SelfPayRates
Hospital Baton Rouge, LA

West Feliciana Parish Hospital

Listed in its price file as “The Hospital Service District of West Feliciana Parish Louisiana”.

West Feliciana Parish Hospital in St Francisville, LA publishes cash prices for 376 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 Louisiana median for 354 of 372 procedures and below it for 18. Click a procedure to compare it with other hospitals nearby.

5266 Commerce St, St Francisville, LA 70775 Collected Sep 27, 2026 Source price file (225) 635-3811

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 191306 · CMS hospital register NPI 1164497533

Scans and imaging

ProcedureCash price List priceInsurers payvs LouisianaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W/WO CONTRAST $1,928.54 $3,214.23 $266.84–$3,535.65 89% above 40%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONTRAST $1,928.54 $3,214.23 $266.84–$3,535.65 — 40%
Abdominal X-ray, 2 views CPT 74019 ABDOMEN FLAT & ERECT OR DECUBITUS $255.77 $426.29 $34.09–$468.91 40% above 40%
Abdominal X-ray, 2 views inpatient CPT 74019 ABDOMEN FLAT & ERECT OR DECUBITUS $255.77 $426.29 $34.09–$468.91 — 40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE LT COMP MIN 3 VIEWS $218.78 $364.63 — 83% above 40%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE RT COMP MIN 3 VIEWS $218.78 $364.63 — 83% above 40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE LT COMP MIN 3 VIEWS $218.78 $364.63 — — 40%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE RT COMP MIN 3 VIEWS $218.78 $364.63 — — 40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US ANKLE BRACHIAL INDICES $355.46 $592.44 $202.31–$651.68 110% above 40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CLIN FAC UPR/LXTREMITY ART 2 LEVELS $355.46 $592.44 $202.31–$651.68 110% above 40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ANKLE BRACHIAL INDICES $355.46 $592.44 $202.31–$651.68 — 40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CLIN FAC UPR/LXTREMITY ART 2 LEVELS $355.46 $592.44 $202.31–$651.68 — 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT FOREARM W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT WRIST W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT HAND WO CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT ELBOW W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT WRIST W/O CONTRAS $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT SHOULDER W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT HAND W/O CONTRAST $1,089.45 $1,815.75 $165.35–$1,997.32 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT UPPER EXTREMITY WO CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT ELBOW W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT HUMEROUS W/O CONTRAST $1,089.45 $1,815.75 $165.35–$1,997.32 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT SHOULDER W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT FOREARM W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT HUMEROUS W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT FINGERS W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT FINGERS W/O CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT UPPER EXTREMITY WO CONTRAST $1,089.45 $1,815.75 — 68% above 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT ELBOW W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT SHOULDER W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT SHOULDER W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT WRIST W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT WRIST W/O CONTRAS $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT HUMEROUS W/O CONTRAST $1,089.45 $1,815.75 $165.35–$1,997.32 — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT FOREARM W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT HAND W/O CONTRAST $1,089.45 $1,815.75 $165.35–$1,997.32 — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT UPPER EXTREMITY WO CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT FOREARM W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT FINGERS W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT FINGERS W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT HUMEROUS W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT ELBOW W/O CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT UPPER EXTREMITY WO CONTRAST $1,089.45 $1,815.75 — — 40%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT HAND WO CONTRAST $1,089.45 $1,815.75 — — 40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS $376.14 $626.90 $89.74–$689.59 74% above 40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS $376.14 $626.90 $89.74–$689.59 — 40%
Bone scan, whole body (nuclear medicine) CPT 78306 INACTIVE $1,205.74 $2,009.57 $262.08–$2,210.52 119% above 40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 INACTIVE $1,205.74 $2,009.57 $262.08–$2,210.52 — 40%
Breast ultrasound, complete, one breast one side CPT 76641 US BREAST/UNILATERAL RT $520.02 $866.70 — 211% above 40%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US BREAST/UNILATERAL RT $520.02 $866.70 — — 40%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN & PELVIS WITH CONTRAST $2,456.99 $4,094.98 $379.71–$4,504.47 175% above 40%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN & PELVIS WITH CONTRAST $2,456.99 $4,094.98 $379.71–$4,504.47 — 40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/WO CONTRAST $1,535.25 $2,558.75 $299.23–$2,814.62 120% above 40%
CT angiography (CTA) of the head CPT 70496 CTA HEAD WITH CONTRAST $1,535.25 $2,558.75 $299.23–$2,814.62 120% above 40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD WITH CONTRAST $1,535.25 $2,558.75 $299.23–$2,814.62 — 40%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/WO CONTRAST $1,535.25 $2,558.75 $299.23–$2,814.62 — 40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/WO CONTRAST $1,560.62 $2,601.04 $298.54–$2,861.14 124% above 40%
CT angiography (CTA) of the neck CPT 70498 CTA NECK WITH CONTRAST $1,560.62 $2,601.04 $298.54–$2,861.14 124% above 40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/WO CONTRAST $1,560.62 $2,601.04 $298.54–$2,861.14 — 40%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK WITH CONTRAST $1,560.62 $2,601.04 $298.54–$2,861.14 — 40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W CONTRAST $1,645.46 $2,742.43 $306.55–$3,016.67 88% above 40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST W CONTRAST $1,645.46 $2,742.43 $306.55–$3,016.67 — 40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CALCIUM SCORING $219.86 $366.43 $65.49–$403.07 176% above 40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HEART CALCIUM SCORING W/O $219.86 $366.43 $65.49–$403.07 176% above 40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HEART CALCIUM SCORING $219.86 $366.43 $65.49–$403.07 — 40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN & PELVIS WO CONTR $2,256.59 $3,760.99 $208.02–$4,137.08 100% above 40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN & PELVIS WO CONTR $2,256.59 $3,760.99 $208.02–$4,137.08 — 40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CONTRAST $2,743.45 $4,572.42 $317.28–$5,029.66 107% above 40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W CONTRAST $2,743.45 $4,572.42 $317.28–$5,029.66 — 40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN & PELVIS WO/W CONTRAS $2,998.69 $4,997.81 $360.05–$5,497.59 107% above 40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN & PELVIS WO/W CONTRAS $2,998.69 $4,997.81 $360.05–$5,497.59 — 40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONTRAST $1,668.72 $2,781.20 $234.97–$3,059.32 88% above 40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH CONTRAST $1,668.72 $2,781.20 $234.97–$3,059.32 — 40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WITHOUT CONTRAST $1,440.56 $2,400.94 $154.43–$2,641.03 89% above 40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WITHOUT CONTRAST $1,440.56 $2,400.94 $154.43–$2,641.03 — 40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTRAST $1,243.39 $2,072.32 $142.15–$2,279.55 87% above 40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST $1,243.39 $2,072.32 $142.15–$2,279.55 87% above 40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL AREA WITHOUT CONTRAST $1,243.39 $2,072.32 $142.15–$2,279.55 87% above 40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST $1,243.39 $2,072.32 $142.15–$2,279.55 — 40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL BONES W/O CONTRAST $1,243.39 $2,072.32 $142.15–$2,279.55 — 40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL AREA WITHOUT CONTRAST $1,243.39 $2,072.32 $142.15–$2,279.55 — 40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WITHOUT CONTRAST $1,180.07 $1,966.78 $119.39–$2,163.45 80% above 40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST $1,180.07 $1,966.78 $119.39–$2,163.45 80% above 40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST $1,180.07 $1,966.78 $119.39–$2,163.45 — 40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WITHOUT CONTRAST $1,180.07 $1,966.78 $119.39–$2,163.45 — 40%
CT scan of the head with contrast CPT 70460 CT HEAD W CONTRAST $1,216.61 $2,027.68 $166.29–$2,230.44 66% above 40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN WITH CONTRAST $1,216.61 $2,027.68 $166.29–$2,230.44 66% above 40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN WITH CONTRAST $1,216.61 $2,027.68 $166.29–$2,230.44 — 40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD W CONTRAST $1,216.61 $2,027.68 $166.29–$2,230.44 — 40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/WO CONTRAST $1,600.04 $2,666.73 $196.45–$2,933.40 75% above 40%
CT scan of the head without and with contrast CPT 70470 CT HEAD W/WO CONTRAST $1,600.04 $2,666.73 $196.45–$2,933.40 75% above 40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/WO CONTRAST $1,600.04 $2,666.73 $196.45–$2,933.40 — 40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST $1,600.04 $2,666.73 $196.45–$2,933.40 — 40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WITHOUT CONTRAST $1,445.47 $2,409.12 $165.35–$2,650.03 91% above 40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WITHOUT CONTRAST $1,445.47 $2,409.12 $165.35–$2,650.03 — 40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE WITHOUT CONTRAST $1,563.66 $2,606.10 $169.17–$2,866.71 112% above 40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE WITHOUT CONTRAST $1,563.66 $2,606.10 $169.17–$2,866.71 — 40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST $1,622.44 $2,704.06 $229.57–$2,974.46 103% above 40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH CONTRAST $1,622.44 $2,704.06 $229.57–$2,974.46 — 40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DUPLEX SCAN BIL $754.88 $1,258.14 $322.55–$1,383.95 62% above 40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DUPLEX SCAN BIL $754.88 $1,258.14 $322.55–$1,383.95 — 40%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST $1,702.88 $2,838.13 $279.00–$3,121.94 61% above 40%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST $1,702.88 $2,838.13 $279.00–$3,121.94 — 40%
Chest X-ray, 2 views CPT 71046 CHEST 2 VIEWS FR/LAT FLOUROSCOPY $228.10 $380.16 $31.24–$418.17 73% above 40%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS $228.10 $380.16 $31.24–$418.17 73% above 40%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS $228.10 $380.16 $31.24–$418.17 — 40%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2 VIEWS FR/LAT FLOUROSCOPY $228.10 $380.16 $31.24–$418.17 — 40%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW $209.84 $349.73 $20.56–$384.70 91% above 40%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW $209.84 $349.73 $20.56–$384.70 — 40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMP LT $209.78 $349.64 — 79% above 40%
Collarbone (clavicle) X-ray, complete one side CPT 73000 CLAVICLE COMP RT $209.78 $349.64 — 79% above 40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMP RT $209.78 $349.64 — — 40%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 CLAVICLE COMP LT $209.78 $349.64 — — 40%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 US OF RENAL/BILATERAL COMPLETE $491.66 $819.44 $116.68–$901.38 — 40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 INACTIVATE $491.66 $819.44 $116.68–$901.38 71% above 40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient both sides CPT 76770 US OF RENAL/BILATERAL COMPLETE $491.66 $819.44 $116.68–$901.38 — 40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 INACTIVATE $491.66 $819.44 $116.68–$901.38 — 40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 CT DXA BONE DENSITY STUDY $333.97 $556.62 $41.76–$612.28 130% above 40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENS STUDY >1 AXIAL SKLT HP,PL, $333.97 $556.62 $41.76–$612.28 130% above 40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 CT DXA BONE DENSITY STUDY $333.97 $556.62 $41.76–$612.28 — 40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENS STUDY >1 AXIAL SKLT HP,PL, $333.97 $556.62 $41.76–$612.28 — 40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY / PERIPHER $148.48 $247.46 $28.90–$272.20 87% above 40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENS ST >1 APPEND SKE PER RAD,W $148.48 $247.46 $28.90–$272.20 87% above 40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY / PERIPHER $148.48 $247.46 $28.90–$272.20 — 40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENS ST >1 APPEND SKE PER RAD,W $148.48 $247.46 $28.90–$272.20 — 40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US PR UT RTI W IM DC F/MAT EVAL 1ST SNGL $729.08 $1,215.13 $194.21–$1,336.64 175% above 40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US PR UT RTI W IM DC F/MAT EVAL 1ST SNGL $729.08 $1,215.13 $194.21–$1,336.64 — 40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST $1,321.55 $2,202.58 $166.50–$2,422.83 73% above 40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT LOW DOSE LUNG SCREENING 3-6 MONTH FU $1,321.55 $2,202.58 $166.50–$2,422.83 73% above 40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST $1,321.55 $2,202.58 $166.50–$2,422.83 — 40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT LOW DOSE LUNG SCREENING 3-6 MONTH FU $1,321.55 $2,202.58 $166.50–$2,422.83 — 40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W CONTRAST $1,670.51 $2,784.18 $233.43–$3,062.59 95% above 40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W CONTRAST $1,670.51 $2,784.18 $233.43–$3,062.59 — 40%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAG MAMMO W/CAD BILATERAL $327.92 $546.54 $124.32–$601.19 — 40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAG MAMMO W/CAD BILATERAL $327.92 $546.54 $124.32–$601.19 — 40%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMO W/CAD UNILATERAL LT $257.15 $428.59 — 111% above 40%
Diagnostic mammogram, one breast one side CPT 77065 DIAG MAMMO W/CAD UNILATERAL RT $257.15 $428.59 — 111% above 40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMO W/CAD UNILATERAL LT $257.15 $428.59 — — 40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 DIAG MAMMO W/CAD UNILATERAL RT $257.15 $428.59 — — 40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US EXTREMITY ARTERIAL LOWER BILATERAL $762.94 $1,271.57 $322.55–$1,398.72 — 40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US EXTREMITY ARTERIAL LOWER BILATERAL $762.94 $1,271.57 $322.55–$1,398.72 — 40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US EXTREMITY VENOUS UPPER BILATERAL $809.71 $1,349.52 $322.55–$1,484.47 — 40%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US EXTREMITY VENOUS LOWER BILATERAL $809.71 $1,349.52 $322.55–$1,484.47 — 40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXTREMITY VENOUS LOWER BILATERAL $809.71 $1,349.52 $322.55–$1,484.47 — 40%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US EXTREMITY VENOUS UPPER BILATERAL $809.71 $1,349.52 $322.55–$1,484.47 — 40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAPHY TRANSTHORACIC $1,601.06 $2,668.43 $915.33–$2,935.27 119% above 40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAPHY TRANSTHORACIC < 2YRS $1,601.06 $2,668.43 $915.33–$2,935.27 119% above 40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAPHY TRANSTHORACIC < 2YRS $1,601.06 $2,668.43 $915.33–$2,935.27 — 40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHOCARDIOGRAPHY TRANSTHORACIC $1,601.06 $2,668.43 $915.33–$2,935.27 — 40%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEWS LT $223.84 $373.06 — 91% above 40%
