Wyoming County
Wyoming County in Warsaw, NY publishes cash prices for 279 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the New York median for 199 of 275 procedures and above it for 71. By typical cash price it ranks #36 of 93 New York hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
400 N Main St,Warsaw,NY,14569 Collected Sep 27, 2026 Source price file (585) 786-8940
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 331323 · CMS hospital register
CMS price transparency record
The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 2 actions for a hospital named Wyoming County in Warsaw, NY:
- Jun 8, 2023 Corrective action plan requested
- Sep 13, 2023 Case closed
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 New York | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE | $183.51 | $262.15 | $36.00 | 8% below | 30% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 SINGLE CONTRAST X-RAY OF ESOPHAGUS | $371.05 | $530.07 | $101.35 | 10% above | 30% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY | $832.90 | $1,189.85 | $308.06 | 3% below | 30% |
| Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE | $222.02 | $317.17 | $109.73 | 30% below | 30% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $183.51 | $262.15 | $90.23 | 18% below | 30% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST | $371.05 | $530.07 | $287.83 | 67% below | 30% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $423.01 | $604.30 | $207.86 | 59% below | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST | $975.30 | $1,393.29 | $339.92 | 37% below | 30% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR | $1,083.60 | $1,548.00 | $380.68 | 34% below | 30% |
| CT scan of the abdomen with contrast CPT 74160 CT SCAN OF ABDOMEN WITH CONTRAST | $782.60 | $1,118.00 | $241.94 | 23% below | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $186.10 | $265.85 | $154.48 | 77% below | 30% |
| CT scan of the abdomen without contrast CPT 74150 CT SCAN OF ABDOMEN WITHOUT CONTRAST | $722.40 | $1,032.00 | $154.48 | 9% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE | $236.00 | $337.14 | $142.01 | 66% below | 30% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SCAN OF FACE WITHOUT CONTRAST | $722.40 | $1,032.00 | $142.01 | 4% above | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE | $722.40 | $1,032.00 | $118.82 | 5% above | 30% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE | $782.60 | $1,118.00 | $167.58 | 11% below | 30% |
| CT scan of the head without and with contrast CPT 70470 CT SCAN OF HEAD OR BRAIN BEFORE AND AFTER CONTRAST | $812.70 | $1,161.00 | $195.71 | 22% below | 30% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT SCAN OF LOWER SPINE WITHOUT CONTRAST | $225.80 | $322.57 | $153.16 | 73% below | 30% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT SCAN OF UPPER SPINE WITHOUT CONTRAST | $312.00 | $445.71 | $155.82 | 63% below | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT SCAN OF PELVIS WITH CONTRAST | $782.60 | $1,118.00 | $236.61 | 13% below | 30% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY | $494.84 | $706.92 | $236.00 | — | 30% |
| Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $183.51 | $262.15 | $33.64 | 9% below | 30% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $183.51 | $262.15 | $25.86 | 1% below | 30% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP | $222.02 | $317.17 | $115.35 | 38% below | 30% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $222.02 | $317.17 | $40.09 | 7% below | 30% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS | $494.84 | $706.92 | $188.84 | 5% below | 30% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT SCAN OF CHEST WITHOUT CONTRAST | $222.02 | $317.17 | $159.32 | 73% below | 30% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT SCAN OF CHEST WITH CONTRAST | $371.05 | $530.07 | $198.41 | 64% below | 30% |
| Diagnostic mammogram, both breasts CPT 77066 DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS | $235.20 | $336.00 | $173.67 | 1% below | 30% |
| Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI | $184.10 | $263.00 | $137.31 | 31% below | 30% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 ULTRASOUND OF LEG ARTERIES OR ARTERY GRAFTS | $494.84 | $706.92 | $298.26 | at median | 30% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 ULTRASOUND STUDY OF ARM OR LEG VEINS WITH COMPRESSION AND MANEUVERS | $494.84 | $706.92 | $229.82 | at median | 30% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ULTRASOUND OF HEART WITH COLOR-DEPICTED BLOOD FLOW; RATE; DIRECTION AND VALVE FUNCTION | $1,114.06 | $1,591.52 | $242.80 | 2% above | 30% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NUCLEAR MEDICINE STUDY OF LIVER AND BILE DUCT SYSTEM | $832.90 | $1,189.85 | $335.21 | 13% below | 30% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT | $315.46 | $450.65 | $105.50 | 2% below | 30% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM | $2,111.41 | $3,016.30 | $618.81 | 4% below | 30% |
| Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3 | $183.51 | $262.15 | $39.66 | 9% above | 30% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 LIMITED ULTRASOUND SCAN OF ABDOMEN | $222.02 | $317.17 | $92.79 | 28% below | 30% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C- | $222.02 | $317.17 | $158.52 | 47% below | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $494.84 | $706.92 | $258.66 | 51% below | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $2,160.50 | $3,086.43 | $506.69 | 18% above | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST | $423.01 | $604.30 | $262.01 | 59% below | 30% |
