Riverside Hospital
Riverside Hospital in Smithfield, VA publishes cash prices for 340 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 Virginia median for 292 of 332 procedures and above it for 35. By typical cash price it ranks #11 of 61 Virginia hospitals and #1 of 11 hospitals in the Virginia Beach, VA area, cheapest first. Click a procedure to compare it with other hospitals nearby.
19339 Benn's Grant Blvd Smithfield, Virginia 23430 Collected Sep 27, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views CPT 73610 Xr Ankle Comp Min 3 Views | $237.63 | $475.25 | — | 25% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 Art Le or Ue Bilateral 1-2 Levels | $300.00 | $600.00 | — | — | 50% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Esophagus | $329.69 | $659.38 | — | 32% below | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 Bone Scan Whole Body | $999.50 | $1,999.00 | — | 33% below | 50% |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Unilateral Complete | $379.63 | $759.25 | — | 32% below | 50% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Unilateral Limited | $274.50 | $549.00 | — | 37% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Cta Chest Ww/O Cntrst and Postprocess | $1,272.50 | $2,545.00 | — | 29% below | 50% |
| CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Cta Heart W/Contrst W/ 3d Postprocess | $1,300.43 | $2,600.85 | — | 28% above | 50% |
| CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Cardiac Scoring | $55.50 | $111.00 | — | 75% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abd and Pelvis W/O Contrast | $1,272.50 | $2,545.00 | — | 42% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abd and Pelvis W Contrast | $1,983.50 | $3,967.00 | — | 41% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd and Pelvis Ww/O Contrast, 1+ Regns | $1,746.50 | $3,493.00 | — | 50% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen W Contrast | $1,272.50 | $2,545.00 | — | 23% below | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen W/O Contrast | $1,272.50 | $2,545.00 | — | 11% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial W/O Contrast | $1,102.50 | $2,205.00 | — | 19% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Head W/O Contrast | $1,055.50 | $2,111.00 | — | 21% below | 50% |
| CT scan of the head with contrast CPT 70460 CT Head W Contrast | $1,272.50 | $2,545.00 | — | 17% below | 50% |
| CT scan of the head without and with contrast CPT 70470 CT Head W and W/O Contrast | $1,272.50 | $2,545.00 | — | 28% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar W/O Contrast | $1,272.50 | $2,545.00 | — | 20% below | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical W/O Contrast | $1,272.50 | $2,545.00 | — | 20% below | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis W Contrast | $1,272.50 | $2,545.00 | — | 25% below | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Bilateral Extracranial Art Duplex | $499.00 | $998.00 | — | — | 50% |
| Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views | $168.95 | $337.89 | — | 40% below | 50% |
| Chest X-ray, single view CPT 71045 Xr Chest Single View | $95.75 | $191.50 | — | 59% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Exam Abdo Back Wall, Comp | $312.00 | $624.00 | — | 52% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA Bone Density Study, Axial | $309.00 | $618.00 | — | 47% below | 50% |
| DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA Peripheral Bone Density | $91.51 | $183.01 | — | 63% below | 50% |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US Preg Uterus W/Detail Fetal Anat 1st Gestation | $454.50 | $909.00 | — | 32% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax W/O Contrast | $1,272.50 | $2,545.00 | — | 7% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax W Contrast | $1,401.00 | $2,802.00 | — | 19% below | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammo Bilat W/Cad | $336.05 | $672.09 | — | — | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Mammogram Diagnostic Ddi Bilat | $336.05 | $672.09 | — | — | 50% |
| Diagnostic mammogram, one breast CPT 77065 Mammogram Diagnostic Ddi Unila | $262.26 | $524.51 | — | 3% below | 50% |
| Diagnostic mammogram, one breast one side CPT 77065 Mammo Unilat W/Cad | $262.26 | $524.51 | — | 3% below | 50% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Bilateral Le Arterial Compl Duplex | $447.83 | $895.65 | — | — | 50% |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Bilateral Venous Duplex Complete | $600.00 | $1,200.00 | — | — | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Tte W/Doppler Complete | $977.00 | $1,954.00 | — | 43% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 Hepatobiliary Study | $1,083.00 | $2,166.00 | — | 5% below | 50% |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 Sleep Study Unatt and Resp Effect | $516.00 | $1,032.00 | — | 13% above | 50% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Polysomnography W Cpap | $1,917.50 | $3,835.00 | — | 3% below | 50% |
| Knee X-ray, 3 views CPT 73562 Xr Knee 3 Views | $247.38 | $494.75 | — | 18% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited | $452.13 | $904.25 | — | 34% below | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Thorax Low Dose Cancer Scr W/O Contrast | $427.60 | $855.19 | — | 52% above | 50% |
| MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast W/O & W Contrast W/Cad Bilateral | $3,582.88 | $7,165.75 | — | — | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI Lower Joint W/O Contrast | $1,430.63 | $2,861.25 | — | 19% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI Lower Joint W and W/O Cntrst | $2,542.28 | $5,084.55 | — | 11% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen W/O Contrast | $1,430.63 | $2,861.25 | — | 19% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen W and W/O Contrast | $2,548.43 | $5,096.86 | — | 11% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain Incl Stem W/O Contrast | $1,430.63 | $2,861.25 | — | 26% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain W and W/O Contrast | $2,582.90 | $5,165.80 | — | 5% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar W/O Contrast | $1,430.63 | $2,861.25 | — | 28% below | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar W and W/O Contrast | $2,582.90 | $5,165.80 | — | 22% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic W/O Contrast | $1,430.63 | $2,861.25 | — | 28% below | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical W and W/O Contrast | $2,582.90 | $5,165.80 | — | 21% below | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical W/O Contrast | $1,430.63 | $2,861.25 | — | 28% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis W and W/O Contrast | $2,548.43 | $5,096.86 | — | 20% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis W/O Contrast | $1,430.63 | $2,861.25 | — | 23% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI Upper Joint W/O Contrast | $1,430.63 | $2,861.25 | — | 19% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 Myocardial Perfusion Multi W/Spect | $2,043.83 | $4,087.65 | — | 35% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 Pet Image W/CT Skull-Thigh | $5,520.98 | $11,041.96 | — | 25% above | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Pelvic Non-OB, Limited or F/U | $291.88 | $583.75 | — | 32% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Non-OB, Complete | $549.88 | $1,099.75 | — | 25% below | 50% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB >/=14 Wks Single Fetus | $406.25 | $812.50 | — | 42% below | 50% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB 1st Trimester Abdominal | $380.75 | $761.50 | — | 21% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB, Limited | $221.50 | $443.00 | — | 53% below | 50% |
| Screening mammogram, both breasts both sides CPT 77067 Mammogram,Screen,Ddi,Bilateral | $272.47 | $544.94 | — | — | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 Xr Shoulder Comp Min 2 View | $187.50 | $375.00 | — | 37% below | 50% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysomnography 4 or More Parameters | $2,117.00 | $4,234.00 | — | 3% below | 50% |
| Stress echocardiogram, complete, including the stress test and supervision CPT 93351 Stress Tte Complete Incl Cont Ekg Monitor | $902.38 | $1,804.75 | — | 47% below | 50% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Swallow Fnctn W Cine/Videoradiography | $224.97 | $449.93 | — | 57% below | 50% |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal, Non-OB | $472.38 | $944.75 | — | 19% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB, Transvaginal | $356.38 | $712.75 | — | 24% below | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $613.75 | $1,227.50 | — | 29% below | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum and Contents | $384.38 | $768.75 | — | 46% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Soft Tissue Head or Neck | $420.00 | $840.00 | — | 34% below | 50% |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 Xr Xm Uper GI Trc 1contrst | $338.50 | $677.00 | — | 59% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Unilateral/Limited Venous Duplex | $340.00 | $680.00 | — | 54% below | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 Xr Wrist Comp Min 3 Views | $210.75 | $421.50 | — | 30% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip Unilat W or W/O Pelvis 2-3 View | $241.88 | $483.75 | — | 25% above | 50% |
| X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen Single View | $206.00 | $412.00 | — | 26% below | 50% |
| X-ray of the ankle, 2 views CPT 73600 Xr Ankle 2 Views | $218.00 | $436.00 | — | 14% below | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 Xr Finger(S) Min 2 Views | $206.00 | $412.00 | — | 1% above | 50% |
| X-ray of the foot, 2 views CPT 73620 Xr Foot 2 Views | $206.00 | $412.00 | — | 12% below | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 Xr Foot Comp Min 3 Views | $222.38 | $444.75 | — | 30% below | 50% |
| X-ray of the hand, 3 or more views CPT 73130 Xr Hand Min 3 View | $206.00 | $412.00 | — | 27% below | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 Xr Knee 1 or 2 View | $206.00 | $412.00 | — | 14% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 or 3 View | $248.13 | $496.25 | — | 32% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 Xr Spine Lumbosacral Min 4 View | $313.00 | $626.00 | — | 41% below | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 Xr Spine Thoracic 2 View | $274.50 | $549.00 | — | 18% below | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Comp Min 3 Views | $206.00 | $412.00 | — | 31% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 or 3 View | $206.00 | $412.00 | — | 45% below | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 or 2 View | $206.00 | $412.00 | — | 37% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum Coccyx Min 2 Views | $220.25 | $440.50 | — | 47% below | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Amino (Alt) (Sgpt) | $28.57 | $57.14 | — | 43% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt (Alanine Aminotransferase | $29.54 | $59.08 | — | 41% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt (Sgpt) - Fibro | $31.96 | $63.92 | — | 36% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT | $29.06 | $58.11 | — | 42% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Ast (Sgot) - Fibro | $31.96 | $63.92 | — | 36% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel | $159.12 | $318.23 | — | 45% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Antigen,Each | $24.74 | $49.47 | — | at median | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 Allergen(Ige) | $26.23 | $52.46 | — | 6% above | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide A | $65.79 | $131.58 | — | 15% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibody Screen | $56.85 | $113.70 | — | 59% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA | $66.45 | $132.89 | — | 52% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide | $114.95 | $229.90 | — | 43% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Pro-Bnp | $119.07 | $238.13 | — | 41% below | 50% |
