Pana Community Hospital
Listed in its price file as “Pana Community Hospital Association”.
Pana Community Hospital in Pana, IL publishes cash prices for 269 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are above the Illinois median for 195 of 265 procedures and below it for 67. By typical cash price it ranks #80 of 115 Illinois hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
101 East Ninth Street, Pana, IL 62557 Collected Sep 27, 2026 Source price file Check a bill from this hospital (217) 562-2131
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CMS star rating 4 of 5 CCN 141341 · CMS hospital register NPI 1942326970
The price file shows no self-pay discount
For 1290 of the 1290 prices listed here, the cash price in Pana Community Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Pana Community Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT Adrenal Protocol | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | 45% above | — |
| Abdominal CT scan without and with contrast CPT 74170 CT Liver Protocol | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | 45% above | — |
| Abdominal CT scan without and with contrast CPT 74170 CT Renal Mass Protocol | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | 45% above | — |
| Abdominal CT scan without and with contrast CPT 74170 CT Abdomen w/ + w/o Contrast | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | 45% above | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Abdomen w/ + w/o Contrast | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | — | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Liver Protocol | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | — | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Adrenal Protocol | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | — | — |
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT Renal Mass Protocol | $4,241.00 | $4,241.00 | $641.11–$1,139.13 | — | — |
| Abdominal X-ray, 2 views CPT 74019 XR Abdomen 2 Views | $450.00 | $450.00 | $118.35–$121.42 | 27% above | — |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR Abdomen 2 Views | $450.00 | $450.00 | $118.35–$121.42 | — | — |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral | $1,032.25 | $1,032.25 | $88.76–$455.84 | — | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Left | $518.00 | $518.00 | $88.76–$455.84 | 51% above | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Right | $518.00 | $518.00 | $88.76–$455.84 | 51% above | — |
| Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral | $1,032.25 | $1,032.25 | $88.76–$455.84 | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Right | $518.00 | $518.00 | $88.76–$455.84 | — | — |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Left | $518.00 | $518.00 | $88.76–$455.84 | — | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US Ankle Brachial Index | $405.25 | $405.25 | $102.91–$230.51 | 1% below | — |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US Ankle Brachial Index | $405.25 | $405.25 | $102.91–$230.51 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Humerus w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Forearm w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Shoulder w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Scapula w/o Contrast Bilat | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Hand w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Clavicle w/o Contrast Bilat | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Elbow w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) both sides CPT 73200 CT Wrist w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Finger(s) w/o Contrast Right | $1,836.75 | $1,836.75 | $225.06–$1,749.25 | 1% below | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Finger(s) w/o Contrast Left | $1,836.75 | $1,836.75 | $225.06–$1,749.25 | 1% below | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Clavicle w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Elbow w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Wrist w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Clavicle w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Humerus w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Shoulder w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Scapula w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Forearm w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Scapula w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT Hand w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | 4% above | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Forearm w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Scapula w/o Contrast Bilat | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Humerus w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Hand w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Wrist w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Shoulder w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Clavicle w/o Contrast Bilat | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient both sides CPT 73200 CT Elbow w/o Contrast Bilateral | $3,856.00 | $3,856.00 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Finger(s) w/o Contrast Right | $1,836.75 | $1,836.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Finger(s) w/o Contrast Left | $1,836.75 | $1,836.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Scapula w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Clavicle w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Elbow w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Clavicle w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Wrist w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Forearm w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Hand w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Shoulder w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Humerus w/o Contrast Left | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT Scapula w/o Contrast Right | $1,928.75 | $1,928.75 | $225.06–$1,749.25 | — | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 78306 NM Bone Imaging Whole Body | $1,502.50 | $1,502.50 | $403.58 | 5% below | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body | $1,502.50 | $1,502.50 | $403.58 | 5% below | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 78306 NM Bone Imaging Whole Body | $1,502.50 | $1,502.50 | $403.58 | — | — |
| Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body | $1,502.50 | $1,502.50 | $403.58 | — | — |
| Breast ultrasound, complete, one breast both sides CPT 76641 US Breast Complete Bilat | $2,570.25 | $2,570.25 | $230.34–$1,130.91 | — | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left | $1,285.75 | $1,285.75 | $230.34–$1,130.91 | 142% above | — |
| Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right | $1,285.75 | $1,285.75 | $230.34–$1,130.91 | 142% above | — |
| Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US Breast Complete Bilat | $2,570.25 | $2,570.25 | $230.34–$1,130.91 | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right | $1,285.75 | $1,285.75 | $230.34–$1,130.91 | — | — |
| Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left | $1,285.75 | $1,285.75 | $230.34–$1,130.91 | — | — |
| Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US Breast Limited Bilat | $1,402.75 | $1,402.75 | $174.27–$1,119.36 | — | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right | $686.00 | $686.00 | $174.27–$1,119.36 | 56% above | — |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left | $686.00 | $686.00 | $174.27–$1,119.36 | 56% above | — |
| Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US Breast Limited Bilat | $1,402.75 | $1,402.75 | $174.27–$1,119.36 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right | $686.00 | $686.00 | $174.27–$1,119.36 | — | — |
| Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left | $686.00 | $686.00 | $174.27–$1,119.36 | — | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 74174 CT Angio Abdomen and Pelvis | $4,136.25 | $4,136.25 | $1,111.00 | 5% above | — |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT Angio Abdomen and Pelvis | $4,136.25 | $4,136.25 | $1,111.00 | 5% above | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 74174 CT Angio Abdomen and Pelvis | $4,136.25 | $4,136.25 | $1,111.00 | — | — |
| CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT Angio Abdomen and Pelvis | $4,136.25 | $4,136.25 | $1,111.00 | — | — |
| CT angiography (CTA) of the head CPT 70496 CT Angio Brain/Head | $3,409.00 | $3,409.00 | $783.33–$2,999.92 | 32% above | — |
| CT angiography (CTA) of the head CPT 70496 CT Venogram Brain/Head | $3,409.00 | $3,409.00 | $783.33–$2,999.92 | 32% above | — |
| CT angiography (CTA) of the head CPT 70496 70496 CT Angio Brain/Head | $4,436.00 | $4,436.00 | $783.33–$2,999.92 | 72% above | — |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Venogram Brain/Head | $3,409.00 | $3,409.00 | $783.33–$2,999.92 | — | — |
| CT angiography (CTA) of the head inpatient CPT 70496 CT Angio Brain/Head | $3,409.00 | $3,409.00 | $783.33–$2,999.92 | — | — |
| CT angiography (CTA) of the head inpatient CPT 70496 70496 CT Angio Brain/Head | $4,436.00 | $4,436.00 | $783.33–$2,999.92 | — | — |
| CT angiography (CTA) of the neck CPT 70498 CT Angio Neck | $3,409.00 | $3,409.00 | $916.05 | 26% above | — |
| CT angiography (CTA) of the neck CPT 70498 70498 CT Angio Neck | $3,409.00 | $3,409.00 | $916.05 | 26% above | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 CT Angio Neck | $3,409.00 | $3,409.00 | $916.05 | — | — |
| CT angiography (CTA) of the neck inpatient CPT 70498 70498 CT Angio Neck | $3,409.00 | $3,409.00 | $916.05 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest PE | $3,409.00 | $3,409.00 | $782.72–$2,999.92 | 15% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 71275 CT Angio Chest | $3,409.00 | $3,409.00 | $782.72–$2,999.92 | 15% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest | $4,436.00 | $4,436.00 | $782.72–$2,999.92 | 50% above | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest PE | $3,409.00 | $3,409.00 | $782.72–$2,999.92 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 71275 CT Angio Chest | $3,409.00 | $3,409.00 | $782.72–$2,999.92 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest | $4,436.00 | $4,436.00 | $782.72–$2,999.92 | — | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Renal Stone Study | $5,282.50 | $5,282.50 | $641.11–$4,648.60 | 42% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 74176 CT Abdomen and Pelvis w/o Contrast | $5,282.50 | $5,282.50 | $641.11–$4,648.60 | 42% above | — |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast | $5,282.50 | $5,282.50 | $641.11–$4,648.60 | 42% above | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 74176 CT Abdomen and Pelvis w/o Contrast | $5,282.50 | $5,282.50 | $641.11–$4,648.60 | — | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast | $5,282.50 | $5,282.50 | $641.11–$4,648.60 | — | — |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Renal Stone Study | $5,282.50 | $5,282.50 | $641.11–$4,648.60 | — | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 74177 CT Abdomen and Pelvis w/ Contrast | $6,091.25 | $6,091.25 | $641.11–$5,360.30 | 35% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast | $6,091.25 | $6,091.25 | $641.11–$5,360.30 | 35% above | — |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography w/ Contrast | $6,091.25 | $6,091.25 | $641.11–$5,360.30 | 35% above | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast | $6,091.25 | $6,091.25 | $641.11–$5,360.30 | — | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography w/ Contrast | $6,091.25 | $6,091.25 | $641.11–$5,360.30 | — | — |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 74177 CT Abdomen and Pelvis w/ Contrast | $6,091.25 | $6,091.25 | $641.11–$5,360.30 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | 63% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen w/o Cont + Abd/Pel w/ Contras | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | 63% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urogram | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | 63% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | 63% above | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen w/o Cont + Abd/Pel w/ Contras | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | — | — |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urogram | $8,481.25 | $8,481.25 | $640.61–$7,463.50 | — | — |
| CT scan of the abdomen with contrast CPT 74160 74160 CT Abdomen w/ Contrast | $2,888.00 | $2,888.00 | $641.11–$775.72 | 19% above | — |
| CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast | $2,888.00 | $2,888.00 | $641.11–$775.72 | 19% above | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 74160 CT Abdomen w/ Contrast | $2,888.00 | $2,888.00 | $641.11–$775.72 | — | — |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast | $2,888.00 | $2,888.00 | $641.11–$775.72 | — | — |
| CT scan of the abdomen without contrast CPT 74150 74150 CT Chest w/o Contrast | $2,610.25 | $2,610.25 | $696.32–$2,187.46 | 32% above | — |
| CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast | $2,610.25 | $2,610.25 | $696.32–$2,187.46 | 32% above | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast | $2,610.25 | $2,610.25 | $696.32–$2,187.46 | — | — |
| CT scan of the abdomen without contrast inpatient CPT 74150 74150 CT Chest w/o Contrast | $2,610.25 | $2,610.25 | $696.32–$2,187.46 | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | 51% above | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | 51% above | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | — | — |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head Stroke Protocol | $3,080.25 | $3,080.25 | $641.11–$2,710.62 | 62% above | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast | $3,080.25 | $3,080.25 | $641.11–$2,710.62 | 62% above | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head Stroke Protocol | $3,080.25 | $3,080.25 | $641.11–$2,710.62 | — | — |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast | $3,080.25 | $3,080.25 | $641.11–$2,710.62 | — | — |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast Charge | $3,690.00 | $3,690.00 | $641.11 | 48% above | — |
| CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast | $3,690.00 | $3,690.00 | $641.11 | 48% above | — |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast Charge | $3,690.00 | $3,690.00 | $641.11 | — | — |
| CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast | $3,690.00 | $3,690.00 | $641.11 | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast | $2,939.75 | $2,939.75 | $225.06–$2,586.98 | 31% above | — |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast | $2,939.75 | $2,939.75 | $225.06–$2,586.98 | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast | $2,939.75 | $2,939.75 | $225.06–$2,586.98 | 24% above | — |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast | $2,939.75 | $2,939.75 | $225.06–$2,586.98 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral | $1,364.00 | $1,364.00 | $354.89–$1,200.32 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral | $1,364.00 | $1,364.00 | $354.89–$1,200.32 | — | — |
| Chest CT scan without and with contrast CPT 71270 71270 CT Chest w/ + w/o Contrast | $4,241.00 | $4,241.00 | $1,084.88–$1,163.74 | 44% above | — |
| Chest CT scan without and with contrast CPT 71270 CT Chest w/ + w/o Contrast | $4,241.00 | $4,241.00 | $1,084.88–$1,163.74 | 44% above | — |
| Chest CT scan without and with contrast inpatient CPT 71270 CT Chest w/ + w/o Contrast | $4,241.00 | $4,241.00 | $1,084.88–$1,163.74 | — | — |
| Chest CT scan without and with contrast inpatient CPT 71270 71270 CT Chest w/ + w/o Contrast | $4,241.00 | $4,241.00 | $1,084.88–$1,163.74 | — | — |
| Chest X-ray, 2 views CPT 71046 XR Chest 2 Views | $423.75 | $423.75 | $102.81–$372.90 | 35% above | — |
| Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views | $423.75 | $423.75 | $102.81–$372.90 | — | — |
| Chest X-ray, single view CPT 71045 XR Chest 1 View | $342.50 | $342.50 | $86.26–$301.40 | 32% above | — |
| Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View | $342.50 | $342.50 | $86.26–$301.40 | — | — |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 XR Clavicle Bilat | $868.25 | $868.25 | $118.44–$441.32 | — | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Left | $501.50 | $501.50 | $118.44–$441.32 | 66% above | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 XR Clavicle Right | $501.50 | $501.50 | $118.44–$441.32 | 66% above | — |
| Collarbone (clavicle) X-ray, complete inpatient both sides CPT 73000 XR Clavicle Bilat | $868.25 | $868.25 | $118.44–$441.32 | — | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Right | $501.50 | $501.50 | $118.44–$441.32 | — | — |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR Clavicle Left | $501.50 | $501.50 | $118.44–$441.32 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Retroperitoneal Complete | $1,500.00 | $1,500.00 | $265.78–$870.76 | 79% above | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Retroperitoneal Complete | $1,500.00 | $1,500.00 | $265.78–$870.76 | — | — |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton | $755.25 | $755.25 | $166.30–$664.62 | 52% above | — |
| DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton | $755.25 | $755.25 | $166.30–$664.62 | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 71250 CT Abdomen w/o Contrast | $2,435.50 | $2,435.50 | $224.89–$2,297.02 | 29% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 71250 CT Chest w/o Contrast | $2,435.50 | $2,435.50 | $224.89–$2,297.02 | 29% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest High Resolution | $2,435.50 | $2,435.50 | $224.89–$2,297.02 | 29% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Sternum w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | 38% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | 38% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung Cancer Follow Up | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | 38% above | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Sternoclavicular Jts w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | 38% above | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 71250 CT Abdomen w/o Contrast | $2,435.50 | $2,435.50 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest High Resolution | $2,435.50 | $2,435.50 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 71250 CT Chest w/o Contrast | $2,435.50 | $2,435.50 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Sternum w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Lung Cancer Follow Up | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Sternoclavicular Jts w/o Contrast | $2,610.25 | $2,610.25 | $224.89–$2,297.02 | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 71260 CT Chest w/ Contrast | $3,323.25 | $3,323.25 | $641.11–$2,924.46 | 37% above | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w/ Contrast | $3,323.25 | $3,323.25 | $641.11–$2,924.46 | 37% above | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w/ Contrast | $3,323.25 | $3,323.25 | $641.11–$2,924.46 | — | — |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 71260 CT Chest w/ Contrast | $3,323.25 | $3,323.25 | $641.11–$2,924.46 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $533.50 | $533.50 | $100.64–$469.48 | — | — |
| Diagnostic mammogram, both breasts both sides CPT 77066 77066 MG Mammo Digital Diagnostic Bilat | $533.50 | $533.50 | $100.64–$469.48 | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 77066 MG Mammo Digital Diagnostic Bilat | $533.50 | $533.50 | $100.64–$469.48 | — | — |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bilat | $533.50 | $533.50 | $100.64–$469.48 | — | — |
| Diagnostic mammogram, one breast one side CPT 77065 77065 MG Mammo Digital Diagnostic Left | $328.25 | $328.25 | $82.70–$299.53 | 3% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Right | $328.25 | $328.25 | $82.70–$299.53 | 3% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Left | $328.25 | $328.25 | $82.70–$299.53 | 3% above | — |
| Diagnostic mammogram, one breast one side CPT 77065 77065 MG Mammo Digital Diagnostic Right | $328.25 | $328.25 | $82.70–$299.53 | 3% above | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 MG Mammo Digital Diagnostic Right | $328.25 | $328.25 | $82.70–$299.53 | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 77065 MG Mammo Digital Diagnostic Left | $328.25 | $328.25 | $82.70–$299.53 | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Right | $328.25 | $328.25 | $82.70–$299.53 | — | — |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Left | $328.25 | $328.25 | $82.70–$299.53 | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $1,448.00 | $1,448.00 | $355.16–$388.93 | — | — |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral | $1,448.00 | $1,448.00 | $355.16–$388.93 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $998.50 | $998.50 | $354.89–$663.98 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $1,473.50 | $1,473.50 | $354.89–$663.98 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral | $998.50 | $998.50 | $354.89–$663.98 | — | — |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral | $1,473.50 | $1,473.50 | $354.89–$663.98 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echocardiogram 2D + M-Mode EO | $2,756.25 | $2,756.25 | $735.26–$2,425.50 | 22% above | — |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US Echocardiogram 2D + M-Mode | $2,756.25 | $2,756.25 | $735.26–$2,425.50 | 22% above | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echocardiogram 2D + M-Mode EO | $2,756.25 | $2,756.25 | $735.26–$2,425.50 | — | — |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US Echocardiogram 2D + M-Mode | $2,756.25 | $2,756.25 | $735.26–$2,425.50 | — | — |
| Elbow X-ray, 2 views both sides CPT 73070 XR Elbow 2 Views Bilateral | $841.50 | $841.50 | $118.44–$427.02 | — | — |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Left | $485.25 | $485.25 | $118.44–$427.02 | 70% above | — |
| Elbow X-ray, 2 views one side CPT 73070 XR Elbow 2 Views Right | $485.25 | $485.25 | $118.44–$427.02 | 70% above | — |
| Elbow X-ray, 2 views inpatient both sides CPT 73070 XR Elbow 2 Views Bilateral | $841.50 | $841.50 | $118.44–$427.02 | — | — |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Right | $485.25 | $485.25 | $118.44–$427.02 | — | — |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR Elbow 2 Views Left | $485.25 | $485.25 | $118.44–$427.02 | — | — |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 XR Elbow Complete 3+ Views Bilateral | $1,177.00 | $1,177.00 | $118.44–$518.54 | — | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Left | $589.25 | $589.25 | $118.44–$518.54 | 71% above | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 XR Elbow Complete 3+ Views Right | $589.25 | $589.25 | $118.44–$518.54 | 71% above | — |
| Elbow X-ray, complete, 3 or more views inpatient both sides CPT 73080 XR Elbow Complete 3+ Views Bilateral | $1,177.00 | $1,177.00 | $118.44–$518.54 | — | — |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Right | $589.25 | $589.25 | $118.44–$518.54 | — | — |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR Elbow Complete 3+ Views Left | $589.25 | $589.25 | $118.44–$518.54 | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Temporal Bones w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | 51% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Orbits Sella w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | 51% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | 51% above | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT Mastoids w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | 51% above | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Orbits Sella w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Mastoids w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT Temporal Bones w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | — | — |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Zygomatic Arches | $359.00 | $359.00 | $118.44–$188.14 | 17% below | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 XR Facial Bones 3+ Views | $708.75 | $708.75 | $118.44–$188.14 | 64% above | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Zygomatic Arches | $359.00 | $359.00 | $118.44–$188.14 | — | — |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR Facial Bones 3+ Views | $708.75 | $708.75 | $118.44–$188.14 | — | — |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 XR Forearm 2 Views Bilateral | $818.00 | $818.00 | $59.22–$460.35 | — | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Right | $469.75 | $469.75 | $59.22–$460.35 | 46% above | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR Forearm 2 Views Left | $469.75 | $469.75 | $59.22–$460.35 | 46% above | — |
| Forearm X-ray (radius and ulna), 2 views inpatient both sides CPT 73090 XR Forearm 2 Views Bilateral | $818.00 | $818.00 | $59.22–$460.35 | — | — |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Left | $469.75 | $469.75 | $59.22–$460.35 | — | — |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR Forearm 2 Views Right | $469.75 | $469.75 | $59.22–$460.35 | — | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging | $1,507.50 | $1,507.50 | $775.00 | at median | — |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging | $1,507.50 | $1,507.50 | $775.00 | — | — |
| Hand X-ray, 2 views both sides CPT 73120 XR Hand 1 View On One Film Bilateral | $464.00 | $464.00 | $97.19–$372.90 | — | — |
| Hand X-ray, 2 views both sides CPT 73120 XR Hand 2 Views Bilateral | $841.50 | $841.50 | $97.19–$372.90 | — | — |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Right | $423.75 | $423.75 | $97.19–$372.90 | 47% above | — |
| Hand X-ray, 2 views one side CPT 73120 XR Hand 2 Views Left | $423.75 | $423.75 | $97.19–$372.90 | 47% above | — |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 1 View On One Film Bilateral | $464.00 | $464.00 | $97.19–$372.90 | — | — |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR Hand 2 Views Bilateral | $841.50 | $841.50 | $97.19–$372.90 | — | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Right | $423.75 | $423.75 | $97.19–$372.90 | — | — |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR Hand 2 Views Left | $423.75 | $423.75 | $97.19–$372.90 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 XR Calcaneus Bilateral | $819.75 | $819.75 | $109.51–$118.44 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Right | $410.50 | $410.50 | $109.51–$118.44 | 56% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR Calcaneus Left | $410.50 | $410.50 | $109.51–$118.44 | 56% above | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient both sides CPT 73650 XR Calcaneus Bilateral | $819.75 | $819.75 | $109.51–$118.44 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Right | $410.50 | $410.50 | $109.51–$118.44 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR Calcaneus Left | $410.50 | $410.50 | $109.51–$118.44 | — | — |
| Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT RESP EFFT CHARGE | $1,227.25 | $1,227.25 | $309.25–$1,079.98 | 111% above | — |
| Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT RESP EFFT CHARGE | $1,227.25 | $1,227.25 | $309.25–$1,079.98 | — | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 95811 POLYSOMNOGRAPHY W/CPAP > 4 PARAMETERS CHARGE | $5,733.00 | $5,733.00 | $1,446.52–$5,045.04 | 19% above | — |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 95811 POLYSOMNOGRAPHY W/CPAP > 4 PARAMETERS CHARGE | $5,733.00 | $5,733.00 | $1,446.52–$5,045.04 | — | — |
| Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral | $965.50 | $965.50 | $88.76–$474.44 | — | — |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right | $484.50 | $484.50 | $88.76–$474.44 | 27% above | — |
| Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left | $484.50 | $484.50 | $88.76–$474.44 | 27% above | — |
| Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral | $965.50 | $965.50 | $88.76–$474.44 | — | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right | $484.50 | $484.50 | $88.76–$474.44 | — | — |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left | $484.50 | $484.50 | $88.76–$474.44 | — | — |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 XR Knee Complete 4+ Views Bilateral | $1,608.50 | $1,608.50 | $88.76–$804.25 | — | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Left | $531.00 | $531.00 | $88.76–$804.25 | 15% above | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 XR Knee Complete 4+ Views Right | $531.00 | $531.00 | $88.76–$804.25 | 15% above | — |
| Knee X-ray, complete, 4 or more views inpatient both sides CPT 73564 XR Knee Complete 4+ Views Bilateral | $1,608.50 | $1,608.50 | $88.76–$804.25 | — | — |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Left | $531.00 | $531.00 | $88.76–$804.25 | — | — |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR Knee Complete 4+ Views Right | $531.00 | $531.00 | $88.76–$804.25 | — | — |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Lower Leg w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Femur w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Hip w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Knee w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) both sides CPT 73700 CT Foot w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Hip w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Foot w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Femur w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Ankle w/ Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Knee w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | 43% above | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Hip w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Foot w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Femur w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Knee w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Ankle w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient both sides CPT 73700 CT Lower Leg w/o Contrast Bilateral | $5,218.25 | $5,218.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/ Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Hip w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Knee w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Foot w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Femur w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Ankle w/o Contrast Right | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT Tibia/Fibula w/o Contrast Left | $2,610.25 | $2,610.25 | $225.06–$2,187.46 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Abd/Pel | $774.25 | $774.25 | $230.51–$823.68 | 8% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 76705 US Abdomen/Lower Back Limited | $936.00 | $936.00 | $230.51–$823.68 | 30% above | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Abd/Pel | $774.25 | $774.25 | $230.51–$823.68 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 76705 US Abdomen/Lower Back Limited | $936.00 | $936.00 | $230.51–$823.68 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tissue Groin | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US Soft Tissue | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Lower Ext Left | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Lower Ext Right | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Upper Ext Left | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Soft Tissue Upper Ext Right | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Right | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US Axilla Left | $739.25 | $739.25 | $199.60–$619.52 | 83% above | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tissue Groin | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US Soft Tissue | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Lower Ext Right | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Lower Ext Left | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Right | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Upper Ext Right | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Soft Tissue Upper Ext Left | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US Axilla Left | $739.25 | $739.25 | $199.60–$619.52 | — | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening | $702.50 | $702.50 | $177.02–$618.20 | 24% above | — |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screening | $702.50 | $702.50 | $177.02–$618.20 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 XR Tibia/Fibula Bilateral | $927.75 | $927.75 | $118.35–$442.75 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Right | $465.00 | $465.00 | $118.35–$442.75 | 43% above | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR Tibia/Fibula Left | $465.00 | $465.00 | $118.35–$442.75 | 43% above | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient both sides CPT 73590 XR Tibia/Fibula Bilateral | $927.75 | $927.75 | $118.35–$442.75 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Right | $465.00 | $465.00 | $118.35–$442.75 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR Tibia/Fibula Left | $465.00 | $465.00 | $118.35–$442.75 | — | — |
| MR angiography (MRA) of the head without contrast CPT 70544 MRA Brain/Head w/o Contrast | $2,559.75 | $2,559.75 | $654.78 | 8% below | — |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA Brain/Head w/o Contrast | $2,559.75 | $2,559.75 | $654.78 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | 25% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | 25% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | 25% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | 25% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | 25% above | — |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | 25% above | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right | $3,578.75 | $3,578.75 | $508.89–$3,149.30 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | 2% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | 2% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | 2% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | 2% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | 2% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | 2% above | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Left | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | — | — |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Hip w/ + w/o Contrast Right | $3,758.25 | $3,758.25 | $1,035.47–$2,598.54 | — | — |
