$282.45–$2,546.04	17% below	15%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL W/WO	$2,164.13	$2,546.04	—	—	15%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL W/O	$1,030.40	$1,212.23	$237.03–$1,212.23	40% below	15%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL W/O	$1,030.40	$1,212.23	—	—	15%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO	$985.15	$1,159.00	$294.26–$1,159.00	64% below	15%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO	$985.15	$1,159.00	—	—	15%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O	$878.30	$1,033.29	$237.03–$1,033.29	49% below	15%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O	$878.30	$1,033.29	—	—	15%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 SPECT MYO PERF MULTI	$2,397.85	$2,821.00	$292.26–$1,692.60	36% below	15%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 SPECT MYO PERF MULTI	$2,397.85	$2,821.00	—	—	15%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BCC PELVIS LIMITED	$170.00	$200.00	$19.95–$148.79	58% below	15%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED	$170.00	$200.00	$19.95–$148.79	58% below	15%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED	$170.00	$200.00	—	—	15%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BCC PELVIS LIMITED	$170.00	$200.00	—	—	15%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMPLETE	$280.50	$330.00	$48.83–$238.66	46% below	15%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US BCC PELVIS COMPLETE	$280.50	$330.00	$48.83–$238.66	46% below	15%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIC ULTRASOUND	$397.80	$468.00	$48.83–$280.80	23% below	15%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US BCC PELVIS COMPLETE	$280.50	$330.00	—	—	15%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMPLETE	$280.50	$330.00	—	—	15%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIC ULTRASOUND	$397.80	$468.00	—	—	15%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG 2/3 TRIMESTER	$329.80	$388.00	$48.83–$347.64	41% below	15%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG 2/3 TRIMESTER	$329.80	$388.00	—	—	15%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG 1 TRIMESTER	$332.35	$391.00	$40.31–$350.40	30% below	15%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG 1 TRIMESTER	$332.35	$391.00	—	—	15%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANCY LIMITED	$193.80	$228.00	$40.95–$228.00	55% below	15%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANCY LIMITED	$193.80	$228.00	—	—	15%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCR BILAT W/WO CAD	$297.50	$350.00	$72.36–$210.00	—	15%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCR RT W/WO CAD	$280.50	$330.00	$72.36–$198.00	15% above	15%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCR LT W/WO CAD	$280.50	$330.00	$72.36–$198.00	15% above	15%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCR BILAT W/WO CAD	$297.50	$350.00	—	—	15%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCR LT W/WO CAD	$280.50	$330.00	—	—	15%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCR RT W/WO CAD	$280.50	$330.00	—	—	15%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 SHOULDER MIN 2 VIEW BILAT	$237.15	$279.00	$17.32–$167.40	—	15%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 SHOULDER MIN 2 VIEW BILAT	$237.15	$279.00	—	—	15%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM SWALLOW MODIFIED	$286.45	$337.00	$29.40–$202.20	35% below	15%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM SWALLOW MODIFIED	$286.45	$337.00	—	—	15%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$336.60	$396.00	$48.83–$250.26	15% below	15%
Transvaginal pelvic ultrasound CPT 76830 US BCC PELVIS TRANSVAGINL	$336.60	$396.00	$48.83–$250.26	15% below	15%
Transvaginal pelvic ultrasound CPT 76830 US BCC PELVIS TRANSVAGINAL	$336.60	$396.00	$48.83–$250.26	15% below	15%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$336.60	$396.00	—	—	15%
Transvaginal pelvic ultrasound inpatient CPT 76830 US BCC PELVIS TRANSVAGINL	$336.60	$396.00	—	—	15%
Transvaginal pelvic ultrasound inpatient CPT 76830 US BCC PELVIS TRANSVAGINAL	$336.60	$396.00	—	—	15%
Transvaginal ultrasound during pregnancy CPT 76817 US PREGNANCY TRANSVAGINAL	$352.75	$415.00	$55.68–$362.15	29% below	15%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PREGNANCY TRANSVAGINAL	$352.75	$415.00	—	—	15%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE	$234.87	$276.32	$60.38–$276.32	64% below	15%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE	$234.87	$276.32	—	—	15%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$362.10	$426.00	$46.20–$255.60	35% below	15%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$362.10	$426.00	—	—	15%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD/NECK	$170.00	$200.00	$53.53–$200.00	58% below	15%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD/NECK	$170.00	$200.00	—	—	15%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI W/OR WO KUB NO AIR	$354.09	$416.58	$40.95–$249.95	37% below	15%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 BA SWALLOW LAP BAND	$354.45	$417.00	$40.95–$250.20	37% below	15%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI W/OR WO KUB NO AIR	$354.09	$416.58	—	—	15%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 BA SWALLOW LAP BAND	$354.45	$417.00	—	—	15%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 WRIST MIN 3 VIEWS BILAT	$192.95	$227.00	$12.07–$136.20	—	15%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 WRIST MIN 3 VIEWS BILAT	$192.95	$227.00	—	—	15%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1 VIEW	$125.80	$148.00	$14.46–$88.80	47% below	15%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1 VIEW	$125.80	$148.00	—	—	15%
X-ray of the ankle, 2 views both sides CPT 73600 ANKLE 2 VIEWS BILATERAL	$188.70	$222.00	$12.07–$133.20	—	15%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 ANKLE 2 VIEWS BILATERAL	$188.70	$222.00	—	—	15%
X-ray of the finger(s), 2 or more views both sides CPT 73140 FINGER(S) MIN 2V BILAT	$188.70	$222.00	$9.45–$133.20	—	15%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 FINGER(S) MIN 2V BILAT	$188.70	$222.00	—	—	15%
X-ray of the foot, 2 views both sides CPT 73620 FOOT LIMITED 2 VIEW BILAT	$188.70	$222.00	$10.50–$133.20	—	15%
X-ray of the foot, 2 views inpatient both sides CPT 73620 FOOT LIMITED 2 VIEW BILAT	$188.70	$222.00	—	—	15%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 FOOT MIN 3 VIEWS BILAT	$229.50	$270.00	$12.07–$162.00	—	15%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 FOOT MIN 3 VIEWS BILAT	$229.50	$270.00	—	—	15%
X-ray of the hand, 3 or more views both sides CPT 73130 HAND MIN 3 VIEWS BILAT	$280.50	$330.00	$12.07–$198.00	—	15%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 HAND MIN 3 VIEWS BILAT	$280.50	$330.00	—	—	15%
X-ray of the knee, 1 or 2 views both sides CPT 73560 KNEE 1-2 VIEWS BILAT	$188.70	$222.00	$17.32–$133.20	—	15%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 KNEE 1-2 VIEWS BILAT	$188.70	$222.00	—	—	15%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SPINE LUMBAR 2-3 VIEWS	$174.46	$205.25	$22.06–$123.15	34% below	15%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SPINE LUMBAR 2-3 VIEWS	$174.46	$205.25	—	—	15%
X-ray of the lower back, 4 or more views CPT 72110 SPINE LUMBAR MIN 4 VIEWS	$187.00	$220.00	$23.63–$137.08	46% below	15%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SPINE LUMBAR MIN 4 VIEWS	$187.00	$220.00	—	—	15%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SPINE THOR 2 VIEWS	$174.46	$205.25	$21.20–$123.15	51% below	15%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SPINE THOR 2 VIEWS	$174.46	$205.25	—	—	15%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 VIEWS	$125.80	$148.00	$12.07–$88.80	51% below	15%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 VIEWS	$125.80	$148.00	—	—	15%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SPINE CERVICAL 2-3 VIEWS	$148.75	$175.00	$17.32–$105.00	47% below	15%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SPINE CERVICAL 2-3 VIEWS	$148.75	$175.00	—	—	15%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 VIEWS	$174.46	$205.25	$10.50–$123.15	34% below	15%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 VIEWS	$174.46	$205.25	—	—	15%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM AND COCCYX MIN 2V	$125.80	$148.00	$17.32–$88.80	56% below	15%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM AND COCCYX MIN 2V	$125.80	$148.00	—	—	15%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT	$32.30	$38.00	$4.58–$25.23	4% above	15%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT	$32.30	$38.00	—	—	15%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT	$29.75	$35.00	$3.54–$14.15	at median	15%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT	$29.75	$35.00	—	—	15%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$324.70	$382.00	$41.17–$256.77	5% above	15%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$324.70	$382.00	—	—	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PLUM IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 APPLE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHOLE EGG IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CARROT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GRAPEFRUIT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES FARINAE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUNTAIN CEDAR IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTONWOOD IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CELERY IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 D PTERONYSSIN US IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MAIZE/CORN IGE F8	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE F4	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MEADOW FESCUE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE F24	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITEFISH IGE RF384	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE F40	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GULF FLOUNDER IGE F147	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LEMON IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GOLDENROD IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LIME IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN FEATHERS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BIRCH IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MUGWORT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 TIMOTHY GRASS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKLEBUR IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IGE F20	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IGE F18	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GIANT RAGWEED IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT IGE F17	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE F13	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN NUT IGE F201	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PEDIATRIC PROFILE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 COTTON, CRUDE FIBERS (01) IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MULTIPLE INHALANT SCREEN	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTIN	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ORRIS ROOT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT RAST	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 OAK IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW HORNET IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 YEAST IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 COMMON RAGWEED IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE-FACED HORNET IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMBS QUARTER IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PEAR IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MOUSE URINE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GREEN BEAN IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FLAVUS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 FIRE ANT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERAMSTELODAMI/GLAUCUS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT F7 IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 HICKORY PECAN