| Basic metabolic panel (blood test) CPT 80048 Bmp(Calcium,Total) | $63.94 | $127.87 | — | 27% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Pathology Level IV Mayo | $161.17 | $322.34 | — | 26% below | 50% |
| Blood culture for bacteria CPT 87040 Mycobacteria Blood Culture | $54.80 | $109.60 | — | 47% below | 50% |
| Blood culture for bacteria CPT 87040 Blood Culture | $55.19 | $110.37 | — | 47% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Blood Draw | $14.16 | $28.32 | — | 19% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture Blood Draw Lab | $14.16 | $28.32 | — | 19% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose 2hr Pp Meal | $13.31 | $26.62 | — | 70% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose - Fibro | $13.31 | $26.62 | — | 70% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose Random | $14.26 | $28.52 | — | 68% below | 50% |
| Blood glucose (sugar) test CPT 82947 Glucose POC | $14.26 | $28.52 | — | 68% below | 50% |
| Blood lead test CPT 83655 Urine 24 Hour Lead | $43.09 | $86.18 | — | 34% below | 50% |
| Blood lead test CPT 83655 Lead Level | $43.09 | $86.18 | — | 34% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Serum Pregnancy | $48.14 | $96.28 | — | 54% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 POCT Qualitative Pregnancy | $60.18 | $120.36 | — | 43% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Type | $66.46 | $132.92 | — | 27% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Sl Abo Type | $66.46 | $132.92 | — | 27% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $38.33 | $76.65 | — | 65% below | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C Diff Toxin a/B | $102.61 | $205.22 | — | 34% below | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 Carbohydrate Antigen 19-9 | $75.87 | $151.74 | — | 26% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $86.87 | $173.74 | — | 29% below | 50% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid-19 Amp Prb | $28.22 | $56.44 | — | 63% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis, Dna Pcr | $110.11 | $220.22 | — | 21% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $74.09 | $148.17 | — | 13% below | 50% |
| Complete blood count (CBC) with differential CPT 85025 Cbc With Auto Diff | $47.03 | $94.05 | — | 63% above | 50% |
| Complete blood count (CBC), no differential CPT 85027 Hemogram | $27.69 | $55.37 | — | 66% below | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $97.91 | $195.81 | — | 43% below | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 D-Dimer Quantitative | $65.34 | $130.68 | — | 58% below | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 Dehydroepiandrosterone Sulfate | $98.32 | $196.64 | — | 31% below | 50% |
| Estradiol blood test CPT 82670 Estradiol Level, Enhanced | $83.31 | $166.62 | — | 32% below | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone | $81.40 | $162.79 | — | 23% below | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Fecal | $77.39 | $154.77 | — | 47% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $48.34 | $96.67 | — | 63% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 Ferritin for Thalassemia | $83.28 | $166.55 | — | 35% below | 50% |
| Folate (folic acid) blood test CPT 82746 Folic Acid, Serum | $51.47 | $102.94 | — | 46% below | 50% |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $56.87 | $113.74 | — | 45% below | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free | $54.24 | $108.47 | — | 30% below | 50% |
| Free testosterone test CPT 84402 Testosterone Free | $133.27 | $266.54 | — | 32% below | 50% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 General Health Panel | $72.60 | $145.20 | — | 39% below | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 1 Hr Glucose Pp | $23.30 | $46.59 | — | 43% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 Gtt(Fasting 1/2, 1) | $55.63 | $111.25 | — | 32% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae, Dna Pcr | $110.11 | $220.22 | — | 17% below | 50% |
| H. pylori antibody blood test CPT 86677 H Pylori Igg Qual/Semi-Quant | $71.30 | $142.59 | — | 2% below | 50% |
| H. pylori stool antigen test CPT 87338 Helicobacter Pylori Ag Stool | $65.21 | $130.42 | — | 40% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Rna Pcr Quantitative | $232.93 | $465.85 | — | 25% below | 50% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv 1/2 Ab/Ag | $74.32 | $148.64 | — | 38% below | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv High-Risk Types | $92.47 | $184.94 | — | 20% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $53.93 | $107.86 | — | 51% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $45.91 | $91.82 | — | 45% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $59.28 | $118.56 | — | 6% below | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody | $61.12 | $122.24 | — | 22% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Rna Pcr Quant | $177.13 | $354.25 | — | 30% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1 Igm Titer | $44.17 | $88.33 | — | 47% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type I Igg | $44.83 | $89.66 | — | 46% below | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type 1 Ab Igm | $44.83 | $89.66 | — | 46% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type 2 Ab Igm | $64.74 | $129.47 | — | 35% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igm Titer | $64.74 | $129.47 | — | 35% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 Herpes Simplex Type II Igg | $65.89 | $131.78 | — | 34% below | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 Hsv-2 Igg Inhibition | $75.00 | $150.00 | — | 25% below | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein,High Sensit | $45.89 | $91.77 | — | 24% below | 50% |