| MRI of the abdomen without contrast CPT 74181 MRI SCAN OF ABDOMEN WITHOUT CONTRAST | $494.84 | $706.92 | $262.01 | 52% below | 30% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI SCAN OF ABDOMEN BEFORE AND AFTER CONTRAST | $776.63 | $1,109.47 | $442.17 | 53% below | 30% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE | $494.84 | $706.92 | $252.60 | 50% below | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST | $776.63 | $1,109.47 | $412.55 | 52% below | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE | $423.01 | $604.30 | $246.80 | 60% below | 30% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST | $1,562.20 | $2,231.71 | $246.80 | 46% above | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE | $624.98 | $892.83 | $414.45 | 62% below | 30% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI SCAN OF LOWER SPINAL CANAL BEFORE AND AFTER CONTRAST | $776.63 | $1,109.47 | $414.45 | 53% below | 30% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI SCAN OF MIDDLE SPINAL CANAL WITHOUT CONTRAST | $494.84 | $706.92 | $246.80 | 51% below | 30% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI SCAN OF UPPER SPINAL CANAL BEFORE AND AFTER CONTRAST | $776.63 | $1,109.47 | $415.20 | 52% below | 30% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI SCAN OF UPPER SPINAL CANAL WITHOUT CONTRAST | $1,562.20 | $2,231.71 | $246.43 | 56% above | 30% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE | $776.63 | $1,109.47 | $441.78 | 49% below | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI SCAN OF PELVIS WITHOUT CONTRAST | $494.84 | $706.92 | $299.44 | 50% below | 30% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE | $1,563.30 | $2,233.29 | $299.44 | 58% above | 30% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $494.84 | $706.92 | $258.66 | 59% below | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT | $2,283.62 | $3,262.32 | $482.86 | 4% above | 30% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NUCLEAR MEDICINE STUDIES OF HEART MUSCLE AT REST AND WITH STRESS AND SPECT | $2,867.55 | $4,096.50 | $482.86 | 30% above | 30% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED | $222.02 | $317.17 | $50.78 | 13% below | 30% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE | $301.10 | $430.14 | $111.85 | 17% below | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >= 14 WKS SNGL FETUS | $301.10 | $430.14 | $144.12 | 7% below | 30% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 ULTRASOUND SCAN OF PREGNANT UTERUS (LESS THAN 14 WEEKS); SINGLE OR FIRST FETUS | $271.10 | $387.29 | $126.72 | 12% below | 30% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $222.02 | $317.17 | $86.91 | 28% below | 30% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $194.60 | $278.00 | $140.13 | — | 30% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER | $183.51 | $262.15 | $33.90 | 9% below | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM | $2,111.41 | $3,016.30 | $590.40 | 1% above | 30% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 ULTRASOUND OF HEART WITH CONTINUOUS ELECTROCARDIOGRAM (ECG) DURING REST; EXERCISE AND/OR DRUG INDUCED STRESS WITH REVIEW AND REPORT | $1,114.06 | $1,591.52 | $279.92 | 2% below | 30% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE COMPLETE | $2,091.96 | $2,988.52 | $279.92 | 85% above | 30% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 IMAGING FOR EVALUATION OF SWALLOWING FUNCTION | $371.05 | $530.07 | $130.64 | 10% above | 30% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB | $301.10 | $430.14 | $124.04 | 13% below | 30% |
| Transvaginal ultrasound during pregnancy CPT 76817 VAGINAL ULTRASOUND OF PREGNANT UTERUS | $240.90 | $344.14 | $99.70 | 13% below | 30% |
| Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE | $301.10 | $430.14 | $124.55 | 29% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM | $301.07 | $430.10 | $107.31 | 15% below | 30% |
| Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCAN OF SCROTUM | $301.10 | $430.14 | $107.31 | 15% below | 30% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK | $301.10 | $430.14 | $116.58 | 4% below | 30% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST | $371.05 | $530.07 | $126.55 | 12% below | 30% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY | $301.10 | $430.14 | $143.71 | 14% below | 30% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST | $183.51 | $262.15 | $39.52 | 4% below | 30% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $183.51 | $262.15 | $45.82 | at median | 30% |
| X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW | $183.51 | $262.15 | $29.71 | 9% below | 30% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE | $183.51 | $262.15 | $32.08 | 15% above | 30% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $183.51 | $262.15 | $36.24 | 16% above | 30% |
| X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT | $183.51 | $262.15 | $28.11 | 10% above | 30% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT | $183.51 | $262.15 | $33.70 | 2% above | 30% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND | $183.51 | $262.15 | $35.68 | 9% below | 30% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $183.51 | $262.15 | $33.68 | at median | 30% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY OF LOWER AND SACRAL SPINE; 2-3 VIEWS | $222.02 | $317.17 | $39.44 | 16% below | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS | $222.02 | $317.17 | $50.23 | 20% below | 30% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY OF MIDDLE SPINE; 2 VIEWS | $222.02 | $317.17 | $33.69 | 10% above | 30% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES | $183.51 | $262.15 | $37.28 | 9% below | 30% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY OF UPPER SPINE; 2-3 VIEWS | $183.51 | $262.15 | $39.13 | 9% below | 30% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $222.02 | $317.17 | $29.40 | at median | 30% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY OF SACRUM AND TAILBONE; MINIMUM OF 2 VIEWS | $183.51 | $262.15 | $31.85 | 9% below | 30% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 LIVER ENZYME (SGPT); LEVEL | $9.28 | $13.25 | $3.52 | 60% below | 30% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 LIVER ENZYME (SGOT); LEVEL | $9.07 | $12.95 | $3.45 | 64% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $7.14 | $10.20 | $3.47 | 55% below | 30% |