TREE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE PINE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLUM NOTATUM IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IGE F14	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MAPLE BOX IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX (K82) IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SESAME SEED IGE F10	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ENGLISH PLANTAIN IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 KIDNEY BEAN IGE F287	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PAPER WASP IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LIMA BEAN IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE MULBERRY IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ELM IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CHERRY IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA ALTERNATA IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM HERBARUM IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE BEAN IGE F15	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 DUCK FEATHERS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BLACKBERRY IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 L DESTRUCTOR IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GOOSE FEATHERS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT TREE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET VERNAL GRASS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN F79 IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CARMINE RED DYE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SALMON IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 JUNE GRASS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SCALLOP IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PEACH IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 FALSE RAGWEED IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SHEEP SORREL IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LOBSTER IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 HONEY BEE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SWEET GUM IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 EPICOCCUM PURPURASCENS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PUMPKIN SEED IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA-GAL IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK F26 IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 YELLOW JACKET IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 LAMB F88 IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 WATERMELON IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF F27 IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 TOBACCO LEAF (0201) IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 SYCAMORE IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK (F2) IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 TROUT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 KAPOK IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ORCHARD GRASS IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CHESTNUT IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 ROUGH PIGWEED IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 MACADAMIA IGE	$28.05	$33.00	$4.51–$33.00	6% below	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BLUEBERRY IGE	$37.40	$44.00	$4.51–$33.74	25% above	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PYRETHRUM IGE	$45.05	$53.00	$4.51–$33.74	50% above	15%
Allergy blood test, specific IgE, per allergen CPT 86003 HADDOCK IGE F101	$45.05	$53.00	$4.51–$33.74	50% above	15%
Allergy blood test, specific IgE, per allergen CPT 86003 BREWERS YEAST IGE	$45.05	$53.00	$4.51–$33.74	50% above	15%
Allergy blood test, specific IgE, per allergen CPT 86003 PINTO BEAN IGE	$45.05	$53.00	$4.51–$33.74	50% above	15%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW NUT IGE	$56.10	$66.00	$4.51–$33.74	87% above	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE MULBERRY IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FIRE ANT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GIANT RAGWEED IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN F79 IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOLDENROD IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORCHARD GRASS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARROT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACKBERRY IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LOBSTER IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK (F2) IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEAR IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PLUM IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUNTAIN CEDAR IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MEADOW FESCUE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MUGWORT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PAPER WASP IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WATERMELON IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ROUGH PIGWEED IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX (K82) IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE PINE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN BEAN IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHOLE EGG IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES FARINAE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTONWOOD IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN FEATHERS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TIMOTHY GRASS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COTTON, CRUDE FIBERS (01) IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORRIS ROOT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAK IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COMMON RAGWEED IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ENGLISH PLANTAIN IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA ALTERNATA IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUCK FEATHERS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GOOSE FEATHERS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET VERNAL GRASS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JUNE GRASS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN SEED IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HONEY BEE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW JACKET IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TROUT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOBACCO LEAF (0201) IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KAPOK IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHESTNUT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLUM NOTATUM IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MACADAMIA IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HICKORY PECAN TREE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAPLE BOX IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMBS QUARTER IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MOUSE URINE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FLAVUS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERAMSTELODAMI/GLAUCUS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT F7 IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GRAPEFRUIT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LEMON IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CELERY IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MAIZE/CORN IGE F8	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE F4	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP IGE F24	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITEFISH IGE RF384	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE F40	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GULF FLOUNDER IGE F147	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIME IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BIRCH IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND IGE F20	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKLEBUR IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM HERBARUM IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT IGE F18	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT IGE F17	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE F13	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN NUT IGE F201	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SESAME SEED IGE F10	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEDIATRIC PROFILE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MULTIPLE INHALANT SCREEN	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTIN	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT RAST	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YELLOW HORNET IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 YEAST IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PUMPKIN IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KIDNEY BEAN IGE F287	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LIMA BEAN IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE-FACED HORNET IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D PTERONYSSIN US IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHERRY IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE BEAN IGE F15	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 L DESTRUCTOR IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SYCAMORE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SALMON IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT TREE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHEEP SORREL IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CARMINE RED DYE IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SCALLOP IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN IGE F14	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FALSE RAGWEED IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SWEET GUM IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EPICOCCUM PURPURASCENS IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA-GAL IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK F26 IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LAMB F88 IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF F27 IGE	$28.05	$33.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLUEBERRY IGE	$37.40	$44.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PINTO BEAN IGE	$45.05	$53.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HADDOCK IGE F101	$45.05	$53.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BREWERS YEAST IGE	$45.05	$53.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PYRETHRUM IGE	$45.05	$53.00	—	—	15%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW NUT IGE	$56.10	$66.00	—	—	15%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP	$82.45	$97.00	$11.19–$43.65	14% above	15%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$82.45	$97.00	$11.19–$43.65	14% above	15%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP	$82.45	$97.00	—	—	15%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP	$82.45	$97.00	—	—	15%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR ANTIBODY SCR	$62.05	$73.00	$10.34–$41.34	5% below	15%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI CENTROMERE ANTIBODY	$62.05	$73.00	$10.34–$41.34	5% below	15%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI CENTROMERE ANTIBODY	$62.05	$73.00	—	—	15%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR ANTIBODY SCR	$62.05	$73.00	—	—	15%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-NATRIURETIC PEPTIDE	$124.95	$147.00	$23.20–$92.75	22% below	15%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PROBNP	$150.45	$177.00	$23.20–$92.75	6% below	15%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-NATRIURETIC PEPTIDE	$124.95	$147.00	—	—	15%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PROBNP	$150.45	$177.00	—	—	15%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL(BMP	$96.90	$114.00	$7.31–$39.22	21% above	15%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL(BMP	$96.90	$114.00	—	—	15%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CYTO CELL BLOCK	$235.45	$277.00	$9.00–$74.00	44% above	15%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CELL BLOCK	$235.45	$277.00	$9.00–$74.00	44% above	15%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH LEVEL IV LG/MUL	$235.45	$277.00	$9.00–$74.00	44% above	15%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH LEVEL IV LG/MUL	$235.45	$277.00	—	—	15%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CELL BLOCK	$235.45	$277.00	—	—	15%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CYTO CELL BLOCK	$235.45	$277.00	—	—	15%