| Homocysteine blood test CPT 83090 Homocystine Total | $91.92 | $183.84 | — | 17% below | 50% |
| Insulin blood test CPT 83525 Insulin Level Total | $38.12 | $76.23 | — | 49% below | 50% |
| Iron blood test (serum iron) CPT 83540 IRON | $21.78 | $43.56 | — | 73% below | 50% |
| Iron blood test (serum iron) CPT 83540 Iron Liver Tissue | $35.63 | $71.25 | — | 56% below | 50% |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $33.25 | $66.50 | — | 50% below | 50% |
| Kidney function blood test panel CPT 80069 Renal Panel | $62.48 | $124.95 | — | 40% below | 50% |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone | $79.90 | $159.80 | — | 41% below | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase,Serum | $63.57 | $127.14 | — | 41% below | 50% |
| Liver function blood test panel CPT 80076 Hepatic Function | $60.11 | $120.21 | — | 28% below | 50% |
| Lyme disease antibody test CPT 86618 Lyme Disease Serology | $57.58 | $115.16 | — | 34% below | 50% |
| Magnesium blood test CPT 83735 Magnesium Urine Random | $34.50 | $69.00 | — | 37% below | 50% |
| Magnesium blood test CPT 83735 Magnesium Urine 24 Hr | $34.50 | $69.00 | — | 37% below | 50% |
| Magnesium blood test CPT 83735 Magnesium | $36.58 | $73.15 | — | 33% below | 50% |
| Magnesium blood test CPT 83735 Magnesium Stool | $64.60 | $129.20 | — | 18% above | 50% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody Igm | $59.71 | $119.42 | — | 20% below | 50% |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibody Igg | $59.71 | $119.42 | — | 20% below | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mono Test | $19.11 | $38.22 | — | 80% below | 50% |
| Obstetric blood test panel CPT 80055 Obstetric Panel | $102.25 | $204.49 | — | 46% below | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Prostate Specific Antigen Free | $63.79 | $127.58 | — | 42% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Prostate Specific Antigen,Tota | $61.71 | $123.42 | — | 40% below | 50% |
| Pap test (liquid-based, automated screening with review) CPT 88175 Thin Prep Pap-Automated Diag | $89.54 | $179.08 | — | 9% below | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytopath Cerv/Vag Thinlay | $67.76 | $135.52 | — | 1% above | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone, Intact | $137.94 | $275.88 | — | 41% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $28.26 | $56.52 | — | 45% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Activated Partial Thrombopl.Tm | $40.74 | $81.47 | — | 21% below | 50% |
| Progesterone blood test CPT 84144 Progesterone Level | $62.81 | $125.62 | — | 65% below | 50% |
| Prolactin blood test CPT 84146 Prolactin Level | $86.37 | $172.73 | — | 28% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time | $20.52 | $41.04 | — | 21% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Protime | $21.73 | $43.45 | — | 16% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Protime, I-Stat | $22.35 | $44.70 | — | 14% below | 50% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC Drug Screen, Urine, Rbhc Only | $25.89 | $51.78 | — | 40% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep a by Immuno OP | $39.93 | $79.86 | — | 55% below | 50% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quest | $24.21 | $48.42 | — | 33% below | 50% |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor, Quantitativ | $48.23 | $96.46 | — | 34% above | 50% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Igg Titer | $48.40 | $96.80 | — | 50% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Igg | $48.40 | $96.80 | — | 50% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibody Igm | $48.40 | $96.80 | — | 50% below | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sedimentation Rate,Auto | $28.96 | $57.92 | — | 50% below | 50% |
| Stool ova and parasites exam CPT 87177 Parasitic Examination, Stool | $29.65 | $59.29 | — | 45% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Blood Occult | $15.11 | $30.22 | — | 34% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 POCT Blood Occult | $15.11 | $30.22 | — | 34% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 Occult by Immunoassay | $22.29 | $44.58 | — | 70% below | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $35.99 | $71.98 | — | 43% above | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Vdrl Screen CSF | $35.99 | $71.98 | — | 43% above | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC TB Cell Mediated Antign Response Gamma Interferon | $218.35 | $436.70 | — | 1% below | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total | $117.25 | $234.50 | — | 22% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroperoxidase Antibody | $68.25 | $136.50 | — | 15% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidnet Microsomal (Lkm-1) Igg | $68.97 | $137.94 | — | 14% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $62.38 | $124.75 | — | 36% below | 50% |
| Trichomonas test (NAAT) CPT 87661 Trichomonas by Molecular | $146.86 | $293.72 | — | 33% above | 50% |
| Uric acid blood test CPT 84550 Uric Acid | $33.29 | $66.57 | — | 53% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Auto Urinalysis W/Microscopic | $10.29 | $20.57 | — | 77% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis | $30.76 | $61.52 | — | 31% below | 50% |