Elbow X-ray, 2 views one side CPT 73070 ELBOW 2 VIEWS RT $223.84 $373.06 — 91% above 40%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEWS LT $223.84 $373.06 — — 40%
Elbow X-ray, 2 views inpatient one side CPT 73070 ELBOW 2 VIEWS RT $223.84 $373.06 — — 40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW RT COMPLETE MIN 3 VIEWS $226.48 $377.47 — 73% above 40%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW LT COMPLETE MIN 3 VIEWS $226.48 $377.47 — 73% above 40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW RT COMPLETE MIN 3 VIEWS $226.48 $377.47 — — 40%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW LT COMPLETE MIN 3 VIEWS $226.48 $377.47 — — 40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IACS WO CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 110% above 40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT MASTOIDS W/O CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 110% above 40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL BONE/ORBIT/EAR W/O CONT $1,277.65 $2,129.42 $180.74–$2,342.36 110% above 40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/MASTOID W/O CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 110% above 40%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBITS WO CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 110% above 40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT MASTOIDS W/O CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 — 40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL BONE/ORBIT/EAR W/O CONT $1,277.65 $2,129.42 $180.74–$2,342.36 — 40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IACS WO CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 — 40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS WO CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 — 40%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT/MASTOID W/O CONTRAST $1,277.65 $2,129.42 $180.74–$2,342.36 — 40%
Facial bones X-ray, complete, 3 or more views CPT 70150 XR FACIAL BONES COMPLETE MIN 3 VIEWS $238.59 $397.65 $42.38–$437.41 52% above 40%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES COMPLETE MIN 3 VIEWS $238.59 $397.65 $42.38–$437.41 — 40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM LT 2 VIEWS $223.75 $372.91 — 97% above 40%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM RT 2 VIEWS $223.75 $372.91 — 97% above 40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM RT 2 VIEWS $223.75 $372.91 — — 40%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM LT 2 VIEWS $223.75 $372.91 — — 40%
Hand X-ray, 2 views one side CPT 73120 XR HAND LT 2 VIEWS $251.10 $418.50 — 138% above 40%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND LT 2 VIEWS $251.10 $418.50 — — 40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL CALCANEUS OR CALCIS 2V LT $157.42 $262.37 — 44% above 40%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 XR HEEL CALCANEUS OR CALCIS 2 VIEW RT $157.42 $262.37 — 44% above 40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL CALCANEUS OR CALCIS 2 VIEW RT $157.42 $262.37 — — 40%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL CALCANEUS OR CALCIS 2V LT $157.42 $262.37 — — 40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED-SIMULT RECORDING $546.58 $910.97 $224.40–$1,002.06 171% above 40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED-SIMULT RECORDING $546.58 $910.97 $224.40–$1,002.06 — 40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CPAP/BIPAP/SPLIT <6 HOURS $2,858.90 $4,764.84 $1,125.49–$5,241.32 111% above 40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP< 6 HOURS $2,858.90 $4,764.84 $1,125.49–$5,241.32 111% above 40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 CPAP TITRATION/SPLIT NIGHT ST > 6YRS $2,858.90 $4,764.84 $1,125.49–$5,241.32 111% above 40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP< 6 HOURS $2,858.90 $4,764.84 $1,125.49–$5,241.32 — 40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CPAP/BIPAP/SPLIT <6 HOURS $2,858.90 $4,764.84 $1,125.49–$5,241.32 — 40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 CPAP TITRATION/SPLIT NIGHT ST > 6YRS $2,858.90 $4,764.84 $1,125.49–$5,241.32 — 40%
Knee X-ray, 3 views one side CPT 73562 XR KNEE LT 3 VIEWS $250.17 $416.95 — 85% above 40%
Knee X-ray, 3 views one side CPT 73562 XR KNEE RT 3 VIEWS $250.17 $416.95 — 85% above 40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE LT 3 VIEWS $250.17 $416.95 — — 40%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE RT 3 VIEWS $250.17 $416.95 — — 40%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMP 4 OR MORE VIEWS RT $282.98 $471.64 — 85% above 40%
Knee X-ray, complete, 4 or more views one side CPT 73564 KNEE COMP 4 OR MORE VIEWS LT $282.98 $471.64 — 85% above 40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMP 4 OR MORE VIEWS RT $282.98 $471.64 — — 40%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 KNEE COMP 4 OR MORE VIEWS LT $282.98 $471.64 — — 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT HIP W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT LOWER EXT WITHOUT CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT LOWER LEG W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT FEMUR W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT FOOT W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT KNEE W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT KNEE W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT LOWER EXTREMITY WO CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT LOWER LEG W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT ANKLE W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT FEMUR W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT FOOT W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT ANKLE W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT HIP W/O CONTRAST $1,137.42 $1,895.70 — 87% above 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT LOWER EXTREMITY WO CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT KNEE W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT HIP W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT FOOT W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT FEMUR W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT LOWER LEG W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT LOWER EXT WITHOUT CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT HIP W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT KNEE W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT FOOT W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT ANKLE W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT ANKLE W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT LOWER LEG W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT FEMUR W/O CONTRAST $1,137.42 $1,895.70 — — 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED $428.53 $714.22 $94.17–$785.64 63% above 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN/FLD LOCAL LIMITED $428.53 $714.22 $94.17–$785.64 63% above 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER ECHO ABD B-SCAN LIMITED $428.53 $714.22 $94.17–$785.64 63% above 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER LIMITED $428.53 $714.22 $94.17–$785.64 63% above 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS LIMITED $428.53 $714.22 $94.17–$785.64 63% above 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN LIMITED $428.53 $714.22 $94.17–$785.64 63% above 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS LIMITED $428.53 $714.22 $94.17–$785.64 — 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER ECHO ABD B-SCAN LIMITED $428.53 $714.22 $94.17–$785.64 — 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED $428.53 $714.22 $94.17–$785.64 — 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN/FLD LOCAL LIMITED $428.53 $714.22 $94.17–$785.64 — 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER LIMITED $428.53 $714.22 $94.17–$785.64 — 40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN LIMITED $428.53 $714.22 $94.17–$785.64 — 40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LOW DOSE FOR CANCER SCR WO CO $372.58 $620.96 $117.45–$683.05 142% above 40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LOW DOSE FOR CANCER SCR WO CO $372.58 $620.96 $117.45–$683.05 — 40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB 2 VIEWS LT $228.31 $380.51 — 94% above 40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB LT 1 VIEW $228.31 $380.51 — 94% above 40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB 2 VIEWS RT $228.31 $380.51 — 94% above 40%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 TIB/FIB RT 1 VIEW $228.31 $380.51 — 94% above 40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB RT 1 VIEW $228.31 $380.51 — — 40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB 2 VIEWS LT $228.31 $380.51 — — 40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB 2 VIEWS RT $228.31 $380.51 — — 40%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 TIB/FIB LT 1 VIEW $228.31 $380.51 — — 40%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD W/O CONTRAST $1,906.34 $3,177.24 $286.84–$3,494.96 110% above 40%
MR angiography (MRA) of the head without contrast CPT 70544 MRV HEAD W/O CONTRAST $1,906.34 $3,177.24 $286.84–$3,494.96 110% above 40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD W/O CONTRAST $1,906.34 $3,177.24 $286.84–$3,494.96 — 40%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRV HEAD W/O CONTRAST $1,906.34 $3,177.24 $286.84–$3,494.96 — 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HEEL LT W/O CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP KNEE ANKLE W/O CONTRAST LT $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE RT W/O CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE RT WO CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LT W/O CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP RT W/O CONTRST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP LT W/O CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP KNEE ANKLE W/O CONTRAST RT $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HEEL RT WO CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE LT W/O CONTRAST $1,836.05 $3,060.09 — 69% above 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HEEL LT W/O CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE RT WO CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE RT W/O CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HEEL RT WO CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP KNEE ANKLE W/O CONTRAST LT $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI KNEE LT W/O CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE LT W/O CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP RT W/O CONTRST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP LT W/O CONTRAST $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI HIP KNEE ANKLE W/O CONTRAST RT $1,836.05 $3,060.09 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP RT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE LT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE RT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 INACTIVE $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HEEL LT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HEEL RT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP LT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI KNEE RT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LT W/WO CONTRAST $2,482.79 $4,137.99 — 94% above 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP RT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HIP LT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HEEL RT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE RT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE LT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE RT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI KNEE LT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 INACTIVE $2,482.79 $4,137.99 — — 40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI HEEL LT W/WO CONTRAST $2,482.79 $4,137.99 — — 40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST $1,846.39 $3,077.31 $300.85–$3,385.04 87% above 40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST $1,846.39 $3,077.31 $300.85–$3,385.04 — 40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST $2,905.73 $4,842.88 $512.69–$5,327.16 118% above 40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST $2,905.73 $4,842.88 $512.69–$5,327.16 — 40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN & IACS W/O CONTRAST $1,903.69 $3,172.82 $236.03–$3,490.10 69% above 40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN & PITUATARY W/O CONT $1,903.69 $3,172.82 $236.03–$3,490.10 69% above 40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST $1,903.69 $3,172.82 $236.03–$3,490.10 69% above 40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN & PITUATARY W/O CONT $1,903.69 $3,172.82 $236.03–$3,490.10 — 40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST $1,903.69 $3,172.82 $236.03–$3,490.10 — 40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN & IACS W/O CONTRAST $1,903.69 $3,172.82 $236.03–$3,490.10 — 40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN & IACS W/WO CONTRAST $2,650.42 $4,417.37 $385.36–$4,859.10 83% above 40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST $2,650.42 $4,417.37 $385.36–$4,859.10 83% above 40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN & PITUITARY W WO CONTRAST $2,650.42 $4,417.37 $385.36–$4,859.10 83% above 40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN & PITUITARY W WO CONTRAST $2,650.42 $4,417.37 $385.36–$4,859.10 — 40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST $2,650.42 $4,417.37 $385.36–$4,859.10 — 40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN & IACS W/WO CONTRAST $2,650.42 $4,417.37 $385.36–$4,859.10 — 40%
