Metro Nashville General Hospital
Metro Nashville General Hospital in Nashville, TN publishes cash prices for 400 common procedures listed here, from its own machine-readable price file updated Sep 1, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Tennessee median for 326 of 395 procedures and below it for 65. By typical cash price it ranks #59 of 76 Tennessee hospitals and #7 of 18 hospitals in the Nashville, TN area, cheapest first. Click a procedure to compare it with other hospitals nearby.
1818 Albion Street, Nashville, TN 37208 Collected Sep 27, 2026 Source price file (615) 341-4000
Acute care hospital Emergency department CMS star rating 4 of 5 CCN 440111 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Tennessee | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3 Plus Views Right | $277.20 | $462.00 | — | 123% above | 40% |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3 Plus Views Left | $277.20 | $462.00 | — | 123% above | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3 Plus Views Right | $277.20 | $462.00 | — | — | 40% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3 Plus Views Left | $277.20 | $462.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study | $858.00 | $1,430.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 93922 Non-invasive upper/lower ext arteri | $373.20 | $622.00 | — | 60% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Ankle Brachial Index | $373.20 | $622.00 | — | 60% above | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study | $858.00 | $1,430.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Ankle Brachial Index | $373.20 | $622.00 | — | — | 40% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 93922 Non-invasive upper/lower ext arteri | $373.20 | $622.00 | — | — | 40% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagram | $436.20 | $727.00 | — | 109% above | 40% |
| Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagram | $436.20 | $727.00 | — | — | 40% |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body Injection | $1,312.80 | $2,188.00 | — | 110% above | 40% |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body Injection | $1,312.80 | $2,188.00 | — | — | 40% |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Complete Bilat | $411.60 | $686.00 | — | — | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right | $411.60 | $686.00 | — | 137% above | 40% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left | $411.60 | $686.00 | — | 137% above | 40% |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Complete Bilat | $411.60 | $686.00 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left | $411.60 | $686.00 | — | — | 40% |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right | $411.60 | $686.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilat | $310.80 | $518.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $310.80 | $518.00 | — | 90% above | 40% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right | $310.80 | $518.00 | — | 90% above | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilat | $310.80 | $518.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left | $310.80 | $518.00 | — | — | 40% |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right | $310.80 | $518.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE w/ Contrast | $1,925.40 | $3,209.00 | — | 90% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen | $1,925.40 | $3,209.00 | — | 90% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest/Abdomen/Pelvis w/ Runoff | $1,925.40 | $3,209.00 | — | 90% above | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest PE w/ Contrast | $1,925.40 | $3,209.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen | $1,925.40 | $3,209.00 | — | — | 40% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest/Abdomen/Pelvis w/ Runoff | $1,925.40 | $3,209.00 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Coronary Art w/Cont w/FFR/Plaq | $1,489.32 | $2,482.20 | — | 99% above | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Coronary Artery w/Cont w/Plaque | $1,489.32 | $2,482.20 | — | 99% above | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Coronary Artery w/ Cont w/FFR | $1,489.32 | $2,482.20 | — | 99% above | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Heart/Coronary Arteries | $1,489.80 | $2,483.00 | — | 99% above | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT Angio Coronary Artery Str/Mph/Fnt Cnt | $1,564.20 | $2,607.00 | — | 109% above | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Coronary Art w/Cont w/FFR/Plaq | $1,489.32 | $2,482.20 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Coronary Artery w/Cont w/Plaque | $1,489.32 | $2,482.20 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Coronary Artery w/ Cont w/FFR | $1,489.32 | $2,482.20 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Heart/Coronary Arteries | $1,489.80 | $2,483.00 | — | — | 40% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT Angio Coronary Artery Str/Mph/Fnt Cnt | $1,564.20 | $2,607.00 | — | — | 40% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart Calcium Scoring | $163.20 | $272.00 | — | 65% above | 40% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart Calcium Scoring | $163.20 | $272.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $2,190.00 | $3,650.00 | — | 55% above | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 74176 CT Abdomen and Pelvis w/o Contrast: Profee AddOn | $2,299.80 | $3,833.00 | — | 63% above | 40% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 74176 CT Abdomen and Pelvis w/o Contrast: AddOn | $2,299.80 | $3,833.00 | — | 63% above | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast | $2,190.00 | $3,650.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 74176 CT Abdomen and Pelvis w/o Contrast: AddOn | $2,299.80 | $3,833.00 | — | — | 40% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 74176 CT Abdomen and Pelvis w/o Contrast: Profee AddOn | $2,299.80 | $3,833.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT Abdomen and Pelvis w/ Contrast: AddOn | $2,908.20 | $4,847.00 | — | 61% above | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast | $2,908.20 | $4,847.00 | — | 61% above | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT Abdomen and Pelvis w/ Contrast: Profee AddOn | $2,908.20 | $4,847.00 | — | 61% above | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast | $2,908.20 | $4,847.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT Abdomen and Pelvis w/ Contrast: AddOn | $2,908.20 | $4,847.00 | — | — | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT Abdomen and Pelvis w/ Contrast: Profee AddOn | $2,908.20 | $4,847.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Adrenal Mass Protocol | $3,087.00 | $5,145.00 | — | 54% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $3,087.00 | $5,145.00 | — | 54% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Renal Mass Protocol | $3,087.00 | $5,145.00 | — | 54% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 74178 CT Abdomen and Pelvis w/ + w/o Contrast: Profee AddOn | $3,241.80 | $5,403.00 | — | 62% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 74178 CT Abdomen and Pelvis w/ + w/o Contrast: AddOn | $3,241.80 | $5,403.00 | — | 62% above | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $3,087.00 | $5,145.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Adrenal Mass Protocol | $3,087.00 | $5,145.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Renal Mass Protocol | $3,087.00 | $5,145.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 74178 CT Abdomen and Pelvis w/ + w/o Contrast: AddOn | $3,241.80 | $5,403.00 | — | — | 40% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 74178 CT Abdomen and Pelvis w/ + w/o Contrast: Profee AddOn | $3,241.80 | $5,403.00 | — | — | 40% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $1,612.80 | $2,688.00 | — | 84% above | 40% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $1,612.80 | $2,688.00 | — | — | 40% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $1,309.20 | $2,182.00 | — | 69% above | 40% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $1,309.20 | $2,182.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $142.20 | $237.00 | — | 76% below | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast | $1,223.40 | $2,039.00 | — | 109% above | 40% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $1,223.40 | $2,039.00 | — | 109% above | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 70486 CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $142.20 | $237.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $1,223.40 | $2,039.00 | — | — | 40% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast | $1,223.40 | $2,039.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head Stroke Alert | $1,251.60 | $2,086.00 | — | 82% above | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $1,251.60 | $2,086.00 | — | 82% above | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast | $1,251.60 | $2,086.00 | — | — | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head Stroke Alert | $1,251.60 | $2,086.00 | — | — | 40% |
| CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast | $1,374.60 | $2,291.00 | — | 56% above | 40% |
| CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast | $1,374.60 | $2,291.00 | — | — | 40% |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast | $1,671.60 | $2,786.00 | — | 54% above | 40% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast | $1,671.60 | $2,786.00 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $1,417.80 | $2,363.00 | — | 90% above | 40% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL | $1,417.80 | $2,363.00 | — | 90% above | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 72131 CT LUMBAR SPINE W/O CONTRAST MATERIAL | $1,417.80 | $2,363.00 | — | — | 40% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $1,417.80 | $2,363.00 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL | $142.20 | $237.00 | — | 82% below | 40% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $1,432.80 | $2,388.00 | — | 83% above | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 72125 CT CERVICAL SPINE W/O CONTRAST MATERIAL | $142.20 | $237.00 | — | — | 40% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $1,432.80 | $2,388.00 | — | — | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast | $1,518.00 | $2,530.00 | — | 81% above | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast | $1,518.00 | $2,530.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 93880 Duplex scan of extracranial arteries; complete bilateral study | $841.80 | $1,403.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $841.80 | $1,403.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $841.80 | $1,403.00 | — | — | 40% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 93880 Duplex scan of extracranial arteries; complete bilateral study | $841.80 | $1,403.00 | — | — | 40% |
| Chest X-ray, 2 views both sides CPT 71046 XR Chest Decubitus Bilateral | $243.60 | $406.00 | — | — | 40% |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $243.60 | $406.00 | — | 122% above | 40% |
| Chest X-ray, 2 views inpatient both sides CPT 71046 XR Chest Decubitus Bilateral | $243.60 | $406.00 | — | — | 40% |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $243.60 | $406.00 | — | — | 40% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View Portable | $208.80 | $348.00 | — | 117% above | 40% |
| Chest X-ray, single view CPT 71045 XR Chest 1 View | $208.80 | $348.00 | — | 117% above | 40% |
| Chest X-ray, single view CPT 71045 71045 XR Chest 1 View: AddOn | $219.60 | $366.00 | — | 128% above | 40% |
| Chest X-ray, single view CPT 71045 71045 XR Chest 1 View: Profee AddOn | $219.60 | $366.00 | — | 128% above | 40% |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Left | $208.80 | $348.00 | — | 117% above | 40% |
| Chest X-ray, single view one side CPT 71045 XR Chest Decubitus Right | $208.80 | $348.00 | — | 117% above | 40% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View | $208.80 | $348.00 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Portable | $208.80 | $348.00 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 71045 XR Chest 1 View: Profee AddOn | $219.60 | $366.00 | — | — | 40% |
| Chest X-ray, single view inpatient CPT 71045 71045 XR Chest 1 View: AddOn | $219.60 | $366.00 | — | — | 40% |
| Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Right | $208.80 | $348.00 | — | — | 40% |
| Chest X-ray, single view inpatient one side CPT 71045 XR Chest Decubitus Left | $208.80 | $348.00 | — | — | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal | $576.60 | $961.00 | — | 116% above | 40% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal | $576.60 | $961.00 | — | — | 40% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $355.80 | $593.00 | — | 118% above | 40% |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton | $355.80 | $593.00 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Complete First Gest | $573.00 | $955.00 | — | 45% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Detailed Multi | $573.00 | $955.00 | — | 45% above | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Detailed Complete First Gest | $573.00 | $955.00 | — | — | 40% |
| Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Detailed Multi | $573.00 | $955.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $1,342.20 | $2,237.00 | — | 96% above | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution | $1,342.20 | $2,237.00 | — | 96% above | 40% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest/Abdomen/Pelvis w/o Contrast | $1,342.20 | $2,237.00 | — | 96% above | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast | $1,342.20 | $2,237.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest/Abdomen/Pelvis w/o Contrast | $1,342.20 | $2,237.00 | — | — | 40% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest High Resolution | $1,342.20 | $2,237.00 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $1,696.20 | $2,827.00 | — | 104% above | 40% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast | $1,696.20 | $2,827.00 | — | 104% above | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest/Abdomen/Pelvis w/ Contrast | $1,696.20 | $2,827.00 | — | — | 40% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast | $1,696.20 | $2,827.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $339.00 | $565.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo | $369.60 | $616.00 | — | — | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $369.60 | $616.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $339.00 | $565.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Diagnostic Bilateral w/ Tomo | $369.60 | $616.00 | — | — | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $369.60 | $616.00 | — | — | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Left | $269.40 | $449.00 | — | 88% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo | $269.40 | $449.00 | — | 88% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo | $269.40 | $449.00 | — | 88% above | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Right | $269.40 | $449.00 | — | 88% above | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Right | $269.40 | $449.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Left w/ Tomo | $269.40 | $449.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Diagnostic Right w/ Tomo | $269.40 | $449.00 | — | — | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Left | $269.40 | $449.00 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $857.40 | $1,429.00 | — | — | 40% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $857.40 | $1,429.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Vein Mapping Upper Extremity Bilat | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Vein Mapping Lower Extremity Bilat | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 93970 Duplex scan of extremity veins; complete bilateral study | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 93970 Duplex scan of extremity veins; complete bilateral study | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Vein Mapping Upper Extremity Bilat | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Vein Mapping Lower Extremity Bilat | $923.40 | $1,539.00 | — | — | 40% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $923.40 | $1,539.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echo 2D Complete | $1,571.40 | $2,619.00 | — | 43% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 93306 TTE - TRANSTHORACIC ECHO FLW & SPC W/DPL MNGH | $1,571.40 | $2,619.00 | — | 43% above | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echo 2D Complete | $1,571.40 | $2,619.00 | — | — | 40% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 93306 TTE - TRANSTHORACIC ECHO FLW & SPC W/DPL MNGH | $1,571.40 | $2,619.00 | — | — | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging | $1,230.60 | $2,051.00 | — | 91% above | 40% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging | $1,230.60 | $2,051.00 | — | — | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 Polysomnography; 6 yrs or older, w/ C-Pap therapy or bilevel ventilation, attended by tech | $627.60 | $1,046.00 | — | 57% below | 40% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 Polysomnography; 6 yrs or older, w/ C-Pap therapy or bilevel ventilation, attended by tech | $627.60 | $1,046.00 | — | — | 40% |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral | $292.80 | $488.00 | — | — | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $292.80 | $488.00 | — | 142% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Patella Right | $292.80 | $488.00 | — | 142% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Patella Left | $292.80 | $488.00 | — | 142% above | 40% |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $292.80 | $488.00 | — | 142% above | 40% |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral | $292.80 | $488.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $292.80 | $488.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Patella Right | $292.80 | $488.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Patella Left | $292.80 | $488.00 | — | — | 40% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $292.80 | $488.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Pancreas | $531.60 | $886.00 | — | 111% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $531.60 | $886.00 | — | 111% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Liver (Hepatic) | $531.60 | $886.00 | — | 111% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Gallbladder | $531.60 | $886.00 | — | 111% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Spleen | $531.60 | $886.00 | — | 111% above | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited | $531.60 | $886.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Liver (Hepatic) | $531.60 | $886.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Spleen | $531.60 | $886.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Gallbladder | $531.60 | $886.00 | — | — | 40% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Pancreas | $531.60 | $886.00 | — | — | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Low Dose Lung Screening | $168.60 | $281.00 | — | 6% below | 40% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Low Dose Lung Screening | $168.60 | $281.00 | — | — | 40% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral | $1,953.00 | $3,255.00 | — | — | 40% |
| MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral | $1,953.00 | $3,255.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $1,900.20 | $3,167.00 | — | 137% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $1,900.20 | $3,167.00 | — | 137% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $1,900.20 | $3,167.00 | — | 137% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $1,900.20 | $3,167.00 | — | 137% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $1,900.20 | $3,167.00 | — | 137% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $1,900.20 | $3,167.00 | — | 137% above | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $1,900.20 | $3,167.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $1,900.20 | $3,167.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $1,900.20 | $3,167.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $1,900.20 | $3,167.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $1,900.20 | $3,167.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $1,900.20 | $3,167.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $2,594.40 | $4,324.00 | — | 154% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $2,594.40 | $4,324.00 | — | 154% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $2,594.40 | $4,324.00 | — | 154% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $2,594.40 | $4,324.00 | — | 154% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $2,594.40 | $4,324.00 | — | 154% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $2,594.40 | $4,324.00 | — | 154% above | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $2,594.40 | $4,324.00 | — | — | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $1,914.60 | $3,191.00 | — | 107% above | 40% |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP w/o Contrast | $1,914.60 | $3,191.00 | — | 107% above | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $1,914.60 | $3,191.00 | — | — | 40% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP w/o Contrast | $1,914.60 | $3,191.00 | — | — | 40% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $2,666.40 | $4,444.00 | — | 114% above | 40% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $2,666.40 | $4,444.00 | — | — | 40% |
| MRI of the brain, no contrast dye CPT 70551 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $329.40 | $549.00 | — | 66% below | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/ Orbits w/o Contrast | $1,942.20 | $3,237.00 | — | 98% above | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $1,942.20 | $3,237.00 | — | 98% above | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI IAC w/o Contrast | $1,942.20 | $3,237.00 | — | 98% above | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $329.40 | $549.00 | — | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC w/o Contrast | $1,942.20 | $3,237.00 | — | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $1,942.20 | $3,237.00 | — | — | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/ Orbits w/o Contrast | $1,942.20 | $3,237.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | 96% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | 96% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | 96% above | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ Orbits w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | 96% above | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ Orbits w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | — | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $2,777.40 | $4,629.00 | — | — | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $1,970.40 | $3,284.00 | — | 102% above | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $1,970.40 | $3,284.00 | — | — | 40% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $2,802.60 | $4,671.00 | — | 108% above | 40% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $2,802.60 | $4,671.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 72146 MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL | $329.40 | $549.00 | — | 66% below | 40% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $1,962.00 | $3,270.00 | — | 101% above | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 72146 MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL | $329.40 | $549.00 | — | — | 40% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $1,962.00 | $3,270.00 | — | — | 40% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $2,788.80 | $4,648.00 | — | 110% above | 40% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $2,788.80 | $4,648.00 | — | — | 40% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $1,974.60 | $3,291.00 | — | 102% above | 40% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $1,974.60 | $3,291.00 | — | — | 40% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $2,677.20 | $4,462.00 | — | 116% above | 40% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $2,677.20 | $4,462.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $1,834.20 | $3,057.00 | — | 122% above | 40% |