| Urinalysis with microscope exam, manual CPT 81000 Urinalysis Nonauto W/Sc | $10.29 | $20.57 | — | at median | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Sp Gravity | $7.26 | $14.52 | — | 78% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick WO Micro | $19.64 | $39.27 | — | 40% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urine Blood | $20.43 | $40.85 | — | 38% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis Dipstick | $22.48 | $44.95 | — | 32% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Clinitest | $8.47 | $16.94 | — | 59% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Hemoglobin | $8.47 | $16.94 | — | 59% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Protein Only Dipstick | $8.50 | $16.99 | — | 59% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Dipstick | $8.50 | $16.99 | — | 59% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Glucose (B) | $10.07 | $20.14 | — | 51% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Urine Glucose | $11.62 | $23.23 | — | 43% below | 50% |
| Urinalysis without microscope exam, manual CPT 81002 Ictotest | $17.94 | $35.87 | — | 12% below | 50% |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $37.01 | $74.02 | — | 52% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy | $40.85 | $81.70 | — | 56% below | 50% |
| Urine pregnancy test, read by color change CPT 81025 POCT Urine Pregnancy | $40.85 | $81.70 | — | 56% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B-12 (Cyanocobalamin) | $50.22 | $100.43 | — | 40% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxyvitamin D Total | $99.22 | $198.44 | — | 30% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxyvitamin D3 | $99.22 | $198.44 | — | 30% below | 50% |
| Zinc blood test CPT 84630 Zinc Level | $55.49 | $110.97 | — | 23% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg Total Beta | $101.35 | $202.70 | — | 16% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg (Quant. Pregnancy) | $108.32 | $216.64 | — | 11% below | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Arthroscopic ACL reconstruction or repair of the knee CPT 29888 Knee Arthroscopy/Surgery Anterior Ligament Repai | $5,155.21 | $10,310.41 | — | 76% below | 50% |
| Balloon dilation of the maxillary sinus opening, one side CPT 31295 Sinus Endo W/Balloon Dil | $4,072.04 | $8,144.07 | — | — | 50% |
| Botox injections for chronic migraine CPT 64615 Chemodenerve Muscle Migraine Bil | $369.00 | $738.00 | — | 25% below | 50% |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 Bx Breast Stereotac Lesion 1 | $1,433.50 | $2,867.00 | — | 44% below | 50% |
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 Clsd Tx Distal Fibular Fx W/O Manip | $320.10 | $640.20 | — | 33% above | 50% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 Clsd Tx Metatarsal W/O Manip | $320.10 | $640.20 | — | 10% above | 50% |
| Cardiac catheterization with coronary angiogram CPT 93458 L Hrt Artery/Ventricle Angio | $6,569.88 | $13,139.75 | — | 38% below | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion External Elective | $445.63 | $891.25 | — | 63% below | 50% |
| Catheter ablation for atrial fibrillation CPT 93656 Tx Atrial Fib Pulm Vein Isol | $15,636.78 | $31,273.55 | — | 29% below | 50% |
| Cervical biopsy CPT 57500 Biopsy of Cervix | $448.96 | $897.91 | — | 73% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Procedure | $92.05 | $184.10 | — | 93% below | 50% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Procedure W/Regional Block | $2,225.25 | $4,450.50 | — | 58% above | 50% |
| Circumcision, surgical, older than a newborn CPT 54160 Circumcision for Neonate | $350.52 | $701.04 | — | 77% below | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Clsd Tx Distal Radial/Epi Separation Fx W/O Manip | $320.10 | $640.20 | — | 5% below | 50% |
| Colonoscopy with endoscopic ultrasound CPT 45391 Colsc Flx W/Ndsc US Xm Rctm Et Al Lmtd &Adj Strux | $1,414.02 | $2,828.03 | — | 3% below | 50% |
| Colonoscopy with polyp removal CPT 45385 Colonoscopy W/Polypectomy | $1,292.50 | $2,585.00 | — | 67% below | 50% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy With Biopsy(S) | $1,406.63 | $2,813.25 | — | 4% below | 50% |
| Colonoscopy, diagnostic CPT 45378 Colorectal Ca Screen High Risk | $1,277.70 | $2,555.40 | — | at median | 50% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic Colonoscopy | $1,277.70 | $2,555.40 | — | at median | 50% |
| Colonoscopy, diagnostic CPT 45378 Colorectal Ca Screen Not High Risk | $1,277.70 | $2,555.40 | — | at median | 50% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 Colposcopy Cervix W/Biopsy and Curretage | $354.00 | $708.00 | — | 37% below | 50% |
| Coronary stent placement, one artery CPT 92928 Coronary Stent Placement W/Angio 1 Vsl | $5,847.23 | $11,694.46 | — | 55% below | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Cystoscopy | $825.00 | $1,650.00 | — | 5% below | 50% |
| D&C (dilation and curettage), not related to pregnancy CPT 58120 Dilation &Curettage Dx&/Non OB | $1,951.13 | $3,902.25 | — | 17% below | 50% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 Destruction Permalig 1st Lesion | $102.45 | $204.90 | — | 15% below | 50% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 Create Eardrum Opening | $742.99 | $1,485.97 | — | 9% below | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 Rmvl Impctd Earwax Lavage Uni | $97.50 | $195.00 | — | 23% above | 50% |
| Earwax removal with instruments, one ear CPT 69210 Instrument Rmvl Impacted Ear Wax Uni | $90.13 | $180.25 | — | 39% below | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 Biopsy of Uterus Lining | $270.80 | $541.60 | — | 16% below | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 Inj Spine Cerv/Thor W Image | $893.13 | $1,786.25 | — | 34% below | 50% |
| Eye injection into the vitreous (intravitreal injection) CPT 67028 Inject Intravitreal Pharmcologic | $640.09 | $1,280.18 | — | 1% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 Inj Paravert Facet Jt Lumbar/Sacral 1 Lvl | $922.12 | $1,844.23 | — | 39% below | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Sigmoidoscopy Flex Dx | $640.88 | $1,281.75 | — | 43% below | 50% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 Colorectal Ca Screen Flexi Sigmoidscope | $1,081.38 | $2,162.75 | — | 4% below | 50% |