Blood culture for bacteria CPT 87040 CULTURE BLOOD A/A #1	$122.40	$144.00	$8.92–$45.85	44% above	15%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD A/A #1	$122.40	$144.00	—	—	15%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 SPECIMEN COLLECTION	$13.60	$16.00	$1.08–$17.99	16% above	15%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 JMBCC SPECIMEN COLLECTION	$13.60	$16.00	$1.08–$17.99	16% above	15%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 SPECIMEN COLLECTION	$13.60	$16.00	—	—	15%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 JMBCC SPECIMEN COLLECTION	$13.60	$16.00	—	—	15%
Blood glucose (sugar) test CPT 82947 GLUCOSE 2HR POST PRANDIAL	$26.35	$31.00	$3.40–$21.67	8% above	15%
Blood glucose (sugar) test CPT 82947 GLUCOSE BLOOD	$26.35	$31.00	$3.40–$21.67	8% above	15%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE 2HR POST PRANDIAL	$26.35	$31.00	—	—	15%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE BLOOD	$26.35	$31.00	—	—	15%
Blood lead test CPT 83655 LEAD, BLOOD	$51.00	$60.00	$10.00–$54.49	20% below	15%
Blood lead test CPT 83655 LEAD, URINE RANDOM	$51.00	$60.00	$10.00–$54.49	20% below	15%
Blood lead test CPT 83655 LEAD, URINE 24 HOUR	$51.00	$60.00	$10.00–$54.49	20% below	15%
Blood lead test inpatient CPT 83655 LEAD, BLOOD	$51.00	$60.00	—	—	15%
Blood lead test inpatient CPT 83655 LEAD, URINE RANDOM	$51.00	$60.00	—	—	15%
Blood lead test inpatient CPT 83655 LEAD, URINE 24 HOUR	$51.00	$60.00	—	—	15%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN CHORIONIC;QUAL	$10.20	$12.00	$5.78–$15.79	77% below	15%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST, SERUM	$53.55	$63.00	$5.78–$23.11	21% above	15%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST, URINE	$53.55	$63.00	$5.78–$23.11	21% above	15%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN CHORIONIC;QUAL	$10.20	$12.00	—	—	15%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST, URINE	$53.55	$63.00	—	—	15%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY TEST, SERUM	$53.55	$63.00	—	—	15%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC ABO TYPE	$38.25	$45.00	$3.08–$16.67	49% below	15%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD GROUP	$171.70	$202.00	$3.08–$16.67	130% above	15%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ARC ABO TYPE	$38.25	$45.00	—	—	15%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD GROUP	$171.70	$202.00	—	—	15%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP,QUANTITATIVE	$66.30	$78.00	$3.00–$25.59	98% above	15%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP,QUANTITATIVE	$66.30	$78.00	—	—	15%
C. difficile toxin gene test (stool PCR) CPT 87493 CLOSTRIDIUM DIFFICILE TOX	$130.05	$153.00	$32.21–$78.26	23% below	15%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIN PCR	$130.05	$153.00	$32.21–$78.26	23% below	15%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICILE TOX	$130.05	$153.00	—	—	15%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE TOXIN PCR	$130.05	$153.00	—	—	15%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$176.80	$208.00	$15.70–$62.76	52% above	15%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$176.80	$208.00	—	—	15%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$109.65	$129.00	$14.65–$58.57	13% below	15%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$109.65	$129.00	—	—	15%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS COV-2 RNA PCR	$85.00	$100.00	$35.00–$100.71	13% above	15%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS COV-2 RNA PCR	$85.00	$100.00	—	—	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA; PCR	$142.80	$168.00	$23.19–$168.00	12% below	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA RNA, TMA	$142.80	$168.00	$23.19–$168.00	12% below	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA DNA PAP VIAL	$142.80	$168.00	$23.19–$168.00	12% below	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA RNA, TMA	$142.80	$168.00	—	—	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA DNA PAP VIAL	$142.80	$168.00	—	—	15%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA; PCR	$142.80	$168.00	—	—	15%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE PANEL	$38.25	$45.00	$11.57–$45.00	56% below	15%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE PANEL	$38.25	$45.00	—	—	15%
Complete blood count (CBC) with differential CPT 85025 CBC W AUTO DIFF	$38.25	$45.00	$6.00–$35.30	7% below	15%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W AUTO DIFF	$38.25	$45.00	—	—	15%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF	$29.75	$35.00	$4.70–$18.79	15% below	15%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF	$29.75	$35.00	—	—	15%
Comprehensive metabolic panel (blood test) CPT 80053 COMP.METABOLIC PANEL	$42.50	$50.00	$9.13–$50.00	56% below	15%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP.METABOLIC PANEL	$42.50	$50.00	—	—	15%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUAL	$59.50	$70.00	$8.80–$36.34	4% below	15%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUAL	$59.50	$70.00	—	—	15%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$130.05	$153.00	$19.21–$83.07	15% above	15%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$130.05	$153.00	—	—	15%
Estradiol blood test CPT 82670 ESTRADIOL 17B	$153.85	$181.00	$21.50–$117.33	8% above	15%
Estradiol blood test CPT 82670 ESTRADIOL ULTRASENSITIVE	$199.75	$235.00	$21.50–$117.33	40% above	15%
Estradiol blood test inpatient CPT 82670 ESTRADIOL 17B	$153.85	$181.00	—	—	15%
Estradiol blood test inpatient CPT 82670 ESTRADIOL ULTRASENSITIVE	$199.75	$235.00	—	—	15%
FSH (follicle-stimulating hormone) test CPT 83001 FSH SERUM	$127.50	$150.00	$16.06–$68.60	27% above	15%
FSH (follicle-stimulating hormone) test CPT 83001 FSH,PEDIATRICS	$127.50	$150.00	$16.06–$68.60	27% above	15%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH SERUM	$127.50	$150.00	—	—	15%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH,PEDIATRICS	$127.50	$150.00	—	—	15%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, STOOL	$204.09	$240.10	$16.97–$108.05	97% above	15%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, STOOL	$204.09	$240.10	—	—	15%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$90.95	$107.00	$11.78–$48.57	14% above	15%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$90.95	$107.00	—	—	15%
Folate (folic acid) blood test CPT 82746 FOLATE	$61.20	$72.00	$12.00–$64.00	19% below	15%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$61.20	$72.00	—	—	15%
Free T3 thyroid hormone test CPT 84481 T3 FREE	$136.00	$160.00	$14.64–$72.48	43% above	15%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE	$136.00	$160.00	—	—	15%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE DIRECT DIALYSIS	$46.75	$55.00	$7.80–$41.66	11% below	15%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$46.75	$55.00	$7.80–$41.66	11% below	15%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE DIRECT DIALYSIS	$46.75	$55.00	—	—	15%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$46.75	$55.00	—	—	15%
Free testosterone test CPT 84402 FREE TESTOSTERONE	$104.55	$123.00	$22.01–$109.70	19% below	15%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE	$104.55	$123.00	—	—	15%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GESTATIONAL GLUCOSE CHLNG	$42.50	$50.00	$4.11–$23.47	14% above	15%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR POST LOAD	$42.50	$50.00	$4.11–$23.47	14% above	15%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR POST LOAD	$42.50	$50.00	—	—	15%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GESTATIONAL GLUCOSE CHLNG	$42.50	$50.00	—	—	15%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 1ST 3 GLU	$86.70	$102.00	$11.12–$56.41	13% above	15%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 1ST 3 GLU	$86.70	$102.00	—	—	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 G.C. DNA; PCR	$140.25	$165.00	$23.19–$165.00	5% below	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC RNA, TMA	$140.25	$165.00	$23.19–$165.00	5% below	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC DNA PAP VIAL	$140.25	$165.00	$23.19–$165.00	5% below	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC RNA, TMA	$140.25	$165.00	—	—	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC DNA PAP VIAL	$140.25	$165.00	—	—	15%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 G.C. DNA; PCR	$140.25	$165.00	—	—	15%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY, IGA	$122.06	$143.60	$13.23–$52.89	21% above	15%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY, IGM	$122.06	$143.60	$13.23–$52.89	21% above	15%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY, IGG	$122.06	$143.60	$13.23–$52.89	21% above	15%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY, IGG	$122.06	$143.60	—	—	15%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY, IGM	$122.06	$143.60	—	—	15%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY, IGA	$122.06	$143.60	—	—	15%
H. pylori stool antigen test CPT 87338 H PYLORI STOOL AG	$106.25	$125.00	$11.39–$45.53	29% above	15%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI STOOL AG	$106.25	$125.00	—	—	15%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 RNA QN PC	$402.90	$474.00	$73.55–$466.45	11% below	15%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 RNA QN PC	$402.90	$474.00	—	—	15%
HIV-1 and HIV-2 antibody test CPT 86703 AB HIV1 & HIV2 SNGL ASSAY	$69.70	$82.00	$11.85–$82.00	27% below	15%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 AB HIV1 & HIV2 SNGL ASSAY	$69.70	$82.00	—	—	15%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1/2 ANTIGEN/ANTIBODY	$90.61	$106.60	$20.81–$50.55	27% below	15%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1/2 ANTIGEN/ANTIBODY	$90.61	$106.60	—	—	15%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV, DNA HIGH RISK	$158.95	$187.00	$30.33–$84.15	18% below	15%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HIGH RISK HPV DNA; PCR	$158.95	$187.00	$30.33–$84.15	18% below	15%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HIGH RISK HPV DNA; PCR	$158.95	$187.00	—	—	15%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV, DNA HIGH RISK	$158.95	$187.00	—	—	15%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$38.25	$45.00	$7.00–$45.00	19% below	15%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$38.25	$45.00	—	—	15%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB	$48.73	$57.33	$9.28–$57.33	19% below	15%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE AB	$48.73	$57.33	—	—	15%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG	$53.55	$63.00	$8.93–$47.69	8% below	15%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG	$53.55	$63.00	—	—	15%
Hepatitis C antibody blood test (screening) CPT 86803 HCV AB	$54.87	$64.55	$12.33–$64.55	43% below	15%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$54.87	$64.55	$12.33–$64.55	43% below	15%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV AB	$54.87	$64.55	—	—	15%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$54.87	$64.55	—	—	15%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL RNA QUAN	$432.14	$508.40	$37.03–$237.42	81% above	15%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL / GENOTYPE	$432.14	$508.40	$37.03–$237.42	81% above	15%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL RNA QUAN	$432.14	$508.40	—	—	15%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL / GENOTYPE	$432.14	$508.40	—	—	15%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1/2 IGG	$74.53	$87.68	$11.40–$57.85	1% above	15%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM TITER	$74.53	$87.68	$11.40–$57.85	1% above	15%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IGM SCREEN	$74.53	$87.68	$11.40–$57.85	1% above	15%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES AB (TYPE 1), IGG	$74.53	$87.68	$11.40–$57.85	1% above	15%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM SCREEN	$74.53	$87.68	—	—	15%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1/2 IGG	$74.53	$87.68	—	—	15%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IGM TITER	$74.53	$87.68	—	—	15%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES AB (TYPE 1), IGG	$74.53	$87.68	—	—	15%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM SCREEN	$75.65	$89.00	$16.05–$64.16	16% below	15%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IGM TITER	$75.65	$89.00	$16.05–$64.16	16% below	15%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES AB (TYPE 2), IGG	$75.65	$89.00	$16.05–$64.16	16% below	15%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX II,IGG	$75.65	$89.00	$16.05–$64.16	16% below	15%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES AB (TYPE 2), IGG	$75.65	$89.00	—	—	15%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM TITER	$75.65	$89.00	—	—	15%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX II,IGG	$75.65	$89.00	—	—	15%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IGM SCREEN	$75.65	$89.00	—	—	15%