| Allergy blood test, specific IgE, per allergen CPT 86003 MEASUREMENT OF ANTIBODY (IGE) TO ALLERGIC SUBSTANCE; CRUDE ALLERGEN EXTRACT; EACH | $9.38 | $13.40 | $3.47 | 41% below | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 MEASUREMENT OF ANTIBODY FOR RHEUMATOID ARTHRITIS ASSESSMENT | $22.67 | $32.38 | $8.64 | 52% below | 30% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $36.75 | $52.50 | $8.64 | 22% below | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SCREENING TEST FOR AUTOIMMUNE DISORDER | $21.16 | $30.23 | $8.06 | 52% below | 30% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $32.80 | $46.86 | $8.06 | 25% below | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $55.93 | $79.90 | $26.16 | 54% below | 30% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE (HEART AND BLOOD VESSEL PROTEIN) LEVEL | $69.60 | $99.43 | $26.16 | 43% below | 30% |
| Basic metabolic panel (blood test) CPT 80048 BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL) | $14.81 | $21.16 | $5.64 | 76% below | 30% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $14.84 | $21.20 | $5.64 | 76% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $89.67 | $128.10 | $64.48 | 50% below | 30% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 PATHOLOGY EXAMINATION OF TISSUE USING A MICROSCOPE; INTERMEDIATE COMPLEXITY | $192.72 | $275.31 | $64.48 | 7% above | 30% |
| Blood culture for bacteria CPT 87040 BACTERIAL BLOOD CULTURE | $18.06 | $25.80 | $6.88 | 74% below | 30% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $61.41 | $87.73 | $6.88 | 12% below | 30% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 INSERTION OF NEEDLE INTO VEIN FOR COLLECTION OF BLOOD SAMPLE | $15.46 | $22.08 | $2.00 | 2% below | 30% |
| Blood glucose (sugar) test CPT 82947 BLOOD GLUCOSE (SUGAR) LEVEL | $6.88 | $9.83 | $2.62 | 62% below | 30% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $16.73 | $23.90 | $2.62 | 7% below | 30% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $21.63 | $30.90 | $8.07 | 50% below | 30% |
| Blood lead test CPT 83655 LEAD LEVEL | $48.20 | $68.86 | $8.07 | 12% above | 30% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN (REPRODUCTIVE HORMONE) ANALYSIS | $13.16 | $18.80 | $5.01 | 63% below | 30% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION | $19.80 | $28.29 | $3.45 | 33% below | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $15.82 | $22.60 | $13.87 | 79% below | 30% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 19-9 | $50.80 | $72.57 | $13.87 | 33% below | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOLOGIC ANALYSIS FOR DETECTION OF TUMOR ANTIGEN; QUANTITATIVE; CA 125 | $36.42 | $52.03 | $13.87 | 56% below | 30% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $86.31 | $123.30 | $13.87 | 5% above | 30% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $62.30 | $89.00 | $52.60 | 46% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $23.70 | $33.86 | $23.38 | 73% below | 30% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DETECTION TEST BY NUCLEIC ACID FOR CHLAMYDIA TRACHOMATIS; AMPLIFIED PROBE TECHNIQUE | $378.72 | $541.03 | $23.38 | 338% above | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES) | $23.44 | $33.48 | $8.92 | 68% below | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $23.94 | $34.20 | $8.92 | 67% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT | $13.59 | $19.42 | $5.18 | 67% below | 30% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $25.80 | $36.86 | $5.18 | 38% below | 30% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST | $11.33 | $16.18 | $4.31 | 63% below | 30% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $21.90 | $31.29 | $4.31 | 29% below | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS | $18.48 | $26.40 | $7.03 | 80% below | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $165.90 | $237.00 | $7.03 | 76% above | 30% |
| D-dimer blood test (blood clot marker) CPT 85379 COAGULATION FUNCTION MEASUREMENT; D-DIMER; QUANTITATIVE | $102.50 | $146.43 | $6.79 | 177% above | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE (DHEA-S) HORMONE LEVEL | $23.38 | $33.40 | $14.82 | 76% below | 30% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $75.60 | $108.00 | $14.82 | 22% below | 30% |
| Estradiol blood test CPT 82670 MEASUREMENT OF TOTAL ESTRADIOL (HORMONE) | $12.74 | $18.20 | $18.61 | 87% below | 30% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $189.70 | $271.00 | $18.61 | 88% above | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN; FOLLICLE STIMULATING (REPRODUCTIVE HORMONE) LEVEL | $32.52 | $46.45 | $12.38 | 57% below | 30% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $33.25 | $47.50 | $12.38 | 56% below | 30% |
| Fecal calprotectin (stool inflammation test) CPT 83993 STOOL CALPROTECTIN (PROTEIN) LEVEL | $241.21 | $344.58 | $13.08 | 125% above | 30% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN (BLOOD PROTEIN) LEVEL | $23.86 | $34.08 | $9.08 | 64% below | 30% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $24.22 | $34.60 | $9.79 | 61% below | 30% |
| Folate (folic acid) blood test CPT 82746 FOLIC ACID LEVEL; SERUM | $25.40 | $36.29 | $9.79 | 59% below | 30% |
| Free T3 thyroid hormone test CPT 84481 THYROID HORMONE; T3 MEASUREMENT; FREE | $13.58 | $19.40 | $11.29 | 85% below | 30% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $87.10 | $124.43 | $11.29 | 2% below | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $15.79 | $22.55 | $6.01 | 75% below | 30% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE (THYROID CHEMICAL); FREE | $60.80 | $86.86 | $6.01 | 4% below | 30% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $19.60 | $28.00 | $16.98 | 79% below | 30% |
