Hospital Camden, AR

Ouachita County Medical Center

Ouachita County Medical Center in Camden, AR publishes cash prices for 256 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Arkansas median for 129 of 253 procedures and below it for 118. By typical cash price it ranks #19 of 37 Arkansas hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

638 CALIFORNIA AVE,PO BOX 797,CAMDEN,AR,71701-4604 Collected Sep 27, 2026 Source price file (870) 836-1000

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 040050 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 6 actions for a hospital named Ouachita County Medical Center in Camden, AR:

Jun 16, 2023 Warning notice
Nov 3, 2023 Corrective action plan requested
Apr 3, 2024 Case closed
Jan 16, 2026 Warning notice
Apr 21, 2026 Corrective action plan requested
Jun 5, 2026 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 OR MORE VIEWS LEFT	$150.00	$300.00	$18.00–$600.00	13% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3 OR MORE VIEWS RIGHT	$150.00	$300.00	$18.00–$600.00	13% below	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 OR MORE VIEWS RIGHT	$150.00	$300.00	$18.00–$600.00	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 OR MORE VIEWS LEFT	$150.00	$300.00	$18.00–$600.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 U/S LOWER ARTERY UNI	$700.00	$1,400.00	$27.30–$2,800.00	152% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 U/S LOWER ARTERIAL	$700.00	$1,400.00	$27.30–$2,800.00	152% above	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 U/S LOWER ARTERIAL	$700.00	$1,400.00	$27.30–$2,800.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 U/S LOWER ARTERY UNI	$700.00	$1,400.00	$27.30–$2,800.00	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS W/FLUORO	$400.00	$800.00	$36.00–$800.00	63% above	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS W/FLUORO	$400.00	$800.00	$36.00–$800.00	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN WHOLE BODY	$1,250.00	$2,500.00	$59.00–$2,500.00	95% above	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN WHOLE BODY	$1,250.00	$2,500.00	$59.00–$2,500.00	—	50%
Breast ultrasound, complete, one breast both sides CPT 76641 U/S BREAST BILATERAL	$350.00	$700.00	$63.40–$2,800.00	—	50%
Breast ultrasound, complete, one breast CPT 76641 U/S BREAST BIL COMPL	$350.00	$700.00	$63.40–$2,800.00	91% above	50%
Breast ultrasound, complete, one breast one side CPT 76641 U/S BREAST RIGHT	$350.00	$700.00	$63.40–$2,800.00	91% above	50%
Breast ultrasound, complete, one breast one side CPT 76641 U/S BREAST LEFT	$350.00	$700.00	$63.40–$2,800.00	91% above	50%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 U/S BREAST BILATERAL	$350.00	$700.00	$63.40–$2,800.00	—	50%
Breast ultrasound, complete, one breast inpatient CPT 76641 U/S BREAST BIL COMPL	$350.00	$700.00	$63.40–$2,800.00	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 U/S BREAST LEFT	$350.00	$700.00	$63.40–$2,800.00	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 U/S BREAST RIGHT	$350.00	$700.00	$63.40–$2,800.00	—	50%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 U/S BREAST BI LIMIT	$350.00	$700.00	$48.50–$1,500.00	—	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND LEFT BREAST LIMITED	$200.00	$400.00	$48.50–$1,500.00	6% above	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 ULTRASOUND RIGHT BREAST LIMITED	$200.00	$400.00	$48.50–$1,500.00	6% above	50%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 U/S BREAST BI LIMIT	$350.00	$700.00	$48.50–$1,500.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND LEFT BREAST LIMITED	$200.00	$400.00	$48.50–$1,500.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 ULTRASOUND RIGHT BREAST LIMITED	$200.00	$400.00	$48.50–$1,500.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT PE PROTOCOL (CTA)	$1,515.00	$3,030.00	$174.94–$3,030.00	26% above	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT PE PROTOCOL (CTA)	$1,515.00	$3,030.00	$174.94–$3,030.00	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CORONARY CALCIUM SCORE	$75.00	$150.00	$54.87–$182.03	18% above	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CORONARY CALCIUM SCORE	$75.00	$150.00	$54.87–$182.03	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/PELVIS W/O CO	$2,163.60	$4,327.20	$108.30–$4,327.20	56% above	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/PELVIS W/O CO	$2,163.60	$4,327.20	$108.30–$4,327.20	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/PELVIS W CONT	$2,380.20	$4,760.40	$206.27–$4,760.40	47% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/PELVIS W CONT	$2,380.20	$4,760.40	$206.27–$4,760.40	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/PELVIS W/W/O	$2,523.60	$5,047.20	$272.95–$5,047.20	28% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/PELVIS W/W/O	$2,523.60	$5,047.20	$272.95–$5,047.20	—	50%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST	$1,400.40	$2,800.80	$174.94–$2,800.80	27% above	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONTRAST	$1,400.40	$2,800.80	$174.94–$2,800.80	—	50%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTRAST	$1,174.20	$2,348.40	$107.60–$2,348.40	20% above	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTRAST	$1,174.20	$2,348.40	$107.60–$2,348.40	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTR	$1,251.00	$2,502.00	$107.60–$5,004.00	56% above	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL W/O CONTR	$1,251.00	$2,502.00	$107.60–$5,004.00	56% above	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTR	$1,251.00	$2,502.00	$107.60–$5,004.00	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL W/O CONTR	$1,251.00	$2,502.00	$107.60–$5,004.00	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST	$1,174.20	$2,348.40	$107.60–$2,348.40	31% above	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST	$1,174.20	$2,348.40	$107.60–$2,348.40	—	50%
CT scan of the head with contrast CPT 70460 CT HEAD W/CONTRAST	$1,420.20	$2,840.40	$174.94–$2,840.40	40% above	50%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/CONTRAST	$1,420.20	$2,840.40	$174.94–$2,840.40	—	50%
CT scan of the head without and with contrast CPT 70470 CT HEAD W&W/O CNTRST	$1,468.80	$2,937.60	$174.94–$2,937.60	18% above	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W&W/O CNTRST	$1,468.80	$2,937.60	$174.94–$2,937.60	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE W/OC	$1,174.20	$2,348.40	$107.60–$2,348.40	17% above	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE W/OC	$1,174.20	$2,348.40	$107.60–$2,348.40	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERV SPINE W/O	$1,174.20	$2,348.40	$107.60–$2,348.40	22% above	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERV SPINE W/O	$1,174.20	$2,348.40	$107.60–$2,348.40	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CNTRST	$1,462.80	$2,925.60	$174.94–$2,925.60	39% above	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CNTRST	$1,462.80	$2,925.60	$174.94–$2,925.60	—	50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 U/S CAROTID/VENOUS-D	$800.00	$1,600.00	$70.00–$1,600.00	63% above	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 U/S CAROTID/VENOUS-D	$800.00	$1,600.00	$70.00–$1,600.00	—	50%
Chest X-ray, 2 views CPT 71046 CHEST, 2 VIEWS	$187.50	$375.00	$21.87–$375.00	4% above	50%
Chest X-ray, 2 views inpatient CPT 71046 CHEST, 2 VIEWS	$187.50	$375.00	$21.87–$375.00	—	50%
Chest X-ray, single view CPT 71045 CHEST, 1 VIEW	$125.00	$250.00	$11.86–$250.00	7% below	50%
Chest X-ray, single view inpatient CPT 71045 CHEST, 1 VIEW	$125.00	$250.00	$11.86–$250.00	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 U/S RETROPERITONEAL	$250.00	$500.00	$44.00–$500.00	22% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 U/S RETROPERITONEAL	$250.00	$500.00	$44.00–$500.00	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITOMETRY	$275.00	$550.00	$107.60–$550.00	28% above	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITOMETRY	$275.00	$550.00	$107.60–$550.00	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST/THOR W/O CT	$1,174.20	$2,348.40	$107.60–$2,348.40	47% above	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST/THOR W/O CT	$1,174.20	$2,348.40	$107.60–$2,348.40	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST/THOR W/CNTR	$1,400.40	$2,800.80	$174.94–$2,800.80	19% above	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST/THOR W/CNTR	$1,400.40	$2,800.80	$174.94–$2,800.80	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 DIGITAL MAMMO DIAGNOSTIC BILATERAL	$250.00	$500.00	$95.21–$1,000.00	—	50%
Diagnostic mammogram, both breasts CPT 77066 DIGITAL MAMMO DIAGNOSTIC IMPLANTS	$250.00	$500.00	$95.21–$1,000.00	5% above	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIGITAL MAMMO DIAGNOSTIC BILATERAL	$250.00	$500.00	$95.21–$1,000.00	—	50%
Diagnostic mammogram, both breasts inpatient CPT 77066 DIGITAL MAMMO DIAGNOSTIC IMPLANTS	$250.00	$500.00	$95.21–$1,000.00	—	50%
Diagnostic mammogram, one breast one side CPT 77065 DIGITAL MAMMO DIAGNOSTIC UNILATERAL	$225.00	$450.00	$74.28–$450.00	38% above	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIGITAL MAMMO DIAGNOSTIC UNILATERAL	$225.00	$450.00	$74.28–$450.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 U/S VENOUS,BILATERAL	$1,025.00	$2,050.00	$42.00–$2,050.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 U/S VENOUS,BILATERAL	$1,025.00	$2,050.00	$42.00–$2,050.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM DOPPL	$750.00	$1,500.00	$257.51–$6,000.00	33% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHOCARDIOGRAM 2D	$750.00	$1,500.00	$257.51–$6,000.00	33% below	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM 2D	$750.00	$1,500.00	$257.51–$6,000.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHOCARDIOGRAM DOPPL	$750.00	$1,500.00	$257.51–$6,000.00	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HIDA SCAN - HEPA W/O CCK	$855.00	$1,710.00	$312.39–$1,710.00	24% above	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HIDA SCAN - HEPA W/O CCK	$855.00	$1,710.00	$312.39–$1,710.00	—	50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED REC INTER	$102.50	$205.00	$102.50–$309.00	71% below	50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED REC INTER	$102.50	$205.00	$102.50–$309.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY W/CPAP/B	$1,400.00	$2,800.00	$205.37–$6,275.00	51% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY-SPLIT NIGHT	$1,400.00	$2,800.00	$205.37–$6,275.00	51% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY W/CPAP/B	$1,400.00	$2,800.00	$205.37–$6,275.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY-SPLIT NIGHT	$1,400.00	$2,800.00	$205.37–$6,275.00	—	50%
Knee X-ray, 3 views one side CPT 73562 PATELLA RIGHT 3 VIEWS	$250.00	$500.00	$35.00–$2,000.00	34% above	50%
Knee X-ray, 3 views one side CPT 73562 XR 3 VW KNEE RT	$250.00	$500.00	$35.00–$2,000.00	34% above	50%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3V LEFT	$250.00	$500.00	$35.00–$2,000.00	34% above	50%
Knee X-ray, 3 views one side CPT 73562 PATELLA LEFT 3 VIEWS	$250.00	$500.00	$35.00–$2,000.00	34% above	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR 3 VW KNEE RT	$250.00	$500.00	$35.00–$2,000.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 PATELLA RIGHT 3 VIEWS	$250.00	$500.00	$35.00–$2,000.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3V LEFT	$250.00	$500.00	$35.00–$2,000.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 PATELLA LEFT 3 VIEWS	$250.00	$500.00	$35.00–$2,000.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S R U Q	$350.00	$700.00	$20.00–$2,100.00	10% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S GALLBLADDER	$350.00	$700.00	$20.00–$2,100.00	10% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 U/S ABDOMINAL LIMIT	$350.00	$700.00	$20.00–$2,100.00	10% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S GALLBLADDER	$350.00	$700.00	$20.00–$2,100.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S ABDOMINAL LIMIT	$350.00	$700.00	$20.00–$2,100.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 U/S R U Q	$350.00	$700.00	$20.00–$2,100.00	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST/THOR W/O CT-SCREENING	$1,175.00	$2,350.00	$78.83–$2,350.00	387% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT CHEST/THOR W/O CT-SCREENING	$1,175.00	$2,350.00	$78.83–$2,350.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI BILATERAL LOW EXT JOINT	$1,263.00	$2,526.00	$223.73–$9,933.60	—	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RIGHT LOW EXT JOINT W/O CONT	$1,182.60	$2,365.20	$223.73–$9,933.60	3% above	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LEFT LOW EXT JOINT W/O CONT	$1,260.60	$2,521.20	$223.73–$9,933.60	10% above	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI BILATERAL LOW EXT JOINT	$1,263.00	$2,526.00	$223.73–$9,933.60	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RIGHT LOW EXT JOINT W/O CONT	$1,182.60	$2,365.20	$223.73–$9,933.60	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LEFT LOW EXT JOINT W/O CONT	$1,260.60	$2,521.20	$223.73–$9,933.60	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RIGHT LOW EXT WW/O CONTR	$1,782.00	$3,564.00	$366.59–$3,564.00	34% above	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI RIGHT LOW EXT WW/O CONTR	$1,782.00	$3,564.00	$366.59–$3,564.00	—	50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN	$1,618.20	$3,236.40	$223.73–$6,950.40	34% above	50%