High-sensitivity CRP (hs-CRP) test CPT 86141 HSCRP	$75.65	$89.00	$10.53–$46.01	7% above	15%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HSCRP	$75.65	$89.00	—	—	15%
Homocysteine blood test CPT 83090 HOMOCYSTEINE,SERUM	$113.90	$134.00	$15.49–$77.32	15% above	15%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE,SERUM	$113.90	$134.00	—	—	15%
Insulin blood test CPT 83525 INSULIN 3 HOUR	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN 1/2 HOUR	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN RESPONSE TO GLUCOSE	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN, FASTING	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN 5 HOUR	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN 1 HOUR	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN 2 HOUR	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test CPT 83525 INSULIN 4 HOUR	$106.25	$125.00	$9.82–$39.26	84% above	15%
Insulin blood test inpatient CPT 83525 INSULIN 1 HOUR	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN 5 HOUR	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN 3 HOUR	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN, FASTING	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN RESPONSE TO GLUCOSE	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN 2 HOUR	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN 4 HOUR	$106.25	$125.00	—	—	15%
Insulin blood test inpatient CPT 83525 INSULIN 1/2 HOUR	$106.25	$125.00	—	—	15%
Iron blood test (serum iron) CPT 83540 IRON	$38.25	$45.00	$4.81–$19.23	16% below	15%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$38.25	$45.00	—	—	15%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$124.95	$147.00	$7.50–$52.57	83% above	15%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$124.95	$147.00	—	—	15%
LH (luteinizing hormone) test CPT 83002 LH,PEDIATRICS	$146.20	$172.00	$16.01–$68.32	46% above	15%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH)	$146.20	$172.00	$16.01–$68.32	46% above	15%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE (LH)	$146.20	$172.00	—	—	15%
LH (luteinizing hormone) test inpatient CPT 83002 LH,PEDIATRICS	$146.20	$172.00	—	—	15%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$52.70	$62.00	$5.00–$31.62	25% above	15%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE FLUID	$52.70	$62.00	$5.00–$31.62	25% above	15%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$52.70	$62.00	—	—	15%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE FLUID	$52.70	$62.00	—	—	15%
Liver function blood test panel CPT 80076 HEPATIC FNCTN(LIVER)PANEL	$85.85	$101.00	$7.06–$39.14	8% above	15%
Liver function blood test panel inpatient CPT 80076 HEPATIC FNCTN(LIVER)PANEL	$85.85	$101.00	—	—	15%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$51.00	$60.00	$14.72–$60.00	39% below	15%
Lyme disease antibody test CPT 86618 LYME IGM ANTIBODY	$51.00	$60.00	$14.72–$60.00	39% below	15%
Lyme disease antibody test CPT 86618 LYME IGG ANTIBODY	$51.00	$60.00	$14.72–$60.00	39% below	15%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$51.00	$60.00	—	—	15%
Lyme disease antibody test inpatient CPT 86618 LYME IGG ANTIBODY	$51.00	$60.00	—	—	15%
Lyme disease antibody test inpatient CPT 86618 LYME IGM ANTIBODY	$51.00	$60.00	—	—	15%
Magnesium blood test CPT 83735 MAGNESIUM	$46.75	$55.00	$4.82–$19.27	38% above	15%
Magnesium blood test CPT 83735 MAGNESIUM,RBC	$46.75	$55.00	$4.82–$19.27	38% above	15%
Magnesium blood test CPT 83735 MAGNESIUM, URINE	$46.75	$55.00	$4.82–$19.27	38% above	15%
Magnesium blood test inpatient CPT 83735 MAGNESIUM,RBC	$46.75	$55.00	—	—	15%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, URINE	$46.75	$55.00	—	—	15%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$46.75	$55.00	—	—	15%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$38.25	$45.00	$10.40–$41.58	47% below	15%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$38.25	$45.00	—	—	15%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$37.40	$44.00	$3.36–$13.43	3% below	15%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE SCREEN	$37.40	$44.00	$3.36–$13.43	3% below	15%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$37.40	$44.00	—	—	15%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE SCREEN	$37.40	$44.00	—	—	15%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE	$84.15	$99.00	$15.89–$95.19	8% below	15%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE	$84.15	$99.00	—	—	15%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL	$89.25	$105.00	$15.89–$67.48	at median	15%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL	$89.25	$105.00	—	—	15%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP;SCRN LQUD AUTO W/RES	$106.25	$125.00	$19.40–$77.56	36% above	15%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP;SCRN LQUD AUTO W/RES	$106.25	$125.00	—	—	15%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP, SCREENING THIN PREP	$89.25	$105.00	$16.00–$96.58	46% above	15%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP, DIAGNOSTIC THIN PREP	$89.25	$105.00	$16.00–$96.58	46% above	15%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP, SCREENING THIN PREP	$89.25	$105.00	—	—	15%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP, DIAGNOSTIC THIN PREP	$89.25	$105.00	—	—	15%
Parathyroid hormone (PTH) blood test CPT 83970 PTH, INTACT	$130.05	$153.00	$35.68–$153.00	36% below	15%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, INTACT	$130.05	$153.00	—	—	15%
Partial thromboplastin time (PTT) clotting test CPT 85730 APTT BASELINE REF LAB	$46.75	$55.00	$4.52–$18.07	14% above	15%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLAST TIME	$46.75	$55.00	$4.52–$18.07	14% above	15%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APTT BASELINE REF LAB	$46.75	$55.00	—	—	15%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLAST TIME	$46.75	$55.00	—	—	15%
Progesterone blood test CPT 84144 PROGESTERONE	$155.55	$183.00	$17.00–$76.64	33% above	15%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$155.55	$183.00	—	—	15%
Prolactin blood test CPT 84146 PROLACTIN	$137.70	$162.00	$16.75–$82.83	30% above	15%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$137.70	$162.00	—	—	15%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$23.80	$28.00	$2.32–$9.27	at median	15%
Prothrombin time (PT/INR) clotting test CPT 85610 MIXING CORRECTION STUDIES	$23.80	$28.00	$2.32–$9.27	at median	15%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 MIXING CORRECTION STUDIES	$23.80	$28.00	—	—	15%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$23.80	$28.00	—	—	15%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$22.95	$27.00	$11.92–$34.75	34% below	15%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$22.95	$27.00	—	—	15%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC	$22.95	$27.00	$6.37–$34.69	56% below	15%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP	$37.40	$44.00	$6.30–$34.69	28% below	15%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC	$22.95	$27.00	—	—	15%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP	$37.40	$44.00	—	—	15%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, TITER	$63.75	$75.00	$4.90–$28.18	63% above	15%
Rheumatoid factor (RF) test CPT 86431 RA TITER, QUANT	$63.75	$75.00	$4.90–$28.18	63% above	15%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR, REF LAB	$63.75	$75.00	$4.90–$28.18	63% above	15%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, TITER	$63.75	$75.00	—	—	15%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR, REF LAB	$63.75	$75.00	—	—	15%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER, QUANT	$63.75	$75.00	—	—	15%
Rubella antibody test (immunity check) CPT 86762 RUBACELL (RUBELLA SCRN)	$38.25	$45.00	$11.96–$45.00	52% below	15%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB (IGM)	$38.25	$45.00	$11.96–$45.00	52% below	15%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB (IGG)	$38.25	$45.00	$11.96–$45.00	52% below	15%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB (IGM)	$38.25	$45.00	—	—	15%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBACELL (RUBELLA SCRN)	$38.25	$45.00	—	—	15%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB (IGG)	$38.25	$45.00	—	—	15%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS, COMPLETE	$85.00	$100.00	$10.64–$51.77	4% below	15%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS, COMPLETE	$85.00	$100.00	—	—	15%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$80.75	$95.00	$7.50–$38.94	64% above	15%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$80.75	$95.00	—	—	15%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCLT PERX ACTV FECES 1 DT	$8.50	$10.00	$0.81–$9.21	58% below	15%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD,FECES;SINGL	$29.75	$35.00	$0.81–$9.21	46% above	15%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLD, FECES; 3 SPEC	$34.00	$40.00	$0.81–$9.21	67% above	15%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCLT BLD MEDICAR SCRN;1-3	$34.00	$40.00	$0.81–$9.21	67% above	15%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCLT PERX ACTV FECES 1 DT	$8.50	$10.00	—	—	15%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD,FECES;SINGL	$29.75	$35.00	—	—	15%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCLT BLD MEDICAR SCRN;1-3	$34.00	$40.00	—	—	15%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLD, FECES; 3 SPEC	$34.00	$40.00	—	—	15%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$25.50	$30.00	$2.94–$33.43	29% below	15%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL	$25.50	$30.00	—	—	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$31.45	$37.00	$2.54–$10.15	16% above	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL	$31.45	$37.00	$2.54–$10.15	16% above	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF	$31.45	$37.00	$2.54–$10.15	16% above	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$31.45	$37.00	—	—	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF	$31.45	$37.00	—	—	15%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL	$31.45	$37.00	—	—	15%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD	$285.94	$336.40	$53.57–$151.38	11% above	15%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD	$285.94	$336.40	—	—	15%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL W/FREE	$154.70	$182.00	$22.31–$98.06	5% above	15%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, WOMEN AND CHILDR	$154.70	$182.00	$22.31–$98.06	5% above	15%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL	$154.70	$182.00	$22.31–$98.06	5% above	15%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, WOMEN AND CHILDR	$154.70	$182.00	—	—	15%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL W/FREE	$154.70	$182.00	—	—	15%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL	$154.70	$182.00	—	—	15%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME AB IGG	$59.50	$70.00	$7.91–$41.98	15% below	15%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID MICROSOMAL AB	$59.50	$70.00	$7.91–$41.98	15% below	15%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID MICROSOMAL AB	$59.50	$70.00	—	—	15%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME AB IGG	$59.50	$70.00	—	—	15%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$57.18	$67.27	$14.52–$67.27	34% below	15%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$57.18	$67.27	—	—	15%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS RNA	$156.66	$184.30	$30.33–$82.94	4% above	15%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS RNA	$156.66	$184.30	—	—	15%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$42.50	$50.00	$3.91–$23.83	48% above	15%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$42.50	$50.00	—	—	15%