| Free testosterone test CPT 84402 TESTOSTERONE (HORMONE) LEVEL; FREE | $64.80 | $92.57 | $16.98 | 30% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $8.31 | $11.87 | $3.17 | 61% below | 30% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 BLOOD GLUCOSE (SUGAR) LEVEL AFTER RECEIVING DOSE OF GLUCOSE | $16.20 | $23.14 | $3.17 | 24% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 BLOOD GLUCOSE (SUGAR) TOLERANCE TEST; 3 SPECIMENS | $58.10 | $83.00 | $8.59 | 3% below | 30% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $83.00 | $118.57 | $8.59 | 38% above | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 DETECTION TEST BY NUCLEIC ACID FOR NEISSERIA GONORRHOEAE (GONORRHOEAE BACTERIA); AMPLIFIED PROBE TECHNIQUE | $62.58 | $89.40 | $23.38 | 38% below | 30% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $118.30 | $169.00 | $23.38 | 17% above | 30% |
| H. pylori antibody blood test CPT 86677 ANALYSIS FOR ANTIBODY TO HELICOBACTER PYLORI (GASTROINTESTINAL BACTERIA) | $7.70 | $11.00 | $11.22 | 85% below | 30% |
| H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY | $17.50 | $25.00 | $11.22 | 67% below | 30% |
| H. pylori stool antigen test CPT 87338 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HELICOBACTER PYLORI (GI TRACT BACTERIA) IN STOOL | $33.50 | $47.86 | $9.58 | 47% below | 30% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $133.84 | $191.20 | $56.70 | 43% below | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 ANALYSIS FOR ANTIBODY TO HIV-1 AND HIV-2 VIRUS | $36.10 | $51.57 | $9.13 | 37% below | 30% |
| HIV-1 and HIV-2 antibody test CPT 86703 HIV-1/HIV-2 1 RESULT ANTBDY | $37.00 | $52.86 | $9.13 | 35% below | 30% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HIV-1 ANTIGEN AND HIV-1 AND HIV-2 ANTIBODIES | $42.14 | $60.20 | $16.04 | 48% below | 30% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $58.56 | $83.65 | $23.38 | 34% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $9.10 | $13.00 | $6.46 | 78% below | 30% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C LEVEL | $44.70 | $63.86 | $6.46 | 8% above | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY MEASUREMENT | $18.80 | $26.85 | $7.15 | 56% below | 30% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $33.74 | $48.20 | $7.15 | 22% below | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 DETECTION TEST BY IMMUNOASSAY TECHNIQUE FOR HEPATITIS B SURFACE ANTIGEN | $17.50 | $25.00 | $6.88 | 53% below | 30% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $30.59 | $43.70 | $6.88 | 18% below | 30% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $76.40 | $109.14 | $9.51 | 28% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $192.15 | $274.50 | $28.55 | 45% above | 30% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 DETECTION TEST BY NUCLEIC ACID FOR HEPATITIS C VIRUS; QUANTIFICATION | $198.80 | $284.00 | $28.55 | 50% above | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 1 | $12.43 | $17.75 | $8.79 | 69% below | 30% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $16.73 | $23.90 | $8.79 | 58% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 ANALYSIS FOR ANTIBODY TO HERPES SIMPLEX VIRUS; TYPE 2 | $21.15 | $30.22 | $12.90 | 64% below | 30% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $34.51 | $49.30 | $12.90 | 42% below | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 MEASUREMENT C-REACTIVE PROTEIN FOR DETECTION OF INFECTION OR INFLAMMATION; HIGH SENSITIVITY | $30.85 | $44.07 | $8.64 | 35% below | 30% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $73.08 | $104.40 | $8.64 | 54% above | 30% |
| Homocysteine blood test CPT 83090 HOMOCYSTEINE (AMINO ACID) LEVEL | $20.93 | $29.90 | $11.94 | 73% below | 30% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $197.90 | $282.71 | $11.94 | 158% above | 30% |
| Insulin blood test CPT 83525 INSULIN MEASUREMENT; TOTAL | $39.40 | $56.29 | $7.62 | 16% below | 30% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $152.88 | $218.40 | $7.62 | 227% above | 30% |
| Iron blood test (serum iron) CPT 83540 IRON LEVEL | $11.33 | $16.18 | $4.31 | 63% below | 30% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $15.30 | $21.85 | $5.83 | 63% below | 30% |
| Kidney function blood test panel CPT 80069 KIDNEY FUNCTION BLOOD TEST PANEL | $45.20 | $64.57 | $5.78 | 32% below | 30% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $30.90 | $44.14 | $12.34 | 60% below | 30% |
| LH (luteinizing hormone) test CPT 83002 GONADOTROPIN; LUTEINIZING (REPRODUCTIVE HORMONE) LEVEL | $32.41 | $46.30 | $12.34 | 58% below | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $11.55 | $16.50 | $4.60 | 66% below | 30% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE (FAT ENZYME) LEVEL | $12.06 | $17.23 | $4.60 | 65% below | 30% |
| Liver function blood test panel CPT 80076 LIVER FUNCTION BLOOD TEST PANEL | $78.40 | $112.00 | $5.44 | 6% above | 30% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $28.51 | $40.73 | $11.35 | 38% below | 30% |
| Lyme disease antibody test CPT 86618 ANALYSIS FOR ANTIBODY BORRELIA BURGDORFERI (LYME DISEASE BACTERIA) | $34.30 | $49.00 | $11.35 | 25% below | 30% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $7.63 | $10.90 | $4.47 | 74% below | 30% |
| Magnesium blood test CPT 83735 MAGNESIUM LEVEL | $11.73 | $16.75 | $4.47 | 60% below | 30% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $13.75 | $19.64 | $8.59 | 70% below | 30% |
| Measles (rubeola) antibody test CPT 86765 ANALYSIS FOR ANTIBODY TO RUBEOLA (MEASLES VIRUS) | $35.00 | $50.00 | $8.59 | 23% below | 30% |