MRI of the abdomen without contrast CPT 74181 MRCP	$1,857.00	$3,714.00	$223.73–$6,950.40	54% above	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN	$1,618.20	$3,236.40	$223.73–$6,950.40	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRCP	$1,857.00	$3,714.00	$223.73–$6,950.40	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WW/O CONTRAST	$2,621.40	$5,242.80	$366.59–$5,242.80	107% above	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WW/O CONTRAST	$2,621.40	$5,242.80	$366.59–$5,242.80	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN LIMITED W/O CONTRAST	$1,024.80	$2,049.60	$223.73–$4,197.60	21% below	50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTR	$1,074.00	$2,148.00	$223.73–$4,197.60	18% below	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN LIMITED W/O CONTRAST	$1,024.80	$2,049.60	$223.73–$4,197.60	—	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTR	$1,074.00	$2,148.00	$223.73–$4,197.60	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAINW&W/O CONTR	$2,310.60	$4,621.20	$366.59–$15,025.20	29% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN PITUITARY W/WO CONTRAST	$2,601.00	$5,202.00	$366.59–$15,025.20	45% above	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST IAC	$2,601.00	$5,202.00	$366.59–$15,025.20	45% above	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAINW&W/O CONTR	$2,310.60	$4,621.20	$366.59–$15,025.20	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST IAC	$2,601.00	$5,202.00	$366.59–$15,025.20	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN PITUITARY W/WO CONTRAST	$2,601.00	$5,202.00	$366.59–$15,025.20	—	50%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE-LIMITED	$783.60	$1,567.20	$223.73–$9,526.80	23% below	50%
MRI of the lower back, no contrast dye CPT 72148 MRI COCCYX W/O CONTR	$1,203.00	$2,406.00	$223.73–$9,526.80	18% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI SACRUM W/O CONTR	$1,388.40	$2,776.80	$223.73–$9,526.80	36% above	50%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONT	$1,388.40	$2,776.80	$223.73–$9,526.80	36% above	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE-LIMITED	$783.60	$1,567.20	$223.73–$9,526.80	—	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI COCCYX W/O CONTR	$1,203.00	$2,406.00	$223.73–$9,526.80	—	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O CONT	$1,388.40	$2,776.80	$223.73–$9,526.80	—	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SACRUM W/O CONTR	$1,388.40	$2,776.80	$223.73–$9,526.80	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI COCCYX WW/O CONTRAST	$2,019.60	$4,039.20	$366.59–$12,523.20	19% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI SACRUM W & W/O C	$2,019.60	$4,039.20	$366.59–$12,523.20	19% above	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPNEW&W/O CONT	$2,222.40	$4,444.80	$366.59–$12,523.20	31% above	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI COCCYX WW/O CONTRAST	$2,019.60	$4,039.20	$366.59–$12,523.20	—	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI SACRUM W & W/O C	$2,019.60	$4,039.20	$366.59–$12,523.20	—	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPNEW&W/O CONT	$2,222.40	$4,444.80	$366.59–$12,523.20	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE-LIMITED	$783.60	$1,567.20	$223.73–$4,471.20	31% below	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONT	$1,452.00	$2,904.00	$223.73–$4,471.20	27% above	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE-LIMITED	$783.60	$1,567.20	$223.73–$4,471.20	—	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE W/O CONT	$1,452.00	$2,904.00	$223.73–$4,471.20	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPNEW&W/O CONT	$2,222.40	$4,444.80	$366.59–$4,444.80	29% above	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPNEW&W/O CONT	$2,222.40	$4,444.80	$366.59–$4,444.80	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONT	$1,388.40	$2,776.80	$223.73–$2,776.80	9% above	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O CONT	$1,388.40	$2,776.80	$223.73–$2,776.80	—	50%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WW/O CONTRAST	$2,364.00	$4,728.00	$366.59–$4,728.00	87% above	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WW/O CONTRAST	$2,364.00	$4,728.00	$366.59–$4,728.00	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTR	$1,174.20	$2,348.40	$223.73–$2,348.40	20% above	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTR	$1,174.20	$2,348.40	$223.73–$2,348.40	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI LEFT UP EXT JOINT W/O CONTR	$1,263.00	$2,526.00	$223.73–$5,052.00	9% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI RIGHT UP EXT JOINT W/O CONT	$1,263.00	$2,526.00	$223.73–$5,052.00	9% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI LEFT UP EXT JOINT W/O CONTR	$1,263.00	$2,526.00	$223.73–$5,052.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI RIGHT UP EXT JOINT W/O CONT	$1,263.00	$2,526.00	$223.73–$5,052.00	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 SPECT CARDIAC SCAN R	$1,800.00	$3,600.00	$266.71–$3,600.00	9% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 SPECT CARDIAC SCAN R	$1,800.00	$3,600.00	$266.71–$3,600.00	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 U/S-PELVIC LIMITED	$700.00	$1,400.00	$24.00–$1,400.00	369% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 U/S-PELVIC LIMITED	$700.00	$1,400.00	$24.00–$1,400.00	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 U/S-PELVIC	$700.00	$1,400.00	$40.00–$1,400.00	74% above	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 U/S-PELVIC	$700.00	$1,400.00	$40.00–$1,400.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S OB 2ND/3RD TRIMESTER	$700.00	$1,400.00	$56.00–$2,800.00	114% above	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 U/S-OB MULTIPLE 2ND	$700.00	$1,400.00	$56.00–$2,800.00	114% above	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 U/S OB 2ND/3RD TRIMESTER	$700.00	$1,400.00	$56.00–$2,800.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 U/S-OB MULTIPLE 2ND	$700.00	$1,400.00	$56.00–$2,800.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S-OB MULTIPLE 1ST	$700.00	$1,400.00	$42.75–$2,800.00	119% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 U/S OB 1ST TRI TRANS	$700.00	$1,400.00	$42.75–$2,800.00	119% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 U/S OB 1ST TRI TRANS	$700.00	$1,400.00	$42.75–$2,800.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 U/S-OB MULTIPLE 1ST	$700.00	$1,400.00	$42.75–$2,800.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S-OB-FETALAGE LTD	$700.00	$1,400.00	$26.00–$2,800.00	250% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 U/S O/B LIMITED	$700.00	$1,400.00	$26.00–$2,800.00	250% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 U/S O/B LIMITED	$700.00	$1,400.00	$26.00–$2,800.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 U/S-OB-FETALAGE LTD	$700.00	$1,400.00	$26.00–$2,800.00	—	50%
Screening mammogram, both breasts CPT 77067 DIGITAL MAMMO SCREENING IMPLANTS	$225.00	$450.00	$78.60–$1,450.00	44% above	50%
Screening mammogram, both breasts CPT 77067 DIGITAL MAMMOGRAM SCREENING	$250.00	$500.00	$78.60–$1,450.00	60% above	50%
Screening mammogram, both breasts one side CPT 77067 DIGITAL MAMMO SCREENING UNILATERAL	$250.00	$500.00	$78.60–$1,450.00	60% above	50%
Screening mammogram, both breasts inpatient CPT 77067 DIGITAL MAMMO SCREENING IMPLANTS	$225.00	$450.00	$78.60–$1,450.00	—	50%
Screening mammogram, both breasts inpatient CPT 77067 DIGITAL MAMMOGRAM SCREENING	$250.00	$500.00	$78.60–$1,450.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 DIGITAL MAMMO SCREENING UNILATERAL	$250.00	$500.00	$78.60–$1,450.00	—	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT MIN 2 VIEWS	$200.00	$400.00	$20.00–$1,600.00	12% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT MIN 2 VIEWS	$200.00	$400.00	$20.00–$1,600.00	12% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RIGHT MIN 3 VIEWS	$200.00	$400.00	$20.00–$1,600.00	12% above	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LEFT MIN 3 VIEWS	$200.00	$400.00	$20.00–$1,600.00	12% above	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT MIN 3 VIEWS	$200.00	$400.00	$20.00–$1,600.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LEFT MIN 2 VIEWS	$200.00	$400.00	$20.00–$1,600.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT MIN 2 VIEWS	$200.00	$400.00	$20.00–$1,600.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RIGHT MIN 3 VIEWS	$200.00	$400.00	$20.00–$1,600.00	—	50%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY	$1,400.00	$2,800.00	$122.00–$3,400.00	25% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY	$1,400.00	$2,800.00	$122.00–$3,400.00	—	50%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS ECHO W/PHY	$750.00	$1,500.00	$218.53–$1,500.00	at median	50%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS ECHO W/PHY	$750.00	$1,500.00	$218.53–$1,500.00	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 MOD BARIUM SWALLOW	$525.00	$1,050.00	$29.00–$1,050.00	117% above	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 MOD BARIUM SWALLOW	$525.00	$1,050.00	$29.00–$1,050.00	—	50%
Transvaginal pelvic ultrasound CPT 76830 U/S-PELVIC VAG PROBE	$700.00	$1,400.00	$68.00–$1,400.00	111% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 U/S-PELVIC VAG PROBE	$700.00	$1,400.00	$68.00–$1,400.00	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 U/S OB - (TVP)	$700.00	$1,400.00	$58.50–$1,400.00	104% above	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 U/S OB - (TVP)	$700.00	$1,400.00	$58.50–$1,400.00	—	50%
Ultrasound of the abdomen, complete CPT 76700 U/S-ABDOMINAL C	$600.00	$1,200.00	$56.00–$1,200.00	31% above	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 U/S-ABDOMINAL C	$600.00	$1,200.00	$56.00–$1,200.00	—	50%
Ultrasound of the scrotum and testicles CPT 76870 U/S TESTICULAR	$700.00	$1,400.00	$31.00–$1,400.00	119% above	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 U/S TESTICULAR	$700.00	$1,400.00	$31.00–$1,400.00	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S-NECK/THYROID	$325.00	$650.00	$54.00–$1,300.00	11% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 U/S-THYROID	$325.00	$650.00	$54.00–$1,300.00	11% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S-THYROID	$325.00	$650.00	$54.00–$1,300.00	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 U/S-NECK/THYROID	$325.00	$650.00	$54.00–$1,300.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 U/S RIGHT VENOUS	$700.00	$1,400.00	$73.00–$2,800.00	121% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 U/S LEFT VENOUS	$700.00	$1,400.00	$73.00–$2,800.00	121% above	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 U/S RIGHT VENOUS	$700.00	$1,400.00	$73.00–$2,800.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 U/S LEFT VENOUS	$700.00	$1,400.00	$73.00–$2,800.00	—	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST RIGHT MIN 3 VIEWS	$150.00	$300.00	$23.00–$600.00	8% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 WRIST LEFT MIN 3 VIEWS	$150.00	$300.00	$23.00–$600.00	8% below	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST RIGHT MIN 3 VIEWS	$150.00	$300.00	$23.00–$600.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 WRIST LEFT MIN 3 VIEWS	$150.00	$300.00	$23.00–$600.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 PELVIS XRAY WITH RIGHT HIP TWO VIEWS	$150.00	$300.00	$27.84–$3,400.00	1% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP JOINT RIGHT MIN 2 VIEWS	$175.00	$350.00	$27.84–$3,400.00	18% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP JOINT LEFT MIN 2 VIEWS	$175.00	$350.00	$27.84–$3,400.00	18% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP NAIL RIGHT OR COMPLETE	$600.00	$1,200.00	$27.84–$3,400.00	303% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP NAIL LEFT OR COMPLETE	$600.00	$1,200.00	$27.84–$3,400.00	303% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 PELVIS XRAY WITH RIGHT HIP TWO VIEWS	$150.00	$300.00	$27.84–$3,400.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP JOINT LEFT MIN 2 VIEWS	$175.00	$350.00	$27.84–$3,400.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP JOINT RIGHT MIN 2 VIEWS	$175.00	$350.00	$27.84–$3,400.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP NAIL LEFT OR COMPLETE	$600.00	$1,200.00	$27.84–$3,400.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP NAIL RIGHT OR COMPLETE	$600.00	$1,200.00	$27.84–$3,400.00	—	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 1 VIEW	$150.00	$300.00	$30.00–$1,200.00	6% above	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 1 VIEW	$150.00	$300.00	$30.00–$1,200.00	6% above	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE LEFT 2 VIEWS	$150.00	$300.00	$30.00–$1,200.00	6% above	50%