Urinalysis with microscope exam, automated CPT 81001 UA DIP STICK/TAB AUTO W/MICRO	$6.80	$8.00	$2.45–$8.00	77% below	15%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA DIP STICK/TAB AUTO W/MICRO	$6.80	$8.00	—	—	15%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$8.50	$10.00	$1.45–$8.43	60% below	15%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W/SCOPE	$8.50	$10.00	—	—	15%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$3.40	$4.00	$1.87–$4.72	80% below	15%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS W/O MICRO,AUTO	$17.85	$21.00	$1.94–$17.19	3% above	15%
Urinalysis without microscope exam, automated CPT 81003 TRANSFUSN RXN URINE; AUTO	$17.85	$21.00	$1.94–$17.19	3% above	15%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$3.40	$4.00	—	—	15%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS W/O MICRO,AUTO	$17.85	$21.00	—	—	15%
Urinalysis without microscope exam, automated inpatient CPT 81003 TRANSFUSN RXN URINE; AUTO	$17.85	$21.00	—	—	15%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$5.10	$6.00	$2.90–$7.30	71% below	15%
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK, NON-AUTO	$15.30	$18.00	$3.01–$18.00	13% below	15%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$5.10	$6.00	—	—	15%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK, NON-AUTO	$15.30	$18.00	—	—	15%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$49.30	$58.00	$6.97–$35.30	8% below	15%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$49.30	$58.00	—	—	15%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$11.90	$14.00	$4.20–$18.09	64% below	15%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$11.90	$14.00	—	—	15%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$65.45	$77.00	$13.00–$54.37	15% below	15%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$65.45	$77.00	—	—	15%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25-HYDROXY TOTAL	$181.90	$214.00	$25.58–$124.37	27% above	15%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,25-HYDROXY TOTAL	$181.90	$214.00	—	—	15%
Zinc blood test CPT 84630 ZINC URINE 24 HOUR	$61.20	$72.00	$9.84–$50.81	6% above	15%
Zinc blood test CPT 84630 ZINC, SERUM	$61.20	$72.00	$9.84–$50.81	6% above	15%
Zinc blood test inpatient CPT 84630 ZINC, SERUM	$61.20	$72.00	—	—	15%
Zinc blood test inpatient CPT 84630 ZINC URINE 24 HOUR	$61.20	$72.00	—	—	15%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPN QNT	$75.65	$89.00	$13.01–$58.53	at median	15%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG, QUANTITATIVE	$75.65	$89.00	$13.01–$58.53	at median	15%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 TUMOR MARKER, HCG	$75.65	$89.00	$13.01–$58.53	at median	15%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPN QNT	$75.65	$89.00	—	—	15%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 TUMOR MARKER, HCG	$75.65	$89.00	—	—	15%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG, QUANTITATIVE	$75.65	$89.00	—	—	15%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$872.95	$1,027.00	$616.20–$3,677.04	at median	15%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$872.95	$1,027.00	—	—	15%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREO BIOPSY FIRST	$687.65	$809.00	$147.43–$485.40	81% below	15%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 STEREO BIOP GUIDANCE BCC	$2,601.00	$3,060.00	$147.43–$1,836.00	27% below	15%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 STEREO BIOPSY FIRST	$687.65	$809.00	—	—	15%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 STEREO BIOP GUIDANCE BCC	$2,601.00	$3,060.00	—	—	15%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ORTHO FX RED FIBUL W/O MAN	$391.40	$460.47	$124.42–$1,236.49	32% below	15%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CL TX DST FIB FX LAT ML WO MAN	$425.85	$501.00	$124.42–$1,236.49	27% below	15%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ORTHO FX RED FIBUL W/O MAN	$391.40	$460.47	—	—	15%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CL TX DST FIB FX LAT ML WO MAN	$425.85	$501.00	—	—	15%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 ORTHO FX RED METTRSL W/O MAN	$275.93	$324.62	$74.98–$299.75	45% below	15%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CL TX METATARSAL FX W/O MANIP	$361.25	$425.00	$74.98–$299.75	28% below	15%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 ORTHO FX RED METTRSL W/O MAN	$275.93	$324.62	—	—	15%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CL TX METATARSAL FX W/O MANIP	$361.25	$425.00	—	—	15%
Cardiac catheterization with coronary angiogram one side CPT 93458 LEFT HEART/CORS (+/-)LVG	$9,048.25	$10,645.00	$2,575.00–$6,387.00	12% above	15%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 LEFT HEART/CORS (+/-)LVG	$9,048.25	$10,645.00	—	—	15%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION; EXTERNAL	$872.95	$1,027.00	$91.35–$757.64	30% below	15%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION; EXTERNAL	$872.95	$1,027.00	—	—	15%
Cervical biopsy CPT 57500 BIOPSY OF CERVIX	$210.80	$248.00	$61.74–$3,037.41	87% below	15%
Cervical biopsy inpatient CPT 57500 BIOPSY OF CERVIX	$210.80	$248.00	—	—	15%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CL TX DIST RADI FX/EPIPHYS SEP	$457.30	$538.00	$71.49–$322.80	10% below	15%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CL TX DIST RADI FX/EPIPHYS SEP	$457.30	$538.00	—	—	15%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LES REMOVAL	$623.90	$734.00	$242.81–$1,640.14	75% below	15%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/LES REMOVAL	$623.90	$734.00	—	—	15%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY	$597.55	$703.00	$190.94–$1,641.18	70% below	15%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY AND BIOPSY	$597.55	$703.00	—	—	15%
Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY	$464.95	$547.00	$175.87–$1,653.05	69% below	15%
Colonoscopy, diagnostic inpatient CPT 45378 DIAGNOSTIC COLONOSCOPY	$464.95	$547.00	—	—	15%
Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 BX OF CERVIX W/SCOPE LEEP	$452.20	$532.00	$131.21–$3,689.12	92% below	15%
Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 BX OF CERVIX W/SCOPE LEEP	$452.20	$532.00	—	—	15%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$230.35	$271.00	$74.58–$298.15	34% below	15%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 BX/CURETT OF CERVIX W/SCOPE	$230.35	$271.00	—	—	15%
Coronary stent placement, one artery CPT 92928 BARE METAL STENT; SNGL COR ART	$31,459.35	$37,011.00	$579.70–$22,206.60	91% above	15%
Coronary stent placement, one artery inpatient CPT 92928 BARE METAL STENT; SNGL COR ART	$31,459.35	$37,011.00	—	—	15%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOSCOPY (SEP PRO)	$382.50	$450.00	$73.47–$1,224.42	75% below	15%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOSCOPY (SEP PRO)	$382.50	$450.00	—	—	15%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION AND CURETTAGE	$510.00	$600.00	$194.40–$1,641.14	90% below	15%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION AND CURETTAGE	$510.00	$600.00	—	—	15%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 WART REMOV 1ST LESION	$64.60	$76.00	$21.00–$298.23	67% below	15%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 WART REMOV 1ST LESION	$64.60	$76.00	—	—	15%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$19.55	$23.00	$8.05–$13.80	83% below	15%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$19.55	$23.00	—	—	15%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX	$47.60	$56.00	$8.71–$34.82	61% below	15%
Earwax removal with instruments, one ear CPT 69210 RMV IMPCTED EAR WX UNI SEP PRO	$66.30	$78.00	$8.71–$46.80	45% below	15%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED CERUMEN.	$132.60	$156.00	$8.71–$93.60	10% above	15%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX	$47.60	$56.00	—	—	15%
Earwax removal with instruments, one ear inpatient CPT 69210 RMV IMPCTED EAR WX UNI SEP PRO	$66.30	$78.00	—	—	15%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED CERUMEN.	$132.60	$156.00	—	—	15%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING	$151.30	$178.00	$52.81–$760.60	52% below	15%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 BIOPSY OF UTERUS LINING	$151.30	$178.00	—	—	15%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR ANT HERNIA <3CM REDUCB	$458.15	$539.00	$188.65–$323.40	92% below	15%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR ANT HERNIA <3CM REDUCB	$458.15	$539.00	—	—	15%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$253.30	$298.00	$53.13–$747.57	64% below	15%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 DIAGNOSTIC SIGMOIDOSCOPY	$253.30	$298.00	—	—	15%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$946.90	$1,114.00	$668.40–$4,563.00	88% below	15%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$946.90	$1,114.00	—	—	15%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$977.50	$1,150.00	$690.00–$3,688.60	89% below	15%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPARO CHOLECYSTECTOMY/GRAPH	$977.50	$1,150.00	—	—	15%
Gallbladder removal, open surgery through a larger incision CPT 47600 REMOVAL OF GALLBLADDER	$1,452.65	$1,709.00	$922.98–$3,689.80	6% below	15%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 REMOVAL OF GALLBLADDER	$1,452.65	$1,709.00	—	—	15%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOID BANDING	$370.60	$436.00	$48.30–$1,652.49	36% below	15%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOID BANDING	$370.60	$436.00	—	—	15%
Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$710.60	$836.00	$275.63–$1,882.60	84% below	15%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 REMOVE INT/EXT HEM 1 GROUP	$710.60	$836.00	—	—	15%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL HYSTERECTOMY	$1,372.75	$1,615.00	$565.25–$969.00	52% below	15%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL HYSTERECTOMY	$1,372.75	$1,615.00	—	—	15%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 HYSTEROSALPGRPH INJ	$247.35	$291.00	$46.38–$299.39	25% below	15%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY	$337.45	$397.00	$46.38–$299.39	2% above	15%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 HYSTEROSALPGRPH INJ	$247.35	$291.00	—	—	15%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHETER FOR HYSTEROGRAPHY	$337.45	$397.00	—	—	15%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY ABLATION	$2,946.10	$3,466.00	$203.35–$2,079.60	66% below	15%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY ABLATION	$2,946.10	$3,466.00	—	—	15%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY	$1,849.60	$2,176.00	$190.71–$1,305.60	42% below	15%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY BIOPSY	$1,849.60	$2,176.00	—	—	15%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$119.00	$140.00	$18.11–$214.68	53% below	15%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$119.00	$140.00	—	—	15%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE SKIN ABSCESS SIMP/SG	$140.25	$165.00	$24.68–$287.07	61% below	15%
Incision and drainage of a simple or single skin abscess CPT 10060 I & D ABSCESS; SMMPL/SNGL	$166.60	$196.00	$24.68–$287.07	54% below	15%