| MRI of the pelvis, no contrast dye CPT 72195 MRA Pelvis w/o Contrast | $1,834.20 | $3,057.00 | — | 122% above | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRA Pelvis w/o Contrast | $1,834.20 | $3,057.00 | — | — | 40% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $1,834.20 | $3,057.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $1,902.60 | $3,171.00 | — | 113% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $1,902.60 | $3,171.00 | — | 113% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $1,902.60 | $3,171.00 | — | 113% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $1,902.60 | $3,171.00 | — | 113% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $1,902.60 | $3,171.00 | — | 113% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $1,902.60 | $3,171.00 | — | 113% above | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $1,902.60 | $3,171.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $1,902.60 | $3,171.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $1,902.60 | $3,171.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $1,902.60 | $3,171.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $1,902.60 | $3,171.00 | — | — | 40% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $1,902.60 | $3,171.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial Thallium Spect | $3,118.80 | $5,198.00 | — | 66% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Rest and Stress | $3,118.80 | $5,198.00 | — | 66% above | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial SPECT Rest and Stress | $3,118.80 | $5,198.00 | — | — | 40% |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial Thallium Spect | $3,118.80 | $5,198.00 | — | — | 40% |
| OCT scan of the retina (optical coherence tomography) CPT 92134 92134 Opthalmic Imaging, Retina | $106.80 | $178.00 | — | 118% above | 40% |
| OCT scan of the retina (optical coherence tomography) inpatient CPT 92134 92134 Opthalmic Imaging, Retina | $106.80 | $178.00 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT Skull Base to Midthigh | $4,420.20 | $7,367.00 | — | 128% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT Skull to Midthigh w/ PSMA | $4,420.20 | $7,367.00 | — | 128% above | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT Skull to Midthigh w/ PSMA | $4,420.20 | $7,367.00 | — | — | 40% |
| PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT Skull Base to Midthigh | $4,420.20 | $7,367.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 76857 US Pelvic - Limited | $370.80 | $618.00 | — | 132% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Ltd | $370.80 | $618.00 | — | 132% above | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 76857 US Pelvic - Limited | $370.80 | $618.00 | — | — | 40% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Pelvic Ltd | $370.80 | $618.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Ltd Male | $361.80 | $603.00 | — | 33% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Comp | $587.40 | $979.00 | — | 116% above | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Ltd Male | $361.80 | $603.00 | — | — | 40% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Comp | $587.40 | $979.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks Multi | $528.60 | $881.00 | — | 97% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks Single | $528.60 | $881.00 | — | 97% above | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks Multi | $528.60 | $881.00 | — | — | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks Single | $528.60 | $881.00 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Than 14 Weeks | $478.80 | $798.00 | — | 112% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 Weeks w/ Transvaginal | $478.80 | $798.00 | — | 112% above | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Than 14 Weeks | $478.80 | $798.00 | — | — | 40% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 Weeks w/ Transvaginal | $478.80 | $798.00 | — | — | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited | $361.80 | $603.00 | — | 138% above | 40% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited | $361.80 | $603.00 | — | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Screening Bilateral w/ Tomo | $273.00 | $455.00 | — | — | 40% |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral | $273.00 | $455.00 | — | — | 40% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screening Left w/ Tomo | $273.00 | $455.00 | — | 254% above | 40% |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Screening Right w/ Tomo | $273.00 | $455.00 | — | 254% above | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral | $273.00 | $455.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Screening Bilateral w/ Tomo | $273.00 | $455.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screening Right w/ Tomo | $273.00 | $455.00 | — | — | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Screening Left w/ Tomo | $273.00 | $455.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2 Plus Views Right | $280.20 | $467.00 | — | 140% above | 40% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2 Plus Views Left | $280.20 | $467.00 | — | 140% above | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2 Plus Views Right | $280.20 | $467.00 | — | — | 40% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2 Plus Views Left | $280.20 | $467.00 | — | — | 40% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech | $438.60 | $731.00 | — | 116% above | 40% |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech | $438.60 | $731.00 | — | — | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $508.80 | $848.00 | — | 90% above | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $508.80 | $848.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $412.20 | $687.00 | — | 96% above | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 76817 US OB Transvaginal: Profee AddOn | $433.20 | $722.00 | — | 106% above | 40% |
| Transvaginal ultrasound during pregnancy CPT 76817 76817 US OB Transvaginal: AddOn | $433.20 | $722.00 | — | 106% above | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $412.20 | $687.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 76817 US OB Transvaginal: Profee AddOn | $433.20 | $722.00 | — | — | 40% |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 76817 US OB Transvaginal: AddOn | $433.20 | $722.00 | — | — | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $681.60 | $1,136.00 | — | 113% above | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $681.60 | $1,136.00 | — | — | 40% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) | $546.60 | $911.00 | — | 107% above | 40% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) | $546.60 | $911.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $515.40 | $859.00 | — | 115% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid | $515.40 | $859.00 | — | 115% above | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $515.40 | $859.00 | — | — | 40% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid | $515.40 | $859.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 93971 Duplex scan of extremity veins; unilateral or limited study | $147.60 | $246.00 | — | 51% below | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Vein Mapping Upper Extremity Left | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Vein Mapping Lower Extremity Right | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Vein Mapping Lower Extremity Left | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Vein Mapping Upper Extremity Right | $633.00 | $1,055.00 | — | 109% above | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 93971 Duplex scan of extremity veins; unilateral or limited study | $147.60 | $246.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Vein Mapping Upper Extremity Left | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Vein Mapping Lower Extremity Left | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Vein Mapping Lower Extremity Right | $633.00 | $1,055.00 | — | — | 40% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Vein Mapping Upper Extremity Right | $633.00 | $1,055.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral | $269.40 | $449.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3 Plus Views Right | $269.40 | $449.00 | — | 123% above | 40% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left | $269.40 | $449.00 | — | 123% above | 40% |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral | $269.40 | $449.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left | $269.40 | $449.00 | — | — | 40% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3 Plus Views Right | $269.40 | $449.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right | $249.00 | $415.00 | — | 123% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left | $249.00 | $415.00 | — | 123% above | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right | $249.00 | $415.00 | — | — | 40% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left | $249.00 | $415.00 | — | — | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR Infant Abdomen/Chest 1 View | $223.80 | $373.00 | — | 124% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen 1 View | $223.80 | $373.00 | — | 124% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 XR Sitz Marker | $223.80 | $373.00 | — | 124% above | 40% |
| X-ray of the abdomen, 1 view CPT 74018 74018 XR Abdomen 1 View: AddOn | $235.20 | $392.00 | — | 136% above | 40% |
| X-ray of the abdomen, 1 view one side CPT 74018 XR Abdomen Decubitus Right | $223.80 | $373.00 | — | 124% above | 40% |
| X-ray of the abdomen, 1 view one side CPT 74018 XR Abdomen Decubitus Left | $223.80 | $373.00 | — | 124% above | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Infant Abdomen/Chest 1 View | $223.80 | $373.00 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen 1 View | $223.80 | $373.00 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Sitz Marker | $223.80 | $373.00 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 74018 XR Abdomen 1 View: AddOn | $235.20 | $392.00 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient one side CPT 74018 XR Abdomen Decubitus Right | $223.80 | $373.00 | — | — | 40% |
| X-ray of the abdomen, 1 view inpatient one side CPT 74018 XR Abdomen Decubitus Left | $223.80 | $373.00 | — | — | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $232.20 | $387.00 | — | 172% above | 40% |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $232.20 | $387.00 | — | 172% above | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $232.20 | $387.00 | — | — | 40% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $232.20 | $387.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2 Plus Views Right | $208.20 | $347.00 | — | 81% above | 40% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2 Plus Views Left | $208.20 | $347.00 | — | 81% above | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2 Plus Views Left | $208.20 | $347.00 | — | — | 40% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2 Plus Views Right | $208.20 | $347.00 | — | — | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $229.80 | $383.00 | — | 227% above | 40% |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $229.80 | $383.00 | — | 227% above | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $229.80 | $383.00 | — | — | 40% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $229.80 | $383.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3 plus Views Right | $276.00 | $460.00 | — | 117% above | 40% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3 Plus Views Left | $276.00 | $460.00 | — | 117% above | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3 plus Views Right | $276.00 | $460.00 | — | — | 40% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3 Plus Views Left | $276.00 | $460.00 | — | — | 40% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete 3+ Views Bilateral | $279.00 | $465.00 | — | — | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3 Views Left | $279.00 | $465.00 | — | 134% above | 40% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3 Plus Views Right | $279.00 | $465.00 | — | 134% above | 40% |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete 3+ Views Bilateral | $279.00 | $465.00 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3 Views Left | $279.00 | $465.00 | — | — | 40% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3 Plus Views Right | $279.00 | $465.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $243.00 | $405.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left | $243.00 | $405.00 | — | 139% above | 40% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right | $243.00 | $405.00 | — | 139% above | 40% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $243.00 | $405.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left | $243.00 | $405.00 | — | — | 40% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right | $243.00 | $405.00 | — | — | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $309.00 | $515.00 | — | 119% above | 40% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $309.00 | $515.00 | — | — | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4 Plus Views | $424.20 | $707.00 | — | 101% above | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4 Plus Views | $424.20 | $707.00 | — | — | 40% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $258.60 | $431.00 | — | 165% above | 40% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views | $258.60 | $431.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical Flexion + Extension | $278.40 | $464.00 | — | 118% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $278.40 | $464.00 | — | 118% above | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $278.40 | $464.00 | — | — | 40% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical Flexion + Extension | $278.40 | $464.00 | — | — | 40% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $247.80 | $413.00 | — | 105% above | 40% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $247.80 | $413.00 | — | — | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2 Plus Views | $256.80 | $428.00 | — | 105% above | 40% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2 Plus Views | $256.80 | $428.00 | — | — | 40% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Tennessee | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 FIB-4 Panel | $36.00 | $60.00 | — | 28% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransf., Serum/Plasma ARUP | $37.80 | $63.00 | — | 34% above | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 FIB-4 Panel | $36.00 | $60.00 | — | — | 40% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransf., Serum/Plasma ARUP | $37.80 | $63.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 84450 AST | $37.20 | $62.00 | — | 28% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 84450 FIB-4 Panel | $37.20 | $62.00 | — | 28% above | 40% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate aminotransferase | $39.60 | $66.00 | — | 36% above | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 AST | $37.20 | $62.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 FIB-4 Panel | $37.20 | $62.00 | — | — | 40% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate aminotransferase | $39.60 | $66.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel Acute w Rflx HBsAg and HCV Qnt NAAT ARUP | $259.80 | $433.00 | — | 75% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hep Acute Pnl | $259.80 | $433.00 | — | 75% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Bill Only Acute Hepatitis Panel | $259.80 | $433.00 | — | 75% above | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Bill Only Acute Hepatitis Panel | $259.80 | $433.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hep Acute Pnl | $259.80 | $433.00 | — | — | 40% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel Acute w Rflx HBsAg and HCV Qnt NAAT ARUP | $259.80 | $433.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, English Plantain IgE AR | $12.60 | $21.00 | — | 17% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Fungi/Mold C. albicans IgE ARUP | $12.60 | $21.00 | — | 17% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Meadow Fescue IgE ARUP | $12.60 | $21.00 | — | 17% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, House Dust Greer IgE ARUP | $12.60 | $21.00 | — | 17% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 All, Insect, Cockroach, German IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Pigweed IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Cottonwood Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites,D.pteronyssinus IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 All, Weed, Common/Short Ragweed IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, White Pine Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Sheep Sorrel IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Kochia/Firebush IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Sycamore Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Timothy Grass IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Russian Thistle IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Walnut Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Hormod IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Pecan Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Weed,Sagebrush/Wormwd IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Tree,WhiteMulberryTree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Dog Dander IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Olive Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Fungi/Mold,A.fumigatus IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lobster IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Birch Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Crab IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Catalase | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Oak Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, A. fumigatus ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Elm Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tuna IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Western Ragweed IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Codfish IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Animal,MouseEpithelium IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Tree,MountainCedarTree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Cat Dander IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites, D. farinae IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Shrimp IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Fungi/Mold,M.racemosus IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bermuda Grass IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Tree,BoxElder/MapleTreeIgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen,Fungi/Mold,A.alternata IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, White Ash Tree IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, P.notatum IgE ARUP | $22.20 | $37.00 | — | 107% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pork IgE ARUP | $24.60 | $41.00 | — | 129% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Beef IgE ARUP | $24.60 | $41.00 | — | 129% above | 40% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lamb IgE ARUP | $24.60 | $41.00 | — | 129% above | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, House Dust Greer IgE ARUP | $12.60 | $21.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, English Plantain IgE AR | $12.60 | $21.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Fungi/Mold C. albicans IgE ARUP | $12.60 | $21.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Meadow Fescue IgE ARUP | $12.60 | $21.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Birch Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Olive Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, White Pine Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Kochia/Firebush IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Western Ragweed IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Weed,Sagebrush/Wormwd IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Shrimp IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lobster IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Crab IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Catalase | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, A. fumigatus ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tuna IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Codfish IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Sheep Sorrel IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Dog Dander IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Tree,WhiteMulberryTree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Fungi/Mold,M.racemosus IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Animal,MouseEpithelium IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Pecan Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Walnut Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Sycamore Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 All, Insect, Cockroach, German IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 All, Weed, Common/Short Ragweed IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, P.notatum IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, White Ash Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bermuda Grass IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Fungi/Mold,A.alternata IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites, D. farinae IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites,D.pteronyssinus IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Tree,BoxElder/MapleTreeIgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Cat Dander IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Fungi/Mold,A.fumigatus IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen,Tree,MountainCedarTree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Cottonwood Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Pigweed IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Russian Thistle IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Timothy Grass IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Hormod IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Elm Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Oak Tree IgE ARUP | $22.20 | $37.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pork IgE ARUP | $24.60 | $41.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Beef IgE ARUP | $24.60 | $41.00 | — | — | 40% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lamb IgE ARUP | $24.60 | $41.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Pep Ab, IgG/A ARUP | $56.40 | $94.00 | — | 59% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Antibody, IgG/IgA ARUP | $64.80 | $108.00 | — | 82% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Bacit | $64.80 | $108.00 | — | 82% above | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Pep Ab, IgG/A ARUP | $56.40 | $94.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Antibody, IgG/IgA ARUP | $64.80 | $108.00 | — | — | 40% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Bacit | $64.80 | $108.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA Reflexive Profile ARUP | $69.60 | $116.00 | — | 104% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA, IgG ELISA w/ Reflex to ANA, IgG IFA ARUP | $69.60 | $116.00 | — | 104% above | 40% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 .Antinuclear, Pattern | $69.60 | $116.00 | — | 104% above | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 .Antinuclear, Pattern | $69.60 | $116.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA Reflexive Profile ARUP | $69.60 | $116.00 | — | — | 40% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA, IgG ELISA w/ Reflex to ANA, IgG IFA ARUP | $69.60 | $116.00 | — | — | 40% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N-Terminal Pro B-Type Natriuretic Peptide | $160.80 | $268.00 | — | 75% above | 40% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 N-Terminal Pro B-Type Natriuretic Peptide | $160.80 | $268.00 | — | — | 40% |
| Basic metabolic panel (blood test) CPT 80048 80048: METABOLIC PANEL TOTAL CA | $99.60 | $166.00 | — | 33% above | 40% |
| Basic metabolic panel (blood test) CPT 80048 80048 BASIC METABOLIC PANE CHARGE | $99.60 | $166.00 | — | 33% above | 40% |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $99.60 | $166.00 | — | 33% above | 40% |