| Mono test (heterophile antibody, Monospot) CPT 86308 SCREENING TEST FOR MONONUCLEOSIS (MONO) | $30.70 | $43.86 | $3.45 | 18% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; FREE | $32.18 | $45.97 | $12.25 | 46% below | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $32.19 | $45.98 | $12.25 | 46% below | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $32.19 | $45.98 | $12.25 | 51% below | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL | $61.60 | $88.00 | $12.25 | 6% below | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 PAP TEST; AUTOMATED THIN LAYER PREPARATION; AUTOMATED SYSTEM AND MANUAL RESCREENING | $37.82 | $54.03 | $17.74 | 41% below | 30% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO | $39.20 | $56.00 | $17.74 | 39% below | 30% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER | $34.60 | $49.43 | $13.50 | 53% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE (PARATHYROID HORMONE) LEVEL | $72.24 | $103.20 | $27.50 | 47% below | 30% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $100.40 | $143.43 | $27.50 | 26% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $10.78 | $15.40 | $4.01 | 64% below | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD | $28.50 | $40.71 | $4.01 | 4% below | 30% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FETAL CHRMOML ANEUPLOIDY | $1,328.34 | $1,897.63 | $505.79 | 39% above | 30% |
| Progesterone blood test CPT 84144 PROGESTERONE (REPRODUCTIVE HORMONE) LEVEL | $21.98 | $31.40 | $13.90 | 75% below | 30% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $36.51 | $52.15 | $13.90 | 59% below | 30% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $28.07 | $40.10 | $12.92 | 61% below | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $22.40 | $32.00 | $2.86 | 18% above | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 BLOOD TEST; CLOTTING TIME | $22.60 | $32.29 | $2.86 | 19% above | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 TESTING FOR PRESENCE OF DRUG; READ BY DIRECT OBSERVATION | $22.05 | $31.50 | $8.39 | 37% below | 30% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $35.39 | $50.56 | $8.39 | 2% above | 30% |
| Rapid flu test (influenza antigen) CPT 87804 DETECTION TEST BY IMMUNOASSAY WITH DIRECT VISUAL OBSERVATION FOR INFLUENZA VIRUS | $28.97 | $41.38 | $11.03 | 29% below | 30% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $32.48 | $46.40 | $11.03 | 20% below | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $10.15 | $14.50 | $3.79 | 63% below | 30% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR LEVEL | $30.70 | $43.86 | $3.79 | 12% above | 30% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $16.94 | $24.20 | $9.58 | 60% below | 30% |
| Rubella antibody test (immunity check) CPT 86762 ANALYSIS FOR ANTIBODY TO RUBELLA (GERMAN MEASLES VIRUS) | $25.19 | $35.98 | $9.58 | 41% below | 30% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RED BLOOD CELL SEDIMENTATION RATE; TO DETECT INFLAMMATION; AUTOMATED | $4.73 | $6.75 | $1.81 | 81% below | 30% |
| Stool ova and parasites exam CPT 87177 SMEAR FOR PARASITES | $15.58 | $22.25 | $5.94 | 60% below | 30% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $46.90 | $67.00 | $5.94 | 21% above | 30% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL ANALYSIS FOR BLOOD TO SCREEN FOR COLON TUMORS | $7.67 | $10.95 | $2.92 | 49% below | 30% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL | $14.54 | $20.77 | $10.62 | 68% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS DETECTION TEST | $5.81 | $8.30 | $2.85 | 68% below | 30% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $29.54 | $42.20 | $2.85 | 60% above | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $69.44 | $99.20 | $41.30 | 54% below | 30% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TUBERCULOSIS TEST; GAMMA INTERFERON | $76.30 | $109.00 | $41.30 | 49% below | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $12.74 | $18.20 | $17.20 | 85% below | 30% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE (HORMONE) LEVEL; TOTAL | $45.17 | $64.53 | $17.20 | 48% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES (AUTOANTIBODY) MEASUREMENT | $16.59 | $23.70 | $9.70 | 67% below | 30% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $37.20 | $53.14 | $9.70 | 26% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $29.40 | $42.00 | $11.19 | 63% below | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 BLOOD TEST; THYROID STIMULATING HORMONE (TSH) | $59.15 | $84.50 | $11.19 | 25% below | 30% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $46.84 | $66.92 | $23.38 | 36% below | 30% |
| Trichomonas test (NAAT) CPT 87661 DETECTION TEST BY NUCLEIC ACID FOR TRICHOMONAS VAGINALIS (GENITAL PARASITE); AMPLIFIED PROBE TECHNIQUE | $49.13 | $70.18 | $23.38 | 33% below | 30% |
| Uric acid blood test CPT 84550 URIC ACID LEVEL; BLOOD | $7.91 | $11.30 | $3.01 | 66% below | 30% |
| Urinalysis with microscope exam, automated CPT 81001 MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED | $12.00 | $17.14 | $2.11 | 59% below | 30% |
| Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS TEST | $8.20 | $11.71 | $1.49 | 52% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS; MANUAL TEST | $6.09 | $8.70 | $2.31 | 48% below | 30% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $6.79 | $9.70 | $2.31 | 42% below | 30% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $14.12 | $20.17 | $5.38 | 67% below | 30% |
| Urine culture for bacteria, with colony count CPT 87086 BACTERIAL COLONY COUNT; URINE | $14.13 | $20.18 | $5.38 | 67% below | 30% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $36.20 | $51.71 | $5.74 | 17% above | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN (VITAMIN B-12) LEVEL | $25.40 | $36.29 | $10.05 | 60% below | 30% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $26.39 | $37.70 | $10.05 | 59% below | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $35.28 | $50.40 | $19.73 | 60% below | 30% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D-3 LEVEL | $50.26 | $71.80 | $19.73 | 44% below | 30% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $11.27 | $16.10 | $7.59 | 67% below | 30% |