X-ray of the ankle, 2 views one side CPT 73600 ANKLE RIGHT 2 VIEWS	$150.00	$300.00	$30.00–$1,200.00	6% above	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 2 VIEWS	$150.00	$300.00	$30.00–$1,200.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE RIGHT 1 VIEW	$150.00	$300.00	$30.00–$1,200.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 2 VIEWS	$150.00	$300.00	$30.00–$1,200.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 ANKLE LEFT 1 VIEW	$150.00	$300.00	$30.00–$1,200.00	—	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND RIGHT, SECOND	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND RIGHT, THUMB	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND LEFT, FIFTH	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND LEFT, FOURTH	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND LEFT, THUMB	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND RIGHT, FIFTH	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND LEFT THIRD	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND LEFT, SECOND	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND RIGHT, FOURTH	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 HAND RIGHT, THIRD	$150.00	$300.00	$16.00–$3,000.00	11% above	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND LEFT THIRD	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND RIGHT, SECOND	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND LEFT, SECOND	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND RIGHT, THUMB	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND LEFT, FIFTH	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND LEFT, THUMB	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND LEFT, FOURTH	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND RIGHT, FIFTH	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND RIGHT, FOURTH	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 HAND RIGHT, THIRD	$150.00	$300.00	$16.00–$3,000.00	—	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 2 VIEWS	$150.00	$300.00	$23.00–$1,200.00	17% above	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 2 VIEWS	$150.00	$300.00	$23.00–$1,200.00	17% above	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT RIGHT 1 VIEW	$150.00	$300.00	$23.00–$1,200.00	17% above	50%
X-ray of the foot, 2 views one side CPT 73620 FOOT LEFT 1 VIEW	$150.00	$300.00	$23.00–$1,200.00	17% above	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 2 VIEWS	$150.00	$300.00	$23.00–$1,200.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 1 VIEW	$150.00	$300.00	$23.00–$1,200.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT RIGHT 2 VIEWS	$150.00	$300.00	$23.00–$1,200.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 FOOT LEFT 1 VIEW	$150.00	$300.00	$23.00–$1,200.00	—	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 OR MORE VIEWS RIGHT	$150.00	$300.00	$28.00–$600.00	8% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT 3 OR MORE VIEWS LEFT	$150.00	$300.00	$28.00–$600.00	8% below	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 OR MORE VIEWS LEFT	$150.00	$300.00	$28.00–$600.00	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 OR MORE VIEWS RIGHT	$150.00	$300.00	$28.00–$600.00	—	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MIN 3 VIEWS RIGHT	$150.00	$300.00	$25.00–$900.00	13% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 HAND LEFT 3 V	$150.00	$300.00	$25.00–$900.00	13% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MIN 3 VIEWS LEFT	$150.00	$300.00	$25.00–$900.00	13% below	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 HAND LEFT 3 V	$150.00	$300.00	$25.00–$900.00	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND MIN 3 VIEWS LEFT	$150.00	$300.00	$25.00–$900.00	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND MIN 3 VIEWS RIGHT	$150.00	$300.00	$25.00–$900.00	—	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 1 VIEW	$150.00	$300.00	$25.00–$1,800.00	5% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 PATELLA LEFT	$150.00	$300.00	$25.00–$1,800.00	5% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 2 VIEWS	$150.00	$300.00	$25.00–$1,800.00	5% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 PATELLA RIGHT	$150.00	$300.00	$25.00–$1,800.00	5% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE RIGHT 2 VIEWS	$150.00	$300.00	$25.00–$1,800.00	5% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 KNEE LEFT 1 VIEW	$150.00	$300.00	$25.00–$1,800.00	5% below	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 1 VIEW	$150.00	$300.00	$25.00–$1,800.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 1 VIEW	$150.00	$300.00	$25.00–$1,800.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE RIGHT 2 VIEWS	$150.00	$300.00	$25.00–$1,800.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 PATELLA RIGHT	$150.00	$300.00	$25.00–$1,800.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 KNEE LEFT 2 VIEWS	$150.00	$300.00	$25.00–$1,800.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 PATELLA LEFT	$150.00	$300.00	$25.00–$1,800.00	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2-3 VIE	$175.00	$350.00	$28.00–$350.00	4% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2-3 VIE	$175.00	$350.00	$28.00–$350.00	—	50%
X-ray of the lower back, 4 or more views CPT 72110 L SPINE MIN 4 V	$250.00	$500.00	$40.00–$1,325.00	4% below	50%
X-ray of the lower back, 4 or more views CPT 72110 LUMB/-SACRAL SPINE	$412.50	$825.00	$40.00–$1,325.00	59% above	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 L SPINE MIN 4 V	$250.00	$500.00	$40.00–$1,325.00	—	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMB/-SACRAL SPINE	$412.50	$825.00	$40.00–$1,325.00	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 T-SPINE 2V	$200.00	$400.00	$24.00–$400.00	1% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 T-SPINE 2V	$200.00	$400.00	$24.00–$400.00	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES MIN 3 V	$150.00	$300.00	$23.00–$300.00	10% above	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES MIN 3 V	$150.00	$300.00	$23.00–$300.00	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 C-SPINE 2-3 V	$225.00	$450.00	$28.00–$450.00	28% above	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 C-SPINE 2-3 V	$225.00	$450.00	$28.00–$450.00	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1-2 V	$175.00	$350.00	$21.00–$350.00	11% below	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1-2 V	$175.00	$350.00	$21.00–$350.00	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM & COCCYX 2 V	$250.00	$500.00	$17.00–$500.00	35% above	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM & COCCYX 2 V	$250.00	$500.00	$17.00–$500.00	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT SGPT	$26.00	$52.00	$5.30–$177.00	2% below	50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT-(ALT)	$62.50	$125.00	$5.30–$177.00	135% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT SGPT	$26.00	$52.00	$5.30–$177.00	—	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT-(ALT)	$62.50	$125.00	$5.30–$177.00	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT- (AST)	$62.50	$125.00	$5.18–$125.00	88% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT- (AST)	$62.50	$125.00	$5.18–$125.00	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL	$220.00	$440.00	$47.63–$440.00	4% above	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL	$220.00	$440.00	$47.63–$440.00	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN TEST	$15.00	$30.00	$5.22–$30.00	7% below	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN TEST	$15.00	$30.00	$5.22–$30.00	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 ANTI-CCP	$127.50	$255.00	$12.95–$255.00	94% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 ANTI-CCP	$127.50	$255.00	$12.95–$255.00	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA W/REFLEX IF POSITIVE	$75.50	$151.00	$12.09–$302.00	17% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANIT-NUC. ANTBY	$75.50	$151.00	$12.09–$302.00	17% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANIT-NUC. ANTBY	$75.50	$151.00	$12.09–$302.00	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA W/REFLEX IF POSITIVE	$75.50	$151.00	$12.09–$302.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP-CHF	$63.50	$127.00	$39.26–$127.00	23% below	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP-CHF	$63.50	$127.00	$39.26–$127.00	—	50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC	$148.00	$296.00	$8.46–$296.00	33% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC	$148.00	$296.00	$8.46–$296.00	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 GROSS/MICRO LEVEL IV	$29.00	$58.00	$28.00–$63.56	73% below	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 GROSS/MICRO LEVEL IV	$29.00	$58.00	$28.00–$63.56	—	50%
Blood culture for bacteria CPT 87040 CULT,BLD	$32.00	$64.00	$10.32–$340.00	52% below	50%
Blood culture for bacteria CPT 87040 ERBLBCAN	$46.00	$92.00	$10.32–$340.00	31% below	50%
Blood culture for bacteria CPT 87040 BULYURE BOTTLE FOR BODY FLUIDS	$46.00	$92.00	$10.32–$340.00	31% below	50%
Blood culture for bacteria inpatient CPT 87040 CULT,BLD	$32.00	$64.00	$10.32–$340.00	—	50%
Blood culture for bacteria inpatient CPT 87040 ERBLBCAN	$46.00	$92.00	$10.32–$340.00	—	50%
Blood culture for bacteria inpatient CPT 87040 BULYURE BOTTLE FOR BODY FLUIDS	$46.00	$92.00	$10.32–$340.00	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW	$4.50	$9.00	$4.50–$9.99	62% below	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW	$4.50	$9.00	$4.50–$9.99	—	50%
Blood glucose (sugar) test CPT 82947 GLUC FASTING	$38.00	$76.00	$3.93–$76.00	24% above	50%
Blood glucose (sugar) test inpatient CPT 82947 GLUC FASTING	$38.00	$76.00	$3.93–$76.00	—	50%
Blood lead test CPT 83655 LEAD UR OR SERUM	$75.50	$151.00	$12.11–$151.00	80% above	50%