MRI of the lower back, no contrast dye CPT 72148 MRI L- SPINE W/O CONTRAST $1,865.24 $3,108.74 $229.15–$3,419.61 65% above 40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L- SPINE W/O CONTRAST $1,865.24 $3,108.74 $229.15–$3,419.61 — 40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L- SPINE W/WO CONTRAST $2,795.92 $4,659.86 $386.41–$5,125.84 101% above 40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L- SPINE W/WO CONTRAST $2,795.92 $4,659.86 $386.41–$5,125.84 — 40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T-SPINE W/O CONTRAST $1,868.53 $3,114.21 $230.20–$3,425.63 68% above 40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T-SPINE W/O CONTRAST $1,868.53 $3,114.21 $230.20–$3,425.63 — 40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C-SPINE W/WO CONTRAST $2,796.39 $4,660.65 $387.81–$5,126.71 75% above 40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C-SPINE W/WO CONTRAST $2,796.39 $4,660.65 $387.81–$5,126.71 — 40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONTRAST $1,942.75 $3,237.91 $229.86–$3,561.70 85% above 40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O CONTRAST $1,942.75 $3,237.91 $229.86–$3,561.70 — 40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/WO CONTRAST $2,530.81 $4,218.02 $511.63–$4,639.82 127% above 40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST $2,530.81 $4,218.02 $511.63–$4,639.82 — 40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O CONTRAST $1,925.20 $3,208.66 $301.07–$3,529.52 120% above 40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST $1,925.20 $3,208.66 $301.07–$3,529.52 — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 INACTIVE $1,845.03 $3,075.05 $241.88–$3,382.55 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER ELBOW WRIST W/O CONT RT $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LT W/O CONTRAST $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT OTH JNT WO CONT LT $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RT W/O CONTRAST $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LT W/O CONTRAST $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RT W/O CONTRAST $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LT W/O CONTRAST $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER ELBOW WRIST W/O CONT LT $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RT W/O CONTRAST $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI UPPER EXT OTH JNT WO CONT RT $1,845.03 $3,075.05 — 89% above 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 INACTIVE $1,845.03 $3,075.05 $241.88–$3,382.55 — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW RT W/O CONTRAST $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER RT W/O CONTRAST $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXT OTH JNT WO CONT RT $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER ELBOW WRIST W/O CONT LT $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST RT W/O CONTRAST $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI ELBOW LT W/O CONTRAST $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI UPPER EXT OTH JNT WO CONT LT $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER ELBOW WRIST W/O CONT RT $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SHOULDER LT W/O CONTRAST $1,845.03 $3,075.05 — — 40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI WRIST LT W/O CONTRAST $1,845.03 $3,075.05 — — 40%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR CERVICAL SPINE 4 OR 5 VIEWS $337.82 $563.03 $46.57–$619.33 66% above 40%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERVICAL SPINE 4 OR 5 VIEWS $337.82 $563.03 $46.57–$619.33 — 40%
Neck soft tissue CT scan with contrast CPT 70491 CT NECK-SOFT TISSUE WITH CONTRAST $1,409.38 $2,348.97 $240.14–$2,583.86 105% above 40%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT NECK-SOFT TISSUE WITH CONTRAST $1,409.38 $2,348.97 $240.14–$2,583.86 — 40%
Neck soft tissue CT scan without contrast CPT 70490 CT NECK-SOFT TISSUE WITHOUT CONTRAST $1,150.14 $1,916.90 $180.74–$2,108.59 70% above 40%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT NECK-SOFT TISSUE WITHOUT CONTRAST $1,150.14 $1,916.90 $180.74–$2,108.59 — 40%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE $192.99 $321.65 $28.67–$353.81 69% above 40%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE $192.99 $321.65 $28.67–$353.81 — 40%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WITHOUT CONTRAST $1,142.80 $1,904.66 $150.35–$2,095.12 65% above 40%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WITHOUT CONTRAST $1,142.80 $1,904.66 $150.35–$2,095.12 — 40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED OR FOLLOW UP $325.48 $542.46 $50.70–$596.70 84% above 40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US SOFT TISSUE OF BUTTOCKS $325.48 $542.46 $50.70–$596.70 84% above 40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US SOFT TISSUE OF BUTTOCKS $325.48 $542.46 $50.70–$596.70 — 40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED OR FOLLOW UP $325.48 $542.46 $50.70–$596.70 — 40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMPLETE $505.62 $842.70 $113.65–$926.97 81% above 40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMPLETE $505.62 $842.70 $113.65–$926.97 — 40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US 1ST TRIMESTER > THAN 14 WEEKS $379.88 $633.14 $147.58–$696.45 45% above 40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US 1ST TRIMESTER > THAN 14 WEEKS $379.88 $633.14 $147.58–$696.45 — 40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB FIRST TRIMESTER < 14 WKS $440.61 $734.35 $128.55–$807.78 87% above 40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB FIRST TRIMESTER < 14 WKS $440.61 $734.35 $128.55–$807.78 — 40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US LIMITED OB 1 +/= FETUS $253.15 $421.92 $88.26–$464.11 46% above 40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US LIMITED OB 1 +/= FETUS $253.15 $421.92 $88.26–$464.11 — 40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILATERAL LT 2 VIEWS $196.60 $327.67 — 46% above 40%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILATERAL RT 2 VIEWS $196.60 $327.67 — 46% above 40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNILATERAL RT 2 VIEWS $196.60 $327.67 — — 40%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNILATERAL LT 2 VIEWS $196.60 $327.67 — — 40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RT UNILATERAL RIB WITH CHEST MIN 3 V $325.57 $542.61 — 138% above 40%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR LT UNILATERAL RIB WITH CHEST MIN 3 V $325.57 $542.61 — 138% above 40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RT UNILATERAL RIB WITH CHEST MIN 3 V $325.57 $542.61 — — 40%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR LT UNILATERAL RIB WITH CHEST MIN 3 V $325.57 $542.61 — — 40%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO W/CAD BILATERAL 2 OR 3D $273.64 $456.06 $118.88–$501.66 — 40%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BILATERAL 2 OR 3D $273.64 $456.06 $118.88–$501.66 — 40%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO W/CAD BILATERAL 2 OR 3D $273.64 $456.06 $118.88–$501.66 — 40%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BILATERAL 2 OR 3D $273.64 $456.06 $118.88–$501.66 — 40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER RT COMPLETE MIN 2 VIEWS RT $262.82 $438.04 — 101% above 40%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 SHOULDER LT COMPLETE MIN 2 VIEWS LT $262.82 $438.04 — 101% above 40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER LT COMPLETE MIN 2 VIEWS LT $262.82 $438.04 — — 40%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 SHOULDER RT COMPLETE MIN 2 VIEWS RT $262.82 $438.04 — — 40%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUS COMPLETE MIN 3 VIEWS $233.12 $388.53 $38.48–$427.38 48% above 40%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS COMPLETE MIN 3 VIEWS $233.12 $388.53 $38.48–$427.38 — 40%
Skull X-ray, fewer than 4 views CPT 70250 XR SKULL LESS THAN 4 VIEWS $243.73 $406.21 $37.04–$446.83 81% above 40%
Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL LESS THAN 4 VIEWS $243.73 $406.21 $37.04–$446.83 — 40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 6YRS OR OLDER $2,728.19 $4,546.98 $1,125.49–$5,001.67 112% above 40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 6YRS OR OLDER $2,728.19 $4,546.98 $1,125.49–$5,001.67 — 40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 PT SWALLOW STUDY $438.76 $731.26 $125.19–$804.38 82% above 40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 BARIUM STUDY ESOPHAGRAM $438.76 $731.26 $125.19–$804.38 82% above 40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOW STUDY $443.60 $739.33 $125.19–$813.26 84% above 40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 PT SWALLOW STUDY $438.76 $731.26 $125.19–$804.38 — 40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 BARIUM STUDY ESOPHAGRAM $438.76 $731.26 $125.19–$804.38 — 40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOW STUDY $443.60 $739.33 $125.19–$813.26 — 40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR RT MIN 2 VIEWS $228.99 $381.65 — 99% above 40%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR MIN 2 VIEWS LT $228.99 $381.65 — 99% above 40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR RT MIN 2 VIEWS $228.99 $381.65 — — 40%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR MIN 2 VIEWS LT $228.99 $381.65 — — 40%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE WITHOUT CONTRAST $1,345.87 $2,243.12 $165.35–$2,467.43 78% above 40%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-SPINE WITHOUT CONTRAST $1,345.87 $2,243.12 $165.35–$2,467.43 — 40%
Toe X-ray, 2 or more views CPT 73660 XR TOE(S) MIN 2 VIEWS $173.86 $289.76 $28.49–$318.73 56% above 40%
Toe X-ray, 2 or more views inpatient CPT 73660 XR TOE(S) MIN 2 VIEWS $173.86 $289.76 $28.49–$318.73 — 40%
Transvaginal pelvic ultrasound CPT 76830 US PELVIC TRANSVAGINAL $421.27 $702.11 $125.55–$772.32 100% above 40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US PELVIC TRANSVAGINAL $421.27 $702.11 $125.55–$772.32 — 40%
Transvaginal ultrasound during pregnancy CPT 76817 US OB PREGNANT UTERUS TRANSVAGINAL $440.57 $734.29 $101.44–$807.71 147% above 40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB PREGNANT UTERUS TRANSVAGINAL $440.57 $734.29 $101.44–$807.71 — 40%
Ultrasound of the abdomen, complete CPT 76700 US UPPER ABDOMEN COMPLETE $665.48 $1,109.14 $126.09–$1,220.05 121% above 40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US UPPER ABDOMEN COMPLETE $665.48 $1,109.14 $126.09–$1,220.05 — 40%
Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR $441.55 $735.91 $71.41–$809.50 110% above 40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US TESTICULAR $441.55 $735.91 $71.41–$809.50 — 40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID SOFT TISSUE OF HEAD/NECK $494.32 $823.87 $118.90–$906.25 96% above 40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID SOFT TISSUE OF HEAD/NECK $494.32 $823.87 $118.90–$906.25 — 40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 GI SERIES W/KUB $573.43 $955.71 $115.05–$1,051.28 126% above 40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI SERIES W/O KUB $573.43 $955.71 $115.05–$1,051.28 126% above 40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 GI SERIES W/KUB $573.43 $955.71 $115.05–$1,051.28 — 40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI SERIES W/O KUB $573.43 $955.71 $115.05–$1,051.28 — 40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMEROUS 1 OR 2 VIEWS LT $230.10 $383.50 — 98% above 40%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HUMEROUS 1 OR 2 VIEWS RT $230.10 $383.50 — 98% above 40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMEROUS 1 OR 2 VIEWS LT $230.10 $383.50 — — 40%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 HUMEROUS 1 OR 2 VIEWS RT $230.10 $383.50 — — 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXTREMITY VENOUS LOWER LEFT $501.46 $835.77 — 95% above 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXTREMITY VENOUS LOWER RIGHT $501.46 $835.77 — 95% above 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXTREMITY VENOUS UPPER LEFT $501.46 $835.77 — 95% above 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US EXTREMITY VENOUS UPPER RIGHT $501.46 $835.77 — 95% above 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXTREMITY VENOUS UPPER LEFT $501.46 $835.77 — — 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXTREMITY VENOUS LOWER LEFT $501.46 $835.77 — — 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXTREMITY VENOUS UPPER RIGHT $501.46 $835.77 — — 40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US EXTREMITY VENOUS LOWER RIGHT $501.46 $835.77 — — 40%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST RT 2 VIEWS $206.40 $344.00 — 89% above 40%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEWS LT $206.40 $344.00 — 89% above 40%
Wrist X-ray, 2 views one side CPT 73100 WRIST 2 VIEWS RT $206.40 $344.00 — 89% above 40%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEWS LT $206.40 $344.00 — — 40%
Wrist X-ray, 2 views inpatient one side CPT 73100 WRIST 2 VIEWS RT $206.40 $344.00 — — 40%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST RT 2 VIEWS $206.40 $344.00 — — 40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST RT COMP MIN 3 VIEWS $213.67 $356.12 — 86% above 40%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST LT COMP MIN 3 VIEWS $213.67 $356.12 — 86% above 40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST RT COMP MIN 3 VIEWS $213.67 $356.12 — — 40%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST LT COMP MIN 3 VIEWS $213.67 $356.12 — — 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HIP PELVIS CHILD UNILAT RT MIN 2 VIEWS $238.10 $396.83 — 90% above 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP PELVIS MIN 2 VIEWS LT UNILATERAL $238.10 $396.83 — 90% above 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNLATRL RT, W/O PELVIS 2-3 V $238.10 $396.83 — 90% above 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT UNILA W/PELVIS MIN 2 VIEWS LT $238.10 $396.83 — 90% above 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT UNILAT W/PELVIS MIN 2 VIEWS $238.10 $396.83 — 90% above 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP RT UNILAT W/PELVIS MIN 2 VIEWS $238.10 $396.83 — — 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP PELVIS MIN 2 VIEWS LT UNILATERAL $238.10 $396.83 — — 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP LT UNILA W/PELVIS MIN 2 VIEWS LT $238.10 $396.83 — — 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNLATRL RT, W/O PELVIS 2-3 V $238.10 $396.83 — — 40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 HIP PELVIS CHILD UNILAT RT MIN 2 VIEWS $238.10 $396.83 — — 40%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN FLAT (KUB) XRAY $231.99 $386.65 $27.94–$425.31 81% above 40%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN FLAT (KUB) XRAY $231.99 $386.65 $27.94–$425.31 — 40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS RT $217.24 $362.07 — 101% above 40%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 2 VIEWS LT $217.24 $362.07 — 101% above 40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS RT $217.24 $362.07 — — 40%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEWS LT $217.24 $362.07 — — 40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER RT 5TH DIGIT $156.71 $261.19 — 53% above 40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER RT THUMB $156.71 $261.19 $31.99–$287.30 53% above 40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER LT 2ND DIGIT $156.71 $261.19 $31.99–$287.30 53% above 40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER LT 5TH DIGIT $156.71 $261.19 $31.99–$287.30 53% above 40%
X-ray of the finger(s), 2 or more views one side CPT 73140 FINGER LT THUMB $156.71 $261.19 — 53% above 40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER RT 5TH DIGIT $156.71 $261.19 — — 40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER LT 2ND DIGIT $156.71 $261.19 $31.99–$287.30 — 40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER LT THUMB $156.71 $261.19 — — 40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER RT THUMB $156.71 $261.19 $31.99–$287.30 — 40%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 FINGER LT 5TH DIGIT $156.71 $261.19 $31.99–$287.30 — 40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1 OR 2 VIEWS RT $229.87 $383.11 — 113% above 40%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1 OR 2 VIEWS LT $229.87 $383.11 — 113% above 40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 OR 2 VIEWS LT $229.87 $383.11 — — 40%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1 OR 2 VIEWS RT $229.87 $383.11 — — 40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT LT COMP MIN 3 VIEWS LT $215.23 $358.72 — 76% above 40%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT RT COMP MIN 3 VIEWS $215.23 $358.72 — 76% above 40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT RT COMP MIN 3 VIEWS $215.23 $358.72 — — 40%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT LT COMP MIN 3 VIEWS LT $215.23 $358.72 — — 40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND RT MIN 3 VIEWS $233.05 $388.42 — 84% above 40%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND LT MIN 3 VIEWS $233.05 $388.42 — 84% above 40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND RT MIN 3 VIEWS $233.05 $388.42 — — 40%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND LT MIN 3 VIEWS $233.05 $388.42 — — 40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LT 1 OR 2 VIEWS $213.67 $356.12 — 88% above 40%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE RT 1 OR 2 VIEWS $213.67 $356.12 — 88% above 40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE LT 1 OR 2 VIEWS $213.67 $356.12 — — 40%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE RT 1 OR 2 VIEWS $213.67 $356.12 — — 40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR SPINE LUMBOSCRAL 2 OR 3 VIEWS $285.49 $475.81 $35.89–$523.39 88% above 40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR SPINE LUMBOSCRAL 2 OR 3 VIEWS $285.49 $475.81 $35.89–$523.39 — 40%