| Zinc blood test CPT 84630 ZINC LEVEL | $27.40 | $39.14 | $7.59 | 21% below | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $26.81 | $38.30 | $10.03 | 56% below | 30% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN; CHORIONIC (REPRODUCTIVE HORMONE) LEVEL | $53.90 | $77.00 | $10.03 | 12% below | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT | $1,004.50 | $1,435.00 | $191.16 | 1% above | 30% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO | $476.22 | $680.32 | $361.64 | 4% below | 30% |
| Colonoscopy with polyp removal CPT 45385 REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE | $2,418.50 | $3,455.00 | $674.48 | 95% above | 30% |
| Colonoscopy with tissue sample CPT 45380 BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $2,418.50 | $3,455.00 | $650.13 | 123% above | 30% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $2,205.00 | $3,150.00 | $502.99 | 100% above | 30% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $157.50 | $225.00 | $15.41 | 56% above | 30% |
| Earwax removal with instruments, one ear CPT 69210 REMOVAL OF IMPACTED EAR WAX | $124.70 | $178.14 | $51.96 | at median | 30% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $134.00 | $191.43 | $51.96 | 7% above | 30% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $280.00 | $400.00 | $102.23 | 36% below | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $1,396.54 | $1,995.05 | $284.63 | 53% above | 30% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE | $1,575.00 | $2,250.00 | $284.63 | 73% above | 30% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $1,840.70 | $2,629.57 | $190.78 | 2% above | 30% |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE | $6,804.00 | $9,720.00 | $336.69 | 63% above | 30% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE | $2,047.50 | $2,925.00 | $232.15 | 90% above | 30% |
| Gallbladder removal, laparoscopic CPT 47562 REMOVAL OF GALLBLADDER USING AN ENDOSCOPE | $7,686.00 | $10,980.00 | $722.04 | 275% above | 30% |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE | $4,956.00 | $7,080.00 | $785.04 | 25% below | 30% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP | $4,147.50 | $5,925.00 | $652.69 | 28% above | 30% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHETER FOR HYSTEROGRAPHY | $268.00 | $382.86 | $219.64 | 4% above | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS | $203.00 | $290.00 | $130.70 | 44% below | 30% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $404.30 | $577.57 | $130.70 | 11% above | 30% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $598.13 | $854.47 | $58.53 | 46% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT | $428.00 | $611.43 | $66.49 | 17% above | 30% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $598.13 | $854.47 | $66.49 | 64% above | 30% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $598.13 | $854.47 | $56.04 | 71% above | 30% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $598.13 | $854.47 | $53.90 | 71% above | 30% |
| Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 REMOVAL OF APPENDIX USING AN ENDOSCOPE | $5,481.00 | $7,830.00 | $749.69 | 52% above | 30% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $417.90 | $597.00 | $275.55 | 25% below | 30% |
| 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/< | $805.25 | $1,150.35 | $275.55 | 45% above | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,396.54 | $1,995.05 | $280.63 | at median | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE | $1,522.50 | $2,175.00 | $280.63 | 9% above | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRM EPI L/S 1 | $1,840.70 | $2,629.57 | $262.32 | 46% above | 30% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC FACE-MM B9+MARG 0.5 CM/< | $235.00 | $335.71 | $151.22 | 74% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL | $210.70 | $301.00 | $121.76 | 26% below | 30% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $404.30 | $577.57 | $121.76 | 43% above | 30% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $516.00 | $737.14 | $327.32 | 58% below | 30% |
| Paracentesis with imaging guidance CPT 49083 DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE | $1,830.61 | $2,615.15 | $327.32 | 48% above | 30% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $442.05 | $631.50 | $171.74 | 24% below | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE | $265.60 | $379.43 | $167.25 | 52% below | 30% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $805.25 | $1,150.35 | $167.25 | 45% above | 30% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK | $2,152.50 | $3,075.00 | $352.01 | 100% above | 30% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK | $2,100.00 | $3,000.00 | $351.74 | 95% above | 30% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $542.33 | $774.75 | $94.68 | 73% above | 30% |
| Short arm splint (forearm and hand) CPT 29125 APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT | $124.70 | $178.14 | $70.66 | 33% below | 30% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $257.96 | $368.52 | $70.66 | 39% above | 30% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $542.33 | $774.75 | $88.70 | 63% above | 30% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION OF SHORT LEG SPLINT FROM CALF TO FOOT | $154.00 | $220.00 | $78.57 | 20% below | 30% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $318.20 | $454.57 | $78.57 | 66% above | 30% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS | $207.00 | $295.71 | $97.80 | 27% below | 30% |
| 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/< | $404.30 | $577.57 | $97.80 | 42% above | 30% |
| 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/< | $152.00 | $217.14 | $134.00–$1,457.50 | — | 30% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY; FIRST SKIN GROWTH | $2,835.00 | $4,050.00 | $136.00 | 400% above | 30% |
| Skin tag removal, up to 15 tags CPT 11200 REMOVAL OF SKIN TAG; 1-15 SKIN TAGS | $2,415.00 | $3,450.00 | $97.12 | 735% above | 30% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR | $1,396.54 | $1,995.05 | $152.02 | 48% above | 30% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM | $291.10 | $415.86 | $119.07 | 16% below | 30% |