| Basic metabolic panel (blood test) CPT 80048 Bill Only Basic Metabolic Panel | $99.60 | $166.00 | — | 33% above | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Bill Only Basic Metabolic Panel | $99.60 | $166.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $99.60 | $166.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 80048 BASIC METABOLIC PANE CHARGE | $99.60 | $166.00 | — | — | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 80048: METABOLIC PANEL TOTAL CA | $99.60 | $166.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM | $195.60 | $326.00 | — | 159% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 Pro Fee AP Bill Surgical Pathology Level IV Complexity | $195.60 | $326.00 | — | 159% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Bone Marrow Biopsy | $195.60 | $326.00 | — | 159% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $195.60 | $326.00 | — | 159% above | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Surgical Pathology Level IV Complexity | $195.60 | $326.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM | $195.60 | $326.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 Pro Fee AP Bill Surgical Pathology Level IV Complexity | $195.60 | $326.00 | — | — | 40% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 88305 AP Bill Bone Marrow Biopsy | $195.60 | $326.00 | — | — | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture (Second Set) | $121.80 | $203.00 | — | 108% above | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture x2 | $121.80 | $203.00 | — | 108% above | 40% |
| Blood culture for bacteria CPT 87040 Blood Culture | $121.80 | $203.00 | — | 108% above | 40% |
| Blood culture for bacteria CPT 87040 Ox | $121.80 | $203.00 | — | 108% above | 40% |
| Blood culture for bacteria inpatient CPT 87040 Ox | $121.80 | $203.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $121.80 | $203.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture x2 | $121.80 | $203.00 | — | — | 40% |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture (Second Set) | $121.80 | $203.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Collect Venous Bld By Venipuncture | $18.60 | $31.00 | — | 110% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Vancomycin Level Peak | $18.60 | $31.00 | — | 110% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $18.60 | $31.00 | — | 110% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only VENIPUNCTURE CHARGE ONLY | $18.60 | $31.00 | — | 110% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 Collection of venous blood by venipuncture (without exam, contract only) | $18.60 | $31.00 | — | 110% above | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Vancomycin Level Peak | $18.60 | $31.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 Collect Venous Bld By Venipuncture | $18.60 | $31.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 Collection of venous blood by venipuncture (without exam, contract only) | $18.60 | $31.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Only VENIPUNCTURE CHARGE ONLY | $18.60 | $31.00 | — | — | 40% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $18.60 | $31.00 | — | — | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $33.00 | $55.00 | — | 41% above | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting | $33.00 | $55.00 | — | 41% above | 40% |
| Blood glucose (sugar) test CPT 82947 Glucose 1 Hour | $33.00 | $55.00 | — | 41% above | 40% |
| Blood glucose (sugar) test CPT 82947 82947 Glucose, Serum | $42.60 | $71.00 | — | 82% above | 40% |
| Blood glucose (sugar) test CPT 82947 POC Glucose | $45.00 | $75.00 | — | 92% above | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Fasting | $33.00 | $55.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $33.00 | $55.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose 1 Hour | $33.00 | $55.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 82947 Glucose, Serum | $42.60 | $71.00 | — | — | 40% |
| Blood glucose (sugar) test inpatient CPT 82947 POC Glucose | $45.00 | $75.00 | — | — | 40% |
| Blood lead test CPT 83655 Lead, Blood (Venous) ARUP | $44.40 | $74.00 | — | 21% above | 40% |
| Blood lead test CPT 83655 Lead, Whole Blood (Venous) ARUP | $44.40 | $74.00 | — | 21% above | 40% |
| Blood lead test inpatient CPT 83655 Lead, Blood (Venous) ARUP | $44.40 | $74.00 | — | — | 40% |
| Blood lead test inpatient CPT 83655 Lead, Whole Blood (Venous) ARUP | $44.40 | $74.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Beta hCG Pregnancy Test Urine | $85.80 | $143.00 | — | 56% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 POCT Urinalysis Dipstick | $85.80 | $143.00 | — | 56% above | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 POCT Urinalysis Dipstick | $85.80 | $143.00 | — | — | 40% |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Beta hCG Pregnancy Test Urine | $85.80 | $143.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Discrepancy | $66.00 | $110.00 | — | 40% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type ABO/Rh Typing | $66.00 | $110.00 | — | 40% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .Pre TR ABO/Rh | $66.00 | $110.00 | — | 40% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .Post TR ABO/Rh | $66.00 | $110.00 | — | 40% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord Blood ABORh | $66.00 | $110.00 | — | 40% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh Retype | $66.00 | $110.00 | — | 40% above | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .Post TR ABO/Rh | $66.00 | $110.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh Retype | $66.00 | $110.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Blood Type ABO/Rh Typing | $66.00 | $110.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord Blood ABORh | $66.00 | $110.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .Pre TR ABO/Rh | $66.00 | $110.00 | — | — | 40% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Discrepancy | $66.00 | $110.00 | — | — | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $55.20 | $92.00 | — | 159% above | 40% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $55.20 | $92.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C-Difficile PCR | $131.40 | $219.00 | — | 60% above | 40% |
| C. difficile toxin gene test (stool PCR) CPT 87493 Bill C. diff toxin B by PCR, Stool ARUP | $131.40 | $219.00 | — | 60% above | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Bill C. diff toxin B by PCR, Stool ARUP | $131.40 | $219.00 | — | — | 40% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C-Difficile PCR | $131.40 | $219.00 | — | — | 40% |
| CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen-GI (CA 19-9) ARUP | $94.20 | $157.00 | — | 43% above | 40% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen-GI (CA 19-9) ARUP | $94.20 | $157.00 | — | — | 40% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 ARUP | $108.60 | $181.00 | — | 56% above | 40% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125 ARUP | $108.60 | $181.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ | $32.40 | $54.00 | — | 37% below | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 PCR (SARS Cov2) | $88.80 | $148.00 | — | 73% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) IgG Ab | $89.40 | $149.00 | — | 74% above | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ | $32.40 | $54.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 PCR (SARS Cov2) | $88.80 | $148.00 | — | — | 40% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 (COVID-19) IgG Ab | $89.40 | $149.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 | $54.00 | $90.00 | — | 9% below | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trach - Amp AEL | $107.40 | $179.00 | — | 82% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Bill Only Chlamydia (exploding charge will include GC below) | $107.40 | $179.00 | — | 82% above | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 | $54.00 | $90.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Bill Only Chlamydia (exploding charge will include GC below) | $107.40 | $179.00 | — | — | 40% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trach - Amp AEL | $107.40 | $179.00 | — | — | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Pnl | $97.80 | $163.00 | — | 140% above | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Pnl | $97.80 | $163.00 | — | — | 40% |
| Complete blood count (CBC) with differential CPT 85025 Automated Differential | $67.20 | $112.00 | — | 67% above | 40% |
| Complete blood count (CBC) with differential CPT 85025 Bill Only CBC w/ Differential | $67.20 | $112.00 | — | 67% above | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Diff | $67.20 | $112.00 | — | 67% above | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Bill Only CBC w/ Differential | $67.20 | $112.00 | — | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Diff | $67.20 | $112.00 | — | — | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Automated Differential | $67.20 | $112.00 | — | — | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC w/o Diff | $55.80 | $93.00 | — | 128% above | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/o Diff | $55.80 | $93.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $135.60 | $226.00 | — | 40% above | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 Bill Only Comprehensive Metabolic Panel | $135.60 | $226.00 | — | 40% above | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $135.60 | $226.00 | — | — | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Bill Only Comprehensive Metabolic Panel | $135.60 | $226.00 | — | — | 40% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate, Serum ARUP | $90.00 | $150.00 | — | 26% above | 40% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate, Serum ARUP | $90.00 | $150.00 | — | — | 40% |
| Estradiol blood test CPT 82670 Estradiol by TMS ARUP | $122.40 | $204.00 | — | 44% above | 40% |
| Estradiol blood test inpatient CPT 82670 Estradiol by TMS ARUP | $122.40 | $204.00 | — | — | 40% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone ARUP | $96.60 | $161.00 | — | 55% above | 40% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone ARUP | $96.60 | $161.00 | — | — | 40% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal ARUP | $150.60 | $251.00 | — | 50% above | 40% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal ARUP | $150.60 | $251.00 | — | — | 40% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $87.60 | $146.00 | — | 95% above | 40% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $87.60 | $146.00 | — | — | 40% |
| Folate (folic acid) blood test CPT 82746 Folate, Serum ARUP | $85.20 | $142.00 | — | 73% above | 40% |
| Folate (folic acid) blood test CPT 82746 Folate Level | $85.20 | $142.00 | — | 73% above | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate, Serum ARUP | $85.20 | $142.00 | — | — | 40% |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $85.20 | $142.00 | — | — | 40% |
| Free T3 thyroid hormone test CPT 84481 Triiodothyronine, Free (Free T3) ARUP | $93.00 | $155.00 | — | 65% above | 40% |
| Free T3 thyroid hormone test inpatient CPT 84481 Triiodothyronine, Free (Free T3) ARUP | $93.00 | $155.00 | — | — | 40% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $75.00 | $125.00 | — | 123% above | 40% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level | $75.00 | $125.00 | — | — | 40% |
| Free testosterone test CPT 84402 Testosterone, Free by Dialysis and Mass Spectrometry ARUP | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test CPT 84402 Testosterone Free, Female,Child,Other ARUP | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test CPT 84402 Testosterone Free Adult Male/Other ARUP | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test CPT 84402 Testosterone, Free Calculation ARUP | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test CPT 84402 Testos Free Adult Male ED/LC-MS/MS ARUP | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test CPT 84402 Testosterone Level Total | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test CPT 84402 Testosterone, Free by Mass Spec. ARUP | $94.20 | $157.00 | — | 57% above | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free Calculation ARUP | $94.20 | $157.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Free, Female,Child,Other ARUP | $94.20 | $157.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Level Total | $94.20 | $157.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone Free Adult Male/Other ARUP | $94.20 | $157.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free by Mass Spec. ARUP | $94.20 | $157.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testosterone, Free by Dialysis and Mass Spectrometry ARUP | $94.20 | $157.00 | — | — | 40% |
| Free testosterone test inpatient CPT 84402 Testos Free Adult Male ED/LC-MS/MS ARUP | $94.20 | $157.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour Post Prandial | $33.00 | $55.00 | — | 8% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 2 Hour | $33.00 | $55.00 | — | 8% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Challenge OB1 | $33.00 | $55.00 | — | 8% above | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Challenge OB1 | $33.00 | $55.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour | $33.00 | $55.00 | — | — | 40% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 2 Hour Post Prandial | $33.00 | $55.00 | — | — | 40% |
| Glucose tolerance test, 3 samples CPT 82951 Glucose 3 Hour | $76.80 | $128.00 | — | 84% above | 40% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose 3 Hour | $76.80 | $128.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrhoeae - Amp AEL | $106.80 | $178.00 | — | 77% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Bill Only N.GONORRHOEAE DNA AMP PROB | $107.40 | $179.00 | — | 78% above | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N Gonorrhoeae - Amp AEL | $106.80 | $178.00 | — | — | 40% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 Bill Only N.GONORRHOEAE DNA AMP PROB | $107.40 | $179.00 | — | — | 40% |
| H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag, Fecal by EIA ARUP | $86.40 | $144.00 | — | 45% above | 40% |
| H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag, Fecal by EIA ARUP | $86.40 | $144.00 | — | — | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 by Quantitative NAAT, ARUP | $271.80 | $453.00 | — | 82% above | 40% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 by Quantitative NAAT, ARUP | $271.80 | $453.00 | — | — | 40% |
| HIV-1 and HIV-2 antibody test CPT 86703 Bill Only HIV Ag/Ab Combo 1/2 Screen w/ Interp | $72.60 | $121.00 | — | 135% above | 40% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 Bill Only HIV Ag/Ab Combo 1/2 Screen w/ Interp | $72.60 | $121.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1,2 Combo Ag/Ab, w/Rflx. ARUP | $51.00 | $85.00 | — | 1% below | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab Combo 1/2 Screen | $79.20 | $132.00 | — | 54% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 Antibody Screen | $79.20 | $132.00 | — | 54% above | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1,2 Combo Ag/Ab, w/Rflx. ARUP | $51.00 | $85.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab Combo 1/2 Screen | $79.20 | $132.00 | — | — | 40% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 Antibody Screen | $79.20 | $132.00 | — | — | 40% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 87624 AP Bill HPV High Risk Detection | $108.60 | $181.00 | — | 162% above | 40% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 87624 AP Bill HPV High Risk Detection | $108.60 | $181.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $63.00 | $105.00 | — | 50% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c POCT | $63.00 | $105.00 | — | 50% above | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c POCT | $63.00 | $105.00 | — | — | 40% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c | $63.00 | $105.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B S Ab | $72.60 | $121.00 | — | 46% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Bill Only Hepatitis B surface antibody | $72.60 | $121.00 | — | 46% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Virus Surface Antibody ARUP | $72.60 | $121.00 | — | 46% above | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Virus Surface Antibody ARUP | $72.60 | $121.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Bill Only Hepatitis B surface antibody | $72.60 | $121.00 | — | — | 40% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B S Ab | $72.60 | $121.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Core Antibody IgM | $79.20 | $132.00 | — | 181% above | 40% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Bill Only Hepatitis B surface antigen | $79.20 | $132.00 | — | 181% above | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Bill Only Hepatitis B surface antigen | $79.20 | $132.00 | — | — | 40% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Core Antibody IgM | $79.20 | $132.00 | — | — | 40% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Ab w/Rflx to HCV PCR ARUP | $85.80 | $143.00 | — | 95% above | 40% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Ab w/Rflx to HCV PCR ARUP | $85.80 | $143.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV Qnt w/Rfx to HCV Genotype ARUP | $225.00 | $375.00 | — | 72% above | 40% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV by Quantitative NAAT ARUP | $225.00 | $375.00 | — | 72% above | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV Qnt w/Rfx to HCV Genotype ARUP | $225.00 | $375.00 | — | — | 40% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV by Quantitative NAAT ARUP | $225.00 | $375.00 | — | — | 40% |
| Herpes blood test, HSV-1 antibody CPT 86695 86695 | $52.80 | $88.00 | — | 58% above | 40% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 | $52.80 | $88.00 | — | — | 40% |
| Herpes blood test, HSV-2 antibody CPT 86696 86696 | $63.60 | $106.00 | — | 48% above | 40% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 | $63.60 | $106.00 | — | — | 40% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, High Sensitivity (hsCRP) ARUP 0050182 | $70.80 | $118.00 | — | 80% above | 40% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, High Sensitivity (hsCRP) ARUP 0050182 | $70.80 | $118.00 | — | — | 40% |
| Homocysteine blood test CPT 83090 Homocysteine, Total ARUP | $99.00 | $165.00 | — | 92% above | 40% |
| Homocysteine blood test inpatient CPT 83090 Homocysteine, Total ARUP | $99.00 | $165.00 | — | — | 40% |
| Insulin blood test CPT 83525 Insulin, Fasting ARUP | $59.40 | $99.00 | — | 49% above | 40% |
| Insulin blood test inpatient CPT 83525 Insulin, Fasting ARUP | $59.40 | $99.00 | — | — | 40% |
| Iron blood test (serum iron) CPT 83540 Iron Level | $48.00 | $80.00 | — | 46% above | 40% |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $48.00 | $80.00 | — | — | 40% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $56.40 | $94.00 | — | 28% above | 40% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 Total Iron Binding Capacity | $56.40 | $94.00 | — | — | 40% |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $99.60 | $166.00 | — | 44% above | 40% |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $99.60 | $166.00 | — | — | 40% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone, Serum ARUP | $99.00 | $165.00 | — | 60% above | 40% |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone, Serum ARUP | $99.00 | $165.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase, Fluid ARUP | $74.40 | $124.00 | — | 112% above | 40% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $74.40 | $124.00 | — | 112% above | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $74.40 | $124.00 | — | — | 40% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase, Fluid ARUP | $74.40 | $124.00 | — | — | 40% |
| Liver function blood test panel CPT 80076 Hepatic Panel | $103.20 | $172.00 | — | 25% above | 40% |
| Liver function blood test panel inpatient CPT 80076 Hepatic Panel | $103.20 | $172.00 | — | — | 40% |
| Magnesium blood test CPT 83735 Magnesium Level Urine | $57.00 | $95.00 | — | 188% above | 40% |
| Magnesium blood test CPT 83735 Magnesium Level | $57.00 | $95.00 | — | 188% above | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level Urine | $57.00 | $95.00 | — | — | 40% |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $57.00 | $95.00 | — | — | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles, Rubeola, Antibody IgM ARUP | $52.80 | $88.00 | — | 34% above | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles, Rubeola, Antibody IgG ARUP | $52.80 | $88.00 | — | 34% above | 40% |
| Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) Antibody, IgG ARUP | $52.80 | $88.00 | — | 34% above | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles, Rubeola, Antibody IgM ARUP | $52.80 | $88.00 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles, Rubeola, Antibody IgG ARUP | $52.80 | $88.00 | — | — | 40% |
| Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) Antibody, IgG ARUP | $52.80 | $88.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 86308 HETEROPHILE ANTIBODIES | $54.60 | $91.00 | — | 68% above | 40% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $54.60 | $91.00 | — | 68% above | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 86308 HETEROPHILE ANTIBODIES | $54.60 | $91.00 | — | — | 40% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen | $54.60 | $91.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Specific Antigen, Total ARUP | $16.80 | $28.00 | — | 64% below | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Prostate Specific Antigen, Total ARUP | $16.80 | $28.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen, Free ARUP | $16.80 | $28.00 | — | 70% below | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen ARUP | $95.40 | $159.00 | — | 69% above | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen Total | $95.40 | $159.00 | — | 69% above | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen, Free ARUP | $16.80 | $28.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen ARUP | $95.40 | $159.00 | — | — | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Prostate Specific Antigen Total | $95.40 | $159.00 | — | — | 40% |
| Pap test (liquid-based, automated screening with review) CPT 88175 88175 AP Bill Gyn Cytology Automatic & Manual Screen | $83.40 | $139.00 | — | 179% above | 40% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 88175 AP Bill Gyn Cytology Automatic & Manual Screen | $83.40 | $139.00 | — | — | 40% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact ARUP | $166.80 | $278.00 | — | 45% above | 40% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact ARUP | $166.80 | $278.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Reflexed to PTT Ratio, Treated | $60.00 | $100.00 | — | 171% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coag Latex | $60.60 | $101.00 | — | 174% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA Ratio ARUP | $64.80 | $108.00 | — | 193% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $64.80 | $108.00 | — | 193% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Prothrombin Time (PT) ARUP | $64.80 | $108.00 | — | 193% above | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Lupus Anticoagulant, Interpretation ARUP | $64.80 | $108.00 | — | 193% above | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Reflexed to PTT Ratio, Treated | $60.00 | $100.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Coag Latex | $60.60 | $101.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Lupus Anticoagulant, Interpretation ARUP | $64.80 | $108.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA Ratio ARUP | $64.80 | $108.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Prothrombin Time (PT) ARUP | $64.80 | $108.00 | — | — | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $64.80 | $108.00 | — | — | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NON-Invasive Prenatal Aneuploidy Screen (NIPT) | $685.80 | $1,143.00 | — | 33% below | 40% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NON-Invasive Prenatal Aneuploidy Screen (NIPT) | $685.80 | $1,143.00 | — | — | 40% |
| Progesterone blood test CPT 84144 Progesterone Level | $92.40 | $154.00 | — | 45% above | 40% |
| Progesterone blood test inpatient CPT 84144 Progesterone Level | $92.40 | $154.00 | — | — | 40% |
| Prolactin blood test CPT 84146 Prolactin ARUP | $107.40 | $179.00 | — | 30% above | 40% |