X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL MIN 4 VIEWS $356.66 $594.44 $50.08–$653.88 64% above 40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL MIN 4 VIEWS $356.66 $594.44 $50.08–$653.88 — 40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR SPINE; THORACIC 2 VIEWS $255.69 $426.15 $34.85–$468.76 63% above 40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR SPINE; THORACIC 2 VIEWS $255.69 $426.15 $34.85–$468.76 — 40%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPLETE MIN 3 VIEWS $196.21 $327.01 $33.22–$359.71 68% above 40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPLETE MIN 3 VIEWS $196.21 $327.01 $33.22–$359.71 — 40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR CERVICAL SPINE 2 - 3 VIEWS $257.82 $429.70 $33.79–$472.67 79% above 40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICAL SPINE 2 - 3 VIEWS $257.82 $429.70 $33.79–$472.67 — 40%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS AP 1 OR 2 VIEWS $242.09 $403.48 $32.53–$443.82 83% above 40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS AP 1 OR 2 VIEWS $242.09 $403.48 $32.53–$443.82 — 40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 COCCYX & SACRUM MIN 2 VIEWS $226.05 $376.75 $28.67–$414.42 65% above 40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 COCCYX & SACRUM MIN 2 VIEWS $226.05 $376.75 $28.67–$414.42 — 40%

Lab tests

ProcedureCash price List priceInsurers payvs LouisianaOff list
ACTH blood test CPT 82024 O Z/ ACTH $179.12 $298.54 $38.62–$301.52 69% above 40%
ACTH blood test CPT 82024 Z/ ACTH $179.12 $298.54 $38.62–$301.52 69% above 40%
ACTH blood test inpatient CPT 82024 Z/ ACTH $179.12 $298.54 $38.62–$301.52 — 40%
ACTH blood test inpatient CPT 82024 O Z/ ACTH $179.12 $298.54 $38.62–$301.52 — 40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 O SGPT (ALT) $26.17 $43.62 $5.30–$44.05 35% above 40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 .ALANINE AMINO (ALT)(SGPT) $26.17 $43.62 $5.30–$44.05 35% above 40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT (ALT) $26.17 $43.62 $5.30–$44.05 35% above 40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 .ALANINE AMINO (ALT)(SGPT) $26.17 $43.62 $5.30–$44.05 — 40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 SGPT (ALT) $26.17 $43.62 $5.30–$44.05 — 40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 O SGPT (ALT) $26.17 $43.62 $5.30–$44.05 — 40%
AST (aspartate aminotransferase) enzyme test CPT 84450 .SGOT (AST) $10.20 $17.00 $5.18–$19.19 48% below 40%
AST (aspartate aminotransferase) enzyme test CPT 84450 O SGOT (AST) $23.70 $39.50 $5.18–$39.89 20% above 40%
AST (aspartate aminotransferase) enzyme test CPT 84450 SGOT (AST) $23.70 $39.50 $5.18–$39.89 20% above 40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 .SGOT (AST) $10.20 $17.00 $5.18–$19.19 — 40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 SGOT (AST) $23.70 $39.50 $5.18–$39.89 — 40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 O SGOT (AST) $23.70 $39.50 $5.18–$39.89 — 40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Z/ HEPATITIS PANEL ACUTE $233.68 $389.46 $47.63–$393.35 111% above 40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 O HEPATITIS PANEL $233.68 $389.46 $47.63–$393.35 111% above 40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 DELETE.HEPATITIS PANEL $233.68 $389.46 $47.63–$393.35 111% above 40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 O Z/ HEPATITIS PANEL ACUTE $233.68 $389.46 $47.63–$393.35 111% above 40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 O Z/ HEPATITIS PANEL ACUTE $233.68 $389.46 $47.63–$393.35 — 40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 O HEPATITIS PANEL $233.68 $389.46 $47.63–$393.35 — 40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 DELETE.HEPATITIS PANEL $233.68 $389.46 $47.63–$393.35 — 40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Z/ HEPATITIS PANEL ACUTE $233.68 $389.46 $47.63–$393.35 — 40%
Albumin blood test CPT 82040 ALBUMIN SERUM $38.92 $64.87 $4.95–$65.51 175% above 40%
Albumin blood test CPT 82040 O ALBUMIN SERUM $38.92 $64.87 $4.95–$65.51 175% above 40%
Albumin blood test inpatient CPT 82040 O ALBUMIN SERUM $38.92 $64.87 $4.95–$65.51 — 40%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM $38.92 $64.87 $4.95–$65.51 — 40%
Aldosterone blood test CPT 82088 .R1 RENIN ACT & ADOLESCENCE $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 Z/ ALDOSTERONE URINE, 24HR $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 O Z/ ALDOSTERONE/RENIN ACTIVITY RATIO $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 DELETE.Z/ ALDOSTERONE/RENIN ACTIVITY RA $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 O ALDOSTERONE URINE $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 O Z/ ALDOSTERONE $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 O .R1 RENIN ACT & ADOLESCENCE $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test CPT 82088 Z/ ALDOSTERONE $206.05 $343.42 $40.75–$346.85 116% above 40%
Aldosterone blood test inpatient CPT 82088 O Z/ ALDOSTERONE/RENIN ACTIVITY RATIO $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 O ALDOSTERONE URINE $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 Z/ ALDOSTERONE URINE, 24HR $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 Z/ ALDOSTERONE $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 .R1 RENIN ACT & ADOLESCENCE $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 DELETE.Z/ ALDOSTERONE/RENIN ACTIVITY RA $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 O Z/ ALDOSTERONE $206.05 $343.42 $40.75–$346.85 — 40%
Aldosterone blood test inpatient CPT 82088 O .R1 RENIN ACT & ADOLESCENCE $206.05 $343.42 $40.75–$346.85 — 40%
Alkaline phosphatase (ALP) blood test CPT 84075 O ALKALINE PHOSPHATASE $34.35 $57.25 $5.18–$57.82 80% above 40%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE $34.35 $57.25 $5.18–$57.82 80% above 40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 O ALKALINE PHOSPHATASE $34.35 $57.25 $5.18–$57.82 — 40%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE $34.35 $57.25 $5.18–$57.82 — 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE CAT DANDER $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE DOG DANDER IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ HYMENOPTERA PROFILE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE FOOD CITRUS $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 CRAB ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O .1 ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE FOOD SHELLFISH $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 DELETE.R/ ALLERGEN IGE LATEX $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE FOOD, MILK $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O .1 ALLERGEN SPEC IGE QUANT OR SEMIQUAT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE FOOD/NUT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 DELETE.R/ ALLERGEN PINE NUT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE IGE EGG WHITE COMP $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE IGE EGG YOLK $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 DELETE.R/ ALLERGEN PROFILE-FOOD BASIC $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE W/ IGE RESP 3 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 DELETE.Z/ ALLERGEN CRAWFISH $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PROFILE-FOOD BASIC $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN SPECIFIC CANDIDA ALBICA IG $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE MILK w/RFLX COMPONEN $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN SPECIFIC FOOD IGE W/REFLEX $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 DELETE.Z/ MOLD ALLERGEN $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O RAST PANEL ALLERGY $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O SALMON ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O CATFISH ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O SHRIMP ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O TUNA ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O CEDAR MOUNTAIN ALLERGEN $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 .ALLERGEN 5 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 .ALLERGEN 9 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O CODFISH ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE MILK IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 .1 ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN GRASSES (6) $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O CRAB ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLEREN SPEC IGE QUANT OR SEMIQUAT EA SP $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ MOLD ALLERGEN $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN IGE LATEX $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN ANIMALS (4) $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN CATFISH $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PINE NUT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN CEDAR MOUNTAIN $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN DUST MITES $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE FISH QUANTITATIVE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN FIRE ANT IGE (INVICTA) $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 .1 ALLERGEN SPEC IGE QUANT OR SEMIQUAT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE FOOD CITRUS $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE IGE EGG YOLK $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN LATEX IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PEANUT IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PINE NUT IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O .ALLERGEN 5 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE CAT DANDER $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE FOOD, MILK $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA ALLERGY TEST $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN WEEDS (10) $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST PANEL ALLERGY $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE FOOD/NUT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 R/ PEANUT COMPONENT PANEL $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN TREE (10) $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE DOG DANDER IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE IGE EGG WHITE COMP $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD BASIC IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD BERRY $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE IGE EGG YOLK $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD CITRUS IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD FISH $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN PROFILE-FOOD BASIC $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O .ALLERGEN 9 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O .RAST ZONE 6 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O ALLEREN SPEC IGE QUANT OR SEMIQUAT EA $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O ALLERGENS 24 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O ALLERGENS 4 $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O ALLERGY MILK (COW) $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN SPECIFIC CANDIDA ALBICA IG $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 R/ CAT HAIR/DANDER $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 R/ ASCARIS $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ALLERGEN SPECIFIC FOOD IGE W/REFLEX $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 R/ ALLERGEN SPECIFIC CANDIDA ALBICA IGG $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 R/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD NUT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ ASCARIS $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD SHELLFISH $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE FOOD SHRIMP IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ CAT HAIR/DANDER $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE IGE EGG WHITE COMP $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 R/ ALLERGEN PROFILE FISH QUANTITATIVE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O R/ PEANUT COMPONENT PANEL $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN CRAWFISH $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN SPECIFIC CANDIDA ALBICANS $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN IGE LATEX $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN SALMON $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PEANUT IGE $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN PROFILE PERENNIAL $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 O Z/ ALLERGEN PINE NUT $40.55 $67.58 $5.22–$68.25 315% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 Z/ ALLERGEN INSECTS (7) $40.83 $68.05 $5.22–$68.73 317% above 40%