Incision and drainage of a simple or single skin abscess CPT 10060 ABSCESS I&D SIMPLE	$888.25	$1,045.00	$24.68–$953.00	146% above	15%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE SKIN ABSCESS SIMP/SG	$140.25	$165.00	—	—	15%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I & D ABSCESS; SMMPL/SNGL	$166.60	$196.00	—	—	15%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ABSCESS I&D SIMPLE	$888.25	$1,045.00	—	—	15%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 PRP I/HERN INIT REDUC >5 YR	$711.45	$837.00	$333.38–$2,320.50	77% below	15%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 PRP I/HERN INIT REDUC >5 YR	$711.45	$837.00	—	—	15%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT	$77.35	$91.00	$33.60–$467.05	89% below	15%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT	$77.35	$91.00	—	—	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 I&D FINGER SIMPLE	$60.83	$71.56	$11.87–$47.45	87% below	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJECT JOINT/BURSA	$65.45	$77.00	$11.87–$47.45	86% below	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT/ASPR/INJ; MAJOR JT	$86.70	$102.00	$11.87–$61.20	81% below	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 I&D FINGER SIMPLE	$60.83	$71.56	—	—	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJECT JOINT/BURSA	$65.45	$77.00	—	—	15%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT/ASPR/INJ; MAJOR JT	$86.70	$102.00	—	—	15%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG DELIV IMPL NONBIO	$167.45	$197.00	$56.91–$118.20	23% below	15%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG DELIV IMPL NONBIO	$167.45	$197.00	—	—	15%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 BURSA PROC W/O GUID MEDIUM	$49.97	$58.79	$11.63–$46.49	87% below	15%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT/ASPR/INJ; INTM JT	$102.00	$120.00	$11.63–$72.00	72% below	15%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 BURSA PROC W/O GUID MEDIUM	$49.97	$58.79	—	—	15%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT/ASPR/INJ; INTM JT	$102.00	$120.00	—	—	15%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 BURSA PROC W/O GUID SMALL	$48.14	$56.63	$18.90–$118.09	89% below	15%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENT/ASPR/INJ; SM JT	$72.25	$85.00	$18.90–$118.09	83% below	15%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 BURSA PROC W/O GUID SMALL	$48.14	$56.63	—	—	15%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENT/ASPR/INJ; SM JT	$72.25	$85.00	—	—	15%
Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 LAP,SURGICAL, GASTRIC BYPASS	$2,358.75	$2,775.00	$971.25–$2,775.00	at median	15%
Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 LAP,SURGICAL, GASTRIC BYPASS	$2,358.75	$2,775.00	—	—	15%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAP SURG-APPENDECTOMY	$818.55	$963.00	$577.80–$4,563.00	84% below	15%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAP SURG-APPENDECTOMY	$818.55	$963.00	—	—	15%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAP SURG ESOPHAGOGASTRIC FUNDO	$1,463.70	$1,722.00	$833.26–$3,331.12	62% below	15%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAP SURG ESOPHAGOGASTRIC FUNDO	$1,463.70	$1,722.00	—	—	15%
Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 LAP TOTAL HYSTORECT UTER 250</	$1,530.00	$1,800.00	$630.00–$1,080.00	85% below	15%
Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 LAP TOTAL HYSTORECT UTER 250</	$1,530.00	$1,800.00	—	—	15%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 LAP TOT HYST 250/< RMVL TB/OV	$1,530.00	$1,800.00	$630.00–$1,080.00	70% below	15%
Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 LAP TOT HYST 250/< RMVL TB/OV	$1,530.00	$1,800.00	—	—	15%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$637.50	$750.00	$417.75–$2,332.82	88% below	15%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP ING HERNIA REPAIR INIT	$637.50	$750.00	—	—	15%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP ING HERNIA REPAIR RECUR	$767.55	$903.00	$541.80–$3,689.12	87% below	15%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP ING HERNIA REPAIR RECUR	$767.55	$903.00	—	—	15%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$924.80	$1,088.00	$652.80–$4,563.00	87% below	15%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY REMOVE ADNEXA	$924.80	$1,088.00	—	—	15%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP LONGIT/SLEEVE GASTRECTOMY	$1,976.25	$2,325.00	$813.75–$2,325.00	63% below	15%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAP LONGIT/SLEEVE GASTRECTOMY	$1,976.25	$2,325.00	—	—	15%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/TRK/EXTR 2.5CM/<	$213.35	$251.00	$25.73–$286.44	56% below	15%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/TRK/EXTR 2.5CM/<	$213.35	$251.00	—	—	15%
Left heart catheterization, diagnostic one side CPT 93452 LEFT HEART CATH / LVG	$9,048.25	$10,645.00	$2,575.00–$6,387.00	59% above	15%
Left heart catheterization, diagnostic inpatient one side CPT 93452 LEFT HEART CATH / LVG	$9,048.25	$10,645.00	—	—	15%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL	$952.85	$1,121.00	$392.35–$672.60	84% below	15%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL	$952.85	$1,121.00	—	—	15%
Mastectomy (total removal of the breast) CPT 19303 SIMPLE TOTAL MASTECTOMY	$1,476.45	$1,737.00	$607.95–$1,042.20	78% below	15%
Mastectomy (total removal of the breast) inpatient CPT 19303 SIMPLE TOTAL MASTECTOMY	$1,476.45	$1,737.00	—	—	15%
Miscarriage treatment with D&C, first trimester CPT 59820 CARE OF MISCARRIAGE	$594.15	$699.00	$326.13–$3,038.13	89% below	15%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 CARE OF MISCARRIAGE	$594.15	$699.00	—	—	15%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES TRK/A/L <=0.5 CM	$171.70	$202.00	$39.38–$760.28	85% below	15%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LES TRK/A/L <=0.5 CM	$171.70	$202.00	—	—	15%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BEN LES F/E/N/L/M <=.5CM	$192.10	$226.00	$57.23–$1,235.17	73% below	15%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BEN LES F/E/N/L/M <=.5CM	$192.10	$226.00	—	—	15%
Pacemaker implant (dual chamber) CPT 33208 PERM PACER INSERT A&V	$9,095.00	$10,700.00	$486.22–$6,420.00	44% below	15%
Pacemaker implant (dual chamber) inpatient CPT 33208 PERM PACER INSERT A&V	$9,095.00	$10,700.00	—	—	15%
Paracentesis with imaging guidance CPT 49083 DRAINAGE EXTRPRT LYMPHCL w IMG	$147.05	$173.00	$60.55–$103.80	91% below	15%
Paracentesis with imaging guidance inpatient CPT 49083 DRAINAGE EXTRPRT LYMPHCL w IMG	$147.05	$173.00	—	—	15%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$142.80	$168.00	$100.80–$747.73	76% below	15%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/MATRX PART/COMPLT PRM	$275.40	$324.00	$93.39–$747.73	54% below	15%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$142.80	$168.00	—	—	15%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/MATRX PART/COMPLT PRM	$275.40	$324.00	—	—	15%
Removal of a breast lump, open surgery CPT 19120 EXC BRST CYST/LES OPEN - M/F	$701.25	$825.00	$181.65–$1,895.23	89% below	15%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC BRST CYST/LES OPEN - M/F	$701.25	$825.00	—	—	15%
Removal of a foreign object under the skin, simple CPT 10120 REMOVE FOREIGN BODY	$143.65	$169.00	$32.02–$298.83	71% below	15%
Removal of a foreign object under the skin, simple CPT 10120 INC / REMV FB SUBQ TISS SIMPL	$200.60	$236.00	$32.02–$298.83	59% below	15%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FOREIGN BODY	$143.65	$169.00	—	—	15%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC / REMV FB SUBQ TISS SIMPL	$200.60	$236.00	—	—	15%
Short arm cast (elbow to hand) CPT 29075 APPLY CAST ADLT/PEDS SHORT ARM	$113.90	$134.00	$47.77–$215.60	69% below	15%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLY CAST ADLT/PEDS SHORT ARM	$113.90	$134.00	—	—	15%
Short arm splint (forearm and hand) CPT 29125 ORTHO SPLNT CAST SHRTARM SPLNT	$52.99	$62.34	$27.30–$215.36	82% below	15%
Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT	$55.25	$65.00	$27.30–$215.36	82% below	15%
Short arm splint (forearm and hand) CPT 29125 APPLY SPLINT SH ARM/THMB SPIC	$85.85	$101.00	$27.30–$215.36	71% below	15%
Short arm splint (forearm and hand) inpatient CPT 29125 ORTHO SPLNT CAST SHRTARM SPLNT	$52.99	$62.34	—	—	15%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT	$55.25	$65.00	—	—	15%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SPLINT SH ARM/THMB SPIC	$85.85	$101.00	—	—	15%
Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST	$82.45	$97.00	$53.02–$286.52	78% below	15%
Short leg cast (below the knee) CPT 29405 APPLY CAST AD/PEDS SHORT LEG	$105.40	$124.00	$53.02–$286.52	71% below	15%
Short leg cast (below the knee) inpatient CPT 29405 APPLY SHORT LEG CAST	$82.45	$97.00	—	—	15%
Short leg cast (below the knee) inpatient CPT 29405 APPLY CAST AD/PEDS SHORT LEG	$105.40	$124.00	—	—	15%
Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT	$69.70	$82.00	$36.75–$285.72	79% below	15%
Short leg splint (calf to foot) CPT 29515 APPLY SPLINT AD/PED SHORT LEG	$93.50	$110.00	$36.75–$285.72	71% below	15%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT	$69.70	$82.00	—	—	15%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SPLINT AD/PED SHORT LEG	$93.50	$110.00	—	—	15%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$64.60	$76.00	$25.73–$298.99	87% below	15%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL RPR SCLP/TRNK/ETC <=2.5CM	$204.85	$241.00	$25.73–$298.99	57% below	15%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$64.60	$76.00	—	—	15%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL RPR SCLP/TRNK/ETC <=2.5CM	$204.85	$241.00	—	—	15%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION	$93.50	$110.00	$38.50–$953.00	86% below	15%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY SKIN SG LESION	$170.00	$200.00	$41.80–$120.00	75% below	15%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION	$93.50	$110.00	—	—	15%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY SKIN SG LESION	$170.00	$200.00	—	—	15%
Skin tag removal, up to 15 tags CPT 11200 REMOV SKIN TAGS <= 15 LES	$120.70	$142.00	$32.55–$466.01	68% below	15%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOV SKIN TAGS <= 15 LES	$120.70	$142.00	—	—	15%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$85.85	$101.00	$37.27–$298.23	81% below	15%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$85.85	$101.00	—	—	15%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR SUPRFIC FACE/ET 2.5CM/<	$80.75	$95.00	$33.08–$300.03	83% below	15%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR SUPRFIC FACE/ET 2.5CM/<	$80.75	$95.00	—	—	15%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 BIOPSY OF SKIN SINGLE LES	$136.85	$161.00	$33.55–$96.60	75% below	15%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 BIOPSY OF SKIN SINGLE LES	$136.85	$161.00	—	—	15%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMAGE GUIDNC	$433.50	$510.00	$108.65–$306.00	69% below	15%
Thoracentesis with imaging guidance CPT 32555 US THORACENTESIS W/GUID	$1,056.55	$1,243.00	$108.65–$745.80	23% below	15%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ IMAGE GUIDNC	$433.50	$510.00	—	—	15%
Thoracentesis with imaging guidance inpatient CPT 32555 US THORACENTESIS W/GUID	$1,056.55	$1,243.00	—	—	15%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIG PT SG/MULT, 1-2 MUSC	$74.80	$88.00	$32.61–$157.07	86% below	15%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIG PT SG/MULT, 1-2 MUSC	$74.80	$88.00	—	—	15%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$505.75	$595.00	$309.65–$1,896.03	52% below	15%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAPAROSCOPY TUBAL CAUTERY	$505.75	$595.00	—	—	15%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 CORE BIOPSY W/ IMAGE FIRST	$695.30	$818.00	$139.14–$490.80	78% below	15%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 CORE BIOPSY W/ IMAGE FIRST	$695.30	$818.00	—	—	15%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UGI ENDO W/BALLN DILAT ESOPH	$1,516.40	$1,784.00	$146.18–$1,640.22	56% below	15%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 UGI ENDO W/BALLN DILAT ESOPH	$1,516.40	$1,784.00	—	—	15%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY BIOPSY	$197.20	$232.00	$139.20–$1,653.69	91% below	15%
Upper endoscopy (EGD) with biopsy CPT 43239 UGI ENDO W/BX SG OR MULT	$521.05	$613.00	$131.53–$1,653.69	76% below	15%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY BIOPSY	$197.20	$232.00	—	—	15%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UGI ENDO W/BX SG OR MULT	$521.05	$613.00	—	—	15%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UGI ENDO W/ SUBMUCOSAL INJ	$555.05	$653.00	$130.93–$848.79	80% below	15%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UGI ENDO W/ SUBMUCOSAL INJ	$555.05	$653.00	—	—	15%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UGI W SNARE REMVL TUM/POLP/LES	$686.80	$808.00	$186.69–$1,653.77	78% below	15%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UGI W SNARE REMVL TUM/POLP/LES	$686.80	$808.00	—	—	15%