Blood lead test inpatient CPT 83655 LEAD UR OR SERUM	$75.50	$151.00	$12.11–$151.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 MX RHOG WORK-UP ABO	$36.50	$73.00	$2.99–$400.00	42% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO BLOOD TYPE	$163.50	$327.00	$2.99–$400.00	161% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 MX RHOG WORK-UP ABO	$36.50	$73.00	$2.99–$400.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO BLOOD TYPE	$163.50	$327.00	$2.99–$400.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACT PROT.	$50.50	$101.00	$5.18–$202.00	29% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN LC	$50.50	$101.00	$5.18–$202.00	29% above	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACT PROT.	$50.50	$101.00	$5.18–$202.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN LC	$50.50	$101.00	$5.18–$202.00	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIN GENE,NAA	$85.50	$171.00	$37.27–$171.00	20% below	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE TOXIN GENE,NAA	$85.50	$171.00	$37.27–$171.00	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 CA 19-9	$86.00	$172.00	$20.81–$172.00	10% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9	$86.00	$172.00	$20.81–$172.00	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$164.50	$329.00	$20.81–$329.00	126% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$164.50	$329.00	$20.81–$329.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 SARS -COV-2 AB	$60.00	$120.00	$51.31–$395.00	54% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COV-19-SARS-COVID-19	$60.00	$120.00	$51.31–$395.00	54% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19/CORONAVIRUS	$77.50	$155.00	$51.31–$395.00	40% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 SARS -COV-2 AB	$60.00	$120.00	$51.31–$395.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COV-19-SARS-COVID-19	$60.00	$120.00	$51.31–$395.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19/CORONAVIRUS	$77.50	$155.00	$51.31–$395.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PR	$74.50	$149.00	$35.09–$149.00	at median	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PR	$74.50	$149.00	$35.09–$149.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPIDS-PROFILE	$56.00	$112.00	$13.39–$112.00	38% below	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPIDS-PROFILE	$56.00	$112.00	$13.39–$112.00	—	50%
Complete blood count (CBC) with differential CPT 85025 CBC W/AUTO DIFF	$59.00	$118.00	$7.77–$118.00	21% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/AUTO DIFF	$59.00	$118.00	$7.77–$118.00	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL	$169.50	$339.00	$10.56–$339.00	32% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL	$169.50	$339.00	$10.56–$339.00	—	50%
D-dimer blood test (blood clot marker) CPT 85379 DDIMER	$90.00	$180.00	$10.18–$180.00	47% above	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 DDIMER	$90.00	$180.00	$10.18–$180.00	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SULFATE	$135.00	$270.00	$22.23–$270.00	70% above	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SULFATE	$135.00	$270.00	$22.23–$270.00	—	50%
Estradiol blood test CPT 82670 ESTRADIOL BY RIA	$131.50	$263.00	$27.94–$529.00	34% above	50%
Estradiol blood test CPT 82670 ESTRIOL BY RIA	$133.00	$266.00	$27.94–$529.00	36% above	50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL BY RIA	$131.50	$263.00	$27.94–$529.00	—	50%
Estradiol blood test inpatient CPT 82670 ESTRIOL BY RIA	$133.00	$266.00	$27.94–$529.00	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH BY RIA	$108.50	$217.00	$18.58–$217.00	49% above	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH BY RIA	$108.50	$217.00	$18.58–$217.00	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN, FECAL	$45.50	$91.00	$19.63–$91.00	63% below	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN, FECAL	$45.50	$91.00	$19.63–$91.00	—	50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$99.50	$199.00	$13.63–$398.00	58% above	50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$99.50	$199.00	$13.63–$398.00	—	50%
Folate (folic acid) blood test CPT 82746 FOLATE SER	$118.50	$237.00	$14.70–$474.00	86% above	50%
Folate (folic acid) blood test CPT 82746 FOLATE	$118.50	$237.00	$14.70–$474.00	86% above	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$118.50	$237.00	$14.70–$474.00	—	50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE SER	$118.50	$237.00	$14.70–$474.00	—	50%
Free T3 thyroid hormone test CPT 84481 T-3 FREE	$62.50	$125.00	$16.94–$125.00	2% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 T-3 FREE	$62.50	$125.00	$16.94–$125.00	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$60.00	$120.00	$9.02–$240.00	25% above	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$60.00	$120.00	$9.02–$240.00	—	50%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$131.00	$262.00	$25.47–$262.00	44% above	50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$131.00	$262.00	$25.47–$262.00	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLU 1 HR/GLUCOLA	$42.00	$84.00	$4.75–$169.00	22% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 O'SULLIVAN TEST	$42.50	$85.00	$4.75–$169.00	23% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLU 1 HR/GLUCOLA	$42.00	$84.00	$4.75–$169.00	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 O'SULLIVAN TEST	$42.50	$85.00	$4.75–$169.00	—	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLLERANCE TEST UP TO 3 SPECIMEN	$83.50	$167.00	$12.87–$1,080.00	24% above	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 3 HR	$124.00	$248.00	$12.87–$1,080.00	84% above	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 4 HR	$148.00	$296.00	$12.87–$1,080.00	120% above	50%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 5 HR	$184.50	$369.00	$12.87–$1,080.00	174% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLLERANCE TEST UP TO 3 SPECIMEN	$83.50	$167.00	$12.87–$1,080.00	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 3 HR	$124.00	$248.00	$12.87–$1,080.00	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 4 HR	$148.00	$296.00	$12.87–$1,080.00	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 5 HR	$184.50	$369.00	$12.87–$1,080.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 IADNA NEISSERIA GONORRHOEAE AMPLIFIED PR	$83.00	$166.00	$35.09–$166.00	8% above	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 IADNA NEISSERIA GONORRHOEAE AMPLIFIED PR	$83.00	$166.00	$35.09–$166.00	—	50%
H. pylori antibody blood test CPT 86677 HPYLORI IGA	$57.00	$114.00	$16.85–$342.00	23% below	50%
H. pylori antibody blood test CPT 86677 HELICOBACTOR IGM	$57.00	$114.00	$16.85–$342.00	23% below	50%
H. pylori antibody blood test CPT 86677 HELICOBACTOR PYLORI	$57.00	$114.00	$16.85–$342.00	23% below	50%
H. pylori antibody blood test inpatient CPT 86677 HPYLORI IGA	$57.00	$114.00	$16.85–$342.00	—	50%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTOR IGM	$57.00	$114.00	$16.85–$342.00	—	50%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTOR PYLORI	$57.00	$114.00	$16.85–$342.00	—	50%
H. pylori stool antigen test CPT 87338 H. PYLORI STOOL AG	$36.00	$72.00	$6.12–$90.78	49% below	50%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI STOOL AG	$36.00	$72.00	$6.12–$90.78	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV 1 VIRAL LOAD	$132.00	$264.00	$85.10–$275.83	41% below	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV 1 VIRAL LOAD	$132.00	$264.00	$85.10–$275.83	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 RAPID HIV (SUDS)	$65.00	$130.00	$13.71–$130.00	15% below	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 RAPID HIV (SUDS)	$65.00	$130.00	$13.71–$130.00	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/0/Z AB W/REPLEX TO WESTERN BLOT	$64.00	$128.00	$24.08–$256.00	11% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV COMBO	$64.00	$128.00	$24.08–$256.00	11% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/0/Z AB W/REPLEX TO WESTERN BLOT	$64.00	$128.00	$24.08–$256.00	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV COMBO	$64.00	$128.00	$24.08–$256.00	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$60.00	$120.00	$9.71–$120.00	53% above	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$60.00	$120.00	$9.71–$120.00	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 B SURF. ANTIBODY	$57.00	$114.00	$10.74–$114.00	3% below	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 B SURF. ANTIBODY	$57.00	$114.00	$10.74–$114.00	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SUR ANTIGEN	$16.00	$32.00	$10.33–$175.00	62% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSABOCM	$16.00	$32.00	$10.33–$175.00	62% below	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 ANTI HEP B S AG	$55.50	$111.00	$10.33–$175.00	33% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SUR ANTIGEN	$16.00	$32.00	$10.33–$175.00	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSABOCM	$16.00	$32.00	$10.33–$175.00	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 ANTI HEP B S AG	$55.50	$111.00	$10.33–$175.00	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 HBC AB-M (HEP - C)	$56.00	$112.00	$14.27–$268.00	1% below	50%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$78.00	$156.00	$14.27–$268.00	38% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HBC AB-M (HEP - C)	$56.00	$112.00	$14.27–$268.00	—	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$78.00	$156.00	$14.27–$268.00	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C QUANT	$126.00	$252.00	$42.84–$252.00	5% below	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C QUANT	$126.00	$252.00	$42.84–$252.00	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX/AB IGG	$34.50	$69.00	$13.19–$277.00	27% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX I IGM	$34.50	$69.00	$13.19–$277.00	27% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX, TYPE	$69.50	$139.00	$13.19–$277.00	46% above	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX I IGM	$34.50	$69.00	$13.19–$277.00	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX/AB IGG	$34.50	$69.00	$13.19–$277.00	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX, TYPE	$69.50	$139.00	$13.19–$277.00	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE	$69.50	$139.00	$19.35–$139.00	20% above	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE	$69.50	$139.00	$19.35–$139.00	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-CARD-HS	$50.50	$101.00	$12.95–$101.00	1% below	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-CARD-HS	$50.50	$101.00	$12.95–$101.00	—	50%
Homocysteine blood test CPT 83090 HOMOCYSTINE/URINE	$75.00	$150.00	$17.92–$417.00	2% above	50%
Homocysteine blood test CPT 83090 HOMOCYSTINE/SERUM	$133.50	$267.00	$17.92–$417.00	82% above	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE/URINE	$75.00	$150.00	$17.92–$417.00	—	50%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTINE/SERUM	$133.50	$267.00	$17.92–$417.00	—	50%
Insulin blood test CPT 83525 INSULIN SERUM	$80.50	$161.00	$11.43–$161.00	75% above	50%
Insulin blood test inpatient CPT 83525 INSULIN SERUM	$80.50	$161.00	$11.43–$161.00	—	50%
Iron blood test (serum iron) CPT 83540 IRON	$50.50	$101.00	$6.47–$202.00	25% above	50%
Iron blood test (serum iron) CPT 83540 IRON FE	$50.50	$101.00	$6.47–$202.00	25% above	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON FE	$50.50	$101.00	$6.47–$202.00	—	50%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$50.50	$101.00	$6.47–$202.00	—	50%
Iron-binding capacity (TIBC) test CPT 83550 DIRECT TOTAL IRON BINDING CAPACITY	$15.00	$30.00	$8.74–$152.00	52% below	50%
Iron-binding capacity (TIBC) test CPT 83550 TIBC	$61.00	$122.00	$8.74–$152.00	96% above	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 DIRECT TOTAL IRON BINDING CAPACITY	$15.00	$30.00	$8.74–$152.00	—	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 TIBC	$61.00	$122.00	$8.74–$152.00	—	50%
Kidney function blood test panel CPT 80069 RENAL PANEL	$127.50	$255.00	$8.68–$545.00	41% above	50%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$145.00	$290.00	$8.68–$545.00	60% above	50%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$127.50	$255.00	$8.68–$545.00	—	50%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE	$145.00	$290.00	$8.68–$545.00	—	50%
LH (luteinizing hormone) test CPT 83002 LH BY RIA	$109.50	$219.00	$18.52–$219.00	65% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 LH BY RIA	$109.50	$219.00	$18.52–$219.00	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$50.50	$101.00	$6.89–$101.00	22% above	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$50.50	$101.00	$6.89–$101.00	—	50%
Liver function blood test panel CPT 80076 HEPATIC PANEL CHC	$14.50	$29.00	$8.17–$180.00	84% below	50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION	$75.50	$151.00	$8.17–$180.00	15% below	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC PANEL CHC	$14.50	$29.00	$8.17–$180.00	—	50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION	$75.50	$151.00	$8.17–$180.00	—	50%
Lyme disease antibody test CPT 86618 LYME DISEASE SERUM	$153.50	$307.00	$17.03–$307.00	87% above	50%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SERUM	$153.50	$307.00	$17.03–$307.00	—	50%
Magnesium blood test CPT 83735 MAGNESIUM, SERUM	$56.00	$112.00	$6.70–$112.00	77% above	50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM, SERUM	$56.00	$112.00	$6.70–$112.00	—	50%