Allergy blood test, specific IgE, per allergen CPT 86003 .ALLERGENS 25 $70.87 $118.11 $5.22–$119.29 625% above 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN SPECIFIC CANDIDA ALBICA IG $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CRAB ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DELETE.R/ ALLERGEN IGE LATEX $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DELETE.R/ ALLERGEN PINE NUT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DELETE.R/ ALLERGEN PROFILE-FOOD BASIC $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DELETE.Z/ ALLERGEN CRAWFISH $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DELETE.Z/ MOLD ALLERGEN $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O CATFISH ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O CEDAR MOUNTAIN ALLERGEN $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O CODFISH ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O CRAB ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN IGE LATEX $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PINE NUT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE FISH QUANTITATIVE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE FOOD CITRUS $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE FOOD, MILK $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE FOOD/NUT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE IGE EGG WHITE COMP $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE IGE EGG YOLK $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN PROFILE-FOOD BASIC $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN SPECIFIC CANDIDA ALBICA IG $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ALLERGEN SPECIFIC FOOD IGE W/REFLEX $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ ASCARIS $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ CAT HAIR/DANDER $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O R/ PEANUT COMPONENT PANEL $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN CRAWFISH $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN IGE LATEX $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PEANUT IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PINE NUT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE CAT DANDER $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE DOG DANDER IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE FOOD CITRUS $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE FOOD SHELLFISH $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE FOOD, MILK $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE FOOD/NUT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE IGE EGG WHITE COMP $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE IGE EGG YOLK $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE W/ IGE RESP 3 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN PROFILE-FOOD BASIC $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ ALLERGEN SPECIFIC FOOD IGE W/REFLEX $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O RAST PANEL ALLERGY $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O SALMON ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O SHRIMP ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O TUNA ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .ALLERGEN 5 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .ALLERGEN 9 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .1 ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .1 ALLERGEN SPEC IGE QUANT OR SEMIQUAT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLEREN SPEC IGE QUANT OR SEMIQUAT EA SP $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O Z/ MOLD ALLERGEN $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN ANIMALS (4) $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN CATFISH $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN CEDAR MOUNTAIN $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN DUST MITES $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN FIRE ANT IGE (INVICTA) $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN GRASSES (6) $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN LATEX IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PEANUT IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PINE NUT IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA ALLERGY TEST $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST PANEL ALLERGY $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 R/ PEANUT COMPONENT PANEL $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE CAT DANDER $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE DOG DANDER IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD BASIC IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD BERRY $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD CITRUS IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD FISH $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 R/ CAT HAIR/DANDER $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 R/ ASCARIS $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 R/ ALLERGEN SPECIFIC CANDIDA ALBICA IGG $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 R/ ALLERGEN PROFILE FOOD FRUIT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD NUT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD SHELLFISH $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE FOOD SHRIMP IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 R/ ALLERGEN PROFILE FISH QUANTITATIVE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O ALLERGY MILK (COW) $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O ALLERGENS 4 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O ALLERGENS 24 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O ALLEREN SPEC IGE QUANT OR SEMIQUAT EA $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O .RAST ZONE 6 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O .ALLERGEN 9 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE IGE EGG WHITE COMP $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE IGE EGG YOLK $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE MILK IGE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE MILK w/RFLX COMPONEN $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN PROFILE PERENNIAL $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN SALMON $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN SPECIFIC CANDIDA ALBICANS $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN TREE (10) $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN WEEDS (10) $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O .ALLERGEN 5 $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O .1 ALLERGEN SPEC IGE QUANT OR SEMIQUAT $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 O .1 ALLERGEN PROFILE MOLD $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ HYMENOPTERA PROFILE $40.55 $67.58 $5.22–$68.25 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Z/ ALLERGEN INSECTS (7) $40.83 $68.05 $5.22–$68.73 — 40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 .ALLERGENS 25 $70.87 $118.11 $5.22–$119.29 — 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 O .1 R/ ALPHA FETOPROTEIN SERUM $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 O Z/ AFP - FETOPROTEIN TETRA PROFILE $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 .1 R/ ALPHA FETOPROTEIN SERUM $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Z/ AFP ALPHA-FETOPROTEIN TETRA PROFILE $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 Z/ AFP ALPHA-FETOPROTEIN TUMOR MARKER $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 DELETE.Z/ AFP - FETOPROTEIN TETRA PR $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test CPT 82105 O Z/ AFP (ALPHA FETOPROTEIN) TUMOR MARKR $102.13 $170.21 $16.77–$171.91 109% above 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Z/ AFP ALPHA-FETOPROTEIN TETRA PROFILE $102.13 $170.21 $16.77–$171.91 — 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 O Z/ AFP - FETOPROTEIN TETRA PROFILE $102.13 $170.21 $16.77–$171.91 — 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 .1 R/ ALPHA FETOPROTEIN SERUM $102.13 $170.21 $16.77–$171.91 — 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 DELETE.Z/ AFP - FETOPROTEIN TETRA PR $102.13 $170.21 $16.77–$171.91 — 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 O .1 R/ ALPHA FETOPROTEIN SERUM $102.13 $170.21 $16.77–$171.91 — 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 Z/ AFP ALPHA-FETOPROTEIN TUMOR MARKER $102.13 $170.21 $16.77–$171.91 — 40%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 O Z/ AFP (ALPHA FETOPROTEIN) TUMOR MARKR $102.13 $170.21 $16.77–$171.91 — 40%
Ammonia blood test CPT 82140 O Z/ AMMONIA $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test CPT 82140 O AMMONIA $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test CPT 82140 O .3 FACTOR II PROTIME DNA ANALYSIS $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test CPT 82140 Z/ AMMONIA $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test CPT 82140 AMMONIA $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test CPT 82140 .3 FACTOR II PROTIME DNA ANALYSIS $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test CPT 82140 .AMMONIUM, URINE $103.97 $173.28 $14.57–$175.01 111% above 40%
Ammonia blood test inpatient CPT 82140 .AMMONIUM, URINE $103.97 $173.28 $14.57–$175.01 — 40%
Ammonia blood test inpatient CPT 82140 .3 FACTOR II PROTIME DNA ANALYSIS $103.97 $173.28 $14.57–$175.01 — 40%
Ammonia blood test inpatient CPT 82140 O AMMONIA $103.97 $173.28 $14.57–$175.01 — 40%
Ammonia blood test inpatient CPT 82140 AMMONIA $103.97 $173.28 $14.57–$175.01 — 40%
Ammonia blood test inpatient CPT 82140 Z/ AMMONIA $103.97 $173.28 $14.57–$175.01 — 40%
Ammonia blood test inpatient CPT 82140 O Z/ AMMONIA $103.97 $173.28 $14.57–$175.01 — 40%
Ammonia blood test inpatient CPT 82140 O .3 FACTOR II PROTIME DNA ANALYSIS $103.97 $173.28 $14.57–$175.01 — 40%
Amylase blood test CPT 82150 AMYLASE URINE TIME/RANDOM $71.02 $118.36 $6.48–$119.54 220% above 40%
Amylase blood test CPT 82150 O AMYLASE SERUM $71.02 $118.36 $6.48–$119.54 220% above 40%
Amylase blood test CPT 82150 O AMYLASE URINE TIME/RANDOM $71.02 $118.36 $6.48–$119.54 220% above 40%
Amylase blood test CPT 82150 AMYLASE SERUM $71.02 $118.36 $6.48–$119.54 220% above 40%
Amylase blood test inpatient CPT 82150 AMYLASE URINE TIME/RANDOM $71.02 $118.36 $6.48–$119.54 — 40%
Amylase blood test inpatient CPT 82150 O AMYLASE URINE TIME/RANDOM $71.02 $118.36 $6.48–$119.54 — 40%
Amylase blood test inpatient CPT 82150 AMYLASE SERUM $71.02 $118.36 $6.48–$119.54 — 40%
Amylase blood test inpatient CPT 82150 O AMYLASE SERUM $71.02 $118.36 $6.48–$119.54 — 40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 R/ CCP AB $77.19 $128.65 $12.95–$129.93 84% above 40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Z/ CCP ANITBODIES IgG/IGA $77.19 $128.65 $12.95–$129.93 84% above 40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 O CCP ANITBODIES IgG/IgA $77.19 $128.65 $12.95–$129.93 84% above 40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 O Z/ RHEUMATOID FACTOR PANEL REFLX G/A/M $77.19 $128.65 $12.95–$129.93 84% above 40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 O Z/ CCP ANITBODIES IgG $77.19 $128.65 $12.95–$129.93 84% above 40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 .Z/ CCP ANITBODIES IgG/IGA $77.19 $128.65 $12.95–$129.93 84% above 40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 R/ CCP AB $77.19 $128.65 $12.95–$129.93 — 40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 O CCP ANITBODIES IgG/IgA $77.19 $128.65 $12.95–$129.93 — 40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 O Z/ CCP ANITBODIES IgG $77.19 $128.65 $12.95–$129.93 — 40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 .Z/ CCP ANITBODIES IgG/IGA $77.19 $128.65 $12.95–$129.93 — 40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 O Z/ RHEUMATOID FACTOR PANEL REFLX G/A/M $77.19 $128.65 $12.95–$129.93 — 40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Z/ CCP ANITBODIES IgG/IGA $77.19 $128.65 $12.95–$129.93 — 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Z/ ANA WITH REFLEX TITER & PATTERN $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O ANA TEST ANTINUCLEAR ANTIB $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Z/ LUPUS DX PANEL (ANA II) $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA WITH REFLEX $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES/W REFLEX $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O ANTINUCLEAR AB REFLEX CASCADE $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O ANTINUCLEAR ANTIBODIES IFA $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA TEST ANTINUCLEAR ANTIB $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES IFA $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 .Z/ ANTI - NUCLEAR AB BY IFA RDL $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 .1 ANA/ENA/RA PROFILE $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O Z/ ANA II (LUPUS PANEL) $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O .1 ANA/ENA/RA PROFILE $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O Z/ ANA WITH REFLEX TITER & PATTERN $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O ANTINUCLEAR ANTIBODIES/W REFLEX $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 O ANA WITH REFLEX $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB REFLEX CASCADE $69.41 $115.68 $12.09–$116.83 51% above 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O Z/ ANA WITH REFLEX TITER & PATTERN $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O .1 ANA/ENA/RA PROFILE $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Z/ LUPUS DX PANEL (ANA II) $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O Z/ ANA II (LUPUS PANEL) $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Z/ ANA WITH REFLEX TITER & PATTERN $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA WITH REFLEX $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES/W REFLEX $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA TEST ANTINUCLEAR ANTIB $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB REFLEX CASCADE $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES IFA $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 .1 ANA/ENA/RA PROFILE $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 .Z/ ANTI - NUCLEAR AB BY IFA RDL $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O ANTINUCLEAR ANTIBODIES/W REFLEX $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O ANTINUCLEAR ANTIBODIES IFA $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O ANTINUCLEAR AB REFLEX CASCADE $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O ANA WITH REFLEX $69.41 $115.68 $12.09–$116.83 — 40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 O ANA TEST ANTINUCLEAR ANTIB $69.41 $115.68 $12.09–$116.83 — 40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 O R/ B-TYPE NATNURETIC PEPTIDE $161.72 $269.54 $39.26–$272.23 147% above 40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 R/ .1 GALECTIN B-TYPE BNP $161.72 $269.54 $39.26–$272.23 147% above 40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 O R/ .1 GALECTIN B-TYPE BNP $161.72 $269.54 $39.26–$272.23 147% above 40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 R/ B-TYPE NATNURETIC PEPTIDE $161.72 $269.54 $39.26–$272.23 147% above 40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-pBNP $161.72 $269.54 $39.26–$272.23 147% above 40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 O NT-pBNP $161.72 $269.54 $39.26–$272.23 147% above 40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-pBNP $161.72 $269.54 $39.26–$272.23 — 40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 O R/ .1 GALECTIN B-TYPE BNP $161.72 $269.54 $39.26–$272.23 — 40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 O R/ B-TYPE NATNURETIC PEPTIDE $161.72 $269.54 $39.26–$272.23 — 40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 O NT-pBNP $161.72 $269.54 $39.26–$272.23 — 40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 R/ .1 GALECTIN B-TYPE BNP $161.72 $269.54 $39.26–$272.23 — 40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 R/ B-TYPE NATNURETIC PEPTIDE $161.72 $269.54 $39.26–$272.23 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE TRANSFUSION RXN $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE BODY FLUID $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE UPPER RESPIRATORY (NP/THR/EA) $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE TISSUE $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE SPUTUM W/GRAM STAIN RFLX $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE GENITAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O CULTURE WOUND $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE WOUND (AEROBIC) $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE TRANSFUSION RXN $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE THROAT $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE SPUTUM W/G $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE BORDETELLA PERTUSSIS $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE BODY FLUID $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ CULTURE AEROBIC&ANAEROBIC w/GRAM STAI $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE SINUS $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE NASOPHARYNGEAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE EYE $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE GENITAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE ENVIRONMENTAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE EAR $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE CATHETER TIP $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE BODY FLUID $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE EYE $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE ENVIRONMENTAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 DELETE.Z/ CULTURE GENITAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O