| Prolactin blood test inpatient CPT 84146 Prolactin ARUP | $107.40 | $179.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR | $72.00 | $120.00 | — | 265% above | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $72.00 | $120.00 | — | 265% above | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time | $72.00 | $120.00 | — | — | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR | $72.00 | $120.00 | — | — | 40% |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/B Clinic POC (RE) | $68.40 | $114.00 | — | 130% above | 40% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A/B Clinic POC (RE) | $68.40 | $114.00 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A, Rapid | $63.00 | $105.00 | — | 80% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep A POCT | $63.00 | $105.00 | — | 80% above | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Strep A POCT | $63.00 | $105.00 | — | — | 40% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A, Rapid | $63.00 | $105.00 | — | — | 40% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor ARUP | $56.40 | $94.00 | — | 91% above | 40% |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor ARUP | $56.40 | $94.00 | — | — | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgM ARUP | $58.80 | $98.00 | — | 85% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody, IgG ARUP | $58.80 | $98.00 | — | 85% above | 40% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody IgG ARUP | $58.80 | $98.00 | — | 85% above | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgM ARUP | $58.80 | $98.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody IgG ARUP | $58.80 | $98.00 | — | — | 40% |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibody, IgG ARUP | $58.80 | $98.00 | — | — | 40% |
| Stool ova and parasites exam CPT 87177 Ova & Parasites AEL | $166.80 | $278.00 | — | 456% above | 40% |
| Stool ova and parasites exam inpatient CPT 87177 Ova & Parasites AEL | $166.80 | $278.00 | — | — | 40% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Stool Screen | $27.00 | $45.00 | — | 43% above | 40% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Stool Screen | $27.00 | $45.00 | — | — | 40% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Immunological Fecal Occult Blood | $49.20 | $82.00 | — | 60% above | 40% |
| Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Immunological Fecal Occult Blood | $49.20 | $82.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Bill Only Rapid Plasma Reagin | $40.20 | $67.00 | — | 56% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL with Reflex to Titer, CSF ARUP | $40.20 | $67.00 | — | 56% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin | $40.20 | $67.00 | — | 56% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL with Reflex to Titer, Serum ARUP | $40.20 | $67.00 | — | 56% above | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL with Reflex to Titer, CSF ARUP | $40.20 | $67.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin | $40.20 | $67.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Bill Only Rapid Plasma Reagin | $40.20 | $67.00 | — | — | 40% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL with Reflex to Titer, Serum ARUP | $40.20 | $67.00 | — | — | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Gold Plus, 4-Tube ARUP | $157.20 | $262.00 | — | 32% above | 40% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Gold Plus, 4-Tube ARUP | $157.20 | $262.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone by Mass Spec. ARUP | $109.80 | $183.00 | — | 53% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone by Immunoassay ARUP | $109.80 | $183.00 | — | 53% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total, LC-MS/MS, Males ARUP | $109.80 | $183.00 | — | 53% above | 40% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Adult Male/Other ARUP | $109.80 | $183.00 | — | 53% above | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Adult Male/Other ARUP | $109.80 | $183.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone by Mass Spec. ARUP | $109.80 | $183.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone by Immunoassay ARUP | $109.80 | $183.00 | — | — | 40% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total, LC-MS/MS, Males ARUP | $109.80 | $183.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kid Micro-1 Ab, IgG by ELISA ARUP | $37.80 | $63.00 | — | 7% below | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Antibody ARUP | $68.40 | $114.00 | — | 68% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab ARUP | $68.40 | $114.00 | — | 68% above | 40% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome Abs, IgG ARUP | $68.40 | $114.00 | — | 68% above | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kid Micro-1 Ab, IgG by ELISA ARUP | $37.80 | $63.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Antibody ARUP | $68.40 | $114.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab ARUP | $68.40 | $114.00 | — | — | 40% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsome Abs, IgG ARUP | $68.40 | $114.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $105.00 | $175.00 | — | 106% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Parathyroid Hormone Intact | $105.00 | $175.00 | — | 106% above | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $105.00 | $175.00 | — | — | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Parathyroid Hormone Intact | $105.00 | $175.00 | — | — | 40% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas Amplified AEL | $93.00 | $155.00 | — | 50% above | 40% |
| Trichomonas test (NAAT) CPT 87661 Bill Only TRICHOMONAS VAGINALIS AMPLIF | $93.00 | $155.00 | — | 50% above | 40% |
| Trichomonas test (NAAT) CPT 87661 87661 NuSwab, Vaginitis | $219.33 | $365.55 | — | 253% above | 40% |
| Trichomonas test (NAAT) CPT 87661 87661 | $1,152.00 | $1,920.00 | — | 1755% above | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas Amplified AEL | $93.00 | $155.00 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 Bill Only TRICHOMONAS VAGINALIS AMPLIF | $93.00 | $155.00 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 87661 NuSwab, Vaginitis | $219.33 | $365.55 | — | — | 40% |
| Trichomonas test (NAAT) inpatient CPT 87661 87661 | $1,152.00 | $1,920.00 | — | — | 40% |
| Uric acid blood test CPT 84550 Uric Acid | $41.40 | $69.00 | — | 41% above | 40% |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $41.40 | $69.00 | — | — | 40% |
| Urinalysis with microscope exam, automated CPT 81001 UA w Micro if Ind & Cult if Ind | $45.60 | $76.00 | — | 61% above | 40% |
| Urinalysis with microscope exam, automated CPT 81001 Bill Only Urinalysis with micro | $45.60 | $76.00 | — | 61% above | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA w Micro if Ind & Cult if Ind | $45.60 | $76.00 | — | — | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Bill Only Urinalysis with micro | $45.60 | $76.00 | — | — | 40% |
| Urinalysis with microscope exam, manual CPT 81000 UA Microscopic | $43.80 | $73.00 | — | 201% above | 40% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 UA Microscopic | $43.80 | $73.00 | — | — | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Dipstick Clinic POC (RE) | $31.80 | $53.00 | — | 194% above | 40% |
| Urinalysis without microscope exam, automated CPT 81003 Bill Only Urinalysis (dipstick, manual, no microscopy) | $31.80 | $53.00 | — | 194% above | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Bill Only Urinalysis (dipstick, manual, no microscopy) | $31.80 | $53.00 | — | — | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urine Dipstick Clinic POC (RE) | $31.80 | $53.00 | — | — | 40% |
| Urinalysis without microscope exam, manual CPT 81002 Specific Gravity Urine | $16.80 | $28.00 | — | 102% above | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Specific Gravity Urine | $16.80 | $28.00 | — | — | 40% |
| Urine culture for bacteria, with colony count CPT 87086 Bill Only URINE CULTURE/COLONY COUNT | $65.40 | $109.00 | — | 79% above | 40% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Bill Only URINE CULTURE/COLONY COUNT | $65.40 | $109.00 | — | — | 40% |
| Urine pregnancy test, read by color change CPT 81025 Bill Only URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS | $82.20 | $137.00 | — | 108% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Clinic POC (RE) | $82.20 | $137.00 | — | 108% above | 40% |
| Urine pregnancy test, read by color change CPT 81025 Beta hCG Urine POCT | $82.20 | $137.00 | — | 108% above | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Beta hCG Urine POCT | $82.20 | $137.00 | — | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy Test Clinic POC (RE) | $82.20 | $137.00 | — | — | 40% |
| Urine pregnancy test, read by color change inpatient CPT 81025 Bill Only URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS | $82.20 | $137.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 ARUP | $84.60 | $141.00 | — | 69% above | 40% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level | $84.60 | $141.00 | — | 69% above | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $84.60 | $141.00 | — | — | 40% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 ARUP | $84.60 | $141.00 | — | — | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy ARUP | $123.00 | $205.00 | — | 70% above | 40% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy ARUP | $123.00 | $205.00 | — | — | 40% |
| Zinc blood test CPT 84630 Zinc, Serum or Plasma ARUP | $51.60 | $86.00 | — | 50% above | 40% |
| Zinc blood test inpatient CPT 84630 Zinc, Serum or Plasma ARUP | $51.60 | $86.00 | — | — | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Blood | $118.80 | $198.00 | — | 116% above | 40% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Blood | $118.80 | $198.00 | — | — | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Tennessee | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 42830 Adenoidectomy, primary; younger than age 12 | $2,145.60 | $3,576.00 | — | 31% below | 40% |
| Adenoid removal (adenoidectomy), child under 12 inpatient CPT 42830 42830 Adenoidectomy, primary; younger than age 12 | $2,145.60 | $3,576.00 | — | — | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 22551 Arthrodesis, fuse and removal, spinal cord and/or nerve roots; cervical below C2 | $5,239.80 | $8,733.00 | — | 4% below | 40% |
| Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 22551 Arthrodesis, fuse and removal, spinal cord and/or nerve roots; cervical below C2 | $5,239.80 | $8,733.00 | — | — | 40% |
| Appendectomy, open surgery CPT 44950 44950 Appendectomy | $2,236.80 | $3,728.00 | — | 275% above | 40% |
| Appendectomy, open surgery inpatient CPT 44950 44950 Appendectomy | $2,236.80 | $3,728.00 | — | — | 40% |
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction | $6,541.80 | $10,903.00 | — | 43% below | 40% |
| Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction | $6,541.80 | $10,903.00 | — | — | 40% |
| Arthroscopic rotator cuff repair of the shoulder CPT 29827 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair | $4,420.20 | $7,367.00 | — | 51% below | 40% |
| Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 29827 Arthroscopy, shoulder, surgical; with rotator cuff repair | $4,420.20 | $7,367.00 | — | — | 40% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 31295 Nasal/sinus endoscopy, surgical | $1,738.80 | $2,898.00 | — | 46% below | 40% |
| Balloon dilation of the maxillary sinus opening, one side inpatient CPT 31295 31295 Nasal/sinus endoscopy, surgical | $1,738.80 | $2,898.00 | — | — | 40% |
| Botox injections for chronic migraine CPT 64615 64615 Chemodenervation of muscle(s); migraine or head | $336.10 | $560.17 | — | 85% above | 40% |
| Botox injections for chronic migraine inpatient CPT 64615 64615 Chemodenervation of muscle(s); migraine or head | $336.10 | $560.17 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 19081 Biopsy, breast, w/ localization device; first lesion, including stereotactic guidance | $2,735.40 | $4,559.00 | — | 82% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right - Report | $2,735.40 | $4,559.00 | — | 82% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right | $2,735.40 | $4,559.00 | — | 82% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left - Report | $2,735.40 | $4,559.00 | — | 82% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left | $2,735.40 | $4,559.00 | — | 82% above | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 19081 Biopsy, breast, w/ localization device; first lesion, including stereotactic guidance | $2,735.40 | $4,559.00 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left - Report | $2,735.40 | $4,559.00 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right | $2,735.40 | $4,559.00 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right - Report | $2,735.40 | $4,559.00 | — | — | 40% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left | $2,735.40 | $4,559.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation | $358.20 | $597.00 | — | 48% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786LT CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $358.20 | $597.00 | — | 48% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786RT CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $358.20 | $597.00 | — | 48% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $358.20 | $597.00 | — | 48% above | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation | $358.20 | $597.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $358.20 | $597.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786RT CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $358.20 | $597.00 | — | — | 40% |
| Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 27786LT CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ TechFee | $358.20 | $597.00 | — | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 - Metatarsal w/o manipulation | $314.40 | $524.00 | — | 372% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 28470 Closed treatment of metatarsal fracture; without manipulation, each | $314.40 | $524.00 | — | 372% above | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 - Metatarsal w/o manipulation | $314.40 | $524.00 | — | — | 40% |
| Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 28470 Closed treatment of metatarsal fracture; without manipulation, each | $314.40 | $524.00 | — | — | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 28296 Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy | $4,381.80 | $7,303.00 | — | 20% below | 40% |
| Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 28296 Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy | $4,381.80 | $7,303.00 | — | — | 40% |
| Bunion correction with removal of part of the big toe joint CPT 28292 28292 Correction, hallux valgus (bunion), w/ or w/o sesamoidectomy; Keller, Mayo type procedure | $4,051.20 | $6,752.00 | — | 48% below | 40% |
| Bunion correction with removal of part of the big toe joint inpatient CPT 28292 28292 Correction, hallux valgus (bunion), w/ or w/o sesamoidectomy; Keller, Mayo type procedure | $4,051.20 | $6,752.00 | — | — | 40% |
| Cardiac catheterization with coronary angiogram CPT 93458 93458 Cath placement w/ injection(s) for coronary angiography; L heart cath for L ventriculography | $1,956.00 | $3,260.00 | — | 47% below | 40% |
| Cardiac catheterization with coronary angiogram one side CPT 93458 93458 HT Cath Left W LV and Cor Angio | $9,116.40 | $15,194.00 | — | 147% above | 40% |
| Cardiac catheterization with coronary angiogram inpatient CPT 93458 93458 Cath placement w/ injection(s) for coronary angiography; L heart cath for L ventriculography | $1,956.00 | $3,260.00 | — | — | 40% |
| Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 93458 HT Cath Left W LV and Cor Angio | $9,116.40 | $15,194.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 ELEC CARDIOVERSION/DEFIBRILATION OP Tech Fee | $873.00 | $1,455.00 | — | 70% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Cardioversion Cath Lab | $1,131.00 | $1,885.00 | — | 120% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 92960 Cardioversion, elective, electrical conversion of arrhythmia; external | $1,188.00 | $1,980.00 | — | 131% above | 40% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CL Cardioversion External | $1,188.00 | $1,980.00 | — | 131% above | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 ELEC CARDIOVERSION/DEFIBRILATION OP Tech Fee | $873.00 | $1,455.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 Cardioversion Cath Lab | $1,131.00 | $1,885.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 92960 Cardioversion, elective, electrical conversion of arrhythmia; external | $1,188.00 | $1,980.00 | — | — | 40% |
| Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CL Cardioversion External | $1,188.00 | $1,980.00 | — | — | 40% |
| Carpal tunnel release, open surgery CPT 64721 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel | $3,403.20 | $5,672.00 | — | 18% above | 40% |
| Carpal tunnel release, open surgery inpatient CPT 64721 64721 Neuroplasty and/or transposition; median nerve at carpal tunnel | $3,403.20 | $5,672.00 | — | — | 40% |
| Cataract surgery with lens implant CPT 66984 66984 Extracapsular cataract removal w/ insertion of intraocular lens prosthesis (1 stage procedure) | $3,282.60 | $5,471.00 | — | 10% above | 40% |
| Cataract surgery with lens implant inpatient CPT 66984 66984 Extracapsular cataract removal w/ insertion of intraocular lens prosthesis (1 stage procedure) | $3,282.60 | $5,471.00 | — | — | 40% |
| Catheter ablation for atrial fibrillation CPT 93656 93656 Comp electrophys eval including transseptal cath, w/ intracard cath ablation of atrial fib | $14,256.60 | $23,761.00 | — | 16% below | 40% |
| Catheter ablation for atrial fibrillation inpatient CPT 93656 93656 Comp electrophys eval including transseptal cath, w/ intracard cath ablation of atrial fib | $14,256.60 | $23,761.00 | — | — | 40% |
| Cervical biopsy CPT 57500 57500 Excision procedures on the cervix uteri | $1,222.20 | $2,037.00 | — | 274% above | 40% |
| Cervical biopsy inpatient CPT 57500 57500 Excision procedures on the cervix uteri | $1,222.20 | $2,037.00 | — | — | 40% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care | $1,554.60 | $2,591.00 | — | 38% below | 40% |
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 59510 Routine obstetric care including antepartum care, cesarean delivery, and postpartum care | $1,554.60 | $2,591.00 | — | — | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 54161 Circumcision >28 days of age | $4,251.60 | $7,086.00 | — | 12% above | 40% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 54161 Circumcision >28 days of age | $4,251.60 | $7,086.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Procedure Performed. -> Circumcision | $3,904.80 | $6,508.00 | — | 815% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 54150 Excision procedures on the penis | $4,100.40 | $6,834.00 | — | 861% above | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Procedure Performed. -> Circumcision | $3,904.80 | $6,508.00 | — | — | 40% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 54150 Excision procedures on the penis | $4,100.40 | $6,834.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600RT CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $385.20 | $642.00 | — | 63% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 Closed treatment of distal radial fracture; without manipulation | $385.20 | $642.00 | — | 63% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $385.20 | $642.00 | — | 63% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 25600LT CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $385.20 | $642.00 | — | 63% above | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600LT CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $385.20 | $642.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600 Closed treatment of distal radial fracture; without manipulation | $385.20 | $642.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600RT CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $385.20 | $642.00 | — | — | 40% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 25600 CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ TechFee | $385.20 | $642.00 | — | — | 40% |
| Colonoscopy with endoscopic ultrasound CPT 45391 45391 Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum | $2,107.80 | $3,513.00 | — | 91% above | 40% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 45391 Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum | $2,107.80 | $3,513.00 | — | — | 40% |
| Colonoscopy with polyp removal CPT 45385 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq | $1,906.80 | $3,178.00 | — | 51% above | 40% |
| Colonoscopy with polyp removal inpatient CPT 45385 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniq | $1,906.80 | $3,178.00 | — | — | 40% |
| Colonoscopy with tissue sample CPT 45380 45380 Colonoscopy, flexible with biopsy, single or multiple | $1,569.60 | $2,616.00 | — | 65% above | 40% |
| Colonoscopy with tissue sample inpatient CPT 45380 45380 Colonoscopy, flexible with biopsy, single or multiple | $1,569.60 | $2,616.00 | — | — | 40% |
| Colonoscopy, diagnostic CPT 45378 45378 Colonoscopy, flexible diagnostic, including collection of specimen(s) by brushing or washing | $1,849.20 | $3,082.00 | — | 47% above | 40% |
| Colonoscopy, diagnostic inpatient CPT 45378 45378 Colonoscopy, flexible diagnostic, including collection of specimen(s) by brushing or washing | $1,849.20 | $3,082.00 | — | — | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) CPT 57460 57460 Colposcopy of the cervix incl. upper vagina; with loop electrode biopsy(s) of the cervix | $2,262.60 | $3,771.00 | — | 98% above | 40% |
| Colposcopy with LEEP (loop electrosurgical excision) inpatient CPT 57460 57460 Colposcopy of the cervix incl. upper vagina; with loop electrode biopsy(s) of the cervix | $2,262.60 | $3,771.00 | — | — | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 57454 Colposcopy of the cervix including upper/adjacent vagina NMMC | $360.00 | $600.00 | — | 150% above | 40% |
| Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 57454 Colposcopy of the cervix including upper/adjacent vagina NMMC | $360.00 | $600.00 | — | — | 40% |
| Complex cataract surgery with lens implant CPT 66982 66982 Extracapsular cataract removal w/ insertion of intraocular lens prosthesis; complex | $1,399.20 | $2,332.00 | — | 53% below | 40% |
| Complex cataract surgery with lens implant inpatient CPT 66982 66982 Extracapsular cataract removal w/ insertion of intraocular lens prosthesis; complex | $1,399.20 | $2,332.00 | — | — | 40% |
| Coronary stent placement, one artery CPT 92928 92928 Stent(s) placement, w/ angioplasty when performed; single major coronary artery or branch | $12,052.20 | $20,087.00 | — | 53% above | 40% |
| Coronary stent placement, one artery CPT 92928 92928 Intracoronary Stent Placement 1St Vessel | $12,052.20 | $20,087.00 | — | 53% above | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 92928 Intracoronary Stent Placement 1St Vessel | $12,052.20 | $20,087.00 | — | — | 40% |
| Coronary stent placement, one artery inpatient CPT 92928 92928 Stent(s) placement, w/ angioplasty when performed; single major coronary artery or branch | $12,052.20 | $20,087.00 | — | — | 40% |
| Cystoscopy with ureteral stent placement both sides CPT 52332 52332 bilat Cystourethroscopy, with indwell cath | $3,973.80 | $6,623.00 | — | — | 40% |
| Cystoscopy with ureteral stent placement CPT 52332 52332 Cystourethroscopy, with insertion of indwelling ureteral stent | $3,973.80 | $6,623.00 | — | at median | 40% |
| Cystoscopy with ureteral stent placement inpatient both sides CPT 52332 52332 bilat Cystourethroscopy, with indwell cath | $3,973.80 | $6,623.00 | — | — | 40% |
| Cystoscopy with ureteral stent placement inpatient CPT 52332 52332 Cystourethroscopy, with insertion of indwelling ureteral stent | $3,973.80 | $6,623.00 | — | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE) | $2,280.00 | $3,800.00 | — | 495% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 52000 Endoscopy-Cystoscopy, urethroscopy, cystourethroscopy procedures on the bladder | $2,394.00 | $3,990.00 | — | 524% above | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE) | $2,280.00 | $3,800.00 | — | — | 40% |
| Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 52000 Endoscopy-Cystoscopy, urethroscopy, cystourethroscopy procedures on the bladder | $2,394.00 | $3,990.00 | — | — | 40% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 58120 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) | $3,753.60 | $6,256.00 | — | 38% above | 40% |
| D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 58120 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) | $3,753.60 | $6,256.00 | — | — | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruct Premalig 1st Lesion | $134.40 | $224.00 | — | 35% above | 40% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 17000 Destruct Premalig 1st Lesion | $134.40 | $224.00 | — | — | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $915.60 | $1,526.00 | — | 58% below | 40% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear inpatient CPT 69436 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia | $915.60 | $1,526.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209-Cerumen Irrigation/Lavage | $117.60 | $196.00 | — | 160% above | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209 REMOVE IMPACTED EAR WAX TechFee | $117.60 | $196.00 | — | 160% above | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209LT REMOVE IMPACTED EAR WAX TechFee | $117.60 | $196.00 | — | 160% above | 40% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 69209RT REMOVE IMPACTED EAR WAX TechFee | $117.60 | $196.00 | — | 160% above | 40% |
| Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal impacted cerumen using irrigation/lavage, unilateral | $117.60 | $196.00 | — | 160% above | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209 REMOVE IMPACTED EAR WAX TechFee | $117.60 | $196.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209RT REMOVE IMPACTED EAR WAX TechFee | $117.60 | $196.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209-Cerumen Irrigation/Lavage | $117.60 | $196.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 69209LT REMOVE IMPACTED EAR WAX TechFee | $117.60 | $196.00 | — | — | 40% |
| Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 69209 Removal impacted cerumen using irrigation/lavage, unilateral | $117.60 | $196.00 | — | — | 40% |
| Earwax removal with instruments, one ear CPT 69210 69210 Removal of ear wax instrumentation | $37.20 | $62.00 | — | 48% below | 40% |
| Earwax removal with instruments, one ear CPT 69210 6921050 REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | 65% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 Ear Irrigation POC | $118.20 | $197.00 | — | 65% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 69210RT REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | 65% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 69210 REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | 65% above | 40% |
| Earwax removal with instruments, one ear CPT 69210 69210LT REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | 65% above | 40% |
| Earwax removal with instruments, one ear one side CPT 69210 69210 Removal impacted cerumen (ear wax) requiring instrumentation, unilateral | $117.81 | $196.35 | — | 64% above | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210 Removal of ear wax instrumentation | $37.20 | $62.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 Ear Irrigation POC | $118.20 | $197.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 6921050 REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210RT REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210LT REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient CPT 69210 69210 REMOVAL EAR WAX INSTRUMENTATIONTECH FEE | $118.20 | $197.00 | — | — | 40% |
| Earwax removal with instruments, one ear inpatient one side CPT 69210 69210 Removal impacted cerumen (ear wax) requiring instrumentation, unilateral | $117.81 | $196.35 | — | — | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100 Endometrial sampling (biopsy) with or without endocervical sampling (biopsy) | $255.00 | $425.00 | — | 221% above | 40% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 58100 Endometrial sampling (biopsy) with or without endocervical sampling (biopsy) | $255.00 | $425.00 | — | — | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 31255 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior) | $3,236.40 | $5,394.00 | — | 54% below | 40% |
| Endoscopic sinus surgery: full ethmoid sinus opening inpatient CPT 31255 31255 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior) | $3,236.40 | $5,394.00 | — | — | 40% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration | $3,107.40 | $5,179.00 | — | 48% below | 40% |
| Endoscopic sinus surgery: opening the frontal sinus inpatient CPT 31276 31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration | $3,107.40 | $5,179.00 | — | — | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 31256 Nasal/sinus endoscopy, surgical, with maxillary antrostomy | $2,398.20 | $3,997.00 | — | 53% below | 40% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus inpatient CPT 31256 31256 Nasal/sinus endoscopy, surgical, with maxillary antrostomy | $2,398.20 | $3,997.00 | — | — | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 31267 Nasal/sinus endoscopy, surgical, w/ maxillary antrostomy; w/ removal of tissue from sinus | $2,888.40 | $4,814.00 | — | 62% below | 40% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue inpatient CPT 31267 31267 Nasal/sinus endoscopy, surgical, w/ maxillary antrostomy; w/ removal of tissue from sinus | $2,888.40 | $4,814.00 | — | — | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 62321 Injection(s), of diagnostic or therapeutic substance(s); cervical or thoracic, with imaging | $1,559.40 | $2,599.00 | — | 217% above | 40% |
| Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 62321 Injection(s), of diagnostic or therapeutic substance(s); cervical or thoracic, with imaging | $1,559.40 | $2,599.00 | — | — | 40% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 67028 Vitreous Procedures on the Posterior Segment of the Eye | $617.40 | $1,029.00 | — | 400% above | 40% |
| Eye injection into the vitreous (intravitreal injection) inpatient CPT 67028 67028 Vitreous Procedures on the Posterior Segment of the Eye | $617.40 | $1,029.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493 Injection Paravertebral Facet Joint - lumbar or sacral; single level | $1,668.60 | $2,781.00 | — | 145% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 IR Facet Inj Lumbar Right | $1,668.60 | $2,781.00 | — | 145% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 IR Facet Inj Lumbar Left - Report | $1,668.60 | $2,781.00 | — | 145% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 IR Facet Inj Lumbar Left | $1,668.60 | $2,781.00 | — | 145% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 IR Facet Inj Lumbar Right - Report | $1,668.60 | $2,781.00 | — | 145% above | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493 Injection Paravertebral Facet Joint - lumbar or sacral; single level | $1,668.60 | $2,781.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 IR Facet Inj Lumbar Left - Report | $1,668.60 | $2,781.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 IR Facet Inj Lumbar Right - Report | $1,668.60 | $2,781.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 IR Facet Inj Lumbar Left | $1,668.60 | $2,781.00 | — | — | 40% |
| Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 IR Facet Inj Lumbar Right | $1,668.60 | $2,781.00 | — | — | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 49593 Anterior abd hernia rpr 1st 3-10 reducible | $4,128.00 | $6,880.00 | — | 6% above | 40% |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 49593 Anterior abd hernia rpr 1st 3-10 reducible | $4,128.00 | $6,880.00 | — | — | 40% |
| First repair of a front abdominal hernia larger than 10 cm CPT 49595 49595 Anterior Abd Hernia Rpr 1ST >10 CM Reducible | $4,128.00 | $6,880.00 | — | 50% below | 40% |
| First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 49595 Anterior Abd Hernia Rpr 1ST >10 CM Reducible | $4,128.00 | $6,880.00 | — | — | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 49591 Anterior Abd Hernia Rpr 1ST < 3 CM Reducible | $2,335.20 | $3,892.00 | — | 13% below | 40% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 49591 Anterior Abd Hernia Rpr 1ST < 3 CM Reducible | $2,335.20 | $3,892.00 | — | — | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 45330 Sigmoidoscopy, flexible | $1,535.40 | $2,559.00 | — | 290% above | 40% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 45330 Sigmoidoscopy, flexible | $1,535.40 | $2,559.00 | — | — | 40% |
| Gallbladder removal, laparoscopic CPT 47562 47562 Laparoscopy, surgical; cholecystectomy | $7,790.40 | $12,984.00 | — | 31% above | 40% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 47562 Laparoscopy, surgical; cholecystectomy | $7,790.40 | $12,984.00 | — | — | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 47563 Lap, cholecystectomy w/ cholangiography | $8,456.40 | $14,094.00 | — | 42% above | 40% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 47563 Lap, cholecystectomy w/ cholangiography | $8,456.40 | $14,094.00 | — | — | 40% |
| Gallbladder removal, open surgery through a larger incision CPT 47600 47600 Cholecystectomy; | $1,917.60 | $3,196.00 | — | 81% below | 40% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 47600 Cholecystectomy; | $1,917.60 | $3,196.00 | — | — | 40% |
| Hammertoe correction surgery CPT 28285 28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) | $2,825.40 | $4,709.00 | — | 24% below | 40% |
| Hammertoe correction surgery inpatient CPT 28285 28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy) | $2,825.40 | $4,709.00 | — | — | 40% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 46221 Excision procedures on the anus | $1,015.80 | $1,693.00 | — | 21% above | 40% |
| Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 46221 Excision procedures on the anus | $1,015.80 | $1,693.00 | — | — | 40% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 46255 Hemorrhoidectomy, internal and external, single column/group | $3,960.60 | $6,601.00 | — | 9% below | 40% |
| Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 46255 Hemorrhoidectomy, internal and external, single column/group | $3,960.60 | $6,601.00 | — | — | 40% |
| Hysteroscopy with endometrial ablation CPT 58563 58563 Hysteroscopy, surgical; with endometrial ablation | $4,842.60 | $8,071.00 | — | 19% above | 40% |
| Hysteroscopy with endometrial ablation inpatient CPT 58563 58563 Hysteroscopy, surgical; with endometrial ablation | $4,842.60 | $8,071.00 | — | — | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C | $4,785.60 | $7,976.00 | — | 29% above | 40% |
| Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 58558 Hysteroscopy, surgical; w/ biopsy of endometrium and/or polypectomy, with or w/o D & C | $4,785.60 | $7,976.00 | — | — | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 58300 Introduction procedures on the corpus uteri | $1,106.40 | $1,844.00 | — | 48% below | 40% |
| IUD insertion (the device itself billed separately) CPT 58300 58300 IUD insertion | $1,106.40 | $1,844.00 | — | 48% below | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 58300 Introduction procedures on the corpus uteri | $1,106.40 | $1,844.00 | — | — | 40% |
| IUD insertion (the device itself billed separately) inpatient CPT 58300 58300 IUD insertion | $1,106.40 | $1,844.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $424.20 | $707.00 | — | 163% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 I & D Abcess Simple/Single Fac | $424.20 | $707.00 | — | 163% above | 40% |
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 Drainage Skin Abscess Simple | $686.40 | $1,144.00 | — | 325% above | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 I & D Abcess Simple/Single Fac | $424.20 | $707.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060-I&D Abscess/Cyst/Hematoma Simple | $424.20 | $707.00 | — | — | 40% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 Drainage Skin Abscess Simple | $686.40 | $1,144.00 | — | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older both sides CPT 49505 49505 bilat Repair initial inguinal hernia, 5 yrs | $6,267.00 | $10,445.00 | — | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 49505 Repair initial inguinal hernia, age 5 years or older; reducible | $6,267.00 | $10,445.00 | — | 130% above | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient both sides CPT 49505 49505 bilat Repair initial inguinal hernia, 5 yrs | $6,267.00 | $10,445.00 | — | — | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 49505 Repair initial inguinal hernia, age 5 years or older; reducible | $6,267.00 | $10,445.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTION(S) SINGLE TENDON SHEATH, OR LIGAMENT APONEUROSIS | $351.60 | $586.00 | — | 56% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection, single tendon or ligament Tech | $351.60 | $586.00 | — | 56% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS TechFee | $351.60 | $586.00 | — | 56% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar - fascia) | $351.60 | $586.00 | — | 56% above | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 Injection, single tendon or ligament Tech | $351.60 | $586.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJECTION(S) SINGLE TENDON SHEATH, OR LIGAMENT APONEUROSIS | $351.60 | $586.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS TechFee | $351.60 | $586.00 | — | — | 40% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar - fascia) | $351.60 | $586.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US TechFee | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Shoulder Injection/Asp Left - Report | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Shoulder Injection/Asp Right | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Hip Injection/Asp Left - Report | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Shoulder Injection/Asp Right - Report | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Knee Injection/Asp Right - Report | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Hip Injection/Asp Right | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Knee Injection/Asp Right | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Hip Injection/Asp Right - Report | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Hip Injection/Asp Left | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Knee Injection/Asp Left | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Shoulder Injection/Asp Left | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 XR Knee Injection/Asp Left - Report | $648.60 | $1,081.00 | — | 110% above | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 Arthrocentesis, aspiration and/or injection, major joint or bursa | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US TechFee | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Knee Injection/Asp Left | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Hip Injection/Asp Left | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Hip Injection/Asp Left - Report | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Hip Injection/Asp Right | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Hip Injection/Asp Right - Report | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Shoulder Injection/Asp Left | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Shoulder Injection/Asp Left - Report | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Shoulder Injection/Asp Right | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Shoulder Injection/Asp Right - Report | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Knee Injection/Asp Right | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Knee Injection/Asp Left - Report | $648.60 | $1,081.00 | — | — | 40% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 XR Knee Injection/Asp Right - Report | $648.60 | $1,081.00 | — | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Admin Other Charge -> 11981: Insert drug delivery implant | $546.00 | $910.00 | — | 355% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insert Drug Implant Device | $573.60 | $956.00 | — | 378% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insertion, non-biodegradable drug delivery implant | $573.60 | $956.00 | — | 378% above | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 Admin Other Charge -> 11981: Insert drug delivery implant | $546.00 | $910.00 | — | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 11981 Insertion, non-biodegradable drug delivery implant | $573.60 | $956.00 | — | — | 40% |
| Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 11981 Insert Drug Implant Device | $573.60 | $956.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee | $420.00 | $700.00 | — | 50% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa | $420.00 | $700.00 | — | 50% above | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa | $420.00 | $700.00 | — | — | 40% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US TechFee | $420.00 | $700.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee | $423.60 | $706.00 | — | 72% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without | $423.60 | $706.00 | — | 72% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, asp and/or inj, sm joint/bursa, w/o US guidance | $423.60 | $706.00 | — | 72% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Aspir/Inj small joint without guidance Tech | $423.60 | $706.00 | — | 72% above | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 Arthrocentesis, asp and/or inj, sm joint/bursa, w/o US guidance | $423.60 | $706.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without | $423.60 | $706.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US TechFee | $423.60 | $706.00 | — | — | 40% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 20600 Aspir/Inj small joint without guidance Tech | $423.60 | $706.00 | — | — | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 29882 Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) | $5,862.60 | $9,771.00 | — | 40% below | 40% |
| Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 29882 Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) | $5,862.60 | $9,771.00 | — | — | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 29881 Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral) including chondroplasty | $5,153.40 | $8,589.00 | — | at median | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 29881 Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral) including chondroplasty | $5,153.40 | $8,589.00 | — | — | 40% |
| Knee arthroscopy with removal of both torn meniscus parts CPT 29880 29880 Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty | $5,433.60 | $9,056.00 | — | 15% below | 40% |
| Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 29880 Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty | $5,433.60 | $9,056.00 | — | — | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) | $4,853.40 | $8,089.00 | — | 17% below | 40% |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) | $4,853.40 | $8,089.00 | — | — | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length CPT 43644 43644 Laparoscopy, surgical, gastric restrictive procedure with gastric bypass and Roux-en-Y gastro | $4,465.20 | $7,442.00 | — | 57% below | 40% |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length inpatient CPT 43644 43644 Laparoscopy, surgical, gastric restrictive procedure with gastric bypass and Roux-en-Y gastro | $4,465.20 | $7,442.00 | — | — | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 44970 Laparoscopy, surgical, appendectomy | $7,070.40 | $11,784.00 | — | 106% above | 40% |
| Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 44970 Laparoscopy, surgical, appendectomy | $7,070.40 | $11,784.00 | — | — | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 43280 Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) | $12,078.00 | $20,130.00 | — | 5% above | 40% |
| Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 43280 Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet procedures) | $12,078.00 | $20,130.00 | — | — | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) CPT 58570 58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; | $10,098.00 | $16,830.00 | — | 1% above | 40% |
| Laparoscopic hysterectomy (uterus 250 g or less) inpatient CPT 58570 58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; | $10,098.00 | $16,830.00 | — | — | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries CPT 58571 58571 Laparoscopy, surgical, w/ total hysterectomy, for uterus 250 g or less; w/ remvl tubes/ovaries | $10,836.00 | $18,060.00 | — | 4% above | 40% |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries inpatient CPT 58571 58571 Laparoscopy, surgical, w/ total hysterectomy, for uterus 250 g or less; w/ remvl tubes/ovaries | $10,836.00 | $18,060.00 | — | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side both sides CPT 49650 49650 bilat Laparoscopy, surg; repair init inguin | $9,575.40 | $15,959.00 | — | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 49650 Laparoscopy, surgical repair initial inguinal hernia | $9,575.40 | $15,959.00 | — | 35% above | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient both sides CPT 49650 49650 bilat Laparoscopy, surg; repair init inguin | $9,575.40 | $15,959.00 | — | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 49650 Laparoscopy, surgical repair initial inguinal hernia | $9,575.40 | $15,959.00 | — | — | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 49651 Laparoscopy, surgical; repair recurrent inguinal hernia | $9,088.20 | $15,147.00 | — | 18% above | 40% |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 49651 Laparoscopy, surgical; repair recurrent inguinal hernia | $9,088.20 | $15,147.00 | — | — | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 58661 Laparoscopy, surgical; with removal of adnexal structures | $7,564.20 | $12,607.00 | — | 67% above | 40% |
| Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 58661 Laparoscopy, surgical; with removal of adnexal structures | $7,564.20 | $12,607.00 | — | — | 40% |
| Laparoscopic sleeve gastrectomy for weight loss CPT 43775 43775 Laparoscopy, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) | $8,376.60 | $13,961.00 | — | 31% above | 40% |
| Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 43775 Laparoscopy, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) | $8,376.60 | $13,961.00 | — | — | 40% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 66821 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior | $1,079.40 | $1,799.00 | — | 193% above | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 66821 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior | $1,079.40 | $1,799.00 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee | $651.00 | $1,085.00 | — | 243% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Simple repair, face/ears/nose/lips/eyelids/muc membr, 5.1-7.5cm | $651.00 | $1,085.00 | — | 243% above | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 Simple repair, face/ears/nose/lips/eyelids/muc membr, 5.1-7.5cm | $651.00 | $1,085.00 | — | — | 40% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 12031 REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee | $651.00 | $1,085.00 | — | — | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 CL Left Heart Cath | $7,404.60 | $12,341.00 | — | 134% above | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 93452 Left Heart Cath | $7,502.40 | $12,504.00 | — | 137% above | 40% |
| Left heart catheterization, diagnostic one side CPT 93452 93452 left hrt cath w/ventrclgrphy | $7,878.00 | $13,130.00 | — | 149% above | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 CL Left Heart Cath | $7,404.60 | $12,341.00 | — | — | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 93452 Left Heart Cath | $7,502.40 | $12,504.00 | — | — | 40% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 93452 left hrt cath w/ventrclgrphy | $7,878.00 | $13,130.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Injection Lmbr/Scrl Epidural | $1,482.60 | $2,471.00 | — | 229% above | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 IR Injection Lmbr/Scrl Epidural - Report | $1,482.60 | $2,471.00 | — | 229% above | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT Injection Lmbr/Scrl Epidural | $1,482.60 | $2,471.00 | — | 229% above | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 62323 Injection(s), of diagnostic or therapeutic substance(s); lumbar or sacral, with imaging | $1,482.60 | $2,471.00 | — | 229% above | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CT Injection Lmbr/Scrl Epidural - Report | $1,482.60 | $2,471.00 | — | 229% above | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT Injection Lmbr/Scrl Epidural - Report | $1,482.60 | $2,471.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 62323 Injection(s), of diagnostic or therapeutic substance(s); lumbar or sacral, with imaging | $1,482.60 | $2,471.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Injection Lmbr/Scrl Epidural | $1,482.60 | $2,471.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR Injection Lmbr/Scrl Epidural - Report | $1,482.60 | $2,471.00 | — | — | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT Injection Lmbr/Scrl Epidural | $1,482.60 | $2,471.00 | — | — | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 62322 Injection(s), of diagnostic or therapeutic substance(s); lumbar or sacral w/o imaging | $1,488.00 | $2,480.00 | — | 202% above | 40% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 62322 Injection(s), of diagnostic or therapeutic substance(s); lumbar or sacral w/o imaging | $1,488.00 | $2,480.00 | — | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 CT Injection Lmbr/Scrl Foramina Epidural | $1,642.20 | $2,737.00 | — | 213% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 64483 Injection Transforaminal Epidural - single level | $1,642.20 | $2,737.00 | — | 213% above | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 CT Injection Lmbr/Scrl Foramina Epidural | $1,642.20 | $2,737.00 | — | — | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 64483 Injection Transforaminal Epidural - single level | $1,642.20 | $2,737.00 | — | — | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 63030 Laminotomy,w/decomp of nerve root/s; 1 interspace, lumbar | $9,613.80 | $16,023.00 | — | at median | 40% |
| Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 63030 Laminotomy,w/decomp of nerve root/s; 1 interspace, lumbar | $9,613.80 | $16,023.00 | — | — | 40% |
| Lumbar laminectomy (spinal decompression), one level CPT 63047 63047 Laminectomy, w/decompression spinal cord,nerve root/s,single vertebral segment; lumbar | $8,479.80 | $14,133.00 | — | 13% below | 40% |
| Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 63047 Laminectomy, w/decompression spinal cord,nerve root/s,single vertebral segment; lumbar | $8,479.80 | $14,133.00 | — | — | 40% |
| Lumbar spinal fusion (posterior), one level CPT 22612 22612 Arthrodesis, posterior or posterolateral technique, single level; lumbar | $5,010.60 | $8,351.00 | — | 12% below | 40% |
| Lumbar spinal fusion (posterior), one level inpatient CPT 22612 22612 Arthrodesis, posterior or posterolateral technique, single level; lumbar | $5,010.60 | $8,351.00 | — | — | 40% |
| Lumpectomy (partial mastectomy) CPT 19301 19301 Mastectomy, partial | $2,965.80 | $4,943.00 | — | 53% below | 40% |
| Lumpectomy (partial mastectomy) inpatient CPT 19301 19301 Mastectomy, partial | $2,965.80 | $4,943.00 | — | — | 40% |
| Mastectomy (total removal of the breast) CPT 19303 19303 Mastectomy, simple, complete | $5,755.20 | $9,592.00 | — | 52% below | 40% |
| Mastectomy (total removal of the breast) inpatient CPT 19303 19303 Mastectomy, simple, complete | $5,755.20 | $9,592.00 | — | — | 40% |
| Miscarriage treatment with D&C, first trimester CPT 59820 59820 CARE OF MISCARRIAGE | $3,411.60 | $5,686.00 | — | 22% above | 40% |
| Miscarriage treatment with D&C, first trimester inpatient CPT 59820 59820 CARE OF MISCARRIAGE | $3,411.60 | $5,686.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 Exc Benign Lesion < 0.5 CM | $1,129.20 | $1,882.00 | — | 510% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/ TechFee | $1,129.20 | $1,882.00 | — | 510% above | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400 Exc Benign Lesion < 0.5 CM | $1,129.20 | $1,882.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 11400 EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/ TechFee | $1,129.20 | $1,882.00 | — | — | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 Exc Benign Lesion Face Under 0.5 CM | $1,005.00 | $1,675.00 | — | 68% above | 40% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 11440 Exc Benign Lesion Face Under 0.5 CM | $1,005.00 | $1,675.00 | — | — | 40% |
| Nail removal (partial or complete), one nail CPT 11730 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee | $273.49 | $455.81 | — | 181% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 11730-Avulsion Nail Plate Single | $287.40 | $479.00 | — | 195% above | 40% |
| Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Nail Plate Simple Single | $287.40 | $479.00 | — | 195% above | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1 TechFee | $273.49 | $455.81 | — | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730 Avulsion Nail Plate Simple Single | $287.40 | $479.00 | — | — | 40% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 11730-Avulsion Nail Plate Single | $287.40 | $479.00 | — | — | 40% |
| Occipital nerve block (injection for headaches) CPT 64405 64405 Injection greater occipital nerve | $696.60 | $1,161.00 | — | 233% above | 40% |
| Occipital nerve block (injection for headaches) inpatient CPT 64405 64405 Injection greater occipital nerve | $696.60 | $1,161.00 | — | — | 40% |
| Pacemaker implant (dual chamber) CPT 33208 33208 Insert or Replace Perm Atr and Ven | $12,433.80 | $20,723.00 | — | 143% above | 40% |
| Pacemaker implant (dual chamber) CPT 33208 CL Pacemaker Removal/Replacement | $13,056.00 | $21,760.00 | — | 156% above | 40% |
| Pacemaker implant (dual chamber) CPT 33208 33208 Insert permanent pacemaker w/ transvenous electrode(s); atrial and ventricular | $13,056.00 | $21,760.00 | — | 156% above | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 33208 Insert or Replace Perm Atr and Ven | $12,433.80 | $20,723.00 | — | — | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 CL Pacemaker Removal/Replacement | $13,056.00 | $21,760.00 | — | — | 40% |
| Pacemaker implant (dual chamber) inpatient CPT 33208 33208 Insert permanent pacemaker w/ transvenous electrode(s); atrial and ventricular | $13,056.00 | $21,760.00 | — | — | 40% |
| Paracentesis with imaging guidance CPT 49083 49083 ABD paracentesis w/ imaging | $1,389.00 | $2,315.00 | — | 160% above | 40% |
| Paracentesis with imaging guidance CPT 49083 US Guided Paracentesis | $1,389.00 | $2,315.00 | — | 160% above | 40% |
| Paracentesis with imaging guidance CPT 49083 US Guided Paracentesis - Report | $1,389.00 | $2,315.00 | — | 160% above | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 49083 ABD paracentesis w/ imaging | $1,389.00 | $2,315.00 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Guided Paracentesis - Report | $1,389.00 | $2,315.00 | — | — | 40% |
| Paracentesis with imaging guidance inpatient CPT 49083 US Guided Paracentesis | $1,389.00 | $2,315.00 | — | — | 40% |
| Partial knee replacement (one compartment) CPT 27446 27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment | $10,663.80 | $17,773.00 | — | 293% above | 40% |
| Partial knee replacement (one compartment) inpatient CPT 27446 27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment | $10,663.80 | $17,773.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Exc Nail Matrix Partial or Complete | $809.40 | $1,349.00 | — | 207% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 Excision of nail & nail matrix Tech | $809.40 | $1,349.00 | — | 207% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL TechFee | $809.40 | $1,349.00 | — | 207% above | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Exc Nail Matrix Partial or Complete | $809.40 | $1,349.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 EXCISION NAIL MATRIX PERMANENT REMOVAL TechFee | $809.40 | $1,349.00 | — | — | 40% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 11750 Excision of nail & nail matrix Tech | $809.40 | $1,349.00 | — | — | 40% |
| Prostate biopsy CPT 55700 55700 Biopsy of prostate | $2,716.80 | $4,528.00 | — | 377% above | 40% |
| Prostate biopsy CPT 55700 CT Biopsy Prostate | $2,716.80 | $4,528.00 | — | 377% above | 40% |
| Prostate biopsy inpatient CPT 55700 55700 Biopsy of prostate | $2,716.80 | $4,528.00 | — | — | 40% |
| Prostate biopsy inpatient CPT 55700 CT Biopsy Prostate | $2,716.80 | $4,528.00 | — | — | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 55866 Laparaoscopy, surgical prostatectomy, retro radical,includes nerve sparing/robot assist | $14,413.20 | $24,022.00 | — | 64% above | 40% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 55866 Laparaoscopy, surgical prostatectomy, retro radical,includes nerve sparing/robot assist | $14,413.20 | $24,022.00 | — | — | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 64635 Destruction,neurolytic,paravertebral facet joint nerve,w/imaging;lumb/sac,single facet | $2,544.60 | $4,241.00 | — | 65% above | 40% |
| Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 64635 Destruction,neurolytic,paravertebral facet joint nerve,w/imaging;lumb/sac,single facet | $2,544.60 | $4,241.00 | — | — | 40% |
| Removal of a breast lump, open surgery CPT 19120 19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue | $4,366.20 | $7,277.00 | — | at median | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue | $4,366.20 | $7,277.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 10120-Subcutaneous Tissue Simple | $579.60 | $966.00 | — | 142% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 Incision & Removal Foreign Body Simp FAC | $579.60 | $966.00 | — | 142% above | 40% |
| Removal of a foreign object under the skin, simple CPT 10120 10120 Remove foreign body | $579.60 | $966.00 | — | 142% above | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 Remove foreign body | $579.60 | $966.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120-Subcutaneous Tissue Simple | $579.60 | $966.00 | — | — | 40% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 Incision & Removal Foreign Body Simp FAC | $579.60 | $966.00 | — | — | 40% |
| Removal of one lobe of the thyroid (lobectomy) one side CPT 60220 60220 Total thyroid lobectomy, unilateral; with or without isthmusectomy | $9,023.40 | $15,039.00 | — | 28% above | 40% |
| Removal of one lobe of the thyroid (lobectomy) inpatient one side CPT 60220 60220 Total thyroid lobectomy, unilateral; with or without isthmusectomy | $9,023.40 | $15,039.00 | — | — | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | $1,762.20 | $2,937.00 | — | 61% above | 40% |
| Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | $1,762.20 | $2,937.00 | — | — | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 G0105 Colorectal cancer screening; colonoscopy on individual at high risk | $1,778.40 | $2,964.00 | — | 63% above | 40% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 G0105 Colorectal cancer screening; colonoscopy on individual at high risk | $1,778.40 | $2,964.00 | — | — | 40% |
| Septoplasty to straighten the nasal septum CPT 30520 30520 Septoplasty or submucous resection, w/ or w/o cartilage scoring/contouring/replcmnt w/ graft | $2,687.40 | $4,479.00 | — | 44% below | 40% |
| Septoplasty to straighten the nasal septum inpatient CPT 30520 30520 Septoplasty or submucous resection, w/ or w/o cartilage scoring/contouring/replcmnt w/ graft | $2,687.40 | $4,479.00 | — | — | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 50590 Lithotripsy, extracorporeal shock wave | $8,269.20 | $13,782.00 | — | 45% above | 40% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 50590 Lithotripsy, extracorporeal shock wave | $8,269.20 | $13,782.00 | — | — | 40% |
| Short arm cast (elbow to hand) CPT 29075 29075 Application, cast; elbow to finger (short arm) | $237.00 | $395.00 | — | 82% above | 40% |
| Short arm cast (elbow to hand) inpatient CPT 29075 29075 Application, cast; elbow to finger (short arm) | $237.00 | $395.00 | — | — | 40% |
| Short arm splint (forearm and hand) CPT 29125 29125 Application of short arm splint (forearm to hand); static | $71.40 | $119.00 | — | 27% below | 40% |
| Short arm splint (forearm and hand) CPT 29125 29125-Short Arm | $270.00 | $450.00 | — | 177% above | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125 Application of short arm splint (forearm to hand); static | $71.40 | $119.00 | — | — | 40% |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125-Short Arm | $270.00 | $450.00 | — | — | 40% |
| Short leg cast (below the knee) CPT 29405 29405 Application of short leg cast (below knee to toes); | $237.00 | $395.00 | — | 138% above | 40% |
| Short leg cast (below the knee) inpatient CPT 29405 29405 Application of short leg cast (below knee to toes); | $237.00 | $395.00 | — | — | 40% |
| Short leg splint (calf to foot) CPT 29515 29515 Application of short leg splint (calf to foot) | $184.20 | $307.00 | — | 94% above | 40% |
| Short leg splint (calf to foot) CPT 29515 29515-Short Leg | $184.20 | $307.00 | — | 94% above | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 29515 Application of short leg splint (calf to foot) | $184.20 | $307.00 | — | — | 40% |
| Short leg splint (calf to foot) inpatient CPT 29515 29515-Short Leg | $184.20 | $307.00 | — | — | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface | $2,750.40 | $4,584.00 | — | 38% below | 40% |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface | $2,750.40 | $4,584.00 | — | — | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 29826 Arthroscopy, shoulder, surgical; decompress subacromial space w/ part acromioplasty w/ release | $2,852.40 | $4,754.00 | — | 34% below | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 29826 Arthroscopy, shoulder, surgical; decompress subacromial space w/ part acromioplasty w/ release | $2,852.40 | $4,754.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $342.60 | $571.00 | — | 68% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 Laceration Repair < 2.5 CM | $342.60 | $571.00 | — | 68% above | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001-Scalp/Neck/Trunk/Genital/Extremity <= 2.5 cm | $342.60 | $571.00 | — | — | 40% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 Laceration Repair < 2.5 CM | $342.60 | $571.00 | — | — | 40% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch biopsy of skin (including simple closure, when performed); single lesion | $342.60 | $571.00 | — | 132% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 11104 BX SKIN PUNCH SINGLE LESION | $342.60 | $571.00 | — | 132% above | 40% |
| Skin biopsy, punch, one lesion CPT 11104 11104 Punch Biopsy of skin, single | $342.60 | $571.00 | — | 132% above | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch biopsy of skin (including simple closure, when performed); single lesion | $342.60 | $571.00 | — | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104 Punch Biopsy of skin, single | $342.60 | $571.00 | — | — | 40% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 11104 BX SKIN PUNCH SINGLE LESION | $342.60 | $571.00 | — | — | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 11600 Exc Malignant Lesion < 0.5 CM | $1,022.40 | $1,704.00 | — | 8% above | 40% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 11600 Exc Malignant Lesion < 0.5 CM | $1,022.40 | $1,704.00 | — | — | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 Removal of skin tags, upto & including 15 Tech | $193.20 | $322.00 | — | 130% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 Remove Skin Tags Up to 15 Lesions | $193.20 | $322.00 | — | 130% above | 40% |
| Skin tag removal, up to 15 tags CPT 11200 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 TechFee | $193.20 | $322.00 | — | 130% above | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 Remove Skin Tags Up to 15 Lesions | $193.20 | $322.00 | — | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 TechFee | $193.20 | $322.00 | — | — | 40% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 11200 Removal of skin tags, upto & including 15 Tech | $193.20 | $322.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Spinal puncture, lumbar, diagnostic | $948.00 | $1,580.00 | — | 161% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 XR Lumbar Puncture - Report | $948.00 | $1,580.00 | — | 161% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Spinal Puncture Lumbar Diagnostic | $948.00 | $1,580.00 | — | 161% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 XR Lumbar Puncture | $948.00 | $1,580.00 | — | 161% above | 40% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 62270-Lumbar Puncture Diagnostic | $948.00 | $1,580.00 | — | 161% above | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270-Lumbar Puncture Diagnostic | $948.00 | $1,580.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 XR Lumbar Puncture | $948.00 | $1,580.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 XR Lumbar Puncture - Report | $948.00 | $1,580.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 Spinal puncture, lumbar, diagnostic | $948.00 | $1,580.00 | — | — | 40% |
| Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 62270 Spinal Puncture Lumbar Diagnostic | $948.00 | $1,580.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 Laceration Repair 2.6 to 7.5 CM | $367.80 | $613.00 | — | 61% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $367.80 | $613.00 | — | 61% above | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 Laceration Repair 2.6 to 7.5 CM | $367.80 | $613.00 | — | — | 40% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002-Scalp/Neck/Trunk/Genital/Extremity 2.6-7.5 cm | $367.80 | $613.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $357.00 | $595.00 | — | 74% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Laceration Repair Face < 2.5 CM | $357.00 | $595.00 | — | 74% above | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011-Face/Ear/Eyelid/Nose/Lip Less Than/Equal to 2.5 cm | $357.00 | $595.00 | — | — | 40% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 Laceration Repair Face < 2.5 CM | $357.00 | $595.00 | — | — | 40% |
| TURP (transurethral resection of the prostate) CPT 52601 52601 Transurethral electrosurgical resection of prostate (TURP), complete | $6,777.60 | $11,296.00 | — | 34% above | 40% |
| TURP (transurethral resection of the prostate) inpatient CPT 52601 52601 Transurethral electrosurgical resection of prostate (TURP), complete | $6,777.60 | $11,296.00 | — | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Shave biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion | $292.80 | $488.00 | — | 98% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 11102 Tangential biopsy of skin single lesion | $292.80 | $488.00 | — | 98% above | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Tangential biopsy of skin single lesion | $292.80 | $488.00 | — | — | 40% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 11102 Shave biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion | $292.80 | $488.00 | — | — | 40% |
| Thoracentesis with imaging guidance CPT 32555 32555 Thorocentesis W/ Imaging | $1,327.80 | $2,213.00 | — | 161% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guida | $1,394.40 | $2,324.00 | — | 174% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 US Thoracentesis (US, CT or Fluro) | $1,394.40 | $2,324.00 | — | 174% above | 40% |
| Thoracentesis with imaging guidance CPT 32555 US Thoracentesis - Report | $1,394.40 | $2,324.00 | — | 174% above | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 32555 Thorocentesis W/ Imaging | $1,327.80 | $2,213.00 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis (US, CT or Fluro) | $1,394.40 | $2,324.00 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis - Report | $1,394.40 | $2,324.00 | — | — | 40% |
| Thoracentesis with imaging guidance inpatient CPT 32555 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guida | $1,394.40 | $2,324.00 | — | — | 40% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 42821 Tonsillectomy and adenoidectomy; age 12 or over | $3,860.40 | $6,434.00 | — | 8% below | 40% |
| Tonsil and adenoid removal, age 12 or older inpatient CPT 42821 42821 Tonsillectomy and adenoidectomy; age 12 or over | $3,860.40 | $6,434.00 | — | — | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 42820 Tonsillectomy and adenoidectomy; younger than age 12 | $3,913.80 | $6,523.00 | — | 10% below | 40% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 42820 Tonsillectomy and adenoidectomy; younger than age 12 | $3,913.80 | $6,523.00 | — | — | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 42826 Tonsillectomy, primary or secondary; age 12 or over | $3,608.40 | $6,014.00 | — | 14% below | 40% |
| Tonsil removal (tonsillectomy) only, age 12 or older inpatient CPT 42826 42826 Tonsillectomy, primary or secondary; age 12 or over | $3,608.40 | $6,014.00 | — | — | 40% |
| Total hip replacement CPT 27130 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement | $12,348.00 | $20,580.00 | — | 12% below | 40% |
| Total hip replacement inpatient CPT 27130 27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement | $12,348.00 | $20,580.00 | — | — | 40% |
| Total knee replacement CPT 27447 27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments | $11,314.80 | $18,858.00 | — | 11% below | 40% |
| Total knee replacement inpatient CPT 27447 27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments | $11,314.80 | $18,858.00 | — | — | 40% |
| Total shoulder replacement CPT 23472 23472 Arthroplasty, glenohumeral joint; total shoulder | $10,269.00 | $17,115.00 | — | 34% below | 40% |
| Total shoulder replacement inpatient CPT 23472 23472 Arthroplasty, glenohumeral joint; total shoulder | $10,269.00 | $17,115.00 | — | — | 40% |
| Total thyroid removal (thyroidectomy) CPT 60240 60240 -THYROIDECTOMY | $10,083.60 | $16,806.00 | — | 187% above | 40% |
| Total thyroid removal (thyroidectomy) inpatient CPT 60240 60240 -THYROIDECTOMY | $10,083.60 | $16,806.00 | — | — | 40% |
| Trigger finger release surgery CPT 26055 26055 Tendon sheath incision (eg, for trigger finger) | $2,500.20 | $4,167.00 | — | 19% below | 40% |
| Trigger finger release surgery inpatient CPT 26055 26055 Tendon sheath incision (eg, for trigger finger) | $2,500.20 | $4,167.00 | — | — | 40% |
| Trigger point injections, 1 or 2 muscles CPT 20552 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) | $476.40 | $794.00 | — | 94% above | 40% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) | $476.40 | $794.00 | — | — | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 58670 Laparoscopy, surgical; with fulguration of oviducts (with or w/o transection) | $4,969.80 | $8,283.00 | — | 43% above | 40% |
| Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 58670 Laparoscopy, surgical; with fulguration of oviducts (with or w/o transection) | $4,969.80 | $8,283.00 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 19083 Biopsy, breast, w/ localization device; first lesion, including ultrasound guidance | $2,307.60 | $3,846.00 | — | 133% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Right - Report | $2,307.60 | $3,846.00 | — | 133% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Left | $2,307.60 | $3,846.00 | — | 133% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Right | $2,307.60 | $3,846.00 | — | 133% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Left - Report | $2,307.60 | $3,846.00 | — | 133% above | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 19083 Biopsy, breast, w/ localization device; first lesion, including ultrasound guidance | $2,307.60 | $3,846.00 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Left | $2,307.60 | $3,846.00 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Right - Report | $2,307.60 | $3,846.00 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Left - Report | $2,307.60 | $3,846.00 | — | — | 40% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Right | $2,307.60 | $3,846.00 | — | — | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 43249 Esophagogastroduodenoscop <30 mm diameter, balloon dilation of esophagus | $1,894.80 | $3,158.00 | — | 73% above | 40% |
| Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 43249 Esophagogastroduodenoscop <30 mm diameter, balloon dilation of esophagus | $1,894.80 | $3,158.00 | — | — | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 43239 Esophagogastroduodenoscopy, flexible, transoral with biopsy, single or multiple | $1,824.00 | $3,040.00 | — | 94% above | 40% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 43239 Esophagogastroduodenoscopy, flexible, transoral with biopsy, single or multiple | $1,824.00 | $3,040.00 | — | — | 40% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 43236 Esophagogastroduodenoscopy, flexible,transoral; w/ directed submucosal injection(s), any subst | $1,603.80 | $2,673.00 | — | 49% above | 40% |
| Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 43236 Esophagogastroduodenoscopy, flexible,transoral; w/ directed submucosal injection(s), any subst | $1,603.80 | $2,673.00 | — | — | 40% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 43251 Esophagogastroduodenoscopy removal of tumor(s) w/ snare technique | $1,829.40 | $3,049.00 | — | 67% above | 40% |
| Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 43251 Esophagogastroduodenoscopy removal of tumor(s) w/ snare technique | $1,829.40 | $3,049.00 | — | — | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 43248 Esophagogastroduodenoscopy, flexible, transoral; w/ passage of dilator(s) through esophagus | $1,720.20 | $2,867.00 | — | 83% above | 40% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 43248 Esophagogastroduodenoscopy, flexible, transoral; w/ passage of dilator(s) through esophagus | $1,720.20 | $2,867.00 | — | — | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, collection of specimen brsh/floss | $1,774.20 | $2,957.00 | — | 89% above | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, collection of specimen brsh/floss | $1,774.20 | $2,957.00 | — | — | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 43240 Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocys | $2,616.00 | $4,360.00 | — | 119% above | 40% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall inpatient CPT 43240 43240 Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocys | $2,616.00 | $4,360.00 | — | — | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 52353 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy | $5,890.20 | $9,817.00 | — | 45% above | 40% |
| Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 52353 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy | $5,890.20 | $9,817.00 | — | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement both sides CPT 52356 52356 bilat Lithotripsy w/insert stent | $7,086.00 | $11,810.00 | — | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 52356 Lithotripsy w/insert stent | $7,086.00 | $11,810.00 | — | 51% above | 40% |
| Ureteroscopy with laser stone breaking and stent placement inpatient both sides CPT 52356 52356 bilat Lithotripsy w/insert stent | $7,086.00 | $11,810.00 | — | — | 40% |
| Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 52356 Lithotripsy w/insert stent | $7,086.00 | $11,810.00 | — | — | 40% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 59400 Routine obstetric care including antepartum care, vaginal delivery, postpartum care | $4,451.40 | $7,419.00 | — | 95% above | 40% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 59400 Routine obstetric care including antepartum care, vaginal delivery, postpartum care | $4,451.40 | $7,419.00 | — | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 55250 Removal of sperm duct(s) | $2,992.80 | $4,988.00 | — | 233% above | 40% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 55250 Vasectomy | $2,992.80 | $4,988.00 | — | 233% above | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 55250 Removal of sperm duct(s) | $2,992.80 | $4,988.00 | — | — | 40% |
| Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 55250 Vasectomy | $2,992.80 | $4,988.00 | — | — | 40% |
| Vein ablation, radiofrequency, first vein CPT 36475 36475 Endovenous ablation therapy of vein, extremity; first vein treated | $4,878.00 | $8,130.00 | — | 154% above | 40% |
| Vein ablation, radiofrequency, first vein inpatient CPT 36475 36475 Endovenous ablation therapy of vein, extremity; first vein treated | $4,878.00 | $8,130.00 | — | — | 40% |
| Wart removal, up to 14 warts CPT 17110 17110 Destruct Benign Up tp 14 Lesions | $153.00 | $255.00 | — | 173% above | 40% |
| Wart removal, up to 14 warts inpatient CPT 17110 17110 Destruct Benign Up tp 14 Lesions | $153.00 | $255.00 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 Debride Skin & Subcutaneous Tissue | $823.80 | $1,373.00 | — | 109% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee | $823.80 | $1,373.00 | — | 109% above | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 Debride Skin & Subcutaneous Tissue | $823.80 | $1,373.00 | — | — | 40% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee | $823.80 | $1,373.00 | — | — | 40% |
| Wrist fracture surgery (plate and screws), distal radius CPT 25607 25607 Open tx distal radial extra-articular fx or epiphyseal separation, with internal fixation | $7,491.60 | $12,486.00 | — | 11% below | 40% |
| Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 25607 Open tx distal radial extra-articular fx or epiphyseal separation, with internal fixation | $7,491.60 | $12,486.00 | — | — | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Tennessee | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Product Admin | $801.00 | $1,335.00 | — | 114% above | 40% |
| Blood transfusion (giving blood or blood components) CPT 36430 36430 Transfusion, blood or blood components | $801.00 | $1,335.00 | — | 114% above | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Product Admin | $801.00 | $1,335.00 | — | — | 40% |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 Transfusion, blood or blood components | $801.00 | $1,335.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI -> Initial | $121.93 | $203.22 | — | 24% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Meter Dose Inhaler Initial CHARGE | $128.40 | $214.00 | — | 31% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Therapy -> Initial | $263.40 | $439.00 | — | 169% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Therapy -> Subsequent | $263.40 | $439.00 | — | 169% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Nebulizer treatment | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Portable Oxygen CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Sputum Collection CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Aero Large Volume, Cool CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Mini-Neb Initial CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Sputum Induction Initial CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Extubation CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT Aerosol Initial CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT PEP Therapy Initial CHARGE | $276.60 | $461.00 | — | 182% above | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI -> Initial | $121.93 | $203.22 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Meter Dose Inhaler Initial CHARGE | $128.40 | $214.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Therapy -> Subsequent | $263.40 | $439.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Therapy -> Initial | $263.40 | $439.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Mini-Neb Initial CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Aero Large Volume, Cool CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT PEP Therapy Initial CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Aerosol Initial CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Extubation CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Sputum Induction Initial CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Sputum Collection CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT Portable Oxygen CHARGE | $276.60 | $461.00 | — | — | 40% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 Nebulizer treatment | $276.60 | $461.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 INF/C IV Infusion initial/single | $546.00 | $910.00 | — | 128% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 CHEMO ADM IV INF 1HR SGL INIT | $546.00 | $910.00 | — | 128% above | 40% |
| Chemotherapy IV infusion, first hour CPT 96413 96413 Chemo Adm IV inf 1 hr SGL Init | $546.00 | $910.00 | — | 128% above | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 CHEMO ADM IV INF 1HR SGL INIT | $546.00 | $910.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 Chemo Adm IV inf 1 hr SGL Init | $546.00 | $910.00 | — | — | 40% |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 INF/C IV Infusion initial/single | $546.00 | $910.00 | — | — | 40% |
| Comprehensive eye exam by an eye doctor, new patient CPT 92004 92004 Eye exam comprehensive new patient | $142.20 | $237.00 | — | 57% above | 40% |
| Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 92004 Eye exam comprehensive new patient | $142.20 | $237.00 | — | — | 40% |
| Comprehensive eye exam, returning patient CPT 92014 92014 Eye exam comprehensive established patient | $141.60 | $236.00 | — | 79% above | 40% |
| Comprehensive eye exam, returning patient inpatient CPT 92014 92014 Eye exam comprehensive established patient | $141.60 | $236.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 99291 TRAUMA ALERT CLASS 1 | $2,048.40 | $3,414.00 | — | 100% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 RT Rapid Response (RT) Units CHARGE | $2,151.00 | $3,585.00 | — | 110% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 RT Evaluation, Respiratory CHARGE | $2,151.00 | $3,585.00 | — | 110% above | 40% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 99291 | $2,151.00 | $3,585.00 | — | 110% above | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 99291 TRAUMA ALERT CLASS 1 | $2,048.40 | $3,414.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Ill/Injured Patient Init 30-74 Min 99291 | $2,151.00 | $3,585.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 RT Rapid Response (RT) Units CHARGE | $2,151.00 | $3,585.00 | — | — | 40% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 RT Evaluation, Respiratory CHARGE | $2,151.00 | $3,585.00 | — | — | 40% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 95816 EEG Awake and Drowsy MNGH | $732.60 | $1,221.00 | — | 146% above | 40% |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 95816 EEG Awake and Drowsy MNGH | $732.60 | $1,221.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG POC. | $26.40 | $44.00 | — | 61% below | 40% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG POC. | $26.40 | $44.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG-ER TechFee | $190.80 | $318.00 | — | 79% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG w/ 12 plus leads Tracing Only | $191.40 | $319.00 | — | 79% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead | $191.40 | $319.00 | — | 79% above | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 EKG-ER TechFee | $190.80 | $318.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 EKG w/ 12 plus leads Tracing Only | $191.40 | $319.00 | — | — | 40% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead | $191.40 | $319.00 | — | — | 40% |
| Electroconvulsive therapy (ECT), one session CPT 90870 90870 Electroconvulsive therapy (includes necessary monitoring) | $322.20 | $537.00 | — | 26% above | 40% |
| Electroconvulsive therapy (ECT), one session inpatient CPT 90870 90870 Electroconvulsive therapy (includes necessary monitoring) | $322.20 | $537.00 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 Emergency Department Visit. Level 1 | $261.60 | $436.00 | — | 91% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ER LEVEL 1 VISIT TechFee | $261.60 | $436.00 | — | 91% above | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 ER LEVEL 1 VISIT TechFee | $261.60 | $436.00 | — | — | 40% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 Emergency Department Visit. Level 1 | $261.60 | $436.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 - Level 2 | $383.40 | $639.00 | — | 85% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ER LEVEL 2 VISIT Tech Fee | $383.40 | $639.00 | — | 85% above | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 ER LEVEL 2 VISIT Tech Fee | $383.40 | $639.00 | — | — | 40% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 - Level 2 | $383.40 | $639.00 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 - Level 3 | $657.00 | $1,095.00 | — | 74% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ER LEVEL 3 VISIT TechFee | $657.00 | $1,095.00 | — | 74% above | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 ER LEVEL 3 VISIT TechFee | $657.00 | $1,095.00 | — | — | 40% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 - Level 3 | $657.00 | $1,095.00 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 - Level 4 | $1,044.60 | $1,741.00 | — | 66% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ER LEVEL 4 VISIT TechFee | $1,044.60 | $1,741.00 | — | 66% above | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 - Level 4 | $1,044.60 | $1,741.00 | — | — | 40% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 ER LEVEL 4 VISIT TechFee | $1,044.60 | $1,741.00 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ER VISIT LEVEL 5 TechFee | $1,438.80 | $2,398.00 | — | 56% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 - Level 5 | $1,510.80 | $2,518.00 | — | 63% above | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 ER VISIT LEVEL 5 TechFee | $1,438.80 | $2,398.00 | — | — | 40% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 - Level 5 | $1,510.80 | $2,518.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Stress Test | $776.40 | $1,294.00 | — | 129% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 93017 Cardiovascular stress test; tracing only, without interpretation and report | $776.40 | $1,294.00 | — | 129% above | 40% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 93017 TREADMILL TRACING MNGH | $777.00 | $1,295.00 | — | 130% above | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Stress Test | $776.40 | $1,294.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 93017 Cardiovascular stress test; tracing only, without interpretation and report | $776.40 | $1,294.00 | — | — | 40% |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 93017 TREADMILL TRACING MNGH | $777.00 | $1,295.00 | — | — | 40% |
| Eye exam, returning patient, intermediate CPT 92012 92012 Eye exam intermediate established patient | $79.80 | $133.00 | — | 14% above | 40% |
| Eye exam, returning patient, intermediate inpatient CPT 92012 92012 Eye exam intermediate established patient | $79.80 | $133.00 | — | — | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 90847 Family psychotherapy w/ patient present CHARGE | $186.60 | $311.00 | — | 129% above | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 90847 Family psychotherapy w/ patient present CHARGE | $186.60 | $311.00 | — | — | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 90846 Family psychotherapy w/o patient present CHARGE | $160.80 | $268.00 | — | 109% above | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 90846 Family psychotherapy w/o patient present CHARGE | $160.80 | $268.00 | — | — | 40% |
| Group psychotherapy session CPT 90853 90853 Group psychotherapy | $130.20 | $217.00 | — | 162% above | 40% |
| Group psychotherapy session CPT 90853 PT Group Therapy Minutes | $207.60 | $346.00 | — | 318% above | 40% |
| Group psychotherapy session inpatient CPT 90853 90853 Group psychotherapy | $130.20 | $217.00 | — | — | 40% |
| Group psychotherapy session inpatient CPT 90853 PT Group Therapy Minutes | $207.60 | $346.00 | — | — | 40% |
| Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 93224 XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I MNGH | $166.20 | $277.00 | — | 64% above | 40% |
| Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 93224 Holter ECG Monitor, up to 48 hr, w/ scan, interp, and report | $166.20 | $277.00 | — | 64% above | 40% |
| Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 93224 XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I MNGH | $166.20 | $277.00 | — | — | 40% |
| Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 93224 Holter ECG Monitor, up to 48 hr, w/ scan, interp, and report | $166.20 | $277.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 INF HYDRATION 31-60 MIN | $261.60 | $436.00 | — | 143% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV infusion, hydration; initial, 31 minutes to 1 hour | $261.60 | $436.00 | — | 143% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - Hydration, first hour | $261.60 | $436.00 | — | 143% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 INF/H IV Inf Initial 31 - 60 min | $333.60 | $556.00 | — | 210% above | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 INF HYDRATION 31-60 MIN | $261.60 | $436.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - Hydration, first hour | $261.60 | $436.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV infusion, hydration; initial, 31 minutes to 1 hour | $261.60 | $436.00 | — | — | 40% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 INF/H IV Inf Initial 31 - 60 min | $333.60 | $556.00 | — | — | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365 THER/PROPH IV INF INIT =<1 HR | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 9636559 IV INFUSION INIT UP TO 1 HR 59 TechFee | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365 INF/NC IV Infusion Ther Initial | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365- IV tx, first hour TechFee | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour CPT 96365 96365 INF THERAPY 1ST HR 16-90 MIN | $371.40 | $619.00 | — | 150% above | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 THER/PROPH IV INF INIT =<1 HR | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 INF THERAPY 1ST HR 16-90 MIN | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 9636559 IV INFUSION INIT UP TO 1 HR 59 TechFee | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour TechFee | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 INF/NC IV Infusion Ther Initial | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365- IV tx, first hour | $371.40 | $619.00 | — | — | 40% |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR | $371.40 | $619.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Bill Only Antibiotic Injection Fee?? | $87.60 | $146.00 | — | 57% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Admin Other Charge -> 96372: SUBQ/IM | $105.00 | $175.00 | — | 88% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 THER/PROPH/DIAG INJ SC/IM ED TECH FEE | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372á THER PROPH/DX NJX SUBQ/IM | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372- Subq/IM Injection TechFee | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJ IM SQ AB | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INF/NC SQ/IM injection | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 9637259 IM/SQ INJECTION 59 TechFee | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Therapeutic, prophylactic, or diagnostic injection subcutaneous or intramuscular | $110.40 | $184.00 | — | 98% above | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Bill Only Antibiotic Injection Fee?? | $87.60 | $146.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Admin Other Charge -> 96372: SUBQ/IM | $105.00 | $175.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372- Subq/IM Injection TechFee | $110.40 | $184.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJ IM SQ AB | $110.40 | $184.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 THER/PROPH/DIAG INJ SC/IM ED TECH FEE | $110.40 | $184.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 Therapeutic, prophylactic, or diagnostic injection subcutaneous or intramuscular | $110.40 | $184.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 9637259 IM/SQ INJECTION 59 TechFee | $110.40 | $184.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INF/NC SQ/IM injection | $110.40 | $184.00 | — | — | 40% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372á THER PROPH/DX NJX SUBQ/IM | $110.40 | $184.00 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psych Diagnostic Evaluation | $237.00 | $395.00 | — | 96% above | 40% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 90791 Psychiatric diagnostic evaluation | $237.00 | $395.00 | — | 96% above | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Psych Diagnostic Evaluation | $237.00 | $395.00 | — | — | 40% |
| Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 90791 Psychiatric diagnostic evaluation | $237.00 | $395.00 | — | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 95910 - NCS: 7-8 STUDIES ProFee | $532.20 | $887.00 | — | 109% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 95910 Nerve conduction 7-8 studies | $532.20 | $887.00 | — | 109% above | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 95910 Nerve conduction 7-8 studies | $532.20 | $887.00 | — | — | 40% |
| Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 95910 - NCS: 7-8 STUDIES ProFee | $532.20 | $887.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Assistant Units | $67.20 | $112.00 | — | 44% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges | $67.20 | $112.00 | — | 44% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Rehab Units | $67.20 | $112.00 | — | 44% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Rehab Minutes | $67.20 | $112.00 | — | 44% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units | $90.00 | $150.00 | — | 93% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Minutes | $90.00 | $150.00 | — | 93% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges | $90.00 | $150.00 | — | 93% above | 40% |
| Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Assistant Units | $90.00 | $150.00 | — | 93% above | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Assistant Units | $67.20 | $112.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Rehab Units | $67.20 | $112.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Rehab Minutes | $67.20 | $112.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges | $67.20 | $112.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Minutes | $90.00 | $150.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Assistant Units | $90.00 | $150.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units | $90.00 | $150.00 | — | — | 40% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Charges | $90.00 | $150.00 | — | — | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 New patient visit- level 3 | $104.40 | $174.00 | — | 22% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 NEW PATIENT 30 MIN VISIT CHARGE | $104.40 | $174.00 | — | 22% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 Office Visit New Pt. Level 3 | $104.40 | $174.00 | — | 22% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 Bill Only OFC/OUTPT E&M NEW LOW 30 MIN | $123.00 | $205.00 | — | 44% above | 40% |
| New patient office visit, about 30 minutes CPT 99203 99203 OFFICE/OUTPATIENT NEW PATIENT 30-44 MIN CHARGE | $198.60 | $331.00 | — | 133% above | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 New patient visit- level 3 | $104.40 | $174.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 Office Visit New Pt. Level 3 | $104.40 | $174.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 NEW PATIENT 30 MIN VISIT CHARGE | $104.40 | $174.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Bill Only OFC/OUTPT E&M NEW LOW 30 MIN | $123.00 | $205.00 | — | — | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 99203 OFFICE/OUTPATIENT NEW PATIENT 30-44 MIN CHARGE | $198.60 | $331.00 | — | — | 40% |
| New patient office visit, about 45 minutes CPT 99204 Bill Only OFC/OUTPT E&M NEW MOD 45 MIN | $132.60 | $221.00 | — | 40% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 OFFICE/OUTPATIENT NEW PATIENT 45-59 MIN CHARGE | $132.60 | $221.00 | — | 40% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 New patient visit- level 4 | $244.20 | $407.00 | — | 158% above | 40% |
| New patient office visit, about 45 minutes CPT 99204 99204 Office Visit New Pt. Level 4 | $244.20 | $407.00 | — | 158% above | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Bill Only OFC/OUTPT E&M NEW MOD 45 MIN | $132.60 | $221.00 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 OFFICE/OUTPATIENT NEW PATIENT 45-59 MIN CHARGE | $132.60 | $221.00 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 Office Visit New Pt. Level 4 | $244.20 | $407.00 | — | — | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 99204 New patient visit- level 4 | $244.20 | $407.00 | — | — | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 Office Visit New Pt. Level 5 | $49.20 | $82.00 | — | 62% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 New patient visit- level 5 | $126.00 | $210.00 | — | 2% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 NEW PATIENT 60 MIN VISIT CHARGE | $126.00 | $210.00 | — | 2% below | 40% |
| New patient office visit, about 60 minutes CPT 99205 Bill Only OFC/OUTPT E&M NEW HI 60 MIN | $154.80 | $258.00 | — | 21% above | 40% |
| New patient office visit, about 60 minutes CPT 99205 99205 OFFICE/OUTPATIENT NEW PATIENT 60-74 MIN CHARGE | $162.60 | $271.00 | — | 27% above | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 Office Visit New Pt. Level 5 | $49.20 | $82.00 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 New patient visit- level 5 | $126.00 | $210.00 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 NEW PATIENT 60 MIN VISIT CHARGE | $126.00 | $210.00 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Bill Only OFC/OUTPT E&M NEW HI 60 MIN | $154.80 | $258.00 | — | — | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 99205 OFFICE/OUTPATIENT NEW PATIENT 60-74 MIN CHARGE | $162.60 | $271.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 OFFICE/OUTPATIENT NEW PATIENT 15-29 MIN CHARGE | $117.00 | $195.00 | — | 86% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 Bill Only OFC/OUTPT E&M NEW LOW-MOD 20 MIN | $117.00 | $195.00 | — | 86% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 New patient visit- level 2 | $132.60 | $221.00 | — | 111% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 NEW PATIENT 20 MIN VISIT CHARGE | $132.60 | $221.00 | — | 111% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 99202 Office Visit New Pt. Level 2 | $132.60 | $221.00 | — | 111% above | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 OFFICE/OUTPATIENT NEW PATIENT 15-29 MIN CHARGE | $117.00 | $195.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Bill Only OFC/OUTPT E&M NEW LOW-MOD 20 MIN | $117.00 | $195.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 Office Visit New Pt. Level 2 | $132.60 | $221.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 New patient visit- level 2 | $132.60 | $221.00 | — | — | 40% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 99202 NEW PATIENT 20 MIN VISIT CHARGE | $132.60 | $221.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity Time | $198.00 | $330.00 | — | 50% above | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Low Complexity Units | $198.00 | $330.00 | — | 50% above | 40% |