| MRI of the abdomen without contrast CPT 74181 MRI MRCP | $3,009.75 | $3,009.75 | $773.36 | 9% above | — |
| MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast | $3,009.75 | $3,009.75 | $773.36 | 9% above | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP | $3,009.75 | $3,009.75 | $773.36 | — | — |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast | $3,009.75 | $3,009.75 | $773.36 | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast | $3,758.25 | $3,758.25 | $858.60–$3,307.26 | at median | — |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast | $3,758.25 | $3,758.25 | $858.60–$3,307.26 | — | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast | $4,129.50 | $4,129.50 | $508.89–$3,633.96 | 40% above | — |
| MRI of the brain, no contrast dye CPT 70551 MRI Pituitary w/o Contrast | $4,129.50 | $4,129.50 | $508.89–$3,633.96 | 40% above | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pituitary w/o Contrast | $4,129.50 | $4,129.50 | $508.89–$3,633.96 | — | — |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast | $4,129.50 | $4,129.50 | $508.89–$3,633.96 | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary w/ + w/o Contrast | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | 22% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrastt - BCE | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | 22% above | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | 22% above | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrastt - BCE | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | — | — |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary w/ + w/o Contrast | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | — | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast | $4,129.50 | $4,129.50 | $508.89–$3,633.96 | 36% above | — |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast | $4,129.50 | $4,129.50 | $508.89–$3,633.96 | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $5,084.75 | $5,084.75 | $857.94–$1,365.76 | 22% above | — |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast | $5,084.75 | $5,084.75 | $857.94–$1,365.76 | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast | $3,052.25 | $3,052.25 | $849.75–$2,685.98 | 2% above | — |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast | $3,052.25 | $3,052.25 | $849.75–$2,685.98 | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | 25% above | — |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast | $5,084.75 | $5,084.75 | $858.60–$4,474.58 | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast | $4,129.50 | $4,129.50 | $508.50–$3,633.96 | 38% above | — |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast | $4,129.50 | $4,129.50 | $508.50–$3,633.96 | — | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI Sacrum/Coccyx w/ + w/o Contrast | $4,421.75 | $4,421.75 | $858.60–$3,891.14 | 18% above | — |
| MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast | $4,421.75 | $4,421.75 | $858.60–$3,891.14 | 18% above | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast | $4,421.75 | $4,421.75 | $858.60–$3,891.14 | — | — |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Sacrum/Coccyx w/ + w/o Contrast | $4,421.75 | $4,421.75 | $858.60–$3,891.14 | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum/Coccyx w/o Contrast | $3,009.75 | $3,009.75 | $766.89 | 11% above | — |
| MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast | $3,009.75 | $3,009.75 | $766.89 | 11% above | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast | $3,009.75 | $3,009.75 | $766.89 | — | — |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum/Coccyx w/o Contrast | $3,009.75 | $3,009.75 | $766.89 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | 23% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | 23% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | 23% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | 23% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | 23% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | 23% above | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right | $3,578.75 | $3,578.75 | $508.50–$3,149.30 | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR Spine Cervical 4 or 5 Views | $871.50 | $871.50 | $118.44–$231.21 | 60% above | — |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR Spine Cervical 4 or 5 Views | $871.50 | $871.50 | $118.44–$231.21 | — | — |
| Neck soft tissue CT scan with contrast CPT 70491 CT Neck Soft Tissue w/ Contrast | $2,888.00 | $2,888.00 | $640.61–$779.22 | 31% above | — |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT Neck Soft Tissue w/ Contrast | $2,888.00 | $2,888.00 | $640.61–$779.22 | — | — |
| Neck soft tissue CT scan without contrast CPT 70490 CT Neck Soft Tissue w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | 42% above | — |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT Neck Soft Tissue w/o Contrast | $2,610.25 | $2,610.25 | $225.06 | — | — |
| Neck soft tissue X-ray CPT 70360 XR Neck Soft Tissue | $350.75 | $350.75 | $59.22 | 31% above | — |
| Neck soft tissue X-ray inpatient CPT 70360 XR Neck Soft Tissue | $350.75 | $350.75 | $59.22 | — | — |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM Myocardial SPECT Rest and Stress EO | $7,169.75 | $7,169.75 | $1,739.84–$6,309.38 | 78% above | — |
| Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM Myocardial SPECT Rest and Stress EO | $7,169.75 | $7,169.75 | $1,739.84–$6,309.38 | — | — |
| Pelvic CT scan without contrast CPT 72192 CT Pelvis w/o Contrast | $2,610.25 | $2,610.25 | $225.06–$701.12 | 37% above | — |
| Pelvic CT scan without contrast inpatient CPT 72192 CT Pelvis w/o Contrast | $2,610.25 | $2,610.25 | $225.06–$701.12 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Bladder Scan | $448.50 | $448.50 | $230.51 | 25% below | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US Soft Tissue Buttocks or Pelvic Wall | $448.50 | $448.50 | $230.51 | 25% below | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Bladder Scan | $448.50 | $448.50 | $230.51 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US Soft Tissue Buttocks or Pelvic Wall | $448.50 | $448.50 | $230.51 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 76856 US Pelvic Complete | $982.75 | $982.75 | $252.48–$864.82 | 18% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US Pelvic Complete | $982.75 | $982.75 | $252.48–$864.82 | 18% above | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 76856 US Pelvic Complete | $982.75 | $982.75 | $252.48–$864.82 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US Pelvic Complete | $982.75 | $982.75 | $252.48–$864.82 | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 76801 US OB < 14 Weeks Single | $883.00 | $883.00 | $212.18–$777.04 | 28% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB < 14 Weeks Single | $883.00 | $883.00 | $212.18–$777.04 | 28% above | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 76801 US OB < 14 Weeks Single | $883.00 | $883.00 | $212.18–$777.04 | — | — |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB < 14 Weeks Single | $883.00 | $883.00 | $212.18–$777.04 | — | — |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Left | $588.75 | $588.75 | $118.44–$493.24 | 66% above | — |
| Rib X-ray, one side, 2 views one side CPT 71100 XR Ribs 2 Views Right | $588.75 | $588.75 | $118.44–$493.24 | 66% above | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Left | $588.75 | $588.75 | $118.44–$493.24 | — | — |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR Ribs 2 Views Right | $588.75 | $588.75 | $118.44–$493.24 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Left | $801.50 | $801.50 | $118.44–$224.71 | 66% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR Ribs w/ PA Chest Right | $801.50 | $801.50 | $118.44–$224.71 | 66% above | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Left | $801.50 | $801.50 | $118.44–$224.71 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR Ribs w/ PA Chest Right | $801.50 | $801.50 | $118.44–$224.71 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral | $454.75 | $454.75 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts both sides CPT 77067 77067 MG Mammo Digital Screening Bilateral | $454.75 | $454.75 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts one side CPT 77067 77067 MG Mammo Digital Screening Left | $175.50 | $175.50 | $80.23–$400.18 | 35% below | — |
| Screening mammogram, both breasts one side CPT 77067 77067 MG Mammo Digital Screening Right | $175.50 | $175.50 | $80.23–$400.18 | 35% below | — |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening Right | $288.75 | $288.75 | $80.23–$400.18 | 7% above | — |
| Screening mammogram, both breasts one side CPT 77067 MG Mammo Digital Screening Left | $288.75 | $288.75 | $80.23–$400.18 | 7% above | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 77067 MG Mammo Digital Screening Bilateral | $454.75 | $454.75 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral | $454.75 | $454.75 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 77067 MG Mammo Digital Screening Right | $175.50 | $175.50 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 77067 MG Mammo Digital Screening Left | $175.50 | $175.50 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening Left | $288.75 | $288.75 | $80.23–$400.18 | — | — |
| Screening mammogram, both breasts inpatient one side CPT 77067 MG Mammo Digital Screening Right | $288.75 | $288.75 | $80.23–$400.18 | — | — |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete 2+ Views Bilat | $892.25 | $892.25 | $88.83–$441.32 | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Right | $448.50 | $448.50 | $88.83–$441.32 | 23% above | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Left | $448.50 | $448.50 | $88.83–$441.32 | 23% above | — |
| Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete 2+ Views Bilat | $892.25 | $892.25 | $88.83–$441.32 | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Right | $448.50 | $448.50 | $88.83–$441.32 | — | — |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Left | $448.50 | $448.50 | $88.83–$441.32 | — | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 XR Sinuses Paranasal Complete | $646.50 | $646.50 | $118.35–$504.27 | 52% above | — |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR Sinuses Paranasal Complete | $646.50 | $646.50 | $118.35–$504.27 | — | — |
| Skull X-ray, fewer than 4 views CPT 70250 XR Skull < 4 Views | $481.25 | $481.25 | $423.50 | 52% above | — |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR Skull < 4 Views | $481.25 | $481.25 | $423.50 | — | — |
| Sleep study in a lab (polysomnography) CPT 95810 95810 POLYSOMNOGRAPHY > 4 PARAMETERS OBSERVATI CHARGE | $5,512.50 | $5,512.50 | $1,667.07 | 37% above | — |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 95810 POLYSOMNOGRAPHY > 4 PARAMETERS OBSERVATI CHARGE | $5,512.50 | $5,512.50 | $1,667.07 | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech | $567.00 | $567.00 | $124.80–$498.96 | 14% below | — |
| Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech | $567.00 | $567.00 | $124.80–$498.96 | — | — |
| Thigh bone (femur) X-ray, 2 or more views both sides CPT 73552 XR Femur 2 Views Bilat | $646.50 | $646.50 | $106.76–$343.20 | — | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Left | $440.00 | $440.00 | $106.76–$343.20 | 56% above | — |
| Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR Femur 2 Views Right | $440.00 | $440.00 | $106.76–$343.20 | 56% above | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient both sides CPT 73552 XR Femur 2 Views Bilat | $646.50 | $646.50 | $106.76–$343.20 | — | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Left | $440.00 | $440.00 | $106.76–$343.20 | — | — |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR Femur 2 Views Right | $440.00 | $440.00 | $106.76–$343.20 | — | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT Spine Thoracic w/o Contrast | $1,928.75 | $1,928.75 | $518.06–$1,697.30 | 11% below | — |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT Spine Thoracic w/o Contrast | $1,928.75 | $1,928.75 | $518.06–$1,697.30 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Right | $320.75 | $320.75 | $85.17–$118.44 | 33% above | — |
| Toe X-ray, 2 or more views one side CPT 73660 XR Toe(s) 2+ Views Left | $320.75 | $320.75 | $85.17–$118.44 | 33% above | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Left | $320.75 | $320.75 | $85.17–$118.44 | — | — |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR Toe(s) 2+ Views Right | $320.75 | $320.75 | $85.17–$118.44 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB | $774.25 | $774.25 | $208.90–$681.34 | 16% above | — |
| Transvaginal pelvic ultrasound CPT 76830 76830 US Transvaginal Non-OB | $774.25 | $774.25 | $208.90–$681.34 | 16% above | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB | $774.25 | $774.25 | $208.90–$681.34 | — | — |
| Transvaginal pelvic ultrasound inpatient CPT 76830 76830 US Transvaginal Non-OB | $774.25 | $774.25 | $208.90–$681.34 | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 76817 US OB Transvaginal | $774.25 | $774.25 | $106.09–$681.34 | 45% above | — |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal | $774.25 | $774.25 | $106.09–$681.34 | 45% above | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 76817 US OB Transvaginal | $774.25 | $774.25 | $106.09–$681.34 | — | — |
| Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal | $774.25 | $774.25 | $106.09–$681.34 | — | — |
| Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete | $1,191.50 | $1,191.50 | $301.96–$355.16 | 12% above | — |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete | $1,191.50 | $1,191.50 | $301.96–$355.16 | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 US Scrotum (Contents) w/ Doppler if ind | $849.75 | $849.75 | $228.24–$747.78 | 12% above | — |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum (Contents) w/ Doppler if ind | $849.75 | $849.75 | $228.24–$747.78 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue | $613.50 | $613.50 | $156.93–$539.88 | 11% below | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue | $613.50 | $613.50 | $156.93–$539.88 | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI Including Esophagus | $565.25 | $565.25 | $152.62 | 28% below | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI | $565.25 | $565.25 | $152.62 | 28% below | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Small Bowel | $565.25 | $565.25 | $152.62 | 28% below | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI Including Esophagus | $565.25 | $565.25 | $152.62 | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Small Bowel | $565.25 | $565.25 | $152.62 | — | — |
| Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI | $565.25 | $565.25 | $152.62 | — | — |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 XR Humerus Bilat | $688.50 | $688.50 | $118.35–$458.54 | — | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Left | $466.00 | $466.00 | $118.35–$458.54 | 49% above | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 XR Humerus Right | $466.00 | $466.00 | $118.35–$458.54 | 49% above | — |
| Upper arm X-ray (humerus), 2 views inpatient both sides CPT 73060 XR Humerus Bilat | $688.50 | $688.50 | $118.35–$458.54 | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Left | $466.00 | $466.00 | $118.35–$458.54 | — | — |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR Humerus Right | $466.00 | $466.00 | $118.35–$458.54 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left | $998.50 | $998.50 | $230.51–$878.68 | 31% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left | $998.50 | $998.50 | $230.51–$878.68 | 31% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right | $998.50 | $998.50 | $230.51–$878.68 | 31% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right | $998.50 | $998.50 | $230.51–$878.68 | 31% above | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left | $998.50 | $998.50 | $230.51–$878.68 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left | $998.50 | $998.50 | $230.51–$878.68 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right | $998.50 | $998.50 | $230.51–$878.68 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right | $998.50 | $998.50 | $230.51–$878.68 | — | — |
| Wrist X-ray, 2 views both sides CPT 73100 XR Wrist 1 View On One Film Bilateral | $405.25 | $405.25 | $81.19–$356.62 | — | — |
| Wrist X-ray, 2 views both sides CPT 73100 XR Wrist 2 Views Bilateral | $405.25 | $405.25 | $81.19–$356.62 | — | — |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Right | $302.25 | $302.25 | $81.19–$356.62 | 9% above | — |
| Wrist X-ray, 2 views one side CPT 73100 XR Wrist 2 Views Left | $524.50 | $524.50 | $81.19–$356.62 | 88% above | — |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 XR Wrist 2 Views Bilateral | $405.25 | $405.25 | $81.19–$356.62 | — | — |