R/.1 AEROBIC CULTURE $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE EAR $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 R/.1 AEROBIC CULTURE $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE NASOPHARYNGEAL $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE SINUS $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE SPUTUM W/GRAM STAIN RFLX $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Z/ DELETE.CULTURE TISSUE $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE THROAT $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE WOUND (AEROBIC) $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE WOUND DEEP (AEROBIC&ANAEROB $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 O Z/ CULTURE CATHETER TIP $104.56 $174.27 $8.62–$176.01 271% above 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE UPPER RESPIRATORY (NP/THR/EA) $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE CATHETER TIP $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE THROAT $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE AEROBIC&ANAEROBIC w/GRAM STAI $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE GENITAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE SINUS $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE NASOPHARYNGEAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE EYE $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O CULTURE WOUND $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE WOUND (AEROBIC) $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE TISSUE $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE TRANSFUSION RXN $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE SINUS $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE ENVIRONMENTAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE BODY FLUID $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE SPUTUM W/GRAM STAIN RFLX $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE SPUTUM W/GRAM STAIN RFLX $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE WOUND (AEROBIC) $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 R/.1 AEROBIC CULTURE $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE BODY FLUID $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE CATHETER TIP $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE EAR $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE EYE $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O R/.1 AEROBIC CULTURE $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE NASOPHARYNGEAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE GENITAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE EAR $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE ENVIRONMENTAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 O Z/ CULTURE WOUND DEEP (AEROBIC&ANAEROB $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE TRANSFUSION RXN $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE THROAT $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ DELETE.CULTURE TISSUE $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE GENITAL $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 DELETE.Z/ CULTURE SPUTUM W/G $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE BORDETELLA PERTUSSIS $104.56 $174.27 $8.62–$176.01 — 40%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 Z/ CULTURE BODY FLUID $104.56 $174.27 $8.62–$176.01 — 40%
Basic metabolic panel (blood test) CPT 80048 O BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 217% above 40%
Basic metabolic panel (blood test) CPT 80048 O R/ BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 217% above 40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 217% above 40%
Basic metabolic panel (blood test) CPT 80048 Z/ BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 217% above 40%
Basic metabolic panel (blood test) inpatient CPT 80048 O BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 — 40%
Basic metabolic panel (blood test) inpatient CPT 80048 Z/ BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 — 40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 — 40%
Basic metabolic panel (blood test) inpatient CPT 80048 O R/ BASIC METABOLIC PANEL $111.40 $185.67 $8.46–$187.52 — 40%
Bilirubin blood test, total CPT 82247 R/ DIRECT & INDIRECT BILIRUBIN SERUM $22.48 $37.46 $4.05–$37.83 36% above 40%
Bilirubin blood test, total CPT 82247 O R/ DIRECT & INDIRECT BILIRUBIN SERUM $22.48 $37.46 $4.05–$37.83 36% above 40%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL $22.48 $37.46 $4.05–$37.83 36% above 40%
Bilirubin blood test, total CPT 82247 O BILIRUBIN TOTAL $22.48 $37.46 $4.05–$37.83 36% above 40%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL $22.48 $37.46 $4.05–$37.83 — 40%
Bilirubin blood test, total inpatient CPT 82247 O BILIRUBIN TOTAL $22.48 $37.46 $4.05–$37.83 — 40%
Bilirubin blood test, total inpatient CPT 82247 R/ DIRECT & INDIRECT BILIRUBIN SERUM $22.48 $37.46 $4.05–$37.83 — 40%
Bilirubin blood test, total inpatient CPT 82247 O R/ DIRECT & INDIRECT BILIRUBIN SERUM $22.48 $37.46 $4.05–$37.83 — 40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 O TISSUE LEVEL IV SURG PATH GROSS & MICR $177.60 $296.00 $60.71–$269.06 127% above 40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE LEVEL IV SURG PATH GROSS & MICR $177.60 $296.00 $60.71–$269.06 127% above 40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE LEVEL IV SURG PATH GROSS & MICR $177.60 $296.00 $60.71–$269.06 — 40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 O TISSUE LEVEL IV SURG PATH GROSS & MICR $177.60 $296.00 $60.71–$269.06 — 40%
Blood culture for bacteria CPT 87040 Z/ CULTURE BLOOD $139.46 $232.43 $10.32–$234.75 210% above 40%
Blood culture for bacteria CPT 87040 O Z/ CULTURE BLOOD $139.46 $232.43 $10.32–$234.75 210% above 40%
Blood culture for bacteria CPT 87040 DELETE.Z/ CULTURE BLOOD $139.46 $232.43 $10.32–$234.75 210% above 40%
Blood culture for bacteria inpatient CPT 87040 Z/ CULTURE BLOOD $139.46 $232.43 $10.32–$234.75 — 40%
Blood culture for bacteria inpatient CPT 87040 O Z/ CULTURE BLOOD $139.46 $232.43 $10.32–$234.75 — 40%
Blood culture for bacteria inpatient CPT 87040 DELETE.Z/ CULTURE BLOOD $139.46 $232.43 $10.32–$234.75 — 40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 FAC VENIPUNCTURE $12.27 $20.45 $3.00–$20.65 49% above 40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 O VENIPUNCTURE $12.27 $20.45 $3.00–$20.65 49% above 40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE COLLECTION $12.27 $20.45 $3.00–$20.65 49% above 40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE COLLECTION $12.27 $20.45 $3.00–$20.65 — 40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 FAC VENIPUNCTURE $12.27 $20.45 $3.00–$20.65 — 40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 O VENIPUNCTURE $12.27 $20.45 $3.00–$20.65 — 40%
Blood glucose (sugar) test CPT 82947 O .1 L/C GLUCOSE QUANT BLD EXC RGT STRIP $60.53 $100.88 $3.93–$101.88 364% above 40%
Blood glucose (sugar) test CPT 82947 O GLUCOSE SERUM $60.53 $100.88 $3.93–$101.88 364% above 40%
Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM QUANTITATIVE $60.53 $100.88 $3.93–$101.88 364% above 40%
Blood glucose (sugar) test CPT 82947 .1 L/C GLUCOSE QUANT BLD EXC RGT STRIP $60.53 $100.88 $3.93–$101.88 364% above 40%
Blood glucose (sugar) test inpatient CPT 82947 .1 L/C GLUCOSE QUANT BLD EXC RGT STRIP $60.53 $100.88 $3.93–$101.88 — 40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE SERUM QUANTITATIVE $60.53 $100.88 $3.93–$101.88 — 40%
Blood glucose (sugar) test inpatient CPT 82947 O GLUCOSE SERUM $60.53 $100.88 $3.93–$101.88 — 40%
Blood glucose (sugar) test inpatient CPT 82947 O .1 L/C GLUCOSE QUANT BLD EXC RGT STRIP $60.53 $100.88 $3.93–$101.88 — 40%
Blood lead test CPT 83655 .R1 LEAD $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 CLIN FAC LEAD LEVEL $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 CLIN GLOBAL LEAD LEVEL $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 DELETE.Z/ LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 O LEAD LEVEL BLOOD $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 O LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 O Z/ LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 .R1 HEAVY METAL PROFILE I URINE $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 .4 HEAVY METAL PROFILE II (URINE) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 Z/ LEAD LEVEL BLOOD (ADULT) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 Z/ LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 O .4 HEAVY METAL PROFILE II (URINE) $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 O .R1 HEAVY METAL PROFILE I URINE $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test CPT 83655 O .R1 LEAD $55.33 $92.22 $12.11–$93.14 105% above 40%
Blood lead test inpatient CPT 83655 O LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 O Z/ LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 .R1 HEAVY METAL PROFILE I URINE $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 Z/ LEAD LEVEL BLOOD (ADULT) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 Z/ LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 O .4 HEAVY METAL PROFILE II (URINE) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 O .R1 HEAVY METAL PROFILE I URINE $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 .R1 LEAD $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 .4 HEAVY METAL PROFILE II (URINE) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 CLIN FAC LEAD LEVEL $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 CLIN GLOBAL LEAD LEVEL $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 DELETE.Z/ LEAD LEVEL BLOOD (PED) $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 O LEAD LEVEL BLOOD $55.33 $92.22 $12.11–$93.14 — 40%
Blood lead test inpatient CPT 83655 O .R1 LEAD $55.33 $92.22 $12.11–$93.14 — 40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 DELETE.BETA HCG QUALITATIVE $84.11 $140.18 $7.52–$141.58 185% above 40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 O PREGNANCY TEST QUALITATIVE SERUM $84.11 $140.18 $7.52–$141.58 185% above 40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY SERUM QUALITATIVE $84.11 $140.18 $7.52–$141.58 185% above 40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREGNANCY SERUM QUALITATIVE $84.11 $140.18 $7.52–$141.58 — 40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 O PREGNANCY TEST QUALITATIVE SERUM $84.11 $140.18 $7.52–$141.58 — 40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 DELETE.BETA HCG QUALITATIVE $84.11 $140.18 $7.52–$141.58 — 40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .BB BLOOD TYPE ABO $99.76 $166.27 $2.99–$167.93 127% above 40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 O BB BLOOD TYPING ABO $99.76 $166.27 $2.99–$167.93 127% above 40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 O .R1 RH GENOTYPE W/ABO GROUPING $99.76 $166.27 $2.99–$167.93 127% above 40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLOOD TYPE ABO $99.76 $166.27 $2.99–$167.93 127% above 40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 .R1 RH GENOTYPE W/ABO GROUPING $99.76 $166.27 $2.99–$167.93 127% above 40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 DELETE.BB BLOOD TYPE ABO (UBS) $99.76 $166.27 $2.99–$167.93 127% above 40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 O BB BLOOD TYPING ABO $99.76 $166.27 $2.99–$167.93 — 40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 DELETE.BB BLOOD TYPE ABO (UBS) $99.76 $166.27 $2.99–$167.93 — 40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .BB BLOOD TYPE ABO $99.76 $166.27 $2.99–$167.93 — 40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 .R1 RH GENOTYPE W/ABO GROUPING $99.76 $166.27 $2.99–$167.93 — 40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB BLOOD TYPE ABO $99.76 $166.27 $2.99–$167.93 — 40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 O .R1 RH GENOTYPE W/ABO GROUPING $99.76 $166.27 $2.99–$167.93 — 40%
Blood urea nitrogen (BUN) test CPT 84520 BUN (BLOOD UREA NITROGEN) QUANTITATIVE $33.76 $56.26 $3.95–$56.82 101% above 40%
Blood urea nitrogen (BUN) test CPT 84520 O BUN $33.76 $56.26 $3.95–$56.82 101% above 40%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN $33.76 $56.26 $3.95–$56.82 101% above 40%
Blood urea nitrogen (BUN) test CPT 84520 R/ UREA NITROGEN BODY FLUID $33.76 $56.26 $3.95–$56.82 101% above 40%
Blood urea nitrogen (BUN) test CPT 84520 O UREA NITROGEN $33.76 $56.26 $3.95–$56.82 101% above 40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 O UREA NITROGEN $33.76 $56.26 $3.95–$56.82 — 40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN $33.76 $56.26 $3.95–$56.82 — 40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 BUN (BLOOD UREA NITROGEN) QUANTITATIVE $33.76 $56.26 $3.95–$56.82 — 40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 O BUN $33.76 $56.26 $3.95–$56.82 — 40%
Blood urea nitrogen (BUN) test inpatient CPT 84520 R/ UREA NITROGEN BODY FLUID $33.76 $56.26 $3.95–$56.82 — 40%
C-peptide blood test CPT 84681 O .2 INSULIN & PEPTIDE SERUM $93.62 $156.04 $24.27–$171.64 83% above 40%
C-peptide blood test CPT 84681 O Z/ C-PEPTIDE $93.62 $156.04 $24.27–$171.64 83% above 40%
C-peptide blood test CPT 84681 .2 INSULIN & PEPTIDE SERUM $93.62 $156.04 $24.27–$171.64 83% above 40%
C-peptide blood test CPT 84681 Z/ C-PEPTIDE $93.62 $156.04 $24.27–$171.64 83% above 40%
C-peptide blood test inpatient CPT 84681 O Z/ C-PEPTIDE $93.62 $156.04 $24.27–$171.64 — 40%
C-peptide blood test inpatient CPT 84681 O .2 INSULIN & PEPTIDE SERUM $93.62 $156.04 $24.27–$171.64 — 40%
C-peptide blood test inpatient CPT 84681 Z/ C-PEPTIDE $93.62 $156.04 $24.27–$171.64 — 40%
C-peptide blood test inpatient CPT 84681 .2 INSULIN & PEPTIDE SERUM $93.62 $156.04 $24.27–$171.64 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 O R/ C-REACTIVE PROTEIN CARDIAC $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 DELETE.R/ CREACTIVE PROTEIN CARDIAC $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Z/ C-REACTIVE PROTEIN $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 DELETE.CRP (hs) $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 O CRP (hs) $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN QUANT IN-HOUSE $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 O Z/ C-REACTIVE PROTEIN $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 O R/ C-REACTIVE PROTEIN QUANT $50.89 $84.82 $5.18–$85.66 118% above 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 DELETE.R/ CREACTIVE PROTEIN CARDIAC $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 O CRP (hs) $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 DELETE.CRP (hs) $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 O R/ C-REACTIVE PROTEIN CARDIAC $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 O R/ C-REACTIVE PROTEIN QUANT $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 O Z/ C-REACTIVE PROTEIN $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Z/ C-REACTIVE PROTEIN $50.89 $84.82 $5.18–$85.66 — 40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN QUANT IN-HOUSE $50.89 $84.82 $5.18–$85.66 — 40%
C. difficile toxin gene test (stool PCR) CPT 87493 Z/ C. DIFF TOXIN GENE NAA w/reflex TOXIN $135.42 $225.70 $37.27–$227.95 115% above 40%
C. difficile toxin gene test (stool PCR) CPT 87493 O R/ C DIFF. TOXIN GENE NAA $135.42 $225.70 $37.27–$227.95 115% above 40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 Z/ C. DIFF TOXIN GENE NAA w/reflex TOXIN $135.42 $225.70 $37.27–$227.95 — 40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 O R/ C DIFF. TOXIN GENE NAA $135.42 $225.70 $37.27–$227.95 — 40%
CA 19-9 blood test (tumor marker) CPT 86301 O Z/ CA 19-9 $87.50 $145.83 $20.81–$147.28 82% above 40%
CA 19-9 blood test (tumor marker) CPT 86301 Z/ CA 19-9 $87.50 $145.83 $20.81–$147.28 82% above 40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Z/ CA 19-9 $87.50 $145.83 $20.81–$147.28 — 40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 O Z/ CA 19-9 $87.50 $145.83 $20.81–$147.28 — 40%