Measles (rubeola) antibody test CPT 86765 REUBOLA	$34.50	$69.00	$12.88–$69.00	18% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 REUBOLA	$34.50	$69.00	$12.88–$69.00	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSPOT	$45.00	$90.00	$5.18–$90.00	36% above	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSPOT	$45.00	$90.00	$5.18–$90.00	—	50%
Obstetric blood test panel CPT 80055 OB PROFILE INT	$118.50	$237.00	$36.52–$237.00	at median	50%
Obstetric blood test panel inpatient CPT 80055 OB PROFILE INT	$118.50	$237.00	$36.52–$237.00	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 PAPSMEAR W/RFX HPP A SCU	$54.13	$108.27	$20.75–$108.27	24% above	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAPSMEAR W/RFX HPP A SCU	$54.13	$108.27	$20.75–$108.27	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTP CERV/VAG AUTO THIN LAYER PREP SCREE	$20.00	$40.00	$19.00–$43.13	60% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTP CERV/VAG AUTO THIN LAYER PREP SCREE	$20.00	$40.00	$19.00–$43.13	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTHI	$77.00	$154.00	$41.28–$308.00	46% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 PARATYPHOID-(PTH)	$77.00	$154.00	$41.28–$308.00	46% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTHI	$77.00	$154.00	$41.28–$308.00	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATYPHOID-(PTH)	$77.00	$154.00	$41.28–$308.00	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT APTT	$63.50	$127.00	$6.01–$127.00	65% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT APTT	$63.50	$127.00	$6.01–$127.00	—	50%
Progesterone blood test CPT 84144 PROGESTERONE	$115.00	$230.00	$20.86–$230.00	76% above	50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$115.00	$230.00	$20.86–$230.00	—	50%
Prolactin blood test CPT 84146 PROLACTIN	$204.50	$409.00	$19.38–$409.00	185% above	50%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$204.50	$409.00	$19.38–$409.00	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$48.00	$96.00	$4.29–$96.00	72% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$48.00	$96.00	$4.29–$96.00	—	50%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$62.50	$125.00	$5.67–$125.00	71% above	50%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$62.50	$125.00	$5.67–$125.00	—	50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA TITER	$45.00	$90.00	$14.39–$90.00	3% above	50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA TITER	$45.00	$90.00	$14.39–$90.00	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR	$38.00	$76.00	$2.70–$76.00	50% above	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR	$38.00	$76.00	$2.70–$76.00	—	50%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALY COMP	$108.50	$217.00	$12.31–$217.00	13% below	50%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALY COMP	$108.50	$217.00	$12.31–$217.00	—	50%
Stool ova and parasites exam CPT 87177 OVA CYSTS & PARASITE	$62.50	$125.00	$8.90–$125.00	54% above	50%
Stool ova and parasites exam inpatient CPT 87177 OVA CYSTS & PARASITE	$62.50	$125.00	$8.90–$125.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 CSF - VDRL	$26.00	$52.00	$4.27–$128.00	35% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$38.00	$76.00	$4.27–$128.00	97% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 CSF - VDRL	$26.00	$52.00	$4.27–$128.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$38.00	$76.00	$4.27–$128.00	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GOLD INCUBATE	$134.14	$268.29	$61.98–$558.29	33% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 OUANTIFERON TB GOLD	$145.00	$290.00	$61.98–$558.29	43% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD INCUBATE	$134.14	$268.29	$61.98–$558.29	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 OUANTIFERON TB GOLD	$145.00	$290.00	$61.98–$558.29	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE	$185.50	$371.00	$25.81–$742.00	134% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$185.50	$371.00	$25.81–$742.00	134% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE	$185.50	$371.00	$25.81–$742.00	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$185.50	$371.00	$25.81–$742.00	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB, EACH	$18.00	$36.00	$14.55–$231.00	56% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEYI MICROSOMAE AB	$28.50	$57.00	$14.55–$231.00	30% below	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE A	$69.00	$138.00	$14.55–$231.00	69% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB, EACH	$18.00	$36.00	$14.55–$231.00	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEYI MICROSOMAE AB	$28.50	$57.00	$14.55–$231.00	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE A	$69.00	$138.00	$14.55–$231.00	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING	$14.50	$29.00	$16.80–$321.00	77% below	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYSTIM HORM TSH	$73.00	$146.00	$16.80–$321.00	17% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYCASPR	$73.00	$146.00	$16.80–$321.00	17% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING	$14.50	$29.00	$16.80–$321.00	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYCASPR	$73.00	$146.00	$16.80–$321.00	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYSTIM HORM TSH	$73.00	$146.00	$16.80–$321.00	—	50%
Uric acid blood test CPT 84550 URIC ACID CHC	$12.00	$24.00	$4.52–$136.00	67% below	50%
Uric acid blood test CPT 84550 URIC AC(SM)	$56.00	$112.00	$4.52–$136.00	55% above	50%
Uric acid blood test inpatient CPT 84550 URIC ACID CHC	$12.00	$24.00	$4.52–$136.00	—	50%
Uric acid blood test inpatient CPT 84550 URIC AC(SM)	$56.00	$112.00	$4.52–$136.00	—	50%
Urinalysis with microscope exam, automated CPT 81001 URINE PROTIEN - WAIV	$21.50	$43.00	$3.17–$131.00	26% below	50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPIC	$44.00	$88.00	$3.17–$131.00	52% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINE PROTIEN - WAIV	$21.50	$43.00	$3.17–$131.00	—	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPIC	$44.00	$88.00	$3.17–$131.00	—	50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE, URINE	$62.50	$125.00	$8.07–$125.00	32% above	50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE, URINE	$62.50	$125.00	$8.07–$125.00	—	50%
Urine pregnancy test, read by color change CPT 81025 HCG-URINE-QUAL	$44.00	$88.00	$8.61–$200.00	26% below	50%
Urine pregnancy test, read by color change CPT 81025 HCG, QUALITATIVE	$56.00	$112.00	$8.61–$200.00	6% below	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG-URINE-QUAL	$44.00	$88.00	$8.61–$200.00	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG, QUALITATIVE	$56.00	$112.00	$8.61–$200.00	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B/SER	$94.50	$189.00	$15.08–$378.00	68% above	50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12/SER	$94.50	$189.00	$15.08–$378.00	68% above	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B/SER	$94.50	$189.00	$15.08–$378.00	—	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12/SER	$94.50	$189.00	$15.08–$378.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D,25 DIHYROX	$147.00	$294.00	$29.60–$588.00	81% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D	$147.00	$294.00	$29.60–$588.00	81% above	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D	$147.00	$294.00	$29.60–$588.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D,25 DIHYROX	$147.00	$294.00	$29.60–$588.00	—	50%
Zinc blood test CPT 84630 ZINC, SERUM	$43.50	$87.00	$11.39–$215.00	1% below	50%
Zinc blood test CPT 84630 ZINC, URINE	$64.00	$128.00	$11.39–$215.00	45% above	50%
Zinc blood test inpatient CPT 84630 ZINC, SERUM	$43.50	$87.00	$11.39–$215.00	—	50%
Zinc blood test inpatient CPT 84630 ZINC, URINE	$64.00	$128.00	$11.39–$215.00	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG,SERUM (QUANT)	$56.00	$112.00	$11.54–$112.00	32% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG,SERUM (QUANT)	$56.00	$112.00	$11.54–$112.00	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TRMT DISTAL F	$175.00	$350.00	$175.00–$2,790.00	53% below	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TRMT DISTAL F	$175.00	$350.00	$175.00–$2,790.00	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 M/TAR FRACT 28470	$150.00	$300.00	$150.00–$2,790.00	62% below	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 M/TAR FRACT 28470	$150.00	$300.00	$150.00–$2,790.00	—	50%
Cardiac catheterization with coronary angiogram CPT 93458 LEFTHEARTCATHW/P PCI	$3,300.35	$6,600.70	$165.64–$11,858.00	27% below	50%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 LEFTHEARTCATHW/P PCI	$3,300.35	$6,600.70	$165.64–$11,858.00	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$275.00	$550.00	$5.17–$6,707.00	55% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION 92960	$275.00	$550.00	$5.17–$6,707.00	55% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$934.50	$1,869.00	$5.17–$6,707.00	54% above	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSIONELECTIVEEXTERNAL	$934.50	$1,869.00	$5.17–$6,707.00	54% above	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$275.00	$550.00	$5.17–$6,707.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION 92960	$275.00	$550.00	$5.17–$6,707.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSIONELECTIVEEXTERNAL	$934.50	$1,869.00	$5.17–$6,707.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$934.50	$1,869.00	$5.17–$6,707.00	—	50%
Cesarean delivery, including prenatal and postpartum care CPT 59510 GLOBAL WITH CESAREAN SECTION	$3,000.00	$6,000.00	$3,000.00–$6,000.00	—	50%
Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 GLOBAL WITH CESAREAN SECTION	$3,000.00	$6,000.00	$3,000.00–$6,000.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION BY HOSPITALIST	$150.00	$300.00	$83.02–$7,063.00	75% below	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION BY PHYSICIAN	$216.40	$432.81	$83.02–$7,063.00	64% below	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$216.40	$300.00	$83.02–$7,063.00	64% below	28%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION BY HOSPITALIST	$150.00	$300.00	$83.02–$7,063.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W/REGIONL BLOCK	$216.40	$300.00	$83.02–$7,063.00	—	28%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION BY PHYSICIAN	$216.40	$432.81	$83.02–$7,063.00	—	50%
Coronary stent placement, one artery CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL	$7,792.12	$15,584.24	$320.00–$15,584.24	3% below	50%
Coronary stent placement, one artery inpatient CPT 92928 PRQ CARD STENT W/ANGIO 1 VSL	$7,792.12	$15,584.24	$320.00–$15,584.24	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION ALL BENI	$38.50	$77.00	$38.50–$2,790.00	62% below	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION ALL BENI	$38.50	$77.00	$38.50–$2,790.00	—	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIAGATI	$11.06	$22.12	$11.06–$2,790.00	78% below	50%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$11.06	$22.12	$11.06–$2,790.00	78% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$11.06	$22.12	$11.06–$2,790.00	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIAGATI	$11.06	$22.12	$11.06–$2,790.00	—	50%
Earwax removal with instruments, one ear CPT 69210 REM IMPACT CERUMEN	$27.50	$55.00	$27.50–$2,790.00	61% below	50%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI	$27.50	$55.00	$27.50–$2,790.00	61% below	50%