| 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 | $404.30 | $577.57 | $119.07 | 17% above | 30% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS | $149.00 | $212.86 | $119.45 | 51% below | 30% |
| 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/< | $404.30 | $577.57 | $119.45 | 33% above | 30% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $1,268.65 | $1,812.35 | $337.10 | 3% above | 30% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $95.00 | $135.71 | $60.94 | 73% below | 30% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1ST LESION US IMAG | $3,274.12 | $4,677.32 | $654.99 | 17% above | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE | $1,764.00 | $2,520.00 | $477.31 | 55% above | 30% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD GUIDE WIRE INSERTION | $468.30 | $669.00 | $515.83 | 58% below | 30% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE | $2,359.00 | $3,370.00 | $515.83 | 113% above | 30% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 REMOVAL OF SPERM DUCT | $3,990.00 | $5,700.00 | $412.93 | 81% above | 30% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $396.30 | $566.14 | $135.12 | 45% below | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $713.30 | $1,019.00 | $38.96 | 2% below | 30% |
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION OF BLOOD OR BLOOD PRODUCTS | $876.65 | $1,252.35 | $38.96 | 20% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT | $430.72 | $615.32 | $17.84 | 92% above | 30% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT FOR AIRWAY OBSTRUCTION OR SPUTUM PRODUCTION | $430.72 | $615.32 | $134.00–$1,457.50 | — | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $430.50 | $615.00 | $339.41 | 72% below | 30% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE; FIRST 30-74 MINUTES | $1,792.00 | $2,560.00 | $339.41 | 16% above | 30% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ROUTINE ELECTROCARDIOGRAM (ECG) USING AT LEAST 12 LEADS WITH TRACING | $152.90 | $218.43 | $8.28 | 6% above | 30% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD SEVERITY | $179.28 | $256.12 | $27.53 | 24% above | 30% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MILD TO MODERATE SEVERITY | $330.27 | $471.82 | $53.01 | 5% above | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $185.99 | $265.70 | $79.41 | 59% below | 30% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY | $576.18 | $823.12 | $79.41 | 27% above | 30% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY | $894.43 | $1,277.75 | $145.46 | 34% above | 30% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY | $1,297.14 | $1,853.05 | $211.25 | 52% above | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EXERCISE OR DRUG-INDUCED HEART STRESS TEST WITH ELECTROCARDIOGRAM (ECG) | $312.00 | $445.71 | $42.10 | 46% below | 30% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $646.10 | $923.00 | $42.10 | 12% above | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $65.00 | $92.86 | $39.93 | 81% below | 30% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION INTO A VEIN FOR HYDRATION; 31-60 MINUTES | $432.85 | $618.35 | $39.93 | 24% above | 30% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT | $121.00 | $172.86 | $77.84 | 68% below | 30% |
| IV infusion of a medicine, first hour CPT 96365 INFUSION INTO A VEIN FOR THERAPY; PREVENTION; OR DIAGNOSIS; 1 HOUR OR LESS | $432.85 | $618.35 | $77.84 | 15% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION OF DRUG OR SUBSTANCE UNDER SKIN OR INTO MUSCLE | $142.25 | $203.22 | $15.91 | 69% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Trulicity | $325.26 | $464.65 | $15.91 | 286% above | 30% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $325.26 | $464.65 | $15.91 | 286% above | 30% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION | $63.80 | $91.14 | $27.87 | 24% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES | $35.00 | $50.00 | $130.72 | 82% below | 30% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE O/P NEW LOW 30 MIN | $192.50 | $275.00 | $130.72 | 2% below | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE O/P NEW LOW 30 MIN | $192.50 | $275.00 | $134.00–$1,457.50 | — | 30% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES | $35.00 | $50.00 | $200.00 | 88% below | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE O/P NEW MOD 45 MIN | $289.10 | $413.00 | $134.00–$1,457.50 | — | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE O/P NEW HI 60 MIN | $381.50 | $545.00 | $134.00–$1,457.50 | — | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 15-29 MINUTES | $35.00 | $50.00 | $51.26 | 78% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $124.60 | $178.00 | $51.26 | 21% below | 30% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE O/P NEW SF 15 MIN | $124.60 | $178.00 | $134.00–$1,457.50 | — | 30% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $135.00 | $192.86 | $86.22 | 21% below | 30% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN | $140.00 | $200.00 | $86.22 | 51% below | 30% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $140.00 | $200.00 | $86.22 | 22% below | 30% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN | $140.00 | $200.00 | $86.22 | 42% below | 30% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS | $72.90 | $104.14 | $22.35 | 12% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES | $61.10 | $87.29 | $24.28 | 25% below | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES | $183.31 | $261.87 | $24.28 | 124% above | 30% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39 | $3,051.49 | $4,359.27 | $162.29 | 1424% above | 30% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $57.96 | $82.80 | $18.83 | 37% above | 30% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 40-54 