| Hemorrhoid banding (rubber band ligation) CPT 46221 Hemorrhoidectomy Int Band Ligation | $924.53 | $1,849.05 | — | 36% below | 50% |
| Hemorrhoidectomy (internal and external), one area CPT 46255 Hemorrhoidectomy Int/Ext One Col/Grp | $2,590.06 | $5,180.11 | — | 18% below | 50% |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 Dx Cath-Intro Saline/Contrast | $256.38 | $512.75 | — | 46% below | 50% |
| IUD insertion (the device itself billed separately) CPT 58300 Insert Intrauterine Device | $195.75 | $391.50 | — | 66% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I and D Skin Abscess Simple | $229.61 | $459.21 | — | 41% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj Tendon Sheath/Ligament | $259.15 | $518.30 | — | 29% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint W/O US | $294.75 | $589.50 | — | 22% below | 50% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 Insertion Non-Biodegradable | $210.00 | $420.00 | — | 63% below | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Arthrocentesis Intermediate Joint W/O US | $290.00 | $580.00 | — | 31% below | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 Arthrocentesis Small Joint W/O US | $259.00 | $518.00 | — | 29% below | 50% |
| Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 Arthroscopy Knee W/Meniscus Rpr Medial/Lateral | $3,287.57 | $6,575.14 | — | 77% below | 50% |
| Knee arthroscopy with meniscus trim CPT 29881 Knee Arthroscopy/Surgery W/Menisectomy | $3,287.57 | $6,575.14 | — | 59% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Int Rep Slp/Trk/Ext <2.5cm | $325.00 | $650.00 | — | 37% below | 50% |
| Left heart catheterization, diagnostic one side CPT 93452 Heart Cath Left Vent/Ventriclgrphy | $4,824.75 | $9,649.50 | — | 27% below | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Inj Spine Lum/Sac/Caud W/ Img | $1,143.98 | $2,287.95 | — | 32% below | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 Inj Spine Lum/Sac/Caud No Img | $858.63 | $1,717.25 | — | 39% below | 50% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj Epidural W/Image Lumb/Sacr Single Lvl | $738.00 | $1,476.00 | — | 51% below | 50% |
| Miscarriage treatment with D&C, first trimester CPT 59820 Tx of Missed Abortion, Completed Surgically: First Trimester | $1,926.32 | $3,852.64 | — | 18% below | 50% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Bengn Les Exc Tr/Arm/Lg 0.5 or < | $499.75 | $999.50 | — | 11% below | 50% |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 Rmvl of Skin Lesion 0.5cm or Less (B) | $482.60 | $965.20 | — | 58% below | 50% |
| Nail removal (partial or complete), one nail CPT 11730 Avulsion of Single Nail Plate | $140.50 | $281.00 | — | 34% below | 50% |
| Occipital nerve block (injection for headaches) CPT 64405 Occipital Nerve Block Inj | $259.15 | $518.30 | — | 54% below | 50% |
| Pacemaker implant (dual chamber) CPT 33208 Insert or Replace Pacemaker Dual | $15,461.38 | $30,922.76 | — | 24% above | 50% |
| Paracentesis with imaging guidance CPT 49083 Paracentesis Abdominal W/Image | $705.44 | $1,410.87 | — | 39% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 Removal Nailbed and Matrix | $482.60 | $965.20 | — | 12% below | 50% |
| Prostate biopsy CPT 55700 Biopsy Prostate Needle/Punch Single/Mult | $1,056.22 | $2,112.43 | — | 56% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 Destroy L/S Facet Joint Single | $1,638.63 | $3,277.26 | — | 37% below | 50% |
| Removal of a breast lump, open surgery CPT 19120 Excis Benign/Malig 1 or More Lesion | $2,057.15 | $4,114.30 | — | 58% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 Remove Foreign Body Simple | $229.63 | $459.25 | — | 59% below | 50% |
| Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 Lithotripsy | $5,744.38 | $11,488.75 | — | 35% below | 50% |
| Short arm cast (elbow to hand) CPT 29075 Application of Forearm Cast | $155.00 | $310.00 | — | 43% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 Apply Short Arm Splint Static | $182.50 | $365.00 | — | 25% below | 50% |
| Short leg cast (below the knee) CPT 29405 Apply Short Leg Cast Below Knee to Toes | $143.25 | $286.50 | — | 55% below | 50% |
| Short leg splint (calf to foot) CPT 29515 Apply Lower Leg Splint Calf to Foot | $132.50 | $265.00 | — | 40% below | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simp Rep Scalp Etc. 2.5cm/< | $251.38 | $502.75 | — | 31% below | 50% |
| Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion | $297.63 | $595.25 | — | 4% below | 50% |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 Exc Skin Malig<0.5 Cm Trunk, Arm Leg | $482.60 | $965.20 | — | 57% below | 50% |
| Skin tag removal, up to 15 tags CPT 11200 Skin Tag Removal 1-15 | $142.75 | $285.50 | — | 39% below | 50% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Spinal Puncture Lumbar Dx | $657.63 | $1,315.25 | — | 23% 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 Simp Rep Scalp Etc. 2.6-7.5cm | $270.00 | $540.00 | — | 36% below | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Simp Rep Face <2.5cm | $251.38 | $502.75 | — | 33% below | 50% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 Tangntl Bx Skin Single Lesion | $305.13 | $610.25 | — | 53% above | 50% |
| Thoracentesis with imaging guidance CPT 32555 Thoracentesis W/Imaging | $793.25 | $1,586.50 | — | 40% below | 50% |
| Total hip replacement CPT 27130 Total Hip Replacement | $6,443.00 | $12,886.00 | — | 69% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 Inj Tnd Trig Pt 1 or 2 Muscles | $259.15 | $518.30 | — | 29% below | 50% |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 Bx Breast US Image Lesion 1 | $1,311.75 | $2,623.50 | — | 35% below | 50% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 Egd Flex W/Balloon Dil < 30 Mm | $1,972.50 | $3,945.00 | — | 29% below | 50% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Flex/Transoral W Bx(S) | $979.50 | $1,959.00 | — | 34% below | 50% |