Earwax removal with instruments, one ear inpatient CPT 69210 REM IMPACT CERUMEN	$27.50	$55.00	$27.50–$2,790.00	—	50%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI	$27.50	$55.00	$27.50–$2,790.00	—	50%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 64493-FLUORO GUIDED SPINAL STEROID INJ	$1,012.50	$2,025.00	$250.00–$3,763.00	9% above	50%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 64493-FLUORO GUIDED SPINAL STEROID INJ	$1,012.50	$2,025.00	$250.00–$3,763.00	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE	$145.00	$290.00	$55.60–$2,790.00	23% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$145.00	$290.00	$55.60–$2,790.00	23% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS: SIMPLE	$145.00	$290.00	$55.60–$2,790.00	23% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS: SIMPLE	$145.00	$290.00	$55.60–$2,790.00	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE/SINGLE	$145.00	$290.00	$55.60–$2,790.00	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE	$145.00	$290.00	$55.60–$2,790.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$102.50	$735.00	$38.82–$2,790.00	48% below	86%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJ J	$102.50	$205.00	$38.82–$2,790.00	48% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610-INJ-STEROID,MAJOR JOINT OR BURSA	$367.50	$735.00	$38.82–$2,790.00	87% above	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US	$102.50	$735.00	$38.82–$2,790.00	—	86%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJ J	$102.50	$205.00	$38.82–$2,790.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610-INJ-STEROID,MAJOR JOINT OR BURSA	$367.50	$735.00	$38.82–$2,790.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAC UP TO 2.5CM	$100.00	$200.00	$100.00–$2,790.00	70% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$100.00	$200.00	$100.00–$2,790.00	70% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/<	$100.00	$200.00	$100.00–$2,790.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC UP TO 2.5CM	$100.00	$200.00	$100.00–$2,790.00	—	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$51.50	$103.00	$47.13–$2,790.00	66% below	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLT	$51.50	$103.00	$47.13–$2,790.00	66% below	50%
Nail removal (partial or complete), one nail CPT 11730 11730-REMOVAL OF NAIL PLATE	$56.80	$113.60	$47.13–$2,790.00	62% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SIMPLE 1	$51.50	$103.00	$47.13–$2,790.00	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLT	$51.50	$103.00	$47.13–$2,790.00	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 11730-REMOVAL OF NAIL PLATE	$56.80	$113.60	$47.13–$2,790.00	—	50%
Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK	$150.00	$300.00	$44.69–$2,790.00	45% below	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 OCCIPITAL NERVE BLOCK	$150.00	$300.00	$44.69–$2,790.00	—	50%
Paracentesis with imaging guidance CPT 49083 49083-ABDOMINAL PARACENTESIS W/IMAGING	$1,125.00	$2,250.00	$250.00–$4,337.00	58% above	50%
Paracentesis with imaging guidance inpatient CPT 49083 49083-ABDOMINAL PARACENTESIS W/IMAGING	$1,125.00	$2,250.00	$250.00–$4,337.00	—	50%
Removal of a foreign object under the skin, simple CPT 10120 FBR-SUBCUTAN TISSUE	$83.00	$166.00	$83.00–$2,790.00	69% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$83.00	$166.00	$83.00–$2,790.00	69% below	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INC&RMVL FB SUBQ TISS SMPL	$83.00	$166.00	$83.00–$2,790.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 FBR-SUBCUTAN TISSUE	$83.00	$166.00	$83.00–$2,790.00	—	50%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING COLONSCOPY	$1,050.00	$2,100.00	$845.19–$3,763.00	68% above	50%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLORECTAL CANCER SCREENING COLONSCOPY	$1,050.00	$2,100.00	$845.19–$3,763.00	—	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 SCREENING COLONOSCOP	$1,100.00	$2,200.00	$845.19–$3,763.00	76% above	50%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 SCREENING COLONOSCOP	$1,100.00	$2,200.00	$845.19–$3,763.00	—	50%
Short arm splint (forearm and hand) CPT 29125 APPL SHORT ARM SPLINT STATIC	$62.50	$125.00	$34.87–$2,790.00	53% below	50%
Short arm splint (forearm and hand) CPT 29125 SPLINT/ARM-WRIST	$62.50	$125.00	$34.87–$2,790.00	53% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT/ARM-WRIST	$62.50	$125.00	$34.87–$2,790.00	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL SHORT ARM SPLINT STATIC	$62.50	$125.00	$34.87–$2,790.00	—	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT	$62.50	$125.00	$43.20–$2,790.00	54% below	50%
Short leg splint (calf to foot) CPT 29515 SPLINT/SHORT LEG	$62.50	$125.00	$43.20–$2,790.00	54% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 SPLINT/SHORT LEG	$62.50	$125.00	$43.20–$2,790.00	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT	$62.50	$125.00	$43.20–$2,790.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 1/2-1" SIM LAC 12001	$175.00	$350.00	$38.09–$2,790.00	26% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 LAC UP TO 2.5 CM	$175.00	$350.00	$38.09–$2,790.00	26% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR LAC <2.5CM EX FACE/EARS	$175.00	$350.00	$38.09–$2,790.00	26% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$175.00	$350.00	$38.09–$2,790.00	26% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 1/2-1" SIM LAC 12001	$175.00	$350.00	$38.09–$2,790.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC UP TO 2.5 CM	$175.00	$350.00	$38.09–$2,790.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE REPAIR LAC <2.5CM EX FACE/EARS	$175.00	$350.00	$38.09–$2,790.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/<	$175.00	$350.00	$38.09–$2,790.00	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL TAP 62270	$159.50	$319.00	$54.34–$3,763.00	76% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$159.50	$319.00	$54.34–$3,763.00	76% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL TAP 62270	$159.50	$319.00	$54.34–$3,763.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$159.50	$319.00	$54.34–$3,763.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$175.00	$350.00	$50.03–$2,790.00	45% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 LAC 2.6CM TO 7.5CM	$175.00	$350.00	$50.03–$2,790.00	45% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 1-3" SIMP LAC 12002	$175.00	$350.00	$50.03–$2,790.00	45% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM	$175.00	$350.00	$50.03–$2,790.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 1-3" SIMP LAC 12002	$175.00	$350.00	$50.03–$2,790.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC 2.6CM TO 7.5CM	$175.00	$350.00	$50.03–$2,790.00	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$61.50	$123.00	$47.42–$2,790.00	63% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 LAC UP TO 2.5CM	$61.50	$123.00	$47.42–$2,790.00	63% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5 CM/<	$61.50	$123.00	$47.42–$2,790.00	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC UP TO 2.5CM	$61.50	$123.00	$47.42–$2,790.00	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LES	$150.00	$350.00	$32.52–$2,790.00	5% below	57%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BX SKIN	$150.00	$300.00	$32.52–$2,790.00	5% below	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGNTL BX SKIN SINGLE LESION	$175.00	$350.00	$32.52–$2,790.00	11% above	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BX SKIN	$150.00	$300.00	$32.52–$2,790.00	—	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES	$150.00	$350.00	$32.52–$2,790.00	—	57%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LESION	$175.00	$350.00	$32.52–$2,790.00	—	50%
Thoracentesis with imaging guidance CPT 32555 ULTRASOUND GUIDED THORACENTESIS	$925.00	$1,850.00	$250.00–$3,763.00	14% above	50%
Thoracentesis with imaging guidance inpatient CPT 32555 ULTRASOUND GUIDED THORACENTESIS	$925.00	$1,850.00	$250.00–$3,763.00	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ, S	$128.00	$256.00	$31.58–$2,790.00	29% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 NJX 1/MLT TRIGGER POINT 1/2	$128.00	$256.00	$31.58–$2,790.00	29% below	50%
Trigger point injections, 1 or 2 muscles CPT 20552 INJECTION, SINGLE OR	$128.00	$256.00	$31.58–$2,790.00	29% below	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECTION, SINGLE OR	$128.00	$256.00	$31.58–$2,790.00	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 NJX 1/MLT TRIGGER POINT 1/2	$128.00	$256.00	$31.58–$2,790.00	—	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ, S	$128.00	$256.00	$31.58–$2,790.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 19083-U/S GUIDED BREAST BIOPSY W/PLACEME	$2,025.00	$4,050.00	$250.00–$4,337.00	97% above	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 19083-U/S GUIDED BREAST BIOPSY W/PLACEME	$2,025.00	$4,050.00	$250.00–$4,337.00	—	50%
Vaginal delivery, including prenatal and postpartum care CPT 59400 GLOBAL WITH VAGINAL DELIVERY	$2,000.00	$4,000.00	$2,000.00–$4,000.00	6% below	50%
Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 GLOBAL WITH VAGINAL DELIVERY	$2,000.00	$4,000.00	$2,000.00–$4,000.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TIS 20 CM/<	$69.81	$139.62	$52.29–$2,790.00	83% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$100.00	$200.00	$52.29–$2,790.00	76% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$100.00	$139.62	$52.29–$2,790.00	76% below	28%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TIS 20 CM/<	$69.81	$139.62	$52.29–$2,790.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEB SUBQ TISSUE 20 SQ CM/<	$100.00	$200.00	$52.29–$2,790.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/<	$100.00	$139.62	$52.29–$2,790.00	—	28%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN	$500.00	$1,000.00	$250.00–$8,000.00	at median	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION-TRANSFUSION	$500.00	$1,000.00	$250.00–$8,000.00	at median	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN	$500.00	$1,000.00	$250.00–$8,000.00	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION-TRANSFUSION	$500.00	$1,000.00	$250.00–$8,000.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MED NEB PER TX	$117.28	$234.57	$6.00–$785.57	10% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI	$275.50	$551.00	$6.00–$785.57	158% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MED NEB PER TX	$117.28	$234.57	$6.00–$785.57	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI	$275.50	$551.00	$6.00–$785.57	—	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION -	$138.00	$276.00	$315.74–$1,900.00	45% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION IN	$144.50	$289.00	$315.74–$1,900.00	43% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO PREP FEE	$217.50	$435.00	$315.74–$1,900.00	14% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMOTHERAPY IV ONLY	$450.00	$900.00	$315.74–$1,900.00	78% above	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION -	$138.00	$276.00	$315.74–$1,900.00	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION IN	$144.50	$289.00	$315.74–$1,900.00	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO PREP FEE	$217.50	$435.00	$315.74–$1,900.00	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMOTHERAPY IV ONLY	$450.00	$900.00	$315.74–$1,900.00	—	50%
Critical care, first 30 to 74 minutes CPT 99291 EXAM CRIT CARE 1STHR	$1,000.00	$2,000.00	$93.05–$8,000.00	at median	50%
Critical care, first 30 to 74 minutes CPT 99291 EXAM-CRIT CARE W PRO	$1,000.00	$2,000.00	$93.05–$8,000.00	at median	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$1,000.00	$2,000.00	$93.05–$8,000.00	at median	50%