CA-125 blood test (ovarian cancer marker) CPT 86304 Z/ CA 125 $109.58 $182.63 $20.81–$184.45 111% above 40%
CA-125 blood test (ovarian cancer marker) CPT 86304 O Z/ CA 125 $109.58 $182.63 $20.81–$184.45 111% above 40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 O Z/ CA 125 $109.58 $182.63 $20.81–$184.45 — 40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Z/ CA 125 $109.58 $182.63 $20.81–$184.45 — 40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Z/ COVID-19 PCR $134.08 $223.47 $38.48–$225.70 88% above 40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 O R/ COVID-19 $134.08 $223.47 $38.48–$225.70 88% above 40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID-19 MOLECULAR IN-HOUSE $134.08 $223.47 $38.48–$225.70 88% above 40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 O COVID-19 MOLECULAR IN-HOUSE $134.08 $223.47 $38.48–$225.70 88% above 40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 O COVID-19 MOLECULAR IN-HOUSE $134.08 $223.47 $38.48–$225.70 — 40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID-19 MOLECULAR IN-HOUSE $134.08 $223.47 $38.48–$225.70 — 40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 O R/ COVID-19 $134.08 $223.47 $38.48–$225.70 — 40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 Z/ COVID-19 PCR $134.08 $223.47 $38.48–$225.70 — 40%
Calcium blood test, total CPT 82310 DELETE.Z/ CALCIUM 24 HR URINE W/CREA $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 O CALCIUM (CA++) SERUM TOTAL $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 O R/ CALCIUM $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 O Z/ CALCIUM /CREATININE RATIO $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 O Z/ CALCIUM 24 HR URINE W/CREATININE $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 R/ CALCIUM $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 CALCIUM (CA++) SERUM TOTAL $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 Z/ RBC CALCIUM $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total CPT 82310 O Z/ RBC CALCIUM $47.41 $79.02 $5.16–$79.81 139% above 40%
Calcium blood test, total inpatient CPT 82310 CALCIUM (CA++) SERUM TOTAL $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 O R/ CALCIUM $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 Z/ RBC CALCIUM $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 O CALCIUM (CA++) SERUM TOTAL $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 O Z/ RBC CALCIUM $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 DELETE.Z/ CALCIUM 24 HR URINE W/CREA $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 R/ CALCIUM $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 O Z/ CALCIUM 24 HR URINE W/CREATININE $47.41 $79.02 $5.16–$79.81 — 40%
Calcium blood test, total inpatient CPT 82310 O Z/ CALCIUM /CREATININE RATIO $47.41 $79.02 $5.16–$79.81 — 40%
Carcinoembryonic antigen (CEA) test CPT 82378 Z/ CEA $125.29 $208.82 $18.96–$210.90 114% above 40%
Carcinoembryonic antigen (CEA) test CPT 82378 O Z/ CEA $125.29 $208.82 $18.96–$210.90 114% above 40%
Carcinoembryonic antigen (CEA) test CPT 82378 O CEA $125.29 $208.82 $18.96–$210.90 114% above 40%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA $125.29 $208.82 $18.96–$210.90 114% above 40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 O CEA $125.29 $208.82 $18.96–$210.90 — 40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 O Z/ CEA $125.29 $208.82 $18.96–$210.90 — 40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 Z/ CEA $125.29 $208.82 $18.96–$210.90 — 40%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA $125.29 $208.82 $18.96–$210.90 — 40%
Chickenpox (varicella) immunity blood test CPT 86787 O VARICELLA ZOSTER (VZV) AB IgG $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 Z/ VARICELLA ZOSTER IgG $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 DELETE.VARICELLA ZOSTER (VZV) AB IgG $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 O Z/ VARICELLA ZOSTER IgM $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 O VARICELLA ZOSTER (VZV) AB IgM $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 O Z/ VARICELLA ZOSTER IgG $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 DELETE.VARICELLA ZOSTER (VZV) AB IgM $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 Z/ VARICELLA ZOSTER IgM $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test CPT 86787 O VARICELLA ZOSTER $64.77 $107.95 $12.88–$109.02 78% above 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Z/ VARICELLA ZOSTER IgM $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 Z/ VARICELLA ZOSTER IgG $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 O Z/ VARICELLA ZOSTER IgM $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 O Z/ VARICELLA ZOSTER IgG $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 DELETE.VARICELLA ZOSTER (VZV) AB IgG $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 O VARICELLA ZOSTER (VZV) AB IgM $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 DELETE.VARICELLA ZOSTER (VZV) AB IgM $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 O VARICELLA ZOSTER $64.77 $107.95 $12.88–$109.02 — 40%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 O VARICELLA ZOSTER (VZV) AB IgG $64.77 $107.95 $12.88–$109.02 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 O Z/ GC/CHLAMYDIA URINE AMP PR $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 R/ CHLAMYDIA TRACHOMATIS AMP PROBE $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 DELETE.Z/ GC & TRICHOMONAS UA PROBE $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Z/ GC,CT & TRICHOMONAS APTIMA AMPLIFIED $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Z/ DELETE.CHLAMYDIA TRACHOMATIS AMP PROB $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Z/ GC/CHLAMYDIA URINE APTIMA AMPLIFIED $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 O R/ GC & TRICHOMONAS UA PROBE $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 O R/ CHLAMYDIA TRACHOMATIS AMP PROBE $120.04 $200.07 $35.09–$202.07 109% above 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Z/ DELETE.CHLAMYDIA TRACHOMATIS AMP PROB $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 R/ CHLAMYDIA TRACHOMATIS AMP PROBE $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Z/ GC/CHLAMYDIA URINE APTIMA AMPLIFIED $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Z/ GC,CT & TRICHOMONAS APTIMA AMPLIFIED $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 O Z/ GC/CHLAMYDIA URINE AMP PR $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 O R/ CHLAMYDIA TRACHOMATIS AMP PROBE $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 O R/ GC & TRICHOMONAS UA PROBE $120.04 $200.07 $35.09–$202.07 — 40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 DELETE.Z/ GC & TRICHOMONAS UA PROBE $120.04 $200.07 $35.09–$202.07 — 40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $70.67 $117.79 $13.39–$118.96 41% above 40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 O Z/ LIPID PANEL $70.67 $117.79 $13.39–$118.96 41% above 40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 O LIPID PANEL $70.67 $117.79 $13.39–$118.96 41% above 40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 O R/ LIPID PANEL $70.67 $117.79 $13.39–$118.96 41% above 40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 .LIPID PANEL $84.00 $140.00 $13.39–$141.40 68% above 40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 O LIPID PANEL $70.67 $117.79 $13.39–$118.96 — 40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 O R/ LIPID PANEL $70.67 $117.79 $13.39–$118.96 — 40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 O Z/ LIPID PANEL $70.67 $117.79 $13.39–$118.96 — 40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $70.67 $117.79 $13.39–$118.96 — 40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 .LIPID PANEL $84.00 $140.00 $13.39–$141.40 — 40%
Complete blood count (CBC) with differential CPT 85025 O R/ CBC $56.66 $94.43 $7.77–$95.37 116% above 40%
Complete blood count (CBC) with differential CPT 85025 .CBC $56.66 $94.43 $7.77–$95.37 116% above 40%
Complete blood count (CBC) with differential CPT 85025 FINGER STICK CBC $56.66 $94.43 $7.77–$95.37 116% above 40%
Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED W/WBC DIFF $56.66 $94.43 $7.77–$95.37 116% above 40%
Complete blood count (CBC) with differential CPT 85025 O CBC AUTOMATED W/WBC DIFF $56.66 $94.43 $7.77–$95.37 116% above 40%
Complete blood count (CBC) with differential CPT 85025 O FINGER STICK CBC $56.66 $94.43 $7.77–$95.37 116% above 40%
Complete blood count (CBC) with differential inpatient CPT 85025 FINGER STICK CBC $56.66 $94.43 $7.77–$95.37 — 40%
Complete blood count (CBC) with differential inpatient CPT 85025 O FINGER STICK CBC $56.66 $94.43 $7.77–$95.37 — 40%
Complete blood count (CBC) with differential inpatient CPT 85025 O R/ CBC $56.66 $94.43 $7.77–$95.37 — 40%
Complete blood count (CBC) with differential inpatient CPT 85025 O CBC AUTOMATED W/WBC DIFF $56.66 $94.43 $7.77–$95.37 — 40%
Complete blood count (CBC) with differential inpatient CPT 85025 .CBC $56.66 $94.43 $7.77–$95.37 — 40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTOMATED W/WBC DIFF $56.66 $94.43 $7.77–$95.37 — 40%
Complete blood count (CBC), no differential CPT 85027 DELETE.CBC-COMPLETE AUTOMATED $69.33 $115.55 $6.47–$116.70 149% above 40%
Complete blood count (CBC), no differential inpatient CPT 85027 DELETE.CBC-COMPLETE AUTOMATED $69.33 $115.55 $6.47–$116.70 — 40%
Comprehensive metabolic panel (blood test) CPT 80053 O R/ COMP METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 59% above 40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 59% above 40%
Comprehensive metabolic panel (blood test) CPT 80053 O COMPREHENSIVE METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 59% above 40%
Comprehensive metabolic panel (blood test) CPT 80053 Z/ COMP METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 59% above 40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 — 40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Z/ COMP METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 — 40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 O COMPREHENSIVE METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 — 40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 O R/ COMP METABOLIC PANEL $117.73 $196.21 $10.56–$198.17 — 40%
Cortisol blood test, total CPT 82533 CORTISOL AM TOTAL $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 O CORTISOL AM TOTAL $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 O Z/ CORTISOL AM $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 O Z/ CORTISOL PM $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 O Z/ CORTISOL TOTAL $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 O SALIVARY CORTISOL MS TOTAL $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 Z/ CORTISOL AM $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 Z/ CORTISOL PM $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 Z/ CORTISOL SALIVA $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 Z/ CORTISOL TOTAL $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total CPT 82533 SALIVARY CORTISOL MS TOTAL $100.71 $167.85 $16.30–$169.52 166% above 40%
Cortisol blood test, total inpatient CPT 82533 O CORTISOL AM TOTAL $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 CORTISOL AM TOTAL $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 Z/ CORTISOL TOTAL $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 SALIVARY CORTISOL MS TOTAL $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 Z/ CORTISOL SALIVA $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 Z/ CORTISOL PM $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 Z/ CORTISOL AM $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 O SALIVARY CORTISOL MS TOTAL $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 O Z/ CORTISOL TOTAL $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 O Z/ CORTISOL PM $100.71 $167.85 $16.30–$169.52 — 40%
Cortisol blood test, total inpatient CPT 82533 O Z/ CORTISOL AM $100.71 $167.85 $16.30–$169.52 — 40%
Creatine kinase (CK) blood test, total CPT 82550 O CK OR CPK TOTAL $57.31 $95.51 $6.51–$96.46 158% above 40%
Creatine kinase (CK) blood test, total CPT 82550 CK $57.31 $95.51 $6.51–$96.46 158% above 40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CK $57.31 $95.51 $6.51–$96.46 — 40%
Creatine kinase (CK) blood test, total inpatient CPT 82550 O CK OR CPK TOTAL $57.31 $95.51 $6.51–$96.46 — 40%
Creatinine blood test CPT 82565 CREATININE SERUM (BLOOD) $42.96 $71.60 $5.12–$72.31 158% above 40%
Creatinine blood test CPT 82565 O CREATININE SERUM (BLOOD) $42.96 $71.60 $5.12–$72.31 158% above 40%
Creatinine blood test inpatient CPT 82565 CREATININE SERUM (BLOOD) $42.96 $71.60 $5.12–$72.31 — 40%
Creatinine blood test inpatient CPT 82565 O CREATININE SERUM (BLOOD) $42.96 $71.60 $5.12–$72.31 — 40%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 O ANTIBODY CYTOMEGALOVIRUS $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IGG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 CMV IgG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 O CYTOMEGALOVIRUS (CMV) AB IGG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 O CMV IGG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 O CMV IgG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 O Z/ CYTOMEGALOVIRUS (CMV) AB IgG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 .CMV AB IGG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test CPT 86644 Z/ CYTOMEGALOVIRUS (CMV) AB IgG $84.69 $141.15 $14.39–$142.56 115% above 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 O ANTIBODY CYTOMEGALOVIRUS $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 O Z/ CYTOMEGALOVIRUS (CMV) AB IgG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IgG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 O CYTOMEGALOVIRUS (CMV) AB IGG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV IGG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 .CMV AB IGG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 O CMV IGG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 Z/ CYTOMEGALOVIRUS (CMV) AB IgG $84.69 $141.15 $14.39–$142.56 — 40%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 O CMV IgG $84.69 $141.15 $14.39–$142.56 — 40%
D-dimer blood test (blood clot marker) CPT 85379 O D-DIMER $109.38 $182.30 $10.18–$184.12 117% above 40%
D-dimer blood test (blood clot marker) CPT 85379 O R/ D-DIMER QUANT $109.38 $182.30 $10.18–$184.12 117% above 40%
D-dimer blood test (blood clot marker) CPT 85379 R/ D-DIMER QUANT $109.38 $182.30 $10.18–$184.12 117% above 40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE $109.38 $182.30 $10.18–$184.12 117% above 40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 R/ D-DIMER QUANT $109.38 $182.30 $10.18–$184.12 — 40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 O D-DIMER $109.38 $182.30 $10.18–$184.12 — 40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE $109.38 $182.30 $10.18–$184.12 — 40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 O R/ D-DIMER QUANT $109.38 $182.30 $10.18–$184.12 — 40%
DHEA sulfate (DHEA-S) blood test CPT 82627 R/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 87% above 40%
DHEA sulfate (DHEA-S) blood test CPT 82627 Z/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 87% above 40%
DHEA sulfate (DHEA-S) blood test CPT 82627 O R/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 87% above 40%