| Upper endoscopy (EGD) with injection into the lining CPT 43236 Egd Flex Transo Diag W Inj | $1,068.13 | $2,136.25 | — | 36% below | 50% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 Egd Flex Transo W Polypectomy | $1,068.75 | $2,137.50 | — | 71% below | 50% |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 Egd Flex Transo W Gd Wire Dilat | $1,972.50 | $3,945.00 | — | 39% above | 50% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd Flex/Transoral/Diagnostic | $945.18 | $1,890.35 | — | 36% below | 50% |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall CPT 43240 Tyransoral Transmural Drainage Pseudocyst | $3,069.29 | $6,138.57 | — | 58% below | 50% |
| Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 Cysteourethroscopy W/Lithotripsy | $3,632.44 | $7,264.87 | — | 72% below | 50% |
| Ureteroscopy with laser stone breaking and stent placement CPT 52356 Cysto/Uretero W Litho and Insert Indwell Stent | $5,544.61 | $11,089.22 | — | 66% below | 50% |
| Vasectomy, one or both sides, including follow-up semen testing CPT 55250 Removal of Sperm Duct(S) | $2,722.00 | $5,444.00 | — | 203% above | 50% |
| Vein ablation, radiofrequency, first vein CPT 36475 Endovenous Ablation 1st Vein | $3,600.00 | $7,200.00 | — | 3% below | 50% |
| Wart removal, up to 14 warts CPT 17110 Destruct Skin #14 Lesions | $94.50 | $189.00 | — | 31% below | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrid Skin/Tissue 20 Sqcm/< | $334.87 | $669.73 | — | 32% below | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Blood Product Transfusion | $515.85 | $1,031.69 | — | 47% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Medication Nebulizer | $104.87 | $209.74 | — | 34% below | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 Chemotherapy IV Infusn,Initial Up to 1 Hr | $601.95 | $1,203.90 | — | 24% below | 50% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 Comprehensive Hearing Test | $125.84 | $251.68 | — | 54% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 Critical Care 1st 30-74 Min | $2,275.00 | $4,550.00 | — | 10% below | 50% |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 Eeg Awake and Drowsy | $313.21 | $626.42 | — | 45% below | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram Tracing | $151.73 | $303.45 | — | 27% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Nursing Visit Level 1 | $97.50 | $195.00 | — | 51% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 Emerg Dept-Brief-Level1 | $296.63 | $593.25 | — | 50% above | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 Emerg Dept-Limited-Level 2 | $495.50 | $991.00 | — | 32% above | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 Emerg Dept-Interm-Level 3 | $847.75 | $1,695.50 | — | 49% above | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 Emerg Dept-Extended-Level 4 | $1,299.38 | $2,598.75 | — | 43% above | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 Emerg Dept-Comp-Level 5 | $1,784.63 | $3,569.25 | — | 11% above | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Hmptnfd Cardiovascular Stress Test Trcng | $173.64 | $347.27 | — | 77% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiovascular Stress Test, Tracing Only | $471.50 | $943.00 | — | 37% below | 50% |
| Group psychotherapy session CPT 90853 Group Psychotherapy | $100.00 | $200.00 | — | 30% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV Hydration Initial 31-60min | $373.84 | $747.67 | — | 11% above | 50% |
| IV infusion of a medicine, first hour CPT 96365 IV Therapy Initial (0-1 Hour) | $373.84 | $747.67 | — | at median | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 Therapeutic Inj Sc or Im | $122.10 | $244.19 | — | 12% above | 50% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 Behavioral Health Screening | $303.48 | $606.95 | — | 3% below | 50% |
| Nerve conduction study, 7 or 8 nerve studies CPT 95910 7-8 Nerve Conduction Studies | $312.50 | $625.00 | — | 28% below | 50% |
| New patient office visit, about 30 minutes CPT 99203 E/M New Patient Level 3 | $161.74 | $323.47 | — | 13% below | 50% |
| New patient office visit, about 45 minutes CPT 99204 E/M New Patient Level 4 | $211.50 | $423.00 | — | 34% above | 50% |
| New patient office visit, about 60 minutes CPT 99205 E/M New Patient Level 5 | $267.11 | $534.22 | — | 30% above | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 E/M New Patient Level 2 | $106.17 | $212.34 | — | 1% above | 50% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Mnt Initial Asses Indiv 15min | $23.38 | $46.75 | — | 10% below | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 New Well Visit 18-39 Yrs | $154.57 | $309.13 | — | 21% above | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 New Well Visit 40-64 Yrs | $190.40 | $380.80 | — | 29% above | 50% |
| Preventive checkup, new patient aged 65 or older CPT 99387 New Well Visit 65 and Over | $207.48 | $414.96 | — | 13% above | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 Est Well Visit 18-39 Yrs | $137.07 | $274.14 | — | at median | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 Est Well Visit 40-64 Yrs | $154.57 | $309.13 | — | 28% below | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 Est Preventive 65 and Over | $172.49 | $344.97 | — | 60% above | 50% |
| Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 Minutes W/ Patient | $84.38 | $168.75 | — | 44% below | 50% |
| Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 Minutes W/ Patient | $84.38 | $168.75 | — | 59% below | 50% |