| Wrist X-ray, 2 views inpatient both sides CPT 73100 XR Wrist 1 View On One Film Bilateral | $405.25 | $405.25 | $81.19–$356.62 | — | — |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Right | $302.25 | $302.25 | $81.19–$356.62 | — | — |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR Wrist 2 Views Left | $524.50 | $524.50 | $81.19–$356.62 | — | — |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral | $900.50 | $900.50 | $44.42–$398.64 | — | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left | $453.00 | $453.00 | $44.42–$398.64 | 36% above | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Right | $453.00 | $453.00 | $44.42–$398.64 | 36% above | — |
| Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral | $900.50 | $900.50 | $44.42–$398.64 | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left | $453.00 | $453.00 | $44.42–$398.64 | — | — |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Right | $453.00 | $453.00 | $44.42–$398.64 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left | $445.25 | $445.25 | $59.22–$495.63 | 44% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right | $445.25 | $445.25 | $59.22–$495.63 | 44% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Left | $505.75 | $505.75 | $59.22–$495.63 | 63% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Right | $505.75 | $505.75 | $59.22–$495.63 | 63% above | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right | $445.25 | $445.25 | $59.22–$495.63 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left | $445.25 | $445.25 | $59.22–$495.63 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Left | $505.75 | $505.75 | $59.22–$495.63 | — | — |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Right | $505.75 | $505.75 | $59.22–$495.63 | — | — |
| X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View | $423.75 | $423.75 | $108.38–$372.90 | 59% above | — |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View | $423.75 | $423.75 | $108.38–$372.90 | — | — |
| X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral | $601.75 | $601.75 | $59.22–$161.63 | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left | $346.50 | $346.50 | $59.22–$161.63 | 23% above | — |
| X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right | $346.50 | $346.50 | $59.22–$161.63 | 23% above | — |
| X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral | $601.75 | $601.75 | $59.22–$161.63 | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left | $346.50 | $346.50 | $59.22–$161.63 | — | — |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right | $346.50 | $346.50 | $59.22–$161.63 | — | — |
| X-ray of the finger(s), 2 or more views CPT 73140 Fingers minimum of 2 Views | $320.75 | $320.75 | $59.17–$282.26 | 21% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Left | $320.75 | $320.75 | $59.17–$282.26 | 21% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Right | $320.75 | $320.75 | $59.17–$282.26 | 21% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(1st Digit) 2+ Views Right | $320.75 | $320.75 | $59.17–$282.26 | 21% above | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(1st Digit) 2+ Views Left | $320.75 | $320.75 | $59.17–$282.26 | 21% above | — |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 Fingers minimum of 2 Views | $320.75 | $320.75 | $59.17–$282.26 | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(1st Digit) 2+ Views Right | $320.75 | $320.75 | $59.17–$282.26 | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Right | $320.75 | $320.75 | $59.17–$282.26 | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(1st Digit) 2+ Views Left | $320.75 | $320.75 | $59.17–$282.26 | — | — |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Left | $320.75 | $320.75 | $59.17–$282.26 | — | — |
| X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral | $610.00 | $610.00 | $106.03–$364.76 | — | — |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left | $414.50 | $414.50 | $106.03–$364.76 | 49% above | — |
| X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right | $414.50 | $414.50 | $106.03–$364.76 | 49% above | — |
| X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral | $610.00 | $610.00 | $106.03–$364.76 | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left | $414.50 | $414.50 | $106.03–$364.76 | — | — |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right | $414.50 | $414.50 | $106.03–$364.76 | — | — |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete 3+ Views Bilateral | $1,032.25 | $1,032.25 | $88.83–$455.84 | — | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Left | $518.00 | $518.00 | $88.83–$455.84 | 50% above | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Right | $518.00 | $518.00 | $88.83–$455.84 | 50% above | — |
| X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete 3+ Views Bilateral | $1,032.25 | $1,032.25 | $88.83–$455.84 | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Left | $518.00 | $518.00 | $88.83–$455.84 | — | — |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Right | $518.00 | $518.00 | $88.83–$455.84 | — | — |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete 3+ Views Bilateral | $1,016.00 | $1,016.00 | $88.83–$448.58 | — | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Right | $509.75 | $509.75 | $88.83–$448.58 | 46% above | — |
| X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Left | $509.75 | $509.75 | $88.83–$448.58 | 46% above | — |
| X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete 3+ Views Bilateral | $1,016.00 | $1,016.00 | $88.83–$448.58 | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Left | $509.75 | $509.75 | $88.83–$448.58 | — | — |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Right | $509.75 | $509.75 | $88.83–$448.58 | — | — |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $646.50 | $646.50 | $82.87–$285.12 | — | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left | $324.00 | $324.00 | $82.87–$285.12 | 8% above | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right | $324.00 | $324.00 | $82.87–$285.12 | 8% above | — |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral | $646.50 | $646.50 | $82.87–$285.12 | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left | $324.00 | $324.00 | $82.87–$285.12 | — | — |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right | $324.00 | $324.00 | $82.87–$285.12 | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $538.25 | $538.25 | $118.44–$473.66 | 19% above | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views | $538.25 | $538.25 | $118.44–$473.66 | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4plus Views | $674.25 | $674.25 | $118.35–$674.25 | 17% above | — |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4plus Views | $674.25 | $674.25 | $118.35–$674.25 | — | — |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views | $405.25 | $405.25 | $59.22–$108.85 | 7% above | — |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views | $405.25 | $405.25 | $59.22–$108.85 | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views | $485.25 | $485.25 | $335.41 | 60% above | — |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views | $485.25 | $485.25 | $335.41 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views | $628.50 | $628.50 | $118.44–$553.08 | 71% above | — |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views | $628.50 | $628.50 | $118.44–$553.08 | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views | $423.75 | $423.75 | $108.38–$372.90 | 21% above | — |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views | $423.75 | $423.75 | $108.38–$372.90 | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views | $501.50 | $501.50 | $59.22–$135.41 | 39% above | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views | $501.50 | $501.50 | $59.22–$135.41 | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ACTH, Plasma LC | $190.00 | $190.00 | $29.89–$167.20 | 3% below | — |
| ACTH blood test inpatient CPT 82024 ACTH, Plasma LC | $190.00 | $190.00 | $29.89–$167.20 | — | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 84460 N FIBRO | $79.25 | $79.25 | $21.43–$22.56 | 51% above | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase | $85.25 | $85.25 | $21.43–$22.56 | 62% above | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 84460 N FIBRO | $79.25 | $79.25 | $21.43–$22.56 | — | — |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 Alanine Aminotransferase | $85.25 | $85.25 | $21.43–$22.56 | — | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 84450 N FIBRO | $79.25 | $79.25 | $22.56 | 51% above | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase | $85.25 | $85.25 | $22.56 | 62% above | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 84450 N FIBRO | $79.25 | $79.25 | $22.56 | — | — |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 Aspartate Aminotransferase | $85.25 | $85.25 | $22.56 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis LC | $258.00 | $258.00 | $7.02–$252.84 | 1% below | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel (4) LC | $287.25 | $287.25 | $7.02–$252.84 | 10% above | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis LC | $258.00 | $258.00 | $7.02–$252.84 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Hepatitis Panel (4) LC | $287.25 | $287.25 | $7.02–$252.84 | — | — |
| Aldosterone blood test CPT 82088 82088 Component | $329.00 | $329.00 | $59.78–$298.54 | 106% above | — |
| Aldosterone blood test CPT 82088 Aldosterone LCMS, Serum LC | $356.25 | $356.25 | $59.78–$298.54 | 123% above | — |
| Aldosterone blood test inpatient CPT 82088 82088 Component | $329.00 | $329.00 | $59.78–$298.54 | — | — |
| Aldosterone blood test inpatient CPT 82088 Aldosterone LCMS, Serum LC | $356.25 | $356.25 | $59.78–$298.54 | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase | $40.75 | $40.75 | $9.24 | 18% below | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 84075 Component | $40.75 | $40.75 | $9.24 | 18% below | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 Alkaline Phosphatase | $40.75 | $40.75 | $9.24 | — | — |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 84075 Component | $40.75 | $40.75 | $9.24 | — | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 Area 8 | $12.50 | $12.50 | $0.52–$286.00 | 52% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F008-IgE Corn LC | $20.50 | $20.50 | $0.52–$286.00 | 21% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Aureobasidi Pullulans LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Common Silver Birch LC 602936 | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Epicoccum Purpur LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 M009-IgE Fusarium proliferatum LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 W010-IgE Lamb's Quarters LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Plantain, English LC 602536 | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 W018-IgE Sheep Sorrel LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Setomelanomma Rostrata LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 Wormwood LC | $25.75 | $25.75 | $0.52–$286.00 | 1% below | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 BASIC FOOD | $27.25 | $27.25 | $0.52–$286.00 | 5% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F340-IgE Carmine Red Dye LC | $35.00 | $35.00 | $0.52–$286.00 | 35% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 CITRUS | $35.00 | $35.00 | $0.52–$286.00 | 35% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F220-IgE Cinnamon LC | $35.00 | $35.00 | $0.52–$286.00 | 35% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F013-IgE Peanut LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 E005-IgE Dog Dander LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Peanut w/Component Reflex LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F203-IgE Pistachio Nut LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F202-IgE Cashew Nut LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 W003-IgE Ragweed, Giant LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 F256-IgE Walnut LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 86003 FOOD | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 G006-IgE Timothy Grass LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen CPT 86003 IgE Milk w/ Component Reflex LC | $57.50 | $57.50 | $0.52–$286.00 | 121% above | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 Area 8 | $12.50 | $12.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F008-IgE Corn LC | $20.50 | $20.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Setomelanomma Rostrata LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Epicoccum Purpur LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W010-IgE Lamb's Quarters LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common Silver Birch LC 602936 | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 M009-IgE Fusarium proliferatum LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Plantain, English LC 602536 | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aureobasidi Pullulans LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Wormwood LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W018-IgE Sheep Sorrel LC | $25.75 | $25.75 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 BASIC FOOD | $27.25 | $27.25 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F220-IgE Cinnamon LC | $35.00 | $35.00 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F340-IgE Carmine Red Dye LC | $35.00 | $35.00 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 CITRUS | $35.00 | $35.00 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F256-IgE Walnut LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 W003-IgE Ragweed, Giant LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 E005-IgE Dog Dander LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Milk w/ Component Reflex LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F013-IgE Peanut LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F202-IgE Cashew Nut LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 G006-IgE Timothy Grass LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 86003 FOOD | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 F203-IgE Pistachio Nut LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IgE Peanut w/Component Reflex LC | $57.50 | $57.50 | $0.52–$286.00 | — | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 AFP, Serum, Tumor Marker LC | $241.00 | $241.00 | $20.45–$221.27 | 114% above | — |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP, Serum, Tumor Marker LC | $241.00 | $241.00 | $20.45–$221.27 | — | — |
| Ammonia blood test CPT 82140 82140 Litho 24 LC | $28.25 | $28.25 | $20.45–$184.24 | 73% below | — |
| Ammonia blood test CPT 82140 82140 24 HR | $64.00 | $64.00 | $20.45–$184.24 | 40% below | — |
| Ammonia blood test CPT 82140 Ammonia LC | $188.00 | $188.00 | $20.45–$184.24 | 77% above | — |
| Ammonia blood test inpatient CPT 82140 82140 Litho 24 LC | $28.25 | $28.25 | $20.45–$184.24 | — | — |
| Ammonia blood test inpatient CPT 82140 82140 24 HR | $64.00 | $64.00 | $20.45–$184.24 | — | — |
| Ammonia blood test inpatient CPT 82140 Ammonia LC | $188.00 | $188.00 | $20.45–$184.24 | — | — |
| Amylase blood test CPT 82150 Amylase Level | $260.25 | $260.25 | $9.23–$255.04 | 218% above | — |
| Amylase blood test inpatient CPT 82150 Amylase Level | $260.25 | $260.25 | $9.23–$255.04 | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies IgG/IgA LC | $76.50 | $76.50 | $9.84 | 9% below | — |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies IgG/IgA LC | $76.50 | $76.50 | $9.84 | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies Direct LC | $48.75 | $48.75 | $9.84–$57.86 | 46% below | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Antinuclear Antibodies, IFA LC | $65.75 | $65.75 | $9.84–$57.86 | 27% below | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies Direct LC | $48.75 | $48.75 | $9.84–$57.86 | — | — |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Antinuclear Antibodies, IFA LC | $65.75 | $65.75 | $9.84–$57.86 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide | $257.25 | $257.25 | $48.13–$252.10 | 36% above | — |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide | $257.25 | $257.25 | $48.13–$252.10 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture Body Fluid SMH | $34.25 | $34.25 | $16.38–$195.14 | 62% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Body Fluid Culture Aer/Ana/GS LC | $52.50 | $52.50 | $16.38–$195.14 | 42% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Cult, Extended LC | $65.75 | $65.75 | $16.38–$195.14 | 27% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Tissue Culture Aerobe/Anaerobe LC | $65.75 | $65.75 | $16.38–$195.14 | 27% below | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Anaerobic and Aerobic Culture LC | $98.00 | $98.00 | $16.38–$195.14 | 9% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Ear Culture | $221.75 | $221.75 | $16.38–$195.14 | 146% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Wound Culture | $221.75 | $221.75 | $16.38–$195.14 | 146% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Sputum Culture | $221.75 | $221.75 | $16.38–$195.14 | 146% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Nasal Culture | $221.75 | $221.75 | $16.38–$195.14 | 146% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Genital Culture | $221.75 | $221.75 | $16.38–$195.14 | 146% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Eye Culture | $221.75 | $221.75 | $16.38–$195.14 | 146% above | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Culture Body Fluid SMH | $34.25 | $34.25 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Body Fluid Culture Aer/Ana/GS LC | $52.50 | $52.50 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Aerobic Cult, Extended LC | $65.75 | $65.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Tissue Culture Aerobe/Anaerobe LC | $65.75 | $65.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Anaerobic and Aerobic Culture LC | $98.00 | $98.00 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Ear Culture | $221.75 | $221.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Nasal Culture | $221.75 | $221.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Sputum Culture | $221.75 | $221.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Wound Culture | $221.75 | $221.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Genital Culture | $221.75 | $221.75 | $16.38–$195.14 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Eye Culture | $221.75 | $221.75 | $16.38–$195.14 | — | — |
| Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel | $223.50 | $223.50 | $15.45–$221.53 | 74% above | — |
| Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel | $223.50 | $223.50 | $15.45–$221.53 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATHOLOGY Add On | $186.75 | $186.75 | $47.04–$164.34 | 22% below | — |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATHOLOGY Add On | $186.75 | $186.75 | $47.04–$164.34 | — | — |
| Blood culture for bacteria CPT 87040 Blood Culture | $257.25 | $257.25 | $9.01–$257.25 | 67% above | — |
| Blood culture for bacteria inpatient CPT 87040 Blood Culture | $257.25 | $257.25 | $9.01–$257.25 | — | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 36415 ONC-VENIPUNCTURE CHARGE | $22.75 | $22.75 | $5.76–$30.13 | 3% below | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Only Phlebotomy | $27.25 | $27.25 | $5.76–$30.13 | 16% above | — |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw | $30.75 | $30.75 | $5.76–$30.13 | 31% above | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 36415 ONC-VENIPUNCTURE CHARGE | $22.75 | $22.75 | $5.76–$30.13 | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Bill Only Phlebotomy | $27.25 | $27.25 | $5.76–$30.13 | — | — |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw | $30.75 | $30.75 | $5.76–$30.13 | — | — |
| Blood glucose (sugar) test CPT 82947 82947 N FIBRO | $79.25 | $79.25 | $9.23–$103.62 | 75% above | — |
| Blood glucose (sugar) test CPT 82947 Glucose Level | $117.75 | $117.75 | $9.23–$103.62 | 159% above | — |
| Blood glucose (sugar) test inpatient CPT 82947 82947 N FIBRO | $79.25 | $79.25 | $9.23–$103.62 | — | — |
| Blood glucose (sugar) test inpatient CPT 82947 Glucose Level | $117.75 | $117.75 | $9.23–$103.62 | — | — |
| Blood lead test CPT 83655 Lead, Blood (Pediatric) LC | $102.50 | $102.50 | $21.05–$90.20 | 83% above | — |
| Blood lead test CPT 83655 Lead, Blood (Adult) LC | $102.50 | $102.50 | $21.05–$90.20 | 83% above | — |
| Blood lead test inpatient CPT 83655 Lead, Blood (Adult) LC | $102.50 | $102.50 | $21.05–$90.20 | — | — |
| Blood lead test inpatient CPT 83655 Lead, Blood (Pediatric) LC | $102.50 | $102.50 | $21.05–$90.20 | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Test Serum Qual | $221.25 | $221.25 | $9.23–$194.70 | 143% above | — |
| Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 Pregnancy Test Serum Qual | $221.25 | $221.25 | $9.23–$194.70 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 86900 PRENATAL PROFILE | $18.50 | $18.50 | $3.79–$57.86 | 78% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Bill Only ABO/Rh | $66.00 | $66.00 | $3.79–$57.86 | 22% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .Pre TR ABO/Rh | $69.25 | $69.25 | $3.79–$57.86 | 18% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh | $69.25 | $69.25 | $3.79–$57.86 | 18% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Only | $69.25 | $69.25 | $3.79–$57.86 | 18% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .Post TR ABO/Rh | $69.25 | $69.25 | $3.79–$57.86 | 18% below | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 86900 PRENATAL PROFILE | $18.50 | $18.50 | $3.79–$57.86 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Bill Only ABO/Rh | $66.00 | $66.00 | $3.79–$57.86 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .Post TR ABO/Rh | $69.25 | $69.25 | $3.79–$57.86 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .Pre TR ABO/Rh | $69.25 | $69.25 | $3.79–$57.86 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Only | $69.25 | $69.25 | $3.79–$57.86 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh | $69.25 | $69.25 | $3.79–$57.86 | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 BUN | $84.00 | $84.00 | $4.62–$78.40 | 62% above | — |
| Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen | $84.00 | $84.00 | $4.62–$78.40 | 62% above | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN | $84.00 | $84.00 | $4.62–$78.40 | — | — |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 Blood Urea Nitrogen | $84.00 | $84.00 | $4.62–$78.40 | — | — |
| C-peptide blood test CPT 84681 C-Peptide, Serum LC | $223.25 | $223.25 | $20.45 | 115% above | — |
| C-peptide blood test inpatient CPT 84681 C-Peptide, Serum LC | $223.25 | $223.25 | $20.45 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein | $95.75 | $95.75 | $9.84–$89.54 | 30% above | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein | $95.75 | $95.75 | $9.84–$89.54 | — | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium difficile Amplification | $257.25 | $257.25 | $36.65–$226.38 | 40% above | — |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Clostridium difficile Amplification | $257.25 | $257.25 | $36.65–$226.38 | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 in the Presence of HAMA LC | $337.25 | $337.25 | $19.69–$296.78 | 109% above | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen (CA) 125 LC | $337.25 | $337.25 | $19.69–$296.78 | 109% above | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 in the Presence of HAMA LC | $337.25 | $337.25 | $19.69–$296.78 | — | — |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen (CA) 125 LC | $337.25 | $337.25 | $19.69–$296.78 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2/RSV (SpotFire)-87635 | $157.50 | $157.50 | $198.25 | 36% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 (COVID-19) (Accula) | $218.75 | $218.75 | $198.25 | 89% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Coronavirus SARS COV 2 PCR SMH | $218.75 | $218.75 | $198.25 | 89% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 2019 Novel Coronavirus (CoVID-19), NAA LC | $218.75 | $218.75 | $198.25 | 89% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2, NAA LC | $218.75 | $218.75 | $198.25 | 89% above | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2/RSV (SpotFire)-87635 | $157.50 | $157.50 | $198.25 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2, NAA LC | $218.75 | $218.75 | $198.25 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 (COVID-19) (Accula) | $218.75 | $218.75 | $198.25 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Coronavirus SARS COV 2 PCR SMH | $218.75 | $218.75 | $198.25 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 2019 Novel Coronavirus (CoVID-19), NAA LC | $218.75 | $218.75 | $198.25 | — | — |
| Calcium blood test, total CPT 82310 Calcium Level Total | $151.50 | $151.50 | $9.24 | 234% above | — |
| Calcium blood test, total inpatient CPT 82310 Calcium Level Total | $151.50 | $151.50 | $9.24 | — | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 CEA LC | $245.75 | $245.75 | $20.43–$216.26 | 74% above | — |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA LC | $245.75 | $245.75 | $20.43–$216.26 | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster V Ab, IgG LC | $80.25 | $80.25 | $9.84 | 8% above | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-Zoster Ab, IgM Qualitative LC | $264.50 | $264.50 | $9.84 | 255% above | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster V Ab, IgG LC | $80.25 | $80.25 | $9.84 | — | — |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 Varicella-Zoster Ab, IgM Qualitative LC | $264.50 | $264.50 | $9.84 | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CT, NG, Trich Vag by NAA LC | $63.00 | $63.00 | $17.29–$72.82 | 49% below | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Component | $82.75 | $82.75 | $17.29–$72.82 | 33% below | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis, NAA LC | $404.25 | $404.25 | $17.29–$72.82 | 227% above | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CT, NG, Trich Vag by NAA LC | $63.00 | $63.00 | $17.29–$72.82 | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 87491 Component | $82.75 | $82.75 | $17.29–$72.82 | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis, NAA LC | $404.25 | $404.25 | $17.29–$72.82 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel | $241.00 | $241.00 | $7.72–$241.00 | 87% above | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel w/Direct LDL | $241.00 | $241.00 | $7.72–$241.00 | 87% above | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel w/Direct LDL | $241.00 | $241.00 | $7.72–$241.00 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $241.00 | $241.00 | $7.72–$241.00 | — | — |
| Complete blood count (CBC) with differential CPT 85025 85025 PRENATAL PROFILE | $47.00 | $47.00 | $10.15–$179.25 | 40% below | — |
| Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential | $179.25 | $179.25 | $10.15–$179.25 | 129% above | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 85025 PRENATAL PROFILE | $47.00 | $47.00 | $10.15–$179.25 | — | — |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential | $179.25 | $179.25 | $10.15–$179.25 | — | — |
| Complete blood count (CBC), no differential CPT 85027 CBC w/ Manual Differential | $134.25 | $134.25 | $10.15–$98.41 | 106% above | — |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC w/ Manual Differential | $134.25 | $134.25 | $10.15–$98.41 | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel | $344.50 | $344.50 | $15.45–$337.61 | 116% above | — |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel | $344.50 | $344.50 | $15.45–$337.61 | — | — |
| Cortisol blood test, total CPT 82533 Cortisol LC | $80.25 | $80.25 | $11.28–$72.75 | 27% below | — |
| Cortisol blood test, total CPT 82533 Cortisol - AM LC | $99.25 | $99.25 | $11.28–$72.75 | 10% below | — |
| Cortisol blood test, total CPT 82533 Cortisol Dexamethasone Reflex LC | $159.00 | $159.00 | $11.28–$72.75 | 45% above | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol LC | $80.25 | $80.25 | $11.28–$72.75 | — | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol - AM LC | $99.25 | $99.25 | $11.28–$72.75 | — | — |
| Cortisol blood test, total inpatient CPT 82533 Cortisol Dexamethasone Reflex LC | $159.00 | $159.00 | $11.28–$72.75 | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 82550 Component | $62.50 | $62.50 | $9.23–$147.24 | 2% above | — |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase | $150.25 | $150.25 | $9.23–$147.24 | 144% above | — |
| Creatine kinase (CK) blood test, total CPT 82550 82550 CPK TOTAL | $150.25 | $150.25 | $9.23–$147.24 | 144% above | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 82550 Component | $62.50 | $62.50 | $9.23–$147.24 | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 82550 CPK TOTAL | $150.25 | $150.25 | $9.23–$147.24 | — | — |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $150.25 | $150.25 | $9.23–$147.24 | — | — |
| Creatinine blood test CPT 82565 CREATININE | $91.25 | $91.25 | $9.23–$90.12 | 82% above | — |
| Creatinine blood test CPT 82565 Creatinine | $91.25 | $91.25 | $9.23–$90.12 | 82% above | — |
| Creatinine blood test inpatient CPT 82565 Creatinine | $91.25 | $91.25 | $9.23–$90.12 | — | — |
| Creatinine blood test inpatient CPT 82565 CREATININE | $91.25 | $91.25 | $9.23–$90.12 | — | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 Bill Only CMV | $81.00 | $81.00 | $9.84 | 5% below | — |
| Cytomegalovirus (CMV) antibody test CPT 86644 86644 Component | $214.00 | $214.00 | $9.84 | 152% above | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Bill Only CMV | $81.00 | $81.00 | $9.84 | — | — |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 86644 Component | $214.00 | $214.00 | $9.84 | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 D Dimer | $135.75 | $135.75 | $7.57–$129.25 | 13% above | — |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer | $135.75 | $135.75 | $7.57–$129.25 | — | — |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-Sulfate LC | $133.25 | $133.25 | $11.28–$97.67 | 24% above | — |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-Sulfate LC | $133.25 | $133.25 | $11.28–$97.67 | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Screen, Urine LC | $41.75 | $41.75 | $13.23–$119.35 | 57% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 80307 Component | $62.00 | $62.00 | $13.23–$119.35 | 36% below | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Synthetic Cannabinoids,Scr,Ur LC | $231.00 | $231.00 | $13.23–$119.35 | 137% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Screen 8 w/Conf, WB LC | $330.75 | $330.75 | $13.23–$119.35 | 239% above | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 12+Oxycodone+Crt-Unbund LC | $479.75 | $479.75 | $13.23–$119.35 | 392% above | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Methadone Screen, Urine LC | $41.75 | $41.75 | $13.23–$119.35 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 80307 Component | $62.00 | $62.00 | $13.23–$119.35 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Synthetic Cannabinoids,Scr,Ur LC | $231.00 | $231.00 | $13.23–$119.35 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen 8 w/Conf, WB LC | $330.75 | $330.75 | $13.23–$119.35 | — | — |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 12+Oxycodone+Crt-Unbund LC | $479.75 | $479.75 | $13.23–$119.35 | — | — |
| Epstein-Barr virus (EBV) antibody test CPT 86665 86665 Component | $107.50 | $107.50 | $4.92 | 1% below | — |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 86665 Component | $107.50 | $107.50 | $4.92 | — | — |
| Estradiol blood test CPT 82670 Estradiol LC | $75.00 | $75.00 | $11.28–$66.00 | 29% below | — |
| Estradiol blood test inpatient CPT 82670 Estradiol LC | $75.00 | $75.00 | $11.28–$66.00 | — | — |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH, Serum LC | $298.25 | $298.25 | $11.28–$262.46 | 152% above | — |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH, Serum LC | $298.25 | $298.25 | $11.28–$262.46 | — | — |
| Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin, Fecal LC | $389.00 | $389.00 | $20.45–$293.18 | 124% above | — |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin, Fecal LC | $389.00 | $389.00 | $20.45–$293.18 | — | — |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $80.00 | $80.00 | $10.22–$78.40 | 40% below | — |
| Ferritin blood test (iron stores) CPT 82728 82728 Anemia Panel | $80.00 | $80.00 | $10.22–$78.40 | 40% below | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin | $80.00 | $80.00 | $10.22–$78.40 | — | — |
| Ferritin blood test (iron stores) inpatient CPT 82728 82728 Anemia Panel | $80.00 | $80.00 | $10.22–$78.40 | — | — |
| Folate (folic acid) blood test CPT 82746 Folate Level | $90.00 | $90.00 | $20.45–$88.20 | 20% below | — |
| Folate (folic acid) blood test CPT 82746 82746 Anemia Panel | $90.00 | $90.00 | $20.45–$88.20 | 20% below | — |
| Folate (folic acid) blood test inpatient CPT 82746 82746 Anemia Panel | $90.00 | $90.00 | $20.45–$88.20 | — | — |
| Folate (folic acid) blood test inpatient CPT 82746 Folate Level | $90.00 | $90.00 | $20.45–$88.20 | — | — |
| Free T3 thyroid hormone test CPT 84481 T3 Free | $176.25 | $176.25 | $11.28–$155.10 | 47% above | — |
| Free T3 thyroid hormone test inpatient CPT 84481 T3 Free | $176.25 | $176.25 | $11.28–$155.10 | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level | $176.25 | $176.25 | $11.27–$172.72 | 51% above | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 by Dialysis/Mass Spec LC | $266.25 | $266.25 | $11.27–$172.72 | 129% above | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level | $176.25 | $176.25 | $11.27–$172.72 | — | — |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 by Dialysis/Mass Spec LC | $266.25 | $266.25 | $11.27–$172.72 | — | — |
| Free testosterone test CPT 84402 84402 Component | $99.25 | $99.25 | $11.27–$87.34 | 19% below | — |
| Free testosterone test CPT 84402 Testosterone, Free, Direct LC | $99.25 | $99.25 | $11.27–$87.34 | 19% below | — |
| Free testosterone test inpatient CPT 84402 Testosterone, Free, Direct LC | $99.25 | $99.25 | $11.27–$87.34 | — | — |