Upper endoscopy (EGD), diagnostic CPT 43235 UGI ENDO DX W OR WO SPEC COL	$410.55	$483.00	$116.79–$1,223.18	78% below	15%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UGI ENDO DX W OR WO SPEC COL	$410.55	$483.00	—	—	15%
Wart removal, up to 14 warts CPT 17110 DESTRCT WARTS/MOLLUSC <=14 LES	$151.30	$178.00	$51.45–$286.36	51% below	15%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRCT WARTS/MOLLUSC <=14 LES	$151.30	$178.00	—	—	15%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRID SKIN SUBQ TISSUE <=20CM	$174.25	$205.00	$34.65–$1,654.29	84% below	15%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SKIN SUBQ TISSUE <=20CM	$174.25	$205.00	—	—	15%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 0-4 HRS	$728.45	$857.00	$29.23–$514.20	18% below	15%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 8-12 HRS	$728.45	$857.00	$29.23–$514.20	18% below	15%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN 4-8 HRS	$728.45	$857.00	$29.23–$514.20	18% below	15%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 8-12 HRS	$728.45	$857.00	—	—	15%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 0-4 HRS	$728.45	$857.00	—	—	15%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN 4-8 HRS	$728.45	$857.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$21.25	$25.00	$10.69–$25.00	86% below	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND NEB TX SUBS	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED RESPIRATORY TX-SUBSQNT	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 ED INITIAL RESPIRATORY TX	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HAND HELD NEB TX INITIAL	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION SUBS	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 SPUTUM INDUCTION INITIAL	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TX SUBSEQUENT	$289.00	$340.00	$10.69–$204.00	84% above	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$21.25	$25.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND HELD NEB TX INITIAL	$289.00	$340.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION INITIAL	$289.00	$340.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 SPUTUM INDUCTION SUBS	$289.00	$340.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED RESPIRATORY TX-SUBSQNT	$289.00	$340.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TX SUBSEQUENT	$289.00	$340.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 ED INITIAL RESPIRATORY TX	$289.00	$340.00	—	—	15%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 HAND NEB TX SUBS	$289.00	$340.00	—	—	15%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; 1ST 30-74MIN	$373.15	$439.00	$100.00–$1,803.00	79% below	15%
Critical care, first 30 to 74 minutes CPT 99291 EMERG SRV, CRITICAL CARE	$1,602.25	$1,885.00	$103.94–$1,803.00	11% below	15%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE ED PHYS SER	$1,602.25	$1,885.00	$103.94–$1,131.00	11% below	15%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE; 1ST 30-74MIN	$373.15	$439.00	—	—	15%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EMERG SRV, CRITICAL CARE	$1,602.25	$1,885.00	—	—	15%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE ED PHYS SER	$1,602.25	$1,885.00	—	—	15%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$432.65	$509.00	$14.18–$314.20	40% below	15%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$432.65	$509.00	—	—	15%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE	$35.70	$42.00	$10.90–$42.00	45% below	15%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM COMPLETE	$35.70	$42.00	—	—	15%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD TRACING ONLY	$174.25	$205.00	$10.74–$123.00	8% above	15%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD TRACING ONLY	$174.25	$205.00	—	—	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER E&M VISIT SELFLIMITED/MINOR	$29.75	$35.00	$22.00–$338.00	88% below	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL I ED PHYSICIAN SERV	$32.30	$38.00	$22.00–$38.00	86% below	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY VISIT, LEVEL I	$108.80	$128.00	$17.32–$338.00	54% below	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 NON-EMERGENT MED ASST VIS	$108.80	$128.00	$17.32–$338.00	54% below	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER E&M VISIT SELFLIMITED/MINOR	$29.75	$35.00	—	—	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LEVEL I ED PHYSICIAN SERV	$32.30	$38.00	—	—	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 NON-EMERGENT MED ASST VIS	$108.80	$128.00	—	—	15%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY VISIT, LEVEL I	$108.80	$128.00	—	—	15%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER E&M VISIT LOW-MOD SEVERITY	$56.95	$67.00	$36.75–$338.00	86% below	15%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL II ED PHYS SERV	$61.20	$72.00	$36.75–$72.00	85% below	15%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY VISIT LEVEL II	$209.95	$247.00	$31.41–$338.00	48% below	15%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER E&M VISIT LOW-MOD SEVERITY	$56.95	$67.00	—	—	15%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LEVEL II ED PHYS SERV	$61.20	$72.00	—	—	15%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY VISIT LEVEL II	$209.95	$247.00	—	—	15%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL III ED PHYSICIAN SE	$91.80	$108.00	$38.50–$108.00	84% below	15%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERG VISIT MOD SEV LVL III	$97.75	$115.00	$38.50–$464.00	83% below	15%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY VISIT LEVEL III	$408.00	$480.00	$38.50–$464.00	28% below	15%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 LEVEL III ED PHYSICIAN SE	$91.80	$108.00	—	—	15%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERG VISIT MOD SEV LVL III	$97.75	$115.00	—	—	15%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY VISIT LEVEL III	$408.00	$480.00	—	—	15%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERG VISIT HIGH SEV LVL IV	$164.90	$194.00	$55.00–$1,030.00	82% below	15%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL IV ED PHYSICIAN	$169.15	$199.00	$55.00–$199.00	82% below	15%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY VISIT LEVEL IV	$703.80	$828.00	$55.00–$1,030.00	25% below	15%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERG VISIT HIGH SEV LVL IV	$164.90	$194.00	—	—	15%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 LEVEL IV ED PHYSICIAN	$169.15	$199.00	—	—	15%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY VISIT LEVEL IV	$703.80	$828.00	—	—	15%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERG VISIT HIGH SEV LVL V	$238.85	$281.00	$55.00–$1,236.00	81% below	15%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVEL V ED PHYSICIAN SERV	$245.65	$289.00	$55.00–$289.00	81% below	15%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY VISIT LEVEL V	$1,067.60	$1,256.00	$55.00–$1,236.00	17% below	15%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERG VISIT HIGH SEV LVL V	$238.85	$281.00	—	—	15%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 LEVEL V ED PHYSICIAN SERV	$245.65	$289.00	—	—	15%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY VISIT LEVEL V	$1,067.60	$1,256.00	—	—	15%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST W/ PHARM AGNT	$658.75	$775.00	$28.36–$465.00	19% below	15%
Exercise stress test, tracing only, the hospital charge CPT 93017 TREADMILL STRESS TEST	$658.75	$775.00	$28.36–$465.00	19% below	15%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 TREADMILL STRESS TEST	$658.75	$775.00	—	—	15%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST W/ PHARM AGNT	$658.75	$775.00	—	—	15%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF RX IV HYDRAT 1ST HR	$317.90	$374.00	$33.11–$224.40	25% below	15%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF RX IV HYDRAT 1ST HR	$317.90	$374.00	—	—	15%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAPY FIRST HR	$317.90	$374.00	$41.27–$224.40	27% below	15%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAPY FIRST HR	$317.90	$374.00	—	—	15%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$43.35	$51.00	$13.34–$30.60	68% below	15%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER, DX, PROPH INJ-IM,SQ	$127.50	$150.00	$13.34–$90.00	5% below	15%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ INJECTION	$127.50	$150.00	$13.98–$90.00	5% below	15%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ IM SUBQ	$127.50	$150.00	$13.34–$90.00	5% below	15%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$43.35	$51.00	—	—	15%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ IM SUBQ	$127.50	$150.00	—	—	15%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER, DX, PROPH INJ-IM,SQ	$127.50	$150.00	—	—	15%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ INJECTION	$127.50	$150.00	—	—	15%
New patient office visit, about 30 minutes CPT 99203 JMBCC PC INIT OFFVIS LEV 3	$106.25	$125.00	$51.65–$125.00	48% below	15%
New patient office visit, about 30 minutes CPT 99203 JMBCC TC INIT OFFVIS LEV 3	$170.85	$201.00	$51.65–$201.00	16% below	15%
New patient office visit, about 30 minutes CPT 99203 OFC/OP E/M NEW MOD 30-44MIN	$174.25	$205.00	$51.65–$205.00	15% below	15%
New patient office visit, about 30 minutes inpatient CPT 99203 JMBCC PC INIT OFFVIS LEV 3	$106.25	$125.00	—	—	15%
New patient office visit, about 30 minutes inpatient CPT 99203 JMBCC TC INIT OFFVIS LEV 3	$170.85	$201.00	—	—	15%
New patient office visit, about 30 minutes inpatient CPT 99203 OFC/OP E/M NEW MOD 30-44MIN	$174.25	$205.00	—	—	15%
New patient office visit, about 45 minutes CPT 99204 JMBCC PC INIT OFFVIS LEV 4	$181.90	$214.00	$66.26–$214.00	33% below	15%
New patient office visit, about 45 minutes CPT 99204 JMBCC TC INIT OFFVIS LEV 4	$236.30	$278.00	$66.26–$264.89	13% below	15%
New patient office visit, about 45 minutes CPT 99204 OFC/OP E/M NEW MOD-HIGH 45-59M	$259.25	$305.00	$66.26–$264.89	5% below	15%
New patient office visit, about 45 minutes inpatient CPT 99204 JMBCC PC INIT OFFVIS LEV 4	$181.90	$214.00	—	—	15%
New patient office visit, about 45 minutes inpatient CPT 99204 JMBCC TC INIT OFFVIS LEV 4	$236.30	$278.00	—	—	15%
New patient office visit, about 45 minutes inpatient CPT 99204 OFC/OP E/M NEW MOD-HIGH 45-59M	$259.25	$305.00	—	—	15%
New patient office visit, about 60 minutes CPT 99205 JMBCC PC INIT OFFVIS LEV 5	$237.15	$279.00	$80.84–$279.00	33% below	15%
New patient office visit, about 60 minutes CPT 99205 DR. CRAIG TC INIT OFFVIS LEV 5	$320.45	$377.00	$80.84–$323.17	10% below	15%
New patient office visit, about 60 minutes CPT 99205 OFC/OP E/M NEW HIGH 60-74 MIN	$331.50	$390.00	$80.84–$323.17	7% below	15%
New patient office visit, about 60 minutes inpatient CPT 99205 JMBCC PC INIT OFFVIS LEV 5	$237.15	$279.00	—	—	15%
New patient office visit, about 60 minutes inpatient CPT 99205 DR. CRAIG TC INIT OFFVIS LEV 5	$320.45	$377.00	—	—	15%
New patient office visit, about 60 minutes inpatient CPT 99205 OFC/OP E/M NEW HIGH 60-74 MIN	$331.50	$390.00	—	—	15%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 JMBCC PC INIT OFFVIS LEV 2	$70.55	$83.00	$42.58–$83.00	37% below	15%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFC/OP E/M NEW LOW-MD 15-29MIN	$114.75	$135.00	$42.58–$135.00	2% above	15%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 JMBCC TC INIT OFFVIS LEV 2	$141.10	$166.00	$42.58–$166.00	25% above	15%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 JMBCC PC INIT OFFVIS LEV 2	$70.55	$83.00	—	—	15%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFC/OP E/M NEW LOW-MD 15-29MIN	$114.75	$135.00	—	—	15%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 JMBCC TC INIT OFFVIS LEV 2	$141.10	$166.00	—	—	15%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL EA 15 MINUTES	$56.95	$67.00	$23.45–$58.71	31% above	15%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INITIAL 15 MIN-TELE	$56.95	$67.00	$23.45–$58.71	31% above	15%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL 15 MIN-TELE	$56.95	$67.00	—	—	15%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INITIAL EA 15 MINUTES	$56.95	$67.00	—	—	15%