| Psychotherapy session, 60 minutes CPT 90837 Individual Therapy 60min | $251.15 | $502.30 | — | 5% below | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 Smoke Tobacco Cess 3-10 Min | $45.00 | $90.00 | — | 19% below | 50% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 E/M Established Patient Level5 | $231.92 | $463.84 | — | 5% below | 50% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 E/M Established Patient Level3 | $82.64 | $165.28 | — | 42% below | 50% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 E/M Established Patient Level4 | $136.70 | $273.39 | — | 2% below | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 E/M Established Patient Level2 | $74.31 | $148.61 | — | 29% below | 50% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 Office Consultation 40 Min | $260.39 | $520.77 | — | 23% below | 50% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Office Consultation 60 Min | $341.64 | $683.27 | — | 26% below | 50% |
| Spirometry (breathing test) CPT 94010 Spirometry W/Graph Record | $127.50 | $255.00 | — | 52% below | 50% |
| Spirometry before and after a bronchodilator CPT 94060 Spirometry Before and After | $251.25 | $502.50 | — | 37% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 Therap Phlebotomy | $144.90 | $289.80 | — | 42% below | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Virginia | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza Vaccine, Inactivated (Iiv), Subunit, for Im Use (Fluad | $98.97 | $197.93 | — | 290% above | 50% |
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Influenza Vaccine, Inactivated (Iiv), Subunit, for Im Use (Fluad | $98.97 | $197.93 | — | — | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Sarscv2 Vac 30mcg Trs-Suc Im per 0.3ml | $90.00 | $180.00 | — | 31% above | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 Sarscv2 Vac 30mcg Trs-Suc Im per 0.3ml | $90.00 | $180.00 | — | — | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomav Vaccine 9-Val (Gardasil) | $384.51 | $769.02 | — | 54% below | 50% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomav Vaccine 9-Val (Gardasil) | $384.51 | $769.02 | — | — | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 Hep a and B Vaccine Adult | $165.58 | $331.15 | — | 47% below | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 Hep a and B Vaccine Adult | $165.58 | $331.15 | — | — | 50% |
| Hepatitis A vaccine, adult dose CPT 90632 Hepatitis a Vaccine Im | $107.71 | $215.42 | — | 66% below | 50% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis a Vaccine Im | $107.71 | $215.42 | — | — | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vacc 11+Yrs | $90.32 | $180.64 | — | 60% below | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vacc 11+Yrs | $90.32 | $180.64 | — | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose Flu Vac | $105.66 | $211.31 | — | 51% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose Quadrivalent 0.7ml Pfs | $116.78 | $233.55 | — | 46% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Influenza Virus Vaccine, (Iiv), Split Virus, Pf, Inhanced Immuno | $138.33 | $276.66 | — | 36% below | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Flu Vac | $105.66 | $211.31 | — | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Quadrivalent 0.7ml Pfs | $116.78 | $233.55 | — | — | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Influenza Virus Vaccine, (Iiv), Split Virus, Pf, Inhanced Immuno | $138.33 | $276.66 | — | — | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Conjugate Vaccine, Serogroups a, C, W, Y, Quadriva | $208.46 | $416.91 | — | 22% below | 50% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal Conjugate Vaccine, Serogroups a, C, W, Y, Quadriva | $208.46 | $416.91 | — | — | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal a C Y & W-135 Conj Im Inj | $296.41 | $592.82 | — | 14% below | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal a C Y & W-135 Conj Im Inj | $296.41 | $592.82 | — | — | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Pneumococcal Conj Vaccine, 20 Valent (Prevnar 20) Im | $343.25 | $686.50 | — | 1% above | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 Pneumococcal Conj Vaccine, 20 Valent (Prevnar 20) Im | $343.25 | $686.50 | — | — | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Immunization | $147.61 | $295.22 | — | 63% below | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Immunization | $147.61 | $295.22 | — | — | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 Nirsevimab, Rsv, Monoclonal Ab (Beyfortus) 50mg Inj per 0.5ml | $695.17 | $1,390.33 | — | 42% below | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 Nirsevimab, Rsv, Monoclonal Ab (Beyfortus) 50mg Inj per 0.5ml | $695.17 | $1,390.33 | — | — | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Respiratory Suncytial Virus Vaccine (Abrysvo) Im per 0.5ml | $383.50 | $767.00 | — | 12% above | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 Respiratory Suncytial Virus Vaccine (Abrysvo) Im per 0.5ml | $383.50 | $767.00 | — | — | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Td Vaccine Prsrv Free 7yr or Older for Im Use | $39.74 | $79.48 | — | 70% below | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Td Vaccine Prsrv Free 7yr or Older for Im Use | $39.74 | $79.48 | — | — | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tdap 7 Yrs or Older | $61.56 | $123.11 | — | 34% below | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tdap 7 Yrs or Older | $61.56 | $123.11 | — | — | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 Typhoid Vaccine, Im | $183.22 | $366.43 | — | 17% above | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 Typhoid Vaccine, Im | $183.22 | $366.43 | — | — | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Admin Hep B Vvfc | $10.62 | $21.24 | — | 80% below | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Immun Admin, Single/Comb Vacc Initial | $37.88 | $75.75 | — | 28% below | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Immun Admin, Single/Comb Vacc Subseq | $22.38 | $44.75 | — | 44% below | 50% |
Source file: https://riverside.pt.panaceainc.com/MRFDownload/riverside/rrsh