| Free testosterone test inpatient CPT 84402 84402 Component | $99.25 | $99.25 | $11.27–$87.34 | — | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase | $229.25 | $229.25 | $9.23–$201.74 | 293% above | — |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Gamma Glutamyl Transferase | $229.25 | $229.25 | $9.23–$201.74 | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 LC | $63.00 | $63.00 | $17.29–$73.30 | 49% below | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Component | $82.75 | $82.75 | $17.29–$73.30 | 33% below | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 LC | $63.00 | $63.00 | $17.29–$73.30 | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 87591 Component | $82.75 | $82.75 | $17.29–$73.30 | — | — |
| H. pylori stool antigen test CPT 87338 H. pylori Stool Ag, EIA LC | $103.25 | $103.25 | $18.02–$90.86 | 11% below | — |
| H. pylori stool antigen test inpatient CPT 87338 H. pylori Stool Ag, EIA LC | $103.25 | $103.25 | $18.02–$90.86 | — | — |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 RNA, Real Time PCR (Non-Graph) LC | $438.25 | $438.25 | $73.30–$122.34 | 29% above | — |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 RNA, Real Time PCR (Non-Graph) LC | $438.25 | $438.25 | $73.30–$122.34 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 87389 PRENATAL PROFILE | $65.25 | $65.25 | $9.01–$87.34 | 42% below | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab Combo 1/2 Screen | $99.25 | $99.25 | $9.01–$87.34 | 12% below | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV Ag/Ab w/ Reflex to Conf LC | $144.25 | $144.25 | $9.01–$87.34 | 28% above | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 87389 PRENATAL PROFILE | $65.25 | $65.25 | $9.01–$87.34 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab Combo 1/2 Screen | $99.25 | $99.25 | $9.01–$87.34 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV Ag/Ab w/ Reflex to Conf LC | $144.25 | $144.25 | $9.01–$87.34 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c w/eAG | $130.00 | $130.00 | $4.62–$114.40 | 46% above | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c w/eAG | $130.00 | $130.00 | $4.62–$114.40 | — | — |
| Hemoglobin blood test CPT 85018 Hemoglobin | $35.50 | $35.50 | $5.07–$24.50 | 11% above | — |
| Hemoglobin blood test CPT 85018 Hemoglobin and Hematocrit | $35.50 | $35.50 | $5.07–$24.50 | 11% above | — |
| Hemoglobin blood test CPT 85018 85018 CO OX HEMOGLOBIN | $58.75 | $58.75 | $10.14–$55.75 | 84% above | — |
| Hemoglobin blood test CPT 85018 85018 CO OX HEMOGLOBIN CHARGE | $58.75 | $58.75 | $10.14–$55.75 | 84% above | — |
| Hemoglobin blood test CPT 85018 CO OX HEMOGLOBIN | $58.75 | $58.75 | $10.14–$55.75 | 84% above | — |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin | $35.50 | $35.50 | $5.07–$24.50 | — | — |
| Hemoglobin blood test inpatient CPT 85018 Hemoglobin and Hematocrit | $35.50 | $35.50 | $5.07–$24.50 | — | — |
| Hemoglobin blood test inpatient CPT 85018 CO OX HEMOGLOBIN | $58.75 | $58.75 | $10.14–$55.75 | — | — |
| Hemoglobin blood test inpatient CPT 85018 85018 CO OX HEMOGLOBIN CHARGE | $58.75 | $58.75 | $10.14–$55.75 | — | — |
| Hemoglobin blood test inpatient CPT 85018 85018 CO OX HEMOGLOBIN | $58.75 | $58.75 | $10.14–$55.75 | — | — |
| Hepatitis B core antibody test (total) CPT 86704 Hep B Core Ab, Tot LC | $79.50 | $79.50 | $9.84 | 2% above | — |
| Hepatitis B core antibody test (total) inpatient CPT 86704 Hep B Core Ab, Tot LC | $79.50 | $79.50 | $9.84 | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hep B Surface Ab, Qual. LC | $135.75 | $135.75 | $9.84–$119.46 | 45% above | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hep B Surface Ab, Qual. LC | $135.75 | $135.75 | $9.84–$119.46 | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 87340 PRENATAL PROFILE | $62.50 | $62.50 | $9.01–$18.02 | 30% below | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HBsAg Screen LC | $197.50 | $197.50 | $9.01–$18.02 | 122% above | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 87340 PRENATAL PROFILE | $62.50 | $62.50 | $9.01–$18.02 | — | — |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBsAg Screen LC | $197.50 | $197.50 | $9.01–$18.02 | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 86803 PRENATAL PROFILE | $65.25 | $65.25 | $9.84–$43.70 | 42% below | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody LC | $159.25 | $159.25 | $9.84–$43.70 | 42% above | — |
| Hepatitis C antibody blood test (screening) CPT 86803 HCV Antibody RFX to Quant PCR LC | $159.25 | $159.25 | $9.84–$43.70 | 42% above | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 86803 PRENATAL PROFILE | $65.25 | $65.25 | $9.84–$43.70 | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody LC | $159.25 | $159.25 | $9.84–$43.70 | — | — |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV Antibody RFX to Quant PCR LC | $159.25 | $159.25 | $9.84–$43.70 | — | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 .HCV Real-Time PCR Qn LC | $232.50 | $232.50 | $63.80–$73.30 | 12% below | — |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) LC | $232.50 | $232.50 | $63.80–$73.30 | 12% below | — |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR, Quant (Graph) LC | $232.50 | $232.50 | $63.80–$73.30 | 12% below | — |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 .HCV Real-Time PCR Qn LC | $232.50 | $232.50 | $63.80–$73.30 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 .HCV RT-PCR, Quant (Non-Graph) LC | $232.50 | $232.50 | $63.80–$73.30 | — | — |
| Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR, Quant (Graph) LC | $232.50 | $232.50 | $63.80–$73.30 | — | — |
| Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 and 2 Ab, IgG 86695 | $80.25 | $80.25 | $8.95–$9.84 | 23% above | — |
| Herpes blood test, HSV-1 antibody CPT 86695 86695 Component | $101.25 | $101.25 | $8.95–$9.84 | 56% above | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 and 2 Ab, IgG 86695 | $80.25 | $80.25 | $8.95–$9.84 | — | — |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 86695 Component | $101.25 | $101.25 | $8.95–$9.84 | — | — |
| Herpes blood test, HSV-2 antibody CPT 86696 HSV 1 and 2 Ab, IgG 86696 | $80.25 | $80.25 | $8.95–$9.84 | at median | — |
| Herpes blood test, HSV-2 antibody CPT 86696 86696 Component | $101.25 | $101.25 | $8.95–$9.84 | 26% above | — |
| Herpes blood test, HSV-2 antibody CPT 86696 .HSV-2 IgG Supplemental LC | $134.75 | $134.75 | $8.95–$9.84 | 68% above | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 1 and 2 Ab, IgG 86696 | $80.25 | $80.25 | $8.95–$9.84 | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 86696 Component | $101.25 | $101.25 | $8.95–$9.84 | — | — |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 .HSV-2 IgG Supplemental LC | $134.75 | $134.75 | $8.95–$9.84 | — | — |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-Reactive Protein, Cardiac LC | $129.50 | $129.50 | $9.84–$113.96 | 40% above | — |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-Reactive Protein, Cardiac LC | $129.50 | $129.50 | $9.84–$113.96 | — | — |
| Insulin blood test CPT 83525 Insulin LC | $67.00 | $67.00 | $11.28–$58.96 | 8% below | — |
| Insulin blood test inpatient CPT 83525 Insulin LC | $67.00 | $67.00 | $11.28–$58.96 | — | — |
| Iron blood test (serum iron) CPT 83540 83540 Iron Panel | $65.00 | $65.00 | $4.62–$67.76 | 18% below | — |
| Iron blood test (serum iron) CPT 83540 83540 Anemia Panel | $65.00 | $65.00 | $4.62–$67.76 | 18% below | — |
| Iron blood test (serum iron) CPT 83540 Iron Level | $113.75 | $113.75 | $4.62–$67.76 | 44% above | — |
| Iron blood test (serum iron) inpatient CPT 83540 83540 Anemia Panel | $65.00 | $65.00 | $4.62–$67.76 | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 83540 Iron Panel | $65.00 | $65.00 | $4.62–$67.76 | — | — |
| Iron blood test (serum iron) inpatient CPT 83540 Iron Level | $113.75 | $113.75 | $4.62–$67.76 | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 83550 Anemia Panel | $75.00 | $75.00 | $4.62–$75.46 | at median | — |
| Iron-binding capacity (TIBC) test CPT 83550 83550 Iron Panel | $75.00 | $75.00 | $4.62–$75.46 | at median | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 Anemia Panel | $75.00 | $75.00 | $4.62–$75.46 | — | — |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 83550 Iron Panel | $75.00 | $75.00 | $4.62–$75.46 | — | — |
| Kidney function blood test panel CPT 80069 Renal Function Panel | $257.25 | $257.25 | $15.45–$252.10 | 73% above | — |
| Kidney function blood test panel inpatient CPT 80069 Renal Function Panel | $257.25 | $257.25 | $15.45–$252.10 | — | — |
| LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone(LH), S LC | $312.75 | $312.75 | $13.65–$275.22 | 172% above | — |
| LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone(LH), S LC | $312.75 | $312.75 | $13.65–$275.22 | — | — |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid | $260.25 | $260.25 | $20.43–$260.25 | 190% above | — |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $260.25 | $260.25 | $20.43–$260.25 | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LDH Body Fluid SMH | $34.25 | $34.25 | $9.23–$78.71 | 40% below | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase | $79.50 | $79.50 | $9.23–$78.71 | 38% above | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH Body Fluid SMH | $34.25 | $34.25 | $9.23–$78.71 | — | — |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Lactate Dehydrogenase | $79.50 | $79.50 | $9.23–$78.71 | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level | $155.00 | $155.00 | $4.62–$151.90 | 66% above | — |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level | $155.00 | $155.00 | $4.62–$151.90 | — | — |
| Liver function blood test panel CPT 80076 Hepatic Function Panel | $232.50 | $232.50 | $7.72–$204.60 | 68% above | — |
| Liver function blood test panel inpatient CPT 80076 Hepatic Function Panel | $232.50 | $232.50 | $7.72–$204.60 | — | — |
| Lyme disease antibody test CPT 86618 .Lyme IgG/IgM LC | $58.25 | $58.25 | $9.84–$64.50 | 20% below | — |
| Lyme disease antibody test CPT 86618 Lyme Disease Serology w/Reflex LC | $88.00 | $88.00 | $9.84–$64.50 | 21% above | — |
| Lyme disease antibody test CPT 86618 86618 Component | $188.75 | $188.75 | $9.84–$64.50 | 160% above | — |
| Lyme disease antibody test inpatient CPT 86618 .Lyme IgG/IgM LC | $58.25 | $58.25 | $9.84–$64.50 | — | — |
| Lyme disease antibody test inpatient CPT 86618 Lyme Disease Serology w/Reflex LC | $88.00 | $88.00 | $9.84–$64.50 | — | — |
| Lyme disease antibody test inpatient CPT 86618 86618 Component | $188.75 | $188.75 | $9.84–$64.50 | — | — |
| Magnesium blood test CPT 83735 83735 Litho 24 LC | $28.25 | $28.25 | $4.62–$132.79 | 60% below | — |
| Magnesium blood test CPT 83735 83735 24 HR | $33.25 | $33.25 | $4.62–$132.79 | 53% below | — |
| Magnesium blood test CPT 83735 Magnesium, Urine LC | $36.75 | $36.75 | $4.62–$132.79 | 48% below | — |
| Magnesium blood test CPT 83735 Magnesium Level | $135.50 | $135.50 | $4.62–$132.79 | 93% above | — |
| Magnesium blood test inpatient CPT 83735 83735 Litho 24 LC | $28.25 | $28.25 | $4.62–$132.79 | — | — |
| Magnesium blood test inpatient CPT 83735 83735 24 HR | $33.25 | $33.25 | $4.62–$132.79 | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium, Urine LC | $36.75 | $36.75 | $4.62–$132.79 | — | — |
| Magnesium blood test inpatient CPT 83735 Magnesium Level | $135.50 | $135.50 | $4.62–$132.79 | — | — |
| Measles (rubeola) antibody test CPT 86765 86765 Component | $52.25 | $52.25 | $45.32 | 28% below | — |
| Measles (rubeola) antibody test CPT 86765 Rubeola Antibodies, IgG LC | $267.25 | $267.25 | $45.32 | 269% above | — |
| Measles (rubeola) antibody test inpatient CPT 86765 86765 Component | $52.25 | $52.25 | $45.32 | — | — |
| Measles (rubeola) antibody test inpatient CPT 86765 Rubeola Antibodies, IgG LC | $267.25 | $267.25 | $45.32 | — | — |
| Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen | $196.00 | $196.00 | $5.08–$172.48 | 142% above | — |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen | $196.00 | $196.00 | $5.08–$172.48 | — | — |
| PSA (prostate-specific antigen) blood test, free CPT 84154 84154 Component | $83.50 | $83.50 | $10.22–$22.91 | 10% below | — |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 84154 Component | $83.50 | $83.50 | $10.22–$22.91 | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic | $171.75 | $171.75 | $20.45–$151.14 | 51% above | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 84153 Component | $192.50 | $192.50 | $20.45–$151.14 | 70% above | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic | $171.75 | $171.75 | $20.45–$151.14 | — | — |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 84153 Component | $192.50 | $192.50 | $20.45–$151.14 | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 PTH, Intact LC | $232.50 | $232.50 | $59.82–$216.82 | 7% above | — |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH, Intact LC | $232.50 | $232.50 | $59.82–$216.82 | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PT/ PTT | $84.50 | $84.50 | $3.79–$82.81 | 21% above | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time | $84.50 | $84.50 | $3.79–$82.81 | 21% above | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time | $84.50 | $84.50 | $3.79–$82.81 | — | — |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PT/ PTT | $84.50 | $84.50 | $3.79–$82.81 | — | — |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level | $221.75 | $221.75 | $9.24–$195.14 | 255% above | — |
| Phosphorus (phosphate) blood test inpatient CPT 84100 Phosphorus Level | $221.75 | $221.75 | $9.24–$195.14 | — | — |
| Potassium blood test CPT 84132 Potassium Level | $77.00 | $77.00 | $4.62–$19.69 | 72% above | — |
| Potassium blood test inpatient CPT 84132 Potassium Level | $77.00 | $77.00 | $4.62–$19.69 | — | — |
| Progesterone blood test CPT 84144 Progesterone LC | $302.25 | $302.25 | $22.57–$265.98 | 124% above | — |
| Progesterone blood test inpatient CPT 84144 Progesterone LC | $302.25 | $302.25 | $22.57–$265.98 | — | — |
| Prolactin blood test CPT 84146 Prolactin LC | $95.25 | $95.25 | $11.28–$83.82 | 25% below | — |
| Prolactin blood test inpatient CPT 84146 Prolactin LC | $95.25 | $95.25 | $11.28–$83.82 | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 85610 Protime | $87.00 | $87.00 | $7.57–$76.56 | 119% above | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR | $87.00 | $87.00 | $7.57–$76.56 | 119% above | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR | $87.00 | $87.00 | $7.57–$76.56 | — | — |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 85610 Protime | $87.00 | $87.00 | $7.57–$76.56 | — | — |
| Rapid flu test (influenza antigen) CPT 87804 Influenza A/B | $199.50 | $199.50 | $52.79–$53.87 | 154% above | — |
| Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A/B | $199.50 | $199.50 | $52.79–$53.87 | — | — |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 Strep A Screen | $84.50 | $84.50 | $9.01–$74.36 | 31% above | — |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Strep A Screen | $84.50 | $84.50 | $9.01–$74.36 | — | — |
| Renin blood test CPT 84244 84244 Component | $329.00 | $329.00 | $22.55–$321.20 | 192% above | — |
| Renin blood test CPT 84244 Renin Activity, Plasma LC | $383.25 | $383.25 | $22.55–$321.20 | 241% above | — |
| Renin blood test inpatient CPT 84244 84244 Component | $329.00 | $329.00 | $22.55–$321.20 | — | — |
| Renin blood test inpatient CPT 84244 Renin Activity, Plasma LC | $383.25 | $383.25 | $22.55–$321.20 | — | — |
| Rh blood typing CPT 86901 86901 PRENATAL PROFILE | $18.50 | $18.50 | $3.79–$52.36 | 73% below | — |
| Rh blood typing CPT 86901 BLOOD TYPING, RH | $62.50 | $62.50 | $3.79–$52.36 | 8% below | — |
| Rh blood typing CPT 86901 Rh Only | $62.50 | $62.50 | $3.79–$52.36 | 8% below | — |
| Rh blood typing inpatient CPT 86901 86901 PRENATAL PROFILE | $18.50 | $18.50 | $3.79–$52.36 | — | — |
| Rh blood typing inpatient CPT 86901 Rh Only | $62.50 | $62.50 | $3.79–$52.36 | — | — |
| Rh blood typing inpatient CPT 86901 BLOOD TYPING, RH | $62.50 | $62.50 | $3.79–$52.36 | — | — |
| Rheumatoid factor (RF) test CPT 86431 86431 Component | $83.50 | $83.50 | $9.84–$182.16 | 32% above | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis Factor LC | $207.00 | $207.00 | $9.84–$182.16 | 227% above | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 86431 Component | $83.50 | $83.50 | $9.84–$182.16 | — | — |
| Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Arthritis Factor LC | $207.00 | $207.00 | $9.84–$182.16 | — | — |
| Rubella antibody test (immunity check) CPT 86762 86762 Component | $52.25 | $52.25 | $19.69–$172.48 | 32% below | — |
| Rubella antibody test (immunity check) CPT 86762 86762 PRENATAL PROFILE | $86.50 | $86.50 | $19.69–$172.48 | 13% above | — |
| Rubella antibody test (immunity check) CPT 86762 Rubella Antibodies, IgG LC | $196.00 | $196.00 | $19.69–$172.48 | 157% above | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 86762 Component | $52.25 | $52.25 | $19.69–$172.48 | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 86762 PRENATAL PROFILE | $86.50 | $86.50 | $19.69–$172.48 | — | — |
| Rubella antibody test (immunity check) inpatient CPT 86762 Rubella Antibodies, IgG LC | $196.00 | $196.00 | $19.69–$172.48 | — | — |
| Stool ova and parasites exam CPT 87177 87177 Component | $144.25 | $144.25 | $9.01–$126.94 | 93% above | — |