Preventive checkup, new patient aged 18–39 CPT 99385 INIT PM E/M NEW PAT AGE 18-39	$172.55	$203.00	$30.67–$122.61	44% above	15%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INIT PM E/M NEW PAT AGE 18-39	$172.55	$203.00	—	—	15%
Preventive checkup, new patient aged 40–64 CPT 99386 INIT PM E/M NEW PAT AGE 40-64	$200.60	$236.00	$30.50–$121.93	67% above	15%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INIT PM E/M NEW PAT AGE 40-64	$200.60	$236.00	—	—	15%
Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT AGE 65+	$218.45	$257.00	$22.82–$128.50	55% above	15%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 INIT PM E/M NEW PAT AGE 65+	$218.45	$257.00	—	—	15%
Preventive checkup, returning patient aged 18–39 CPT 99395 PER PM E/M EST PAT AGE 18-39	$157.25	$185.00	$15.02–$108.00	112% above	15%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PER PM E/M EST PAT AGE 18-39	$157.25	$185.00	—	—	15%
Preventive checkup, returning patient aged 40–64 CPT 99396 PER PM E/M EST PAT AGE 40-64	$165.75	$195.00	$17.27–$108.00	91% above	15%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PER PM E/M EST PAT AGE 40-64	$165.75	$195.00	—	—	15%
Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM E/M EST PAT AGE 65+	$178.50	$210.00	$73.50–$108.00	49% above	15%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PER PM E/M EST PAT AGE 65+	$178.50	$210.00	—	—	15%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$20.40	$24.00	$8.40–$108.00	37% below	15%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10MIN	$54.40	$64.00	$10.98–$38.40	68% above	15%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$20.40	$24.00	—	—	15%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10MIN	$54.40	$64.00	—	—	15%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 JMBCC PC EST OFFVIS LEV 5	$156.40	$184.00	$38.77–$154.99	24% below	15%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 DR. SIMS TC COMP OFF VIS EST	$254.15	$299.00	$38.77–$154.99	23% above	15%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFC/OP E/M ESTAB MD-HI 40-54 M	$259.25	$305.00	$38.77–$154.99	26% above	15%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 JMBCC PC EST OFFVIS LEV 5	$156.40	$184.00	—	—	15%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 DR. SIMS TC COMP OFF VIS EST	$254.15	$299.00	—	—	15%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFC/OP E/M ESTAB MD-HI 40-54 M	$259.25	$305.00	—	—	15%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 JMBCC PC EST OFFVIS LEV 3	$72.25	$85.00	$27.83–$85.00	52% below	15%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 JMBCC TC INTER OFFVIS EST	$116.45	$137.00	$27.83–$111.26	23% below	15%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFC/OP E/M EST LOW-MD 20-29 M	$131.75	$155.00	$27.83–$111.26	13% below	15%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 JMBCC PC EST OFFVIS LEV 3	$72.25	$85.00	—	—	15%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 JMBCC TC INTER OFFVIS EST	$116.45	$137.00	—	—	15%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFC/OP E/M EST LOW-MD 20-29 M	$131.75	$155.00	—	—	15%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 JMBCC PC EST OFFVIS LEV 4	$110.50	$130.00	$33.05–$130.00	34% below	15%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 JMBCC TC EXP OFF VIS EST	$172.55	$203.00	$33.05–$132.12	3% above	15%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFC/OP E/M ESTAB MOD 30-39 MIN	$187.00	$220.00	$33.05–$132.12	11% above	15%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 JMBCC PC EST OFFVIS LEV 4	$110.50	$130.00	—	—	15%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 JMBCC TC EXP OFF VIS EST	$172.55	$203.00	—	—	15%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFC/OP E/M ESTAB MOD 30-39 MIN	$187.00	$220.00	—	—	15%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 JMBCC PC EST OFFVIS LEV 2	$36.55	$43.00	$23.77–$43.00	65% below	15%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFC/OP E/M ESTAB MINOR 10-19 M	$80.75	$95.00	$23.77–$108.00	23% below	15%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 JMBCC TC BRIEF OFFVIS EST	$93.91	$110.48	$23.77–$108.00	10% below	15%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 JMBCC PC EST OFFVIS LEV 2	$36.55	$43.00	—	—	15%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFC/OP E/M ESTAB MINOR 10-19 M	$80.75	$95.00	—	—	15%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 JMBCC TC BRIEF OFFVIS EST	$93.91	$110.48	—	—	15%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFC/OP CONSLT NEW/EST PT 40 MN	$165.75	$195.00	$45.33–$181.22	10% below	15%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFC/OP CONSLT NEW/EST PT 40 MN	$165.75	$195.00	—	—	15%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFC/OP CONSLT NEW/EST PT 60 MN	$235.45	$277.00	$76.23–$277.00	12% below	15%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFC/OP CONSLT NEW/EST PT 60 MN	$235.45	$277.00	—	—	15%
Spirometry before and after a bronchodilator CPT 94060 PFT	$63.75	$75.00	$11.97–$75.00	89% below	15%
Spirometry before and after a bronchodilator CPT 94060 PULM FUNC W/WO DILATOR	$413.95	$487.00	$11.97–$292.20	30% below	15%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT	$63.75	$75.00	—	—	15%
Spirometry before and after a bronchodilator inpatient CPT 94060 PULM FUNC W/WO DILATOR	$413.95	$487.00	—	—	15%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 WET PHLEBOTOMY, THERAPEUT	$192.95	$227.00	$10.50–$136.20	10% below	15%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 WET PHLEBOTOMY	$192.95	$227.00	$11.70–$136.20	10% below	15%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 WET PHLEBOTOMY, THERAPEUT	$192.95	$227.00	—	—	15%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 WET PHLEBOTOMY	$192.95	$227.00	—	—	15%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 CARDIOVASCULAR STRESS TEST	$170.00	$200.00	$55.12–$200.00	59% below	15%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 CARDIOVASCULAR STRESS TEST	$170.00	$200.00	—	—	15%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Pennsylvania	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Flu Vax 65+ NDC 70461002503	$224.05	$263.59	$10.50–$158.15	34% above	15%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 TRIVALENT HIGH DOSE INFLUENZA	$224.09	$263.64	$10.50–$158.18	34% above	15%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Flu Vax 65+ NDC 70461002503	$224.05	$263.59	—	—	15%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 TRIVALENT HIGH DOSE INFLUENZA	$224.09	$263.64	—	—	15%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA	$91.80	$108.00	$10.50–$192.13	68% below	15%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA	$91.80	$108.00	—	—	15%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Flu Vax - std NDC 33332002503	$65.69	$77.28	$10.02–$46.37	52% above	15%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 Flu Vax - std NDC 33332002503	$65.69	$77.28	—	—	15%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$276.25	$325.00	$10.50–$195.00	18% below	15%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 9VHPV VACCINE 2/3 DOSE IM	$276.25	$325.00	—	—	15%
Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM	$91.80	$108.00	$10.50–$108.00	18% below	15%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPA VACCINE ADULT IM	$91.80	$108.00	—	—	15%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$98.60	$116.00	$10.50–$116.00	52% above	15%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPB VACCINE 3 DOSE ADULT IM	$98.60	$116.00	—	—	15%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU SHOT HIGH DOSE 65+	$224.05	$263.59	$10.50–$158.15	114% above	15%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU SHOT HIGH DOSE 65+	$224.05	$263.59	—	—	15%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$127.50	$150.00	$10.50–$90.00	136% above	15%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE SC	$127.50	$150.00	—	—	15%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGITIS VACCINE	$190.40	$224.00	$10.50–$175.06	96% above	15%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACTRA INJECTION	$412.00	$484.71	$10.50–$290.83	324% above	15%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGITIS VACCINE	$190.40	$224.00	—	—	15%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENACTRA INJECTION	$412.00	$484.71	—	—	15%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20 SYRINGE INJ 0.5ML	$800.11	$941.31	$10.50–$564.79	93% above	15%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20 SYRINGE INJ 0.5ML	$800.11	$941.31	—	—	15%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 VIAL	$80.75	$95.00	$10.50–$137.47	37% below	15%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$187.00	$220.00	$10.50–$137.47	46% above	15%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 VIAL	$80.75	$95.00	—	—	15%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$187.00	$220.00	—	—	15%
Rabies vaccine, one dose CPT 90675 RABIES VAC(IMOVAX)PERDOSE	$920.52	$1,082.97	$10.50–$649.78	53% above	15%
Rabies vaccine, one dose CPT 90675 RABIES VAC IMOVAX PERDOSE	$920.52	$1,082.97	$10.50–$649.78	53% above	15%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC(IMOVAX)PERDOSE	$920.52	$1,082.97	—	—	15%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC IMOVAX PERDOSE	$920.52	$1,082.97	—	—	15%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$51.85	$61.00	$10.50–$61.00	7% below	15%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS DIP DECAVAC 0.5ML	$88.33	$103.92	$10.50–$64.44	58% above	15%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIP DECAVAC 0.5ML	$88.33	$103.92	$10.50–$64.44	58% above	15%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$51.85	$61.00	—	—	15%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIP DECAVAC 0.5ML	$88.33	$103.92	—	—	15%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS DIP DECAVAC 0.5ML	$88.33	$103.92	—	—	15%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$50.15	$59.00	$10.50–$39.44	7% below	15%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 BOOSTRIX 0.5ML SYRINGE	$105.34	$123.93	$10.50–$74.36	95% above	15%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$50.15	$59.00	—	—	15%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX 0.5ML SYRINGE	$105.34	$123.93	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$32.30	$38.00	$0.21–$22.80	23% below	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VACC-NO PHY SVC/DAY	$40.80	$48.00	$0.21–$28.80	3% below	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INFLUENZA VACCINE ADMINISTR	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN OF INFLUENZA INJECT	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION, OTHERS	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS B VACCINE ADMINISTR	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION X1	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU HM HLTH FLU VACCINE	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL VACCINE ADMINISTR	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 VACCINE ADMINISTRATION, OTHER	$95.20	$112.00	$0.21–$67.20	127% above	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$32.30	$38.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VACC-NO PHY SVC/DAY	$40.80	$48.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INFLUENZA VACCINE ADMINISTR	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL VACCINE ADMINISTR	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU HM HLTH FLU VACCINE	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN OF INFLUENZA INJECT	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION X1	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION, OTHERS	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 VACCINE ADMINISTRATION, OTHER	$95.20	$112.00	—	—	15%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS B VACCINE ADMINISTR	$95.20	$112.00	—	—	15%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$17.00	$20.00	$0.10–$12.00	14% below	15%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD	$17.00	$20.00	—	—	15%

Source file: https://www.windbercare.org/251244202_Chan-Soon-Shiong-Medical-Center-at-Windber_standardcharges.csv