MINUTES | $35.00 | $50.00 | $176.46 | 85% below | 30% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE O/P EST HI 40 MIN | $311.50 | $445.00 | $134.00–$1,457.50 | — | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES | $35.00 | $50.00 | $51.26 | 79% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE O/P EST LOW 20 MIN | $157.50 | $225.00 | $51.26 | 7% below | 30% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE O/P EST LOW 20 MIN | $157.50 | $225.00 | $134.00–$1,457.50 | — | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES | $35.00 | $50.00 | $131.27 | 82% below | 30% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE O/P EST MOD 30 MIN | $222.60 | $318.00 | $134.00–$1,457.50 | — | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 10-19 MINUTES | $35.00 | $50.00 | $51.26 | 73% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $96.60 | $138.00 | $51.26 | 25% below | 30% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE O/P EST SF 10 MIN | $96.60 | $138.00 | $134.00–$1,457.50 | — | 30% |
| Speech and language evaluation CPT 92523 EVALUATION OF SPEECH SOUND PRODUCTION WITH EVALUATION OF LANGUAGE COMPREHENSION AND EXPRESSION | $351.70 | $502.43 | $254.16 | 10% below | 30% |
| Speech therapy session, individual CPT 92507 TREATMENT OF SPEECH; LANGUAGE; VOICE; COMMUNICATION; AND/OR HEARING PROCESSING DISORDER | $168.30 | $240.43 | $91.29 | 7% below | 30% |
| Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV | $192.10 | $274.43 | $91.29 | 6% above | 30% |
| Spirometry (breathing test) CPT 94010 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME | $315.46 | $450.65 | $34.23 | 36% above | 30% |
| Spirometry before and after a bronchodilator CPT 94060 TEST TO MEASURE EXPIRATORY AIRFLOW AND VOLUME CHANGES BEFORE AND AFTER MEDICATION ADMINISTRATION | $633.85 | $905.50 | $54.73 | 69% above | 30% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES | $66.50 | $95.00 | $30.62 | 29% below | 30% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 DRAWING OF BLOOD FOR A MEDICAL PROBLEM | $91.60 | $130.86 | $118.16 | 57% below | 30% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs New York | Off list |
|---|---|---|---|---|---|
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $80.01 | $114.30 | $134.00–$1,457.50 | — | 30% |
| COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 Spikevax 2023-2024 Formula | $200.03 | $285.75 | $134.00–$1,457.50 | — | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $23.07 | $32.95 | $2,755.78 | 26% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone Quadrivalent | $23.07 | $32.95 | $2,755.78 | 26% below | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2024-2025 Formula PFS | $32.27 | $46.10 | $2,755.78 | 4% above | 30% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 Fluzone 2025-2026 Formula PFS | $33.90 | $48.43 | $2,755.78 | 9% above | 30% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Twinrix | $128.18 | $183.12 | $2,755.78 | 39% below | 30% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM | $128.18 | $183.12 | $2,755.78 | 39% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $32.62 | $46.60 | $2,755.78 | 60% below | 30% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Recombivax HB | $66.02 | $94.31 | $2,755.78 | 19% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose Quadrivalent 2023-2024 Formula | $44.60 | $63.71 | $2,755.78 | 60% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $44.60 | $63.71 | $2,755.78 | 60% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2024-2025 Formula | $45.77 | $65.38 | $2,755.78 | 59% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2025-2026 Formula | $47.66 | $68.09 | $2,755.78 | 57% below | 30% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose 2015-2016 Formula | $50.27 | $71.81 | $2,755.78 | 55% below | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC | $21.00 | $30.00 | $2,755.78 | 81% below | 30% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II | $155.67 | $222.38 | $2,755.78 | 43% above | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Menactra | $311.42 | $444.89 | $2,755.78 | 60% above | 30% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM | $311.42 | $444.89 | $2,755.78 | 60% above | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM | $453.05 | $647.22 | $2,755.78 | 6% above | 30% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 | $453.05 | $647.22 | $2,755.78 | 6% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumovax 23 | $178.75 | $255.35 | $2,755.78 | 26% above | 30% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $178.75 | $255.35 | $2,755.78 | 26% above | 30% |
| Rabies vaccine, one dose CPT 90675 RabAvert | $597.24 | $853.20 | $2,755.78 | 24% above | 30% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $625.11 | $893.02 | $2,755.78 | 30% above | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $42.91 | $61.30 | $2,755.78 | 23% below | 30% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tenivac | $55.78 | $79.68 | $2,755.78 | at median | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $72.64 | $103.77 | $2,755.78 | 29% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Adacel | $77.95 | $111.35 | $2,755.78 | 39% above | 30% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Boostrix | $83.83 | $119.75 | $2,755.78 | 49% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMINISTRATION OF VACCINE | $142.25 | $203.22 | $22.27 | 92% above | 30% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMINISTRATION OF VACCINE | $13.72 | $19.60 | $134.00–$1,457.50 | — | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $45.20 | $64.57 | $17.07 | 42% above | 30% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMINISTRATION OF VACCINE; EACH ADDITIONAL VACCINE | $111.20 | $158.86 | $17.07 | 248% above | 30% |
Source file: https://apim.services.craneware.com/api-pricing-transparency/api/public/4be8e5d7452bc47c57cfa9afaa2bec25/charges/mrf