Critical care, first 30 to 74 minutes CPT 99291 EXAM-CRITICAL CARE	$1,000.00	$2,000.00	$93.05–$8,000.00	at median	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$1,000.00	$2,000.00	$93.05–$8,000.00	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EXAM-CRITICAL CARE	$1,000.00	$2,000.00	$93.05–$8,000.00	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EXAM-CRIT CARE W PRO	$1,000.00	$2,000.00	$93.05–$8,000.00	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 EXAM CRIT CARE 1STHR	$1,000.00	$2,000.00	$93.05–$8,000.00	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM	$95.00	$190.00	$17.00–$380.00	5% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM	$95.00	$190.00	$17.00–$380.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF EXAM WITH PROC	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EXAM-BRIEF W/PROC	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF EXAM 99281	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF FOLLOWUP 99281	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 MEDICAID EMERGENCY V	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EXAM-BRIEF	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER TRIAGE	$250.00	$500.00	$10.38–$3,500.00	46% above	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 MEDICAID EMERGENCY V	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EXAM-BRIEF W/PROC	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF EXAM WITH PROC	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF EXAM 99281	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF FOLLOWUP 99281	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EXAM-BRIEF	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER TRIAGE	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$250.00	$500.00	$10.38–$3,500.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EXAM - LIMITED W/PR	$187.50	$375.00	$35.00–$1,850.00	28% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EXAM - LIMITED	$187.50	$375.00	$35.00–$1,850.00	28% below	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED EXAM 99282	$275.00	$550.00	$35.00–$1,850.00	5% above	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$275.00	$375.00	$35.00–$1,850.00	5% above	27%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED EXAM WITH PR	$275.00	$550.00	$35.00–$1,850.00	5% above	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EXAM - LIMITED	$187.50	$375.00	$35.00–$1,850.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EXAM - LIMITED W/PR	$187.50	$375.00	$35.00–$1,850.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED EXAM WITH PR	$275.00	$550.00	$35.00–$1,850.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$275.00	$375.00	$35.00–$1,850.00	—	27%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED EXAM 99282	$275.00	$550.00	$35.00–$1,850.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EXAM - INTERMEDIATE	$325.00	$650.00	$53.90–$2,600.00	29% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EXAM - INTER W/ PROC	$325.00	$650.00	$53.90–$2,600.00	29% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$325.00	$650.00	$53.90–$2,600.00	29% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMED VISIT 99283	$325.00	$650.00	$53.90–$2,600.00	29% below	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMED VISIT WITH	$325.00	$650.00	$53.90–$2,600.00	29% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EXAM - INTERMEDIATE	$325.00	$650.00	$53.90–$2,600.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMED VISIT WITH	$325.00	$650.00	$53.90–$2,600.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMED VISIT 99283	$325.00	$650.00	$53.90–$2,600.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$325.00	$650.00	$53.90–$2,600.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EXAM - INTER W/ PROC	$325.00	$650.00	$53.90–$2,600.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$153.50	$307.00	$71.50–$2,314.00	73% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED EXAM WITH P	$153.50	$307.00	$71.50–$2,314.00	73% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED EXAM 99284	$153.50	$307.00	$71.50–$2,314.00	73% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXAM - EXTENDED	$425.00	$850.00	$71.50–$2,314.00	24% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXAM - EXTEND W/PROC	$425.00	$850.00	$71.50–$2,314.00	24% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$153.50	$307.00	$71.50–$2,314.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED EXAM 99284	$153.50	$307.00	$71.50–$2,314.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED EXAM WITH P	$153.50	$307.00	$71.50–$2,314.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXAM - EXTENDED	$425.00	$850.00	$71.50–$2,314.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXAM - EXTEND W/PROC	$425.00	$850.00	$71.50–$2,314.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,300.00	$2,600.00	$83.75–$10,400.00	8% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EXAM COMPREHENSIVE	$1,300.00	$2,600.00	$83.75–$10,400.00	8% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE EXAM	$1,300.00	$2,600.00	$83.75–$10,400.00	8% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE EXAM W	$1,300.00	$2,600.00	$83.75–$10,400.00	8% above	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EXAM COMPREHENSIVE W	$1,300.00	$2,600.00	$83.75–$10,400.00	8% above	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,300.00	$2,600.00	$83.75–$10,400.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EXAM COMPREHENSIVE W	$1,300.00	$2,600.00	$83.75–$10,400.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE EXAM W	$1,300.00	$2,600.00	$83.75–$10,400.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE EXAM	$1,300.00	$2,600.00	$83.75–$10,400.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EXAM COMPREHENSIVE	$1,300.00	$2,600.00	$83.75–$10,400.00	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST	$375.00	$750.00	$61.00–$750.00	17% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST	$375.00	$750.00	$61.00–$750.00	—	50%
Family therapy with the patient, 50 minutes CPT 90847 INTENSIVE OP-CRISIS FAM W/PT	$87.00	$174.00	$138.31–$839.43	44% below	50%
Family therapy with the patient, 50 minutes CPT 90847 OUTPATIENT 1-CRISIS FAM W/PT	$87.00	$174.00	$138.31–$839.43	44% below	50%
Family therapy with the patient, 50 minutes CPT 90847 PARTIAL HOSP/DT-CRISIS FAM W/PT	$87.00	$174.00	$138.31–$839.43	44% below	50%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY WITH PATIENT	$138.21	$276.43	$138.31–$839.43	10% below	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 PARTIAL HOSP/DT-CRISIS FAM W/PT	$87.00	$174.00	$138.31–$839.43	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 INTENSIVE OP-CRISIS FAM W/PT	$87.00	$174.00	$138.31–$839.43	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 OUTPATIENT 1-CRISIS FAM W/PT	$87.00	$174.00	$138.31–$839.43	—	50%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY WITH PATIENT	$138.21	$276.43	$138.31–$839.43	—	50%
Family therapy without the patient, 50 minutes CPT 90846 INTENSIVE OP-CRISIS FAM W/O PT	$26.62	$53.25	$138.31–$718.68	82% below	50%
Family therapy without the patient, 50 minutes CPT 90846 OUTPATIENT 1-CRISIS FAM W/O PT	$87.00	$174.00	$138.31–$718.68	42% below	50%
Family therapy without the patient, 50 minutes CPT 90846 PARTIAL HOSP/DT-CRISIS FAM W/O PT	$87.00	$174.00	$138.31–$718.68	42% below	50%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/OUT PATIENT	$138.21	$276.43	$138.31–$718.68	7% below	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 INTENSIVE OP-CRISIS FAM W/O PT	$26.62	$53.25	$138.31–$718.68	—	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 OUTPATIENT 1-CRISIS FAM W/O PT	$87.00	$174.00	$138.31–$718.68	—	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 PARTIAL HOSP/DT-CRISIS FAM W/O PT	$87.00	$174.00	$138.31–$718.68	—	50%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/OUT PATIENT	$138.21	$276.43	$138.31–$718.68	—	50%
Group psychotherapy session CPT 90853 PARTIAL HOSPITALIZATION INTENSIVE FOR AM	$150.00	$300.00	$72.00–$300.00	32% above	50%
Group psychotherapy session inpatient CPT 90853 PARTIAL HOSPITALIZATION INTENSIVE FOR AM	$150.00	$300.00	$72.00–$300.00	—	50%
Holter monitor, heart rhythm recording up to 48 hours, with report CPT 93224 TELEMETRY BED PER	$26.00	$52.00	$26.00–$52.00	75% below	50%
Holter monitor, heart rhythm recording up to 48 hours, with report inpatient CPT 93224 TELEMETRY BED PER	$26.00	$52.00	$26.00–$52.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INITIAL	$108.50	$217.00	$196.08–$1,646.66	39% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31 MIN	$108.50	$217.00	$196.08–$1,646.66	39% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31 MIN	$300.00	$600.00	$196.08–$1,646.66	68% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 31MIN -	$306.33	$612.66	$196.08–$1,646.66	71% above	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31 MIN	$108.50	$217.00	$196.08–$1,646.66	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL	$108.50	$217.00	$196.08–$1,646.66	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31 MIN	$300.00	$600.00	$196.08–$1,646.66	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 31MIN -	$306.33	$612.66	$196.08–$1,646.66	—	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION MEDICATE	$108.50	$217.00	$90.58–$1,646.66	44% below	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUSE MEDICATED	$300.00	$600.00	$90.58–$1,646.66	56% above	50%
IV infusion of a medicine, first hour CPT 96365 IV INFUS MEDICATE IN	$306.33	$612.66	$90.58–$1,646.66	59% above	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION MEDICATE	$108.50	$217.00	$90.58–$1,646.66	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSE MEDICATED	$300.00	$600.00	$90.58–$1,646.66	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUS MEDICATE IN	$306.33	$612.66	$90.58–$1,646.66	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INTRA MUSCULAR/ANTIB	$24.00	$48.00	$64.04–$1,328.72	67% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INTRAMUSCULAR / ANTI	$24.00	$48.00	$64.04–$1,328.72	67% below	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INTRAMUSCULAR/ANTIBI	$87.50	$175.00	$64.04–$1,328.72	20% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION FEE	$87.50	$175.00	$64.04–$1,328.72	20% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION RHOGAM	$87.50	$175.00	$64.04–$1,328.72	20% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPUTIC INJECTION	$100.68	$201.36	$64.04–$1,328.72	38% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INTRA MUSCULAR/ANTIB	$24.00	$48.00	$64.04–$1,328.72	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INTRAMUSCULAR / ANTI	$24.00	$48.00	$64.04–$1,328.72	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION RHOGAM	$87.50	$175.00	$64.04–$1,328.72	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION FEE	$87.50	$175.00	$64.04–$1,328.72	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INTRAMUSCULAR/ANTIBI	$87.50	$175.00	$64.04–$1,328.72	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPUTIC INJECTION	$100.68	$201.36	$64.04–$1,328.72	—	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 PARTIAL HOSP/DT-PSYCHIATRIC INTRV	$262.50	$525.00	$138.31–$1,575.00	65% above	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 OUTPATIENT 1-PSYCHIATRIC INTV	$262.50	$525.00	$138.31–$1,575.00	65% above	50%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 INTENSIVE OP-PSYCHIATRIC INTRV	$262.50	$525.00	$138.31–$1,575.00	65% above	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 INTENSIVE OP-PSYCHIATRIC INTRV	$262.50	$525.00	$138.31–$1,575.00	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 OUTPATIENT 1-PSYCHIATRIC INTV	$262.50	$525.00	$138.31–$1,575.00	—	50%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791 PARTIAL HOSP/DT-PSYCHIATRIC INTRV	$262.50	$525.00	$138.31–$1,575.00	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCT 7-8	$120.70	$241.41	$71.51–$1,191.41	42% below	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CONDUCTION 7-8 NERVES	$475.00	$950.00	$71.51–$1,191.41	127% above	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCT 7-8	$120.70	$241.41	$71.51–$1,191.41	—	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CONDUCTION 7-8 NERVES	$475.00	$950.00	$71.51–$1,191.41	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 NEURO-RE-ED/PROPRIOC	$26.00	$52.00	$26.00–$52.00	60% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEURO-RE-ED/PROPRIOC	$26.00	$52.00	$26.00–$52.00	—	50%
New patient office visit, about 30 minutes CPT 99203 WC NEW PT INTERM VST	$85.59	$171.18	$67.43–$171.18	at median	50%
New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN	$85.59	$171.18	$67.43–$171.18	at median	50%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30 MIN	$85.59	$171.18	$67.43–$171.18	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 WC NEW PT INTERM VST	$85.59	$171.18	$67.43–$171.18	—	50%
New patient office visit, about 45 minutes CPT 99204 OFFICE O/P NEW MOD 45 MIN	$144.75	$289.50	$110.46–$289.50	39% above	50%
New patient office visit, about 45 minutes CPT 99204 WC NEW PT EXTENS VST	$144.75	$289.50	$110.46–$289.50	39% above	50%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45 MIN	$144.75	$289.50	$110.46–$289.50	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 WC NEW PT EXTENS VST	$144.75	$289.50	$110.46–$289.50	—	50%
New patient office visit, about 60 minutes CPT 99205 WC NEW PT COMPLX VST	$188.13	$376.26	$12.00–$376.26	2% above	50%