| Stool ova and parasites exam inpatient CPT 87177 87177 Component | $144.25 | $144.25 | $9.01–$126.94 | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Screen 3 | $90.75 | $90.75 | $75.90 | 180% above | — |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 Occult Blood Screen 3 | $90.75 | $90.75 | $75.90 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 86592 PRENATAL PROFILE | $26.00 | $26.00 | $17.90–$68.42 | 49% below | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR, Rfx Qn RPR/Confirm TP LC | $81.75 | $81.75 | $17.90–$68.42 | 60% above | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 86592 PRENATAL PROFILE | $26.00 | $26.00 | $17.90–$68.42 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR, Rfx Qn RPR/Confirm TP LC | $81.75 | $81.75 | $17.90–$68.42 | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Plus(Client Incubated) LC | $85.25 | $85.25 | $21.77–$75.02 | 61% below | — |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Plus(Client Incubated) LC | $85.25 | $85.25 | $21.77–$75.02 | — | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Serum LC | $99.25 | $99.25 | $11.28–$99.25 | 21% below | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS LC | $99.25 | $99.25 | $11.28–$99.25 | 21% below | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 84403 Component | $99.25 | $99.25 | $11.28–$99.25 | 21% below | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 84403 Component | $99.25 | $99.25 | $11.28–$99.25 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Serum LC | $99.25 | $99.25 | $11.28–$99.25 | — | — |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total, Women, Children, and Hypogonadal Males, LC/MS-MS LC | $99.25 | $99.25 | $11.28–$99.25 | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $108.25 | $108.25 | $9.84–$162.36 | 35% above | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 86376 Component | $184.50 | $184.50 | $9.84–$162.36 | 131% above | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Ab LC | $108.25 | $108.25 | $9.84–$162.36 | — | — |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 86376 Component | $184.50 | $184.50 | $9.84–$162.36 | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone | $232.50 | $232.50 | $22.55–$228.55 | 82% above | — |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone | $232.50 | $232.50 | $22.55–$228.55 | — | — |
| Total IgE blood test CPT 82785 82785 Allergen Profile | $35.50 | $35.50 | $8.93–$65.58 | 58% below | — |
| Total IgE blood test CPT 82785 Immunoglobulin E, Total LC | $239.00 | $239.00 | $8.93–$65.58 | 181% above | — |
| Total IgE blood test CPT 82785 82785 Component | $239.00 | $239.00 | $8.93–$65.58 | 181% above | — |
| Total IgE blood test inpatient CPT 82785 82785 Allergen Profile | $35.50 | $35.50 | $8.93–$65.58 | — | — |
| Total IgE blood test inpatient CPT 82785 82785 Component | $239.00 | $239.00 | $8.93–$65.58 | — | — |
| Total IgE blood test inpatient CPT 82785 Immunoglobulin E, Total LC | $239.00 | $239.00 | $8.93–$65.58 | — | — |
| Total thyroxine (T4) blood test CPT 84436 Thyroxine (T4) LC | $25.50 | $25.50 | $6.42–$11.27 | 69% below | — |
| Total thyroxine (T4) blood test inpatient CPT 84436 Thyroxine (T4) LC | $25.50 | $25.50 | $6.42–$11.27 | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine (T3) LC | $160.75 | $160.75 | $11.27–$141.46 | 64% above | — |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 Triiodothyronine (T3) LC | $160.75 | $160.75 | $11.27–$141.46 | — | — |
| Transferrin blood test CPT 84466 Transferrin LC | $117.25 | $117.25 | $103.18 | 21% above | — |
| Transferrin blood test inpatient CPT 84466 Transferrin LC | $117.25 | $117.25 | $103.18 | — | — |
| Trichomonas test (NAAT) CPT 87661 87661 LC | $63.00 | $63.00 | $17.29–$52.80 | 49% below | — |
| Trichomonas test (NAAT) inpatient CPT 87661 87661 LC | $63.00 | $63.00 | $17.29–$52.80 | — | — |
| Troponin test, quantitative CPT 84484 84484 Troponin Quantitative | $214.25 | $214.25 | $10.22–$209.96 | 36% above | — |
| Troponin test, quantitative CPT 84484 Troponin I | $214.25 | $214.25 | $10.22–$209.96 | 36% above | — |
| Troponin test, quantitative CPT 84484 Troponin-I High Sensitivity | $214.25 | $214.25 | $10.22–$209.96 | 36% above | — |
| Troponin test, quantitative inpatient CPT 84484 Troponin I | $214.25 | $214.25 | $10.22–$209.96 | — | — |
| Troponin test, quantitative inpatient CPT 84484 84484 Troponin Quantitative | $214.25 | $214.25 | $10.22–$209.96 | — | — |
| Troponin test, quantitative inpatient CPT 84484 Troponin-I High Sensitivity | $214.25 | $214.25 | $10.22–$209.96 | — | — |
| Uric acid blood test CPT 84550 Uric Acid | $207.00 | $207.00 | $9.23–$182.16 | 184% above | — |
| Uric acid blood test inpatient CPT 84550 Uric Acid | $207.00 | $207.00 | $9.23–$182.16 | — | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Culture if Indicated | $117.75 | $117.75 | $3.11–$103.62 | 83% above | — |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic | $117.75 | $117.75 | $3.11–$103.62 | 83% above | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Culture if Indicated | $117.75 | $117.75 | $3.11–$103.62 | — | — |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic | $117.75 | $117.75 | $3.11–$103.62 | — | — |
| Urine culture for bacteria, with colony count CPT 87086 Urine Culture | $221.75 | $221.75 | $18.02–$195.14 | 142% above | — |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $221.75 | $221.75 | $18.02–$195.14 | — | — |
| Urine microalbumin (albumin) test CPT 82043 Albumin, Random Urine LC | $45.00 | $45.00 | $5.15–$71.94 | 30% below | — |
| Urine microalbumin (albumin) test CPT 82043 82043 Component | $81.75 | $81.75 | $5.15–$71.94 | 27% above | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 Albumin, Random Urine LC | $45.00 | $45.00 | $5.15–$71.94 | — | — |
| Urine microalbumin (albumin) test inpatient CPT 82043 82043 Component | $81.75 | $81.75 | $5.15–$71.94 | — | — |
| Urine pregnancy test, read by color change CPT 81025 Pregnancy Test Urine Qual | $162.75 | $162.75 | $5.15–$143.22 | 103% above | — |
| Urine pregnancy test, read by color change inpatient CPT 81025 Pregnancy Test Urine Qual | $162.75 | $162.75 | $5.15–$143.22 | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 82607 Anemia Panel | $95.00 | $95.00 | $11.28–$93.10 | 27% below | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vit B12 Lvl | $95.00 | $95.00 | $11.28–$93.10 | 27% below | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vit B12 Lvl | $95.00 | $95.00 | $11.28–$93.10 | — | — |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 82607 Anemia Panel | $95.00 | $95.00 | $11.28–$93.10 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-Hydroxy LC | $71.25 | $71.25 | $17.92–$69.82 | 61% below | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC | $168.75 | $168.75 | $17.92–$69.82 | 7% below | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D, 25-Hydroxy LC | $71.25 | $71.25 | $17.92–$69.82 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-Hydroxyvitamin D LCMS D2+D3 LC | $168.75 | $168.75 | $17.92–$69.82 | — | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Calcitriol(1,25 di-OH Vit D) LC | $584.50 | $584.50 | $48.16–$514.36 | 202% above | — |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Calcitriol(1,25 di-OH Vit D) LC | $584.50 | $584.50 | $48.16–$514.36 | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta hCG Quantitative | $278.00 | $278.00 | $22.57–$244.64 | 165% above | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Beta hCG Quantitative | $278.00 | $278.00 | $22.57–$244.64 | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Incision and drainage of a simple or single skin abscess CPT 10060 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE TechFee | $572.75 | $572.75 | $148.92–$348.20 | 39% above | — |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 10060 INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE TechFee | $572.75 | $572.75 | $148.92–$348.20 | — | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 INJECTION AND OR ASPIRATION MAJOR JOINT | $1,278.75 | $1,278.75 | $328.72–$986.60 | 184% above | — |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 20610 INJECTION AND OR ASPIRATION MAJOR JOINT | $1,278.75 | $1,278.75 | $328.72–$986.60 | — | — |
| Paracentesis with imaging guidance CPT 49083 US Paracentesis | $2,516.00 | $2,516.00 | $554.13 | 72% above | — |
| Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis | $2,516.00 | $2,516.00 | $554.13 | — | — |
| Removal of a foreign object under the skin, simple CPT 10120 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee | $670.50 | $670.50 | $348.20 | 44% above | — |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 10120 INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE TechFee | $670.50 | $670.50 | $348.20 | — | — |
| Short arm splint (forearm and hand) CPT 29125 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC TechFee | $300.00 | $300.00 | $80.58–$264.00 | 20% above | — |
| Short arm splint (forearm and hand) inpatient CPT 29125 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC TechFee | $300.00 | $300.00 | $80.58–$264.00 | — | — |
| Short leg splint (calf to foot) CPT 29515 29515 APPLICATION SHORT LEG SPLINT CALF FOOT TechFee | $508.50 | $508.50 | $159.63 | 74% above | — |
| Short leg splint (calf to foot) inpatient CPT 29515 29515 APPLICATION SHORT LEG SPLINT CALF FOOT TechFee | $508.50 | $508.50 | $159.63 | — | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee | $376.25 | $376.25 | $21.39–$331.10 | 1% above | — |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 12001 SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee | $376.25 | $376.25 | $21.39–$331.10 | — | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee | $376.25 | $376.25 | $96.23–$214.22 | 9% below | — |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 12002 SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee | $376.25 | $376.25 | $96.23–$214.22 | — | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee | $376.25 | $376.25 | $101.06–$331.10 | 8% below | — |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 12011 SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee | $376.25 | $376.25 | $101.06–$331.10 | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Left | $3,956.75 | $3,956.75 | $1,012.15–$3,316.06 | 56% above | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Right | $3,956.75 | $3,956.75 | $1,012.15–$3,316.06 | 56% above | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Right | $3,956.75 | $3,956.75 | $1,012.15–$3,316.06 | — | — |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Left | $3,956.75 | $3,956.75 | $1,012.15–$3,316.06 | — | — |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Illinois | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Platelet Product | $1,100.50 | $1,100.50 | $281.49–$922.24 | 18% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 36430 BLOOD ADMINISTRATION CHARGE | $1,100.50 | $1,100.50 | $281.49–$922.24 | 18% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 Transfuse Red Blood Cells Leukoreduced | $1,100.50 | $1,100.50 | $281.49–$922.24 | 18% above | — |
| Blood transfusion (giving blood or blood components) CPT 36430 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS TechFee | $1,101.75 | $1,101.75 | $281.49–$922.24 | 18% above | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Platelet Product | $1,100.50 | $1,100.50 | $281.49–$922.24 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 Transfuse Red Blood Cells Leukoreduced | $1,100.50 | $1,100.50 | $281.49–$922.24 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 BLOOD ADMINISTRATION CHARGE | $1,100.50 | $1,100.50 | $281.49–$922.24 | — | — |
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 36430 TRANSFUSION BLOOD/BLOOD COMPONENTS TechFee | $1,101.75 | $1,101.75 | $281.49–$922.24 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $191.75 | $191.75 | $49.02–$487.25 | 2% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 SPUTUM INDUCTION CHARGE | $191.75 | $191.75 | $49.02–$487.25 | 2% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 NEBULIZER 1 CHARGE | $191.75 | $191.75 | $49.02–$487.25 | 2% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 NEBULIZER 2 - 3 CHARGE | $487.25 | $487.25 | $49.02–$487.25 | 160% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 NEBULIZER 4 - 5 CHARGE | $702.50 | $702.50 | $49.02–$487.25 | 275% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 NEBULIZER 6 OR MORE CHARGE | $810.50 | $810.50 | $49.02–$487.25 | 332% above | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 NEBULIZER 1 CHARGE | $191.75 | $191.75 | $49.02–$487.25 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 SPUTUM INDUCTION CHARGE | $191.75 | $191.75 | $49.02–$487.25 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT | $191.75 | $191.75 | $49.02–$487.25 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 NEBULIZER 2 - 3 CHARGE | $487.25 | $487.25 | $49.02–$487.25 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 NEBULIZER 4 - 5 CHARGE | $702.50 | $702.50 | $49.02–$487.25 | — | — |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 94640 NEBULIZER 6 OR MORE CHARGE | $810.50 | $810.50 | $49.02–$487.25 | — | — |
| Chemotherapy IV infusion, first hour CPT 96413 96413 IV CHEMO SINGLE INITIAL UP TO 1 HOUR CHARGE | $603.50 | $603.50 | $154.38–$593.84 | 5% below | — |
| Chemotherapy IV infusion, first hour inpatient CPT 96413 96413 IV CHEMO SINGLE INITIAL UP TO 1 HOUR CHARGE | $603.50 | $603.50 | $154.38–$593.84 | — | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG TECHNICAL | $1,104.50 | $1,104.50 | $698.81–$925.54 | 28% above | — |
| EEG (brain wave test), awake and drowsy, routine CPT 95816 95816 EEG TECHNICAL CHARGE | $1,159.75 | $1,159.75 | $698.81–$925.54 | 35% above | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG TECHNICAL | $1,104.50 | $1,104.50 | $698.81–$925.54 | — | — |
| EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 95816 EEG TECHNICAL CHARGE | $1,159.75 | $1,159.75 | $698.81–$925.54 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 93005 EKG, Tracing Only | $180.00 | $180.00 | $54.22–$328.46 | 23% below | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ED EKG CHARGE | $373.25 | $373.25 | $54.22–$328.46 | 61% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD Charge | $448.25 | $448.25 | $54.22–$328.46 | 93% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram 12 Lead | $448.25 | $448.25 | $54.22–$328.46 | 93% above | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 93005 EKG, Tracing Only | $180.00 | $180.00 | $54.22–$328.46 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ED EKG CHARGE | $373.25 | $373.25 | $54.22–$328.46 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 Electrocardiogram 12 Lead | $448.25 | $448.25 | $54.22–$328.46 | — | — |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD Charge | $448.25 | $448.25 | $54.22–$328.46 | — | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281 ED VISIT FOR E&M PATIENT, LEV 1, MAY NOT REQ PRESENCE OF PHYSICIAN OR OTHER, CC | $387.50 | $387.50 | $104.09–$387.50 | 73% above | — |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 99281 ED VISIT FOR E&M PATIENT, LEV 1, MAY NOT REQ PRESENCE OF PHYSICIAN OR OTHER, CC | $387.50 | $387.50 | $104.09–$387.50 | — | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 Level 2 ED TechFee | $410.75 | $410.75 | $105.02–$385.58 | at median | — |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282 ED VISIT E&M PATIENT, LEV 2, REQ MED APPROP HSTRY/EXAM/MDM, CC | $410.75 | $410.75 | $105.02–$385.58 | at median | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 Level 2 ED TechFee | $410.75 | $410.75 | $105.02–$385.58 | — | — |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 99282 ED VISIT E&M PATIENT, LEV 2, REQ MED APPROP HSTRY/EXAM/MDM, CC | $410.75 | $410.75 | $105.02–$385.58 | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 ED VISIT E&M PATIENT, LEV 3, REQ MED APPROP HSTRY/EXAM/LOW MDM, CC | $577.50 | $577.50 | $90.00–$568.26 | 19% below | — |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283 Level 3 ED TechFee | $577.50 | $577.50 | $90.00–$568.26 | 19% below | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 ED VISIT E&M PATIENT, LEV 3, REQ MED APPROP HSTRY/EXAM/LOW MDM, CC | $577.50 | $577.50 | $90.00–$568.26 | — | — |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 99283 Level 3 ED TechFee | $577.50 | $577.50 | $90.00–$568.26 | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 ED VISIT E&M PATIENT, LEV 4, REQ MED APPROP HSTRY/EXAM/MODERATE MDM, CC | $901.75 | $901.75 | $90.00–$886.21 | 22% below | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284 Level 4 ED TechFee | $901.75 | $901.75 | $90.00–$886.21 | 22% below | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 Level 4 ED TechFee | $901.75 | $901.75 | $90.00–$886.21 | — | — |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 99284 ED VISIT E&M PATIENT, LEV 4, REQ MED APPROP HSTRY/EXAM/MODERATE MDM, CC | $901.75 | $901.75 | $90.00–$886.21 | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 Level 5 ED TechFee | $1,463.25 | $1,463.25 | $90.00–$1,436.48 | 14% below | — |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285 ED VISIT E M PATIENT, LEV 5, REQ MED APPROP HSTRY/EXAM/HIGH MDM, CC | $1,463.25 | $1,463.25 | $90.00–$1,436.48 | 14% below | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 Level 5 ED TechFee | $1,463.25 | $1,463.25 | $90.00–$1,436.48 | — | — |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 99285 ED VISIT E M PATIENT, LEV 5, REQ MED APPROP HSTRY/EXAM/HIGH MDM, CC | $1,463.25 | $1,463.25 | $90.00–$1,436.48 | — | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 93017 STRESS TEST CHARGE | $1,339.75 | $1,339.75 | $144.69–$1,178.98 | 40% above | — |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST | $1,339.75 | $1,339.75 | $144.69–$1,178.98 | 40% above | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 93017 STRESS TEST CHARGE | $1,339.75 | $1,339.75 | $144.69–$1,178.98 | — | — |
| Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST | $1,339.75 | $1,339.75 | $144.69–$1,178.98 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV FLUIDS INITIAL CHARGES | $402.50 | $402.50 | $101.42–$394.45 | 15% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 - ED Hydration, first hour | $402.50 | $402.50 | $101.42–$394.45 | 15% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 IV HYDRATION INITIAL CHARGE | $402.50 | $402.50 | $101.42–$394.45 | 15% above | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 - ED Hydration, first hour | $402.50 | $402.50 | $101.42–$394.45 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV HYDRATION INITIAL CHARGE | $402.50 | $402.50 | $101.42–$394.45 | — | — |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 96360 IV FLUIDS INITIAL CHARGES | $402.50 | $402.50 | $101.42–$394.45 | — | — |
| IV infusion of a medicine, first hour CPT 96365 96365 IVPB INITIAL AND UP TO 1 HOUR CHARGE | $752.75 | $752.75 | $192.52–$716.75 | 79% above | — |
| IV infusion of a medicine, first hour CPT 96365 96365- ED IV tx, first hour | $752.75 | $752.75 | $44.10–$737.69 | 79% above | — |
| IV infusion of a medicine, first hour CPT 96365 96365 IV THERAPEUTIC 1ST HR CHARGE | $752.75 | $752.75 | $187.26–$621.27 | 79% above | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IVPB INITIAL AND UP TO 1 HOUR CHARGE | $752.75 | $752.75 | $192.52–$716.75 | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365 IV THERAPEUTIC 1ST HR CHARGE | $752.75 | $752.75 | $187.26–$621.27 | — | — |
| IV infusion of a medicine, first hour inpatient CPT 96365 96365- ED IV tx, first hour | $752.75 | $752.75 | $44.10–$737.69 | — | — |
| IV push of a medicine, first drug CPT 96374 96374- ED Injection, single/initial | $402.50 | $402.50 | $97.61–$394.45 | 87% above | — |
| IV push of a medicine, first drug CPT 96374 96374 IV PUSH MEDS SINGLE WITH INITIAL SUBSTAN CHARGE | $402.50 | $402.50 | $97.61–$383.25 | 87% above | — |
| IV push of a medicine, first drug CPT 96374 96374 IV PUSH SINGLE OR INITIAL DRUG CHARGE | $402.50 | $402.50 | $97.61–$383.25 | 87% above | — |
| IV push of a medicine, first drug inpatient CPT 96374 96374 IV PUSH MEDS SINGLE WITH INITIAL SUBSTAN CHARGE | $402.50 | $402.50 | $97.61–$383.25 | — | — |
| IV push of a medicine, first drug inpatient CPT 96374 96374 IV PUSH SINGLE OR INITIAL DRUG CHARGE | $402.50 | $402.50 | $97.61–$383.25 | — | — |
| IV push of a medicine, first drug inpatient CPT 96374 96374- ED Injection, single/initial | $402.50 | $402.50 | $97.61–$394.45 | — | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 INJECTION SQ OR IM CHARGE | $180.75 | $180.75 | $48.55–$401.72 | 66% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 SQ/IM INJECTION CHARGE | $180.75 | $180.75 | $48.55–$401.72 | 66% above | — |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 ED Subq/IM Injection | $239.75 | $239.75 | $48.55–$401.72 | 120% above | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 INJECTION SQ OR IM CHARGE | $180.75 | $180.75 | $48.55–$401.72 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 SQ/IM INJECTION CHARGE | $180.75 | $180.75 | $48.55–$401.72 | — | — |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 96372 ED Subq/IM Injection | $239.75 | $239.75 | $48.55–$401.72 | — | — |
| Neuromuscular re-education, 15 minutes CPT 97112 97112 NEUROMUSC RE-ED EX 15 CHARGE | $147.00 | $147.00 | $37.04–$129.36 | 20% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 97112 NEUROMUSCULAR RE-ED - IN HOME - 15MIN CHARGE | $147.00 | $147.00 | $37.04–$129.36 | 20% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 97112 OT NEUROMUSCULAR RE-ED CHARGE | $147.00 | $147.00 | $19.01–$76.03 | 20% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 97112 PT - NM-RE-ED 15M | $147.00 | $147.00 | $37.04–$129.36 | 20% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 97112 OT - NM REED 15 MIN | $147.00 | $147.00 | $19.01–$76.03 | 20% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges | $147.00 | $147.00 | $37.04–$129.36 | 20% above | — |
| Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Charges | $147.00 | $147.00 | $19.01–$76.03 | 20% above | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 OT NEUROMUSCULAR RE-ED CHARGE | $147.00 | $147.00 | $19.01–$76.03 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 Neuromuscular Reeducation Charges | $147.00 | $147.00 | $37.04–$129.36 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 NEUROMUSC RE-ED EX 15 CHARGE | $147.00 | $147.00 | $37.04–$129.36 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 NEUROMUSCULAR RE-ED - IN HOME - 15MIN CHARGE | $147.00 | $147.00 | $37.04–$129.36 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 PT - NM-RE-ED 15M | $147.00 | $147.00 | $37.04–$129.36 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Charges | $147.00 | $147.00 | $19.01–$76.03 | — | — |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 97112 OT - NM REED 15 MIN | $147.00 | $147.00 | $19.01–$76.03 | — | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 97802 MEDICAL NUTRITIONAL INITIAL EVAL-15 MIN Charge | $37.75 | $37.75 | $10.07 | 30% below | — |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 97802 MEDICAL NUTRITIONAL INITIAL EVAL-15 MIN Charge | $37.75 | $37.75 | $10.07 | — | — |
| Occupational therapy evaluation, low complexity CPT 97165 97165 OT EVAL, LOW COMPLEXITY | $396.75 | $396.75 | $100.77–$359.75 | 54% above | — |
| Occupational therapy evaluation, low complexity CPT 97165 OT Low Complex Units | $396.75 | $396.75 | $100.77–$359.75 | 54% above | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Low Complex Units | $396.75 | $396.75 | $100.77–$359.75 | — | — |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 97165 OT EVAL, LOW COMPLEXITY | $396.75 | $396.75 | $100.77–$359.75 | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 97161 PT EVAL, LOW COMPLEXITY | $396.75 | $396.75 | $99.96–$396.75 | 76% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Low Complex Units | $396.75 | $396.75 | $99.96–$396.75 | 76% above | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Low Complex Units | $396.75 | $396.75 | $99.96–$396.75 | — | — |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 97161 PT EVAL, LOW COMPLEXITY | $396.75 | $396.75 | $99.96–$396.75 | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Moderate Complex Units | $396.75 | $396.75 | $101.46–$104.98 | 29% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 97162 PHYSICAL THERAPY EVAL MOD COMPLEX CHARGE | $396.75 | $396.75 | $101.46–$104.98 | 29% above | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 97162 PHYSICAL THERAPY EVAL MOD COMPLEX CHARGE | $396.75 | $396.75 | $101.46–$104.98 | — | — |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Moderate Complex Units | $396.75 | $396.75 | $101.46–$104.98 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 JOINT MOBILIZATION(SPINAL/PERIP)/15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANUAL THERAPY CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANIPULATION (CERVICAL, THORAIC)/15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CHARGE. | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 OT - MANUAL THERAPY 15 MIN | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 OT MANUAL THERAPY - IN HOME - 15MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 PR - MANUAL THERAPY/MYOFACIAL/EA 15 MIN | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CH | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANIPULATION (CERVICAL)/ADDITION/15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 MANUAL THERAPY - IN HOME - 15MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Charge Units | $206.25 | $206.25 | $38.02–$181.50 | 46% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 97140 JOINT MOBILIZATION CHARGE | $208.25 | $208.25 | $38.02–$181.50 | 48% above | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 PR - MANUAL THERAPY/MYOFACIAL/EA 15 MIN | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CH | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANUAL THERAPY CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANUAL THERAPY - IN HOME - 15MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Manual Therapy Charge Units | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 OT MANUAL THERAPY - IN HOME - 15MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 OT - MANUAL THERAPY 15 MIN | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANUAL THERAPY TECHNIQUES PLUS EA 15 MIN CHARGE. | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANIPULATION (CERVICAL, THORAIC)/15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 MANIPULATION (CERVICAL)/ADDITION/15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 JOINT MOBILIZATION(SPINAL/PERIP)/15 MIN CHARGE | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Charge Units | $206.25 | $206.25 | $38.02–$181.50 | — | — |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 97140 JOINT MOBILIZATION CHARGE | $208.25 | $208.25 | $38.02–$181.50 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic Exercise Charges | $146.25 | $146.25 | $37.00–$257.40 | 22% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 PT CONTINUOUS PASSIVE MOTION (15 MIN) CHARGE | $146.25 | $146.25 | $37.00–$257.40 | 22% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISE EA 15 MIN | $146.25 | $146.25 | $37.00–$257.40 | 22% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Charges | $146.25 | $146.25 | $25.34–$128.70 | 22% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 OT THERAPEUTIC EX; 15 MINUTES; W/GROUP CHARGE | $146.25 | $146.25 | $25.34–$128.70 | 22% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 OT THER EXERCISE 15 CHARGE | $146.25 | $146.25 | $25.34–$128.70 | 22% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CH | $165.00 | $165.00 | $37.00–$257.40 | 38% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CHARGE. | $165.00 | $165.00 | $25.34–$128.70 | 38% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISE-CONTRACT PCMH-15MIN CHARGE | $165.00 | $165.00 | $25.34–$128.70 | 38% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CHARGE | $165.00 | $165.00 | $37.00–$257.40 | 38% above | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Charges | $146.25 | $146.25 | $25.34–$128.70 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISE EA 15 MIN | $146.25 | $146.25 | $37.00–$257.40 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 PT CONTINUOUS PASSIVE MOTION (15 MIN) CHARGE | $146.25 | $146.25 | $37.00–$257.40 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 OT THER EXERCISE 15 CHARGE | $146.25 | $146.25 | $25.34–$128.70 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic Exercise Charges | $146.25 | $146.25 | $37.00–$257.40 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 OT THERAPEUTIC EX; 15 MINUTES; W/GROUP CHARGE | $146.25 | $146.25 | $25.34–$128.70 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CH | $165.00 | $165.00 | $37.00–$257.40 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CHARGE | $165.00 | $165.00 | $37.00–$257.40 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISE PLUS EA 15 MIN CHARGE. | $165.00 | $165.00 | $25.34–$128.70 | — | — |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 97110 THERAPEUTIC EXERCISE-CONTRACT PCMH-15MIN CHARGE | $165.00 | $165.00 | $25.34–$128.70 | — | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 Nursing OP 15-20min | $136.50 | $136.50 | $34.68 | 10% below | — |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 LEVEL 3 TX RM EST PT CHARGE | $136.50 | $136.50 | $34.68 | 10% below | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 99213 LEVEL 3 TX RM EST PT CHARGE | $136.50 | $136.50 | $34.68 | — | — |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Nursing OP 15-20min | $136.50 | $136.50 | $34.68 | — | — |
| Speech and language evaluation CPT 92523 92523 EVAL LANGUANGE ONLY CHARGE | $512.75 | $512.75 | $137.72–$480.42 | 31% above | — |
| Speech and language evaluation CPT 92523 Speech Sound Prod w/ Language Charge | $512.75 | $512.75 | $137.72–$480.42 | 31% above | — |
| Speech and language evaluation inpatient CPT 92523 Speech Sound Prod w/ Language Charge | $512.75 | $512.75 | $137.72–$480.42 | — | — |
| Speech and language evaluation inpatient CPT 92523 92523 EVAL LANGUANGE ONLY CHARGE | $512.75 | $512.75 | $137.72–$480.42 | — | — |
| Speech therapy session, individual CPT 92507 92507 ST INDIVIDUAL SPEECH THERAPY CHARGE | $425.75 | $425.75 | $114.35–$425.75 | 128% above | — |
| Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid | $425.75 | $425.75 | $114.35–$425.75 | 128% above | — |
| Speech therapy session, individual CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg | $425.75 | $425.75 | $114.35–$425.75 | 128% above | — |
| Speech therapy session, individual inpatient CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid | $425.75 | $425.75 | $114.35–$425.75 | — | — |
| Speech therapy session, individual inpatient CPT 92507 92507 ST INDIVIDUAL SPEECH THERAPY CHARGE | $425.75 | $425.75 | $114.35–$425.75 | — | — |
| Speech therapy session, individual inpatient CPT 92507 Tx of Speech/Lang/Voice/Comm/Auditory Chg | $425.75 | $425.75 | $114.35–$425.75 | — | — |
| Spirometry (breathing test) CPT 94010 94010 TIDAL VOLUME W VITAL CAPACITY CHARGE | $349.75 | $349.75 | $307.78 | 15% above | — |
| Spirometry (breathing test) CPT 94010 TIDAL VOLUME W VITAL CAPACITY | $349.75 | $349.75 | $307.78 | 15% above | — |
| Spirometry (breathing test) inpatient CPT 94010 TIDAL VOLUME W VITAL CAPACITY | $349.75 | $349.75 | $307.78 | — | — |
| Spirometry (breathing test) inpatient CPT 94010 94010 TIDAL VOLUME W VITAL CAPACITY CHARGE | $349.75 | $349.75 | $307.78 | — | — |
| Spirometry before and after a bronchodilator CPT 94060 BRONCHODILATION RESPONSIVENESS | $698.25 | $698.25 | $108.82–$614.46 | 33% above | — |
| Spirometry before and after a bronchodilator CPT 94060 94060 BRONCHODILATION RESPONSIVENESS CHARGE | $698.25 | $698.25 | $108.82–$614.46 | 33% above | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 94060 BRONCHODILATION RESPONSIVENESS CHARGE | $698.25 | $698.25 | $108.82–$614.46 | — | — |
| Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILATION RESPONSIVENESS | $698.25 | $698.25 | $108.82–$614.46 | — | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530 PR - PT DYNAMIC FUNCTION 15 MIN | $147.00 | $147.00 | $37.20–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530 OT - THER ACTIV 15 M | $147.00 | $147.00 | $19.01–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Charges | $147.00 | $147.00 | $19.01–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530 THERAPEUTIC ACT, IN HOME - 15MIN CHARGE | $147.00 | $147.00 | $37.20–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530 OT Therapeutic Activities Charges | $147.00 | $147.00 | $19.01–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charges | $147.00 | $147.00 | $19.01–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530 PT - THER. ACT. 15M | $147.00 | $147.00 | $37.20–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge | $147.00 | $147.00 | $37.20–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes CPT 97530 97530 OT SB-THERAP ACTIVITIES 1 CHARGE | $147.00 | $147.00 | $19.01–$39.48 | 15% above | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 OT - THER ACTIV 15 M | $147.00 | $147.00 | $19.01–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charge | $147.00 | $147.00 | $37.20–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 PR - PT DYNAMIC FUNCTION 15 MIN | $147.00 | $147.00 | $37.20–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 PT - THER. ACT. 15M | $147.00 | $147.00 | $37.20–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 THERAPEUTIC ACT, IN HOME - 15MIN CHARGE | $147.00 | $147.00 | $37.20–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Charges | $147.00 | $147.00 | $19.01–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 OT SB-THERAP ACTIVITIES 1 CHARGE | $147.00 | $147.00 | $19.01–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 97530 OT Therapeutic Activities Charges | $147.00 | $147.00 | $19.01–$39.48 | — | — |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 Therapeutic Activities Charges | $147.00 | $147.00 | $19.01–$39.48 | — | — |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 99195 THERAPEUTIC PHLEBOTOMY CHARGE | $483.00 | $483.00 | $123.56–$158.30 | 133% above | — |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 99195 THERAPEUTIC PHLEBOTOMY CHARGE | $483.00 | $483.00 | $123.56–$158.30 | — | — |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.