| Occupational therapy evaluation, low complexity CPT 97165 OT Low Complex Units | $198.00 | $330.00 | — | 50% above | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Low Complex Units | $198.00 | $330.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Low Complexity Units | $198.00 | $330.00 | — | — | 40% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Low Complexity Time | $198.00 | $330.00 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT High Complex Units | $248.40 | $414.00 | — | 92% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity Time | $248.40 | $414.00 | — | 92% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation High Complexity Units | $248.40 | $414.00 | — | 92% above | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation High Complexity Units | $248.40 | $414.00 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT High Complex Units | $248.40 | $414.00 | — | — | 40% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation High Complexity Time | $248.40 | $414.00 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity Time | $191.40 | $319.00 | — | 50% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Low Complexity Units | $191.40 | $319.00 | — | 50% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Low Complex Units | $191.40 | $319.00 | — | 50% above | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Low Complex Units | $191.40 | $319.00 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Low Complexity Units | $191.40 | $319.00 | — | — | 40% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Low Complexity Time | $191.40 | $319.00 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity Time | $220.20 | $367.00 | — | 70% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Moderate Complex Units | $220.20 | $367.00 | — | 70% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Moderate Complexity Units | $220.20 | $367.00 | — | 70% above | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Moderate Complexity Units | $220.20 | $367.00 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Moderate Complex Units | $220.20 | $367.00 | — | — | 40% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Moderate Complexity Time | $220.20 | $367.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Assistant Units | $78.00 | $130.00 | — | 67% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charge Units | $78.00 | $130.00 | — | 67% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units | $78.00 | $130.00 | — | 67% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units | $91.20 | $152.00 | — | 96% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Minutes | $91.20 | $152.00 | — | 96% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Assistant Units | $91.20 | $152.00 | — | 96% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units | $91.20 | $152.00 | — | 96% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Mechanical Traction Minutes | $91.20 | $152.00 | — | 96% above | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charge Units | $78.00 | $130.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units | $78.00 | $130.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Assistant Units | $78.00 | $130.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units | $91.20 | $152.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Assistant Units | $91.20 | $152.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Minutes | $91.20 | $152.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Mechanical Traction Minutes | $91.20 | $152.00 | — | — | 40% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charge Units | $91.20 | $152.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Rehab Minutes | $56.40 | $94.00 | — | 20% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Rehab Units | $61.20 | $102.00 | — | 30% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Assistant Units | $61.20 | $102.00 | — | 30% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT ROM, Hand Minutes | $61.20 | $102.00 | — | 30% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges | $61.20 | $102.00 | — | 30% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges | $93.00 | $155.00 | — | 98% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Assistant Units | $93.00 | $155.00 | — | 98% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Minutes | $93.00 | $155.00 | — | 98% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units | $93.00 | $155.00 | — | 98% above | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Rehab Minutes | $56.40 | $94.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Rehab Units | $61.20 | $102.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Assistant Units | $61.20 | $102.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT ROM, Hand Minutes | $61.20 | $102.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges | $61.20 | $102.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Minutes | $93.00 | $155.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units | $93.00 | $155.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges | $93.00 | $155.00 | — | — | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Assistant Units | $93.00 | $155.00 | — | — | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 99385 Preventive Eval Initial New Pt. 18-39 year age | $91.98 | $153.30 | — | 6% above | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 99385 Preventive Eval Initial New Pt. 18-39 year age | $91.98 | $153.30 | — | — | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 Preventive Eval Initial New Pt. 40-64 year age | $124.42 | $207.37 | — | 20% above | 40% |
| Preventive checkup, new patient aged 40–64 CPT 99386 99386 Preventative New Patient 40-64 Years | $179.40 | $299.00 | — | 73% above | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 Preventive Eval Initial New Pt. 40-64 year age | $124.42 | $207.37 | — | — | 40% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 99386 Preventative New Patient 40-64 Years | $179.40 | $299.00 | — | — | 40% |
| Preventive checkup, new patient aged 65 or older CPT 99387 99387 Preventive Eval Initial New Pt Greater Than 65 year age | $103.95 | $173.25 | — | at median | 40% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 99387 Preventive Eval Initial New Pt Greater Than 65 year age | $103.95 | $173.25 | — | — | 40% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Preventive Eval Est Pt. 18-39 year age | $151.54 | $252.56 | — | 117% above | 40% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 99395 Preventive Eval Est Pt. 18-39 year age | $151.54 | $252.56 | — | — | 40% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Eval Est Pt. 40-64 year age | $90.09 | $150.15 | — | 1% above | 40% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 99396 Preventive Eval Est Pt. 40-64 year age | $90.09 | $150.15 | — | — | 40% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Eval Est Pt. 65 year age | $91.35 | $152.25 | — | 4% below | 40% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 99397 Preventive Eval Est Pt. 65 year age | $91.35 | $152.25 | — | — | 40% |
| Psychiatric evaluation with medical services CPT 90792 90792 Psychiatric diagnostic evaluation with medical services | $198.60 | $331.00 | — | 60% above | 40% |
| Psychiatric evaluation with medical services CPT 90792 90792 Psych diag eval w/ med services | $210.00 | $350.00 | — | 69% above | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 90792 Psychiatric diagnostic evaluation with medical services | $198.60 | $331.00 | — | — | 40% |
| Psychiatric evaluation with medical services inpatient CPT 90792 90792 Psych diag eval w/ med services | $210.00 | $350.00 | — | — | 40% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 90839 Psychotherapy for crisis; first 60 minutes | $240.60 | $401.00 | — | 147% above | 40% |
| Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 90839 Psychotherapy for crisis; first 60 minutes | $240.60 | $401.00 | — | — | 40% |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy Patient +/ Family 30 minutes | $124.20 | $207.00 | — | 178% above | 40% |
| Psychotherapy session, 30 minutes CPT 90832 90832 Psychotherapy, 30 minutes with patient | $130.80 | $218.00 | — | 193% above | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy Patient +/ Family 30 minutes | $124.20 | $207.00 | — | — | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 90832 Psychotherapy, 30 minutes with patient | $130.80 | $218.00 | — | — | 40% |
| Psychotherapy session, 45 minutes CPT 90834 90834 Psychotherapy, 45 minutes with patient | $169.20 | $282.00 | — | 200% above | 40% |
| Psychotherapy session, 45 minutes CPT 90834 90834 Psych follow up 45-50 minutes | $189.00 | $315.00 | — | 235% above | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Psychotherapy, 45 minutes with patient | $169.20 | $282.00 | — | — | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 90834 Psych follow up 45-50 minutes | $189.00 | $315.00 | — | — | 40% |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psychotherapy, 60 minutes with patient | $201.60 | $336.00 | — | 114% above | 40% |
| Psychotherapy session, 60 minutes CPT 90837 90837 Psych Follow Up 60 Minutes | $201.60 | $336.00 | — | 114% above | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psych Follow Up 60 Minutes | $201.60 | $336.00 | — | — | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 90837 Psychotherapy, 60 minutes with patient | $201.60 | $336.00 | — | — | 40% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 99406 Smoking/Tobacco Cessation Counseling; 3-10 Min | $35.28 | $58.80 | — | 26% above | 40% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 99406 Smoking/Tobacco Cessation Counseling; 3-10 Min | $35.28 | $58.80 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OFFICE/OUTPATIENT ESTABLISHED PATIENT 40-54 MIN CHARGE | $123.00 | $205.00 | — | 37% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Office Visit Established Pt. Level 5 | $262.20 | $437.00 | — | 191% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 Established patient visit- level 5 | $262.20 | $437.00 | — | 191% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 OB Established patient visit, level 5 | $262.20 | $437.00 | — | 191% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 99215 EST PATIENT 40 MIN VISIT CHARGE | $262.20 | $437.00 | — | 191% above | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OFFICE/OUTPATIENT ESTABLISHED PATIENT 40-54 MIN CHARGE | $123.00 | $205.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Established patient visit- level 5 | $262.20 | $437.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 EST PATIENT 40 MIN VISIT CHARGE | $262.20 | $437.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 OB Established patient visit, level 5 | $262.20 | $437.00 | — | — | 40% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 99215 Office Visit Established Pt. Level 5 | $262.20 | $437.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Bill Only OFC/OUTPT E&M ESTAB LOW 20 | $110.40 | $184.00 | — | 79% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Established patient visit- level 3 | $136.20 | $227.00 | — | 120% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office Visit Established Pt. Level 3 | $136.20 | $227.00 | — | 120% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 EST PATIENT 15 MIN VISIT CHARGE | $136.20 | $227.00 | — | 120% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Established patient visit, level 3 | $136.20 | $227.00 | — | 120% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 OFFICE/OUTPATIENT ESTABLISHED PATIENT 20-29 MIN CHARGE | $167.40 | $279.00 | — | 171% above | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Bill Only OFC/OUTPT E&M ESTAB LOW 20 | $110.40 | $184.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Office Visit Established Pt. Level 3 | $136.20 | $227.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Established patient visit- level 3 | $136.20 | $227.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 Established patient visit, level 3 | $136.20 | $227.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 EST PATIENT 15 MIN VISIT CHARGE | $136.20 | $227.00 | — | — | 40% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 OFFICE/OUTPATIENT ESTABLISHED PATIENT 20-29 MIN CHARGE | $167.40 | $279.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 OFFICE/OUTPATIENT ESTABLISHED PATIENT 30-39 MIN CHARGE | $104.40 | $174.00 | — | 40% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Bill Only OFC/OUTPT E&M ESTAB MOD 30 | $117.00 | $195.00 | — | 56% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Established patient visit- level 4 | $261.60 | $436.00 | — | 250% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office Visit Established Pt. Level 4 | $261.60 | $436.00 | — | 250% above | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 OFFICE/OUTPATIENT ESTABLISHED PATIENT 30-39 MIN CHARGE | $104.40 | $174.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Bill Only OFC/OUTPT E&M ESTAB MOD 30 | $117.00 | $195.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Office Visit Established Pt. Level 4 | $261.60 | $436.00 | — | — | 40% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 99214 Established patient visit- level 4 | $261.60 | $436.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 OFFICE/OUTPATIENT NEW PATIENT 10-19 MIN CHARGE | $104.40 | $174.00 | — | 89% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office Visit Level 2 | $268.80 | $448.00 | — | 385% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office Visit Established Pt. Level 2 | $268.80 | $448.00 | — | 385% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Established patient visit- level 2 | $268.80 | $448.00 | — | 385% above | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 OFFICE/OUTPATIENT NEW PATIENT 10-19 MIN CHARGE | $104.40 | $174.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office Visit Level 2 | $268.80 | $448.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Established patient visit- level 2 | $268.80 | $448.00 | — | — | 40% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 99212 Office Visit Established Pt. Level 2 | $268.80 | $448.00 | — | — | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 99243 Office Consult New or Est. L3 Pt 40 min | $47.40 | $79.00 | — | 48% below | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 99243 Office Consult New or Est. L3 Pt 40 min | $47.40 | $79.00 | — | — | 40% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 99244 Office Consult New or Est. L4 Pt 60 min | $51.60 | $86.00 | — | 52% below | 40% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 99244 Office Consult New or Est. L4 Pt 60 min | $51.60 | $86.00 | — | — | 40% |
| Speech and language evaluation CPT 92523 SLP Sound Production Minutes | $332.40 | $554.00 | — | 79% above | 40% |
| Speech and language evaluation CPT 92523 SLP Eval of Speech Sound Prod Units | $332.40 | $554.00 | — | 79% above | 40% |
| Speech and language evaluation CPT 92523 Speech Sound Prod w/ Language Charge | $332.40 | $554.00 | — | 79% above | 40% |
| Speech and language evaluation CPT 92523 SLP Auditory Processing Tx Minutes | $332.40 | $554.00 | — | 79% above | 40% |
| Speech and language evaluation CPT 92523 SLP Sound Prod w/ Lang Comp Eval Units | $332.40 | $554.00 | — | 79% above | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Eval of Speech Sound Prod Units | $332.40 | $554.00 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Sound Production Minutes | $332.40 | $554.00 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Sound Prod w/ Lang Comp Eval Units | $332.40 | $554.00 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 Speech Sound Prod w/ Language Charge | $332.40 | $554.00 | — | — | 40% |
| Speech and language evaluation inpatient CPT 92523 SLP Auditory Processing Tx Minutes | $332.40 | $554.00 | — | — | 40% |
| Speech therapy session, individual CPT 92507 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder | $199.20 | $332.00 | — | 47% above | 40% |
| Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Charge | $199.20 | $332.00 | — | 47% above | 40% |
| Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid | $199.20 | $332.00 | — | 47% above | 40% |
| Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units | $199.20 | $332.00 | — | 47% above | 40% |
| Speech therapy session, individual inpatient CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid | $199.20 | $332.00 | — | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder | $199.20 | $332.00 | — | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units | $199.20 | $332.00 | — | — | 40% |
| Speech therapy session, individual inpatient CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Charge | $199.20 | $332.00 | — | — | 40% |
| Spirometry (breathing test) CPT 94010 RT CHARGE PFT -> Spirometry | $228.00 | $380.00 | — | 109% above | 40% |
| Spirometry (breathing test) CPT 94010 RT Spirometry w/ Graphic Record CHARGE | $239.40 | $399.00 | — | 119% above | 40% |
| Spirometry (breathing test) inpatient CPT 94010 RT CHARGE PFT -> Spirometry | $228.00 | $380.00 | — | — | 40% |
| Spirometry (breathing test) inpatient CPT 94010 RT Spirometry w/ Graphic Record CHARGE | $239.40 | $399.00 | — | — | 40% |
| Spirometry before and after a bronchodilator CPT 94060 RT CHARGE PFT -> Spirometry before & after | $418.20 | $697.00 | — | 71% above | 40% |
| Spirometry before and after a bronchodilator CPT 94060 RT Pre & Post Spiro CHARGE | $439.20 | $732.00 | — | 79% above | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE PFT -> Spirometry before & after | $418.20 | $697.00 | — | — | 40% |
| Spirometry before and after a bronchodilator inpatient CPT 94060 RT Pre & Post Spiro CHARGE | $439.20 | $732.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Assistant Units | $87.60 | $146.00 | — | 89% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges | $87.60 | $146.00 | — | 89% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Rehab Units | $87.60 | $146.00 | — | 89% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge | $91.20 | $152.00 | — | 97% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Assistant Units | $91.20 | $152.00 | — | 97% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Minutes | $91.20 | $152.00 | — | 97% above | 40% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units | $91.20 | $152.00 | — | 97% above | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Assistant Units | $87.60 | $146.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges | $87.60 | $146.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Rehab Units | $87.60 | $146.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Assistant Units | $91.20 | $152.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge | $91.20 | $152.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Minutes | $91.20 | $152.00 | — | — | 40% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units | $91.20 | $152.00 | — | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 Phlebotomy, therapeutic (separate procedure) | $184.20 | $307.00 | — | 143% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 Phlebotomy Thera Separate Procedure | $184.20 | $307.00 | — | 143% above | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 Phlebotomy, therapeutic (separate procedure) | $184.20 | $307.00 | — | — | 40% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 Phlebotomy Thera Separate Procedure | $184.20 | $307.00 | — | — | 40% |
| Visual field test, extended CPT 92083 92083 VF, visual field threshold test (KSB) | $76.80 | $128.00 | — | 16% below | 40% |
| Visual field test, extended inpatient CPT 92083 92083 VF, visual field threshold test (KSB) | $76.80 | $128.00 | — | — | 40% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Tennessee | Off list |
|---|---|---|---|---|---|
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AMB influenza vacc Charge -> 90656 no prsv 3+> | $141.93 | $236.55 | — | 365% above | 40% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AMB influenza vacc Charge -> 90656 no prsv 3+> | $141.93 | $236.55 | — | — | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 90636 Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use | $147.00 | $245.00 | — | 74% above | 40% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 90636 Hepatitis A and hepatitis B vaccine (HepA-HepB), adult dosage, for intramuscular use | $147.00 | $245.00 | — | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 AMB influenza vacc Charge -> 90662 prsv free inc antig | $103.20 | $172.00 | — | 21% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 90662 INFLUENZA HIGH DOSE ProFee | $104.40 | $174.00 | — | 22% above | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 AMB influenza vacc Charge -> 90662 prsv free inc antig | $103.20 | $172.00 | — | — | 40% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 90662 INFLUENZA HIGH DOSE ProFee | $104.40 | $174.00 | — | — | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 AMB pneumococcal 20-valent vac Charge -> Pneumococcal 20-valent conjugate | $394.34 | $657.24 | — | 28% above | 40% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 AMB pneumococcal 20-valent vac Charge -> Pneumococcal 20-valent conjugate | $394.34 | $657.24 | — | — | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Med Charge (RSV) -> 90380 RSV 0.5mL im | $1,901.98 | $3,169.96 | — | 209% above | 40% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Med Charge (RSV) -> 90380 RSV 0.5mL im | $1,901.98 | $3,169.96 | — | — | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 AMB Tdap Charge | $136.90 | $228.16 | — | 63% above | 40% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 AMB Tdap Charge | $136.90 | $228.16 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 INF Immunization Administration | $25.80 | $43.00 | — | 22% below | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscula | $70.80 | $118.00 | — | 115% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IMMUN/VACCIN ADMIN 1ST DRUG | $70.80 | $118.00 | — | 115% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Immunization Charge -> 90471: IM/SUBQ First dose | $100.80 | $168.00 | — | 206% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Immunization Charge | $105.84 | $176.40 | — | 221% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE TechFee | $105.84 | $176.40 | — | 221% above | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 INF Immunization Administration | $25.80 | $43.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IMMUN/VACCIN ADMIN 1ST DRUG | $70.80 | $118.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscula | $70.80 | $118.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Immunization Charge -> 90471: IM/SUBQ First dose | $100.80 | $168.00 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE TechFee | $105.84 | $176.40 | — | — | 40% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 Admin Immunization Charge | $105.84 | $176.40 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immunization Charge -> Each Additional 90472 | $33.60 | $56.00 | — | 9% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Admin Immunization Charge -> 90472: IM/SUBQ Each additional | $33.60 | $56.00 | — | 9% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IMMUN/VACCINE ADMIN,EA ADDTL | $35.40 | $59.00 | — | 15% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Administration Charge | $35.40 | $59.00 | — | 15% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 IMMUNIZAITON ADMIN, EA ADD VACCINE ProFee | $44.83 | $74.72 | — | 45% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 INF Immunization Administration Add'l | $762.60 | $1,271.00 | — | 2368% above | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Immunization Charge -> 90472: IM/SUBQ Each additional | $33.60 | $56.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Admin Immunization Charge -> Each Additional 90472 | $33.60 | $56.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 Administration Charge | $35.40 | $59.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IMMUN/VACCINE ADMIN,EA ADDTL | $35.40 | $59.00 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 IMMUNIZAITON ADMIN, EA ADD VACCINE ProFee | $44.83 | $74.72 | — | — | 40% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 INF Immunization Administration Add'l | $762.60 | $1,271.00 | — | — | 40% |
Source file: https://hospitalpricedisclosure.com/download.aspx?pi=9g8QBtWNOUgTiaQxrsd8yQ*-*