New patient office visit, about 60 minutes inpatient CPT 99205 WC NEW PT COMPLX VST	$188.13	$376.26	$12.00–$376.26	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CDU MED DIR-OUTPT VISIT, NEW	$50.00	$100.00	$39.06–$211.21	14% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC NEW PT LIMIT VST	$55.60	$111.21	$39.06–$211.21	4% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN	$55.60	$111.21	$39.06–$211.21	4% below	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CDU MED DIR-OUTPT VISIT, NEW	$50.00	$100.00	$39.06–$211.21	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC NEW PT LIMIT VST	$55.60	$111.21	$39.06–$211.21	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15 MIN	$55.60	$111.21	$39.06–$211.21	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX WITH 4 COMPONENTS	$112.50	$225.00	$88.58–$225.00	2% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX WITH 4 COMPONENTS	$112.50	$225.00	$88.58–$225.00	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXTIY W/5 COMPONEN	$112.50	$225.00	$88.58–$336.69	14% below	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXTIY W/5 COMPONEN	$112.50	$225.00	$88.58–$336.69	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY	$36.50	$73.00	$24.58–$73.00	43% below	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY	$36.50	$73.00	$24.58–$73.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 EXERCISE 0 - 15 MIN	$34.50	$69.00	$21.76–$69.00	44% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 EXERCISE 0 - 15 MIN	$34.50	$69.00	$21.76–$69.00	—	50%
Psychological testing evaluation by a psychologist or physician, first hour CPT 96130 PSYCHOLOGICAL TESTING PER HOUR	$243.56	$487.13	$243.56–$487.13	—	50%
Psychological testing evaluation by a psychologist or physician, first hour inpatient CPT 96130 PSYCHOLOGICAL TESTING PER HOUR	$243.56	$487.13	$243.56–$487.13	—	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 OUTPATIENT 1-CRISIS INDV SESSN	$75.00	$150.00	$138.31–$450.00	5% below	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 INTENSIVE OP-CRISIS INDV SESSN	$75.00	$150.00	$138.31–$450.00	5% below	50%
Psychotherapy for crisis, first 60 minutes CPT 90839 PARTIAL HOSP/DT-CRISIS INDV SESSN	$75.00	$150.00	$138.31–$450.00	5% below	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 INTENSIVE OP-CRISIS INDV SESSN	$75.00	$150.00	$138.31–$450.00	—	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 OUTPATIENT 1-CRISIS INDV SESSN	$75.00	$150.00	$138.31–$450.00	—	50%
Psychotherapy for crisis, first 60 minutes inpatient CPT 90839 PARTIAL HOSP/DT-CRISIS INDV SESSN	$75.00	$150.00	$138.31–$450.00	—	50%
Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY,45MIN W/PT&/OR FAMILY MEMB	$182.00	$364.00	$138.31–$364.00	22% above	50%
Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY,45MIN W/PT&/OR FAMILY MEMB	$182.00	$364.00	$138.31–$364.00	—	50%
Psychotherapy session, 60 minutes CPT 90837 INTENSIVE OP-GROUP SESSN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 OUTPATIENT 1-FAM CNF W/PT	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 OUTPATIENT 1-GRP FMLY THR SESN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 OUTPATIENT 1-FAM CNF W/O PT	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 PARTIAL HOSP/DT-INDV SESSN 60 MIN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 PARTIAL HOSP/DT-GROUP SESSN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 PARTIAL HOSP/DT-GRP FMLY THR SESN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 PARTIAL HOSP/DT-FAM CNF W/PT	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 PARTIAL HOSP/DT-FAM CNF W/O PT	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 INTENSIVE OP-INDV SESSN 60 MIN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 INTESIVE OP-GRP FMLY THR SESN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 INTENSIVE OP-FAM CNF W/PT	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 INTENSIVE OP-FAM CNF W/O PT	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 OUTPATIENT 1-INDV SESSN 60 MIN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 OUTPATIENT 1-GROUP SESSN	$75.00	$150.00	$138.31–$2,526.43	35% below	50%
Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MIN W/PT AND/OR FAMILY	$138.21	$276.43	$138.31–$2,526.43	20% above	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 OUTPATIENT 1-GRP FMLY THR SESN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INTESIVE OP-GRP FMLY THR SESN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PARTIAL HOSP/DT-FAM CNF W/PT	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INTENSIVE OP-FAM CNF W/O PT	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PARTIAL HOSP/DT-FAM CNF W/O PT	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INTENSIVE OP-FAM CNF W/PT	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INTENSIVE OP-INDV SESSN 60 MIN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 OUTPATIENT 1-FAM CNF W/PT	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 INTENSIVE OP-GROUP SESSN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PARTIAL HOSP/DT-INDV SESSN 60 MIN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 OUTPATIENT 1-INDV SESSN 60 MIN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PARTIAL HOSP/DT-GRP FMLY THR SESN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 OUTPATIENT 1-GROUP SESSN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 OUTPATIENT 1-FAM CNF W/O PT	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PARTIAL HOSP/DT-GROUP SESSN	$75.00	$150.00	$138.31–$2,526.43	—	50%
Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY 60 MIN W/PT AND/OR FAMILY	$138.21	$276.43	$138.31–$2,526.43	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION LESS THAN 10 MINUTES	$17.88	$35.76	$28.17–$100.76	50% below	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION 3-10 MIN	$32.50	$65.00	$28.17–$100.76	9% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION LESS THAN 10 MINUTES	$17.88	$35.76	$28.17–$100.76	—	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION 3-10 MIN	$32.50	$65.00	$28.17–$100.76	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC EST PT COMPLX VST	$125.00	$250.00	$119.25–$250.00	3% below	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC EST PT COMPLX VST	$125.00	$250.00	$119.25–$250.00	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC EST PT INTERM VST	$56.40	$112.80	$54.71–$112.80	33% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN	$56.40	$112.80	$54.71–$112.80	33% below	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20 MIN	$56.40	$112.80	$54.71–$112.80	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC EST PT INTERM VST	$56.40	$112.80	$54.71–$112.80	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC EST PT EXTENS VST	$100.00	$200.00	$80.42–$200.00	at median	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE O/P EST MOD 30 MIN	$100.00	$200.00	$80.42–$200.00	at median	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN	$100.00	$200.00	$80.42–$200.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC EST PT EXTENS VST	$100.00	$200.00	$80.42–$200.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CDU MED DIR-OUTPT VISIT, ESTABLISHED	$62.50	$125.00	$29.44–$375.00	1% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN	$62.50	$125.00	$29.44–$375.00	1% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EEG ESTABLISHED PATIENT VISIT 1	$62.50	$125.00	$29.44–$375.00	1% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC EST PT LIMIT VST	$62.50	$125.00	$29.44–$375.00	1% below	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CDU MED DIR-OUTPT VISIT, ESTABLISHED	$62.50	$125.00	$29.44–$375.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10 MIN	$62.50	$125.00	$29.44–$375.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC EST PT LIMIT VST	$62.50	$125.00	$29.44–$375.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 EEG ESTABLISHED PATIENT VISIT 1	$62.50	$125.00	$29.44–$375.00	—	50%
Speech and language evaluation CPT 92523 EVAL OF SPEECH SND PRODUCTION W/LANGUAGE	$270.54	$541.09	$202.92–$541.09	49% above	50%
Speech and language evaluation inpatient CPT 92523 EVAL OF SPEECH SND PRODUCTION W/LANGUAGE	$270.54	$541.09	$202.92–$541.09	—	50%
Speech therapy session, individual CPT 92507 TREATMENT 1/2 HOUR	$53.00	$106.00	$21.76–$300.00	61% below	50%
Speech therapy session, individual CPT 92507 TREATMENT PER HOUR	$76.00	$152.00	$21.76–$300.00	45% below	50%
Speech therapy session, individual inpatient CPT 92507 TREATMENT 1/2 HOUR	$53.00	$106.00	$21.76–$300.00	—	50%
Speech therapy session, individual inpatient CPT 92507 TREATMENT PER HOUR	$76.00	$152.00	$21.76–$300.00	—	50%
Spirometry (breathing test) CPT 94010 PFT. PRE STUDY ONLY	$89.00	$178.00	$24.00–$178.00	56% below	50%
Spirometry (breathing test) inpatient CPT 94010 PFT. PRE STUDY ONLY	$89.00	$178.00	$24.00–$178.00	—	50%
Spirometry before and after a bronchodilator CPT 94060 PF/BRONCHODITORS	$307.00	$614.00	$39.00–$614.00	13% below	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PF/BRONCHODITORS	$307.00	$614.00	$39.00–$614.00	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 FUNCTIONAL TRAINING	$37.00	$74.00	$21.76–$74.00	44% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 FUNCTIONAL TRAINING	$37.00	$74.00	$21.76–$74.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY (THER)999	$38.00	$76.00	$110.22–$403.00	72% below	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUT PHLEBOTOMY	$163.50	$327.00	$110.22–$403.00	22% above	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY (THER)999	$38.00	$76.00	$110.22–$403.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUT PHLEBOTOMY	$163.50	$327.00	$110.22–$403.00	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Arkansas	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 AFLURIA FLU VACCINE	$32.65	$65.30	$13.12–$138.60	17% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 INFLUENZA VACCINE	$36.65	$73.30	$13.12–$138.60	7% below	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 AFLURIA FLU VACCINE	$32.65	$65.30	$13.12–$138.60	—	50%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 INFLUENZA VACCINE	$36.65	$73.30	$13.12–$138.60	—	50%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 GARDASIL9 HPV VACCIN	$517.32	$1,034.65	$307.61–$1,034.65	72% above	50%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 GARDASIL9 HPV VACCIN	$517.32	$1,034.65	$307.61–$1,034.65	—	50%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE	$87.85	$175.70	$34.64–$175.70	41% below	50%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE	$87.85	$175.70	$34.64–$175.70	—	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PREVNAR 20	$555.32	$1,110.65	$283.71–$1,110.65	34% below	50%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PREVNAR 20	$555.32	$1,110.65	$283.71–$1,110.65	—	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX-23	$210.72	$421.45	$125.92–$421.45	30% above	50%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX-23	$210.72	$421.45	$125.92–$421.45	—	50%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE	$782.30	$1,564.60	$262.98–$1,564.60	15% below	50%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE	$782.30	$1,564.60	$262.98–$1,564.60	—	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DECAVAC VACCINE	$71.07	$142.15	$14.00–$142.15	4% above	50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DECAVAC VACCINE	$71.07	$142.15	$14.00–$142.15	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 ADACEL (TDAP)0.5ML V	$87.05	$174.10	$28.80–$354.90	11% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE	$90.40	$180.80	$28.80–$354.90	7% below	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 ADACEL (TDAP)0.5ML V	$87.05	$174.10	$28.80–$354.90	—	50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE	$90.40	$180.80	$28.80–$354.90	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZTION ADMINIST	$36.50	$73.00	$13.14–$496.00	5% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS ADMINISTRATI	$36.50	$73.00	$13.14–$496.00	5% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINIS	$87.50	$175.00	$13.14–$496.00	152% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZTION ADMINIST	$36.50	$73.00	$13.14–$496.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TETANUS ADMINISTRATI	$36.50	$73.00	$13.14–$496.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINIS	$87.50	$175.00	$13.14–$496.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZTION ADMIN EA	$18.00	$36.00	$13.14–$186.00	5% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN E	$50.00	$100.00	$13.14–$186.00	165% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZTION ADMIN EA	$18.00	$36.00	$13.14–$186.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN E	$50.00	$100.00	$13.14–$186.00	—	50%

Source file: https://s3.amazonaws.com/ycubaa-production-marlin-1-charge-management-public/facilities/f76605c4-3372-458f-b443-765cba65564a/710766341_OUACHITA-COUNTY-MEDICAL-CENTER_standardcharges.csv