DHEA sulfate (DHEA-S) blood test CPT 82627 O Z/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 87% above 40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 R/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 — 40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 O Z/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 — 40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 O R/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 — 40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 Z/ DHEA SULFATE $105.83 $176.39 $22.23–$178.15 — 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 WORKMANS COMP DRUG SCREEN COLLECTION FE $30.00 $50.00 $28.37–$177.75 9% below 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ MDMA SCREEN w/ REFLEX CONFIRM $205.80 $343.00 $62.14–$346.43 524% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE PROF 10 SERUM w/REFLEX CON $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE PROF 11 SERUM w/REFLEX CON $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE PROF 6 BLOOD w/REFLEX CONF $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE PROF 9 BLOOD w/REFLEX CONF $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE PROF 9 URNE w/ REFLEX CONF $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN, KIT $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE SYNTHETIC CANNABINOIDS(K2S $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Z/ DRUG ABUSE SYNTHETIC OPIOIDS W/REFLEX $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 O Z/ DRUG ABUSE PROF 9 URINE w/REFLEX $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 R/ THC SCREEN W/REFLEX CONFIRMATION $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 O Z/ DRUG ABUSE PROF 9 BLOOD w/REFLEX CO $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN, EXL $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 O URINE DRUG SCREEN $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 O R/ DRUG SCREEN 6 REFLEX $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 O R/ THC SCREEN W/REFLEX CONFIRMATION $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 O R/ DRUG SCREEN 6 (WHOLE BLOOD) $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) CPT 80307 CLIN GLOBAL URINE DRUG SCREEN PRESUMP $206.24 $343.73 $62.14–$347.16 525% above 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 WORKMANS COMP DRUG SCREEN COLLECTION FE $30.00 $50.00 $28.37–$177.75 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ MDMA SCREEN w/ REFLEX CONFIRM $205.80 $343.00 $62.14–$346.43 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 O R/ DRUG SCREEN 6 REFLEX $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 O Z/ DRUG ABUSE PROF 9 BLOOD w/REFLEX CO $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 R/ THC SCREEN W/REFLEX CONFIRMATION $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 O R/ THC SCREEN W/REFLEX CONFIRMATION $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE PROF 6 BLOOD w/REFLEX CONF $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE PROF 11 SERUM w/REFLEX CON $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE PROF 9 BLOOD w/REFLEX CONF $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 O R/ DRUG SCREEN 6 (WHOLE BLOOD) $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE PROF 9 URNE w/ REFLEX CONF $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN, KIT $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 O URINE DRUG SCREEN $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN, EXL $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE PROF 10 SERUM w/REFLEX CON $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE SYNTHETIC CANNABINOIDS(K2S $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 O Z/ DRUG ABUSE PROF 9 URINE w/REFLEX $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 CLIN GLOBAL URINE DRUG SCREEN PRESUMP $206.24 $343.73 $62.14–$347.16 — 40%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Z/ DRUG ABUSE SYNTHETIC OPIOIDS W/REFLEX $206.24 $343.73 $62.14–$347.16 — 40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 O ELECTROLYTE PROFILE $75.32 $125.53 $7.01–$126.78 106% above 40%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PROFILE $75.32 $125.53 $7.01–$126.78 106% above 40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PROFILE $75.32 $125.53 $7.01–$126.78 — 40%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 O ELECTROLYTE PROFILE $75.32 $125.53 $7.01–$126.78 — 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-IGM $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Z/ EPSTEIN BARR VIRUS VCA (IgM) $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 O EBV-IGM $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 O Z/ EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 Z/ EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 O EPSTEIN-BARR VCA IgG $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 .EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 O EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 O EBV-SEROLOGY $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 EBV-SEROLOGY $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test CPT 86665 .EPSTEIN-BARR VCA IgG $77.75 $129.58 $18.14–$130.87 53% above 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-IGM $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Z/ EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 .EPSTEIN-BARR VCA IgG $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 .EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 O Z/ EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 O EPSTEIN-BARR VCA IgG $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 O EPSTEIN BARR VIRUS VCA (IgG) $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 O EBV-SEROLOGY $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 O EBV-IGM $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 Z/ EPSTEIN BARR VIRUS VCA (IgM) $77.75 $129.58 $18.14–$130.87 — 40%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV-SEROLOGY $77.75 $129.58 $18.14–$130.87 — 40%
Estradiol blood test CPT 82670 ESTRADIOL SENSITIVE $125.08 $208.47 $27.94–$210.55 119% above 40%
Estradiol blood test CPT 82670 O ESTRADIOL SENSITIVE $125.08 $208.47 $27.94–$210.55 119% above 40%
Estradiol blood test CPT 82670 Z/ ESTRADIOL (E2) $125.08 $208.47 $27.94–$210.55 119% above 40%
Estradiol blood test CPT 82670 Z/ ESTROGEN FRACTIONATED $125.08 $208.47 $27.94–$210.55 119% above 40%
Estradiol blood test inpatient CPT 82670 Z/ ESTROGEN FRACTIONATED $125.08 $208.47 $27.94–$210.55 — 40%
Estradiol blood test inpatient CPT 82670 Z/ ESTRADIOL (E2) $125.08 $208.47 $27.94–$210.55 — 40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL SENSITIVE $125.08 $208.47 $27.94–$210.55 — 40%
Estradiol blood test inpatient CPT 82670 O ESTRADIOL SENSITIVE $125.08 $208.47 $27.94–$210.55 — 40%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $99.20 $165.34 $18.58–$166.99 79% above 40%
FSH (follicle-stimulating hormone) test CPT 83001 O Z/ FSH $99.20 $165.34 $18.58–$166.99 79% above 40%
FSH (follicle-stimulating hormone) test CPT 83001 Z/ FSH $99.20 $165.34 $18.58–$166.99 79% above 40%
FSH (follicle-stimulating hormone) test CPT 83001 O FSH $99.20 $165.34 $18.58–$166.99 79% above 40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $99.20 $165.34 $18.58–$166.99 — 40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 O Z/ FSH $99.20 $165.34 $18.58–$166.99 — 40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Z/ FSH $99.20 $165.34 $18.58–$166.99 — 40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 O FSH $99.20 $165.34 $18.58–$166.99 — 40%
Fecal calprotectin (stool inflammation test) CPT 83993 R/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 112% above 40%
Fecal calprotectin (stool inflammation test) CPT 83993 Z/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 112% above 40%
Fecal calprotectin (stool inflammation test) CPT 83993 O R/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 112% above 40%
Fecal calprotectin (stool inflammation test) CPT 83993 O Z/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 112% above 40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 O Z/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 — 40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 R/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 — 40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 O R/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 — 40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Z/ CALPROTECTIN $200.86 $334.77 $19.63–$338.11 — 40%
Ferritin blood test (iron stores) CPT 82728 O Z/ FERRITIN $87.75 $146.25 $13.63–$147.71 92% above 40%
Ferritin blood test (iron stores) CPT 82728 DELETE.R/ FERRITIN $87.75 $146.25 $13.63–$147.71 92% above 40%
Ferritin blood test (iron stores) CPT 82728 O FERRITIN (RIA) $87.75 $146.25 $13.63–$147.71 92% above 40%
Ferritin blood test (iron stores) CPT 82728 Z/ FERRITIN $87.75 $146.25 $13.63–$147.71 92% above 40%
Ferritin blood test (iron stores) CPT 82728 .FERRITIN $87.75 $146.25 $13.63–$147.71 92% above 40%
Ferritin blood test (iron stores) CPT 82728 O R/ FERRITIN $87.75 $146.25 $13.63–$147.71 92% above 40%
Ferritin blood test (iron stores) inpatient CPT 82728 O R/ FERRITIN $87.75 $146.25 $13.63–$147.71 — 40%
Ferritin blood test (iron stores) inpatient CPT 82728 O FERRITIN (RIA) $87.75 $146.25 $13.63–$147.71 — 40%
Ferritin blood test (iron stores) inpatient CPT 82728 O Z/ FERRITIN $87.75 $146.25 $13.63–$147.71 — 40%
Ferritin blood test (iron stores) inpatient CPT 82728 .FERRITIN $87.75 $146.25 $13.63–$147.71 — 40%
Ferritin blood test (iron stores) inpatient CPT 82728 Z/ FERRITIN $87.75 $146.25 $13.63–$147.71 — 40%
Ferritin blood test (iron stores) inpatient CPT 82728 DELETE.R/ FERRITIN $87.75 $146.25 $13.63–$147.71 — 40%
Fibrinogen blood test CPT 85384 O Z/ FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 219% above 40%
Fibrinogen blood test CPT 85384 O FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 219% above 40%
Fibrinogen blood test CPT 85384 Z/ FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 219% above 40%
Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 219% above 40%
Fibrinogen blood test inpatient CPT 85384 Z/ FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 — 40%
Fibrinogen blood test inpatient CPT 85384 O FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 — 40%
Fibrinogen blood test inpatient CPT 85384 O Z/ FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 — 40%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN ACTIVITY $99.25 $165.42 $9.72–$167.07 — 40%
Folate (folic acid) blood test CPT 82746 .FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 141% above 40%
Folate (folic acid) blood test CPT 82746 O FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 141% above 40%
Folate (folic acid) blood test CPT 82746 O Z/ FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 141% above 40%
Folate (folic acid) blood test CPT 82746 Z/ FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 141% above 40%
Folate (folic acid) blood test inpatient CPT 82746 Z/ FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 — 40%
Folate (folic acid) blood test inpatient CPT 82746 .FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 — 40%
Folate (folic acid) blood test inpatient CPT 82746 O Z/ FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 — 40%
Folate (folic acid) blood test inpatient CPT 82746 O FOLIC ACID SERUM $90.91 $151.52 $14.70–$153.03 — 40%
Free T3 thyroid hormone test CPT 84481 T3 FREE $61.05 $101.75 $11.50–$102.76 24% above 40%
Free T3 thyroid hormone test CPT 84481 Z/ T3 FREE $61.05 $101.75 $11.50–$102.76 24% above 40%
Free T3 thyroid hormone test CPT 84481 O T3 FREE $61.05 $101.75 $11.50–$102.76 24% above 40%
Free T3 thyroid hormone test CPT 84481 O Z/ T3 FREE $61.05 $101.75 $11.50–$102.76 24% above 40%
Free T3 thyroid hormone test inpatient CPT 84481 O T3 FREE $61.05 $101.75 $11.50–$102.76 — 40%
Free T3 thyroid hormone test inpatient CPT 84481 Z/ T3 FREE $61.05 $101.75 $11.50–$102.76 — 40%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE $61.05 $101.75 $11.50–$102.76 — 40%
Free T3 thyroid hormone test inpatient CPT 84481 O Z/ T3 FREE $61.05 $101.75 $11.50–$102.76 — 40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 O Z/ T4 FREE $67.06 $111.76 $9.02–$112.87 92% above 40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 .R1 FREE T4 $67.06 $111.76 $9.02–$112.87 92% above 40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Z/ T4 FREE $67.06 $111.76 $9.02–$112.87 92% above 40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE $67.06 $111.76 $9.02–$112.87 92% above 40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 O .R1 FREE T4 $67.06 $111.76 $9.02–$112.87 92% above 40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 O T4 FREE $67.06 $111.76 $9.02–$112.87 92% above 40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE $67.06 $111.76 $9.02–$112.87 — 40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 O .R1 FREE T4 $67.06 $111.76 $9.02–$112.87 — 40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Z/ T4 FREE $67.06 $111.76 $9.02–$112.87 — 40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 O Z/ T4 FREE $67.06 $111.76 $9.02–$112.87 — 40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 O T4 FREE $67.06 $111.76 $9.02–$112.87 — 40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 .R1 FREE T4 $67.06 $111.76 $9.02–$112.87 — 40%
Free testosterone test CPT 84402 O Z/ TESTOSTERONE FREE-MALE $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test CPT 84402 .O Z/ TESTOSTERONE FREE -FEMALE/CHILD $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test CPT 84402 .O Z/ TESTOSTERONE FREE-MALE $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test CPT 84402 .Z/ TESTOSTERONE FREE $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test CPT 84402 .Z/ TESTOSTERONE FREE -FEMALE/CHILD $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test CPT 84402 O Z/ TESTOSTERONE FREE -FEMALE/CHILD $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test CPT 84402 Z/ TESTOSTERONE FREE $122.90 $204.83 $25.47–$206.87 104% above 40%
Free testosterone test inpatient CPT 84402 .Z/ TESTOSTERONE FREE $122.90 $204.83 $25.47–$206.87 — 40%
Free testosterone test inpatient CPT 84402 .O Z/ TESTOSTERONE FREE -FEMALE/CHILD $122.90 $204.83 $25.47–$206.87 — 40%
Free testosterone test inpatient CPT 84402 .Z/ TESTOSTERONE FREE -FEMALE/CHILD $122.90 $204.83 $25.47–$206.87 — 40%
Free testosterone test inpatient CPT 84402 O Z/ TESTOSTERONE FREE -FEMALE/CHILD $122.90 $204.83 $25.47–$206.87 — 40%
Free testosterone test inpatient CPT 84402 O Z/ TESTOSTERONE FREE-MALE $122.90 $204.83 $25.47–$206.87 — 40%
Free testosterone test inpatient CPT 84402 Z/ TESTOSTERONE FREE $122.90 $204.83 $25.47–$206.87 — 40%
Free testosterone test inpatient CPT 84402 .O Z/ TESTOSTERONE FREE-MALE $122.90 $204.83 $25.47–$206.87 — 40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT $49.12 $81.87 $7.20–$82.68 99% above 40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 O GGT $49.12 $81.87 $7.20–$82.68 99% above 40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 O Z/ GGT $49.12 $81.87 $7.20–$82.68 99% above 40%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Z/ GGT $49.12 $81.87 $7.20–$82.68 99% above 40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 O Z/ GGT $49.12 $81.87 $7.20–$82.68 — 40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT $49.12 $81.87 $7.20–$82.68 — 40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 O GGT $49.12 $81.87 $7.20–$82.68 — 40%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 Z/ GGT $49.12 $81.87 $7.20–$82.68 — 40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL $180.46 $300.76 $30.13–$303.76 2% below 40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 O GENERAL HEALTH PANEL $180.46 $300.76 $30.13–$303.76 2% below 40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH CMP $180.46 $300.76 $30.13–$303.76 2% below 40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 O GENERAL HEALTH PANEL $180.46 $300.76 $30.13–$303.76 — 40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH CMP $180.46 $300.76 $30.13–$303.76 — 40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL $180.46 $300.76 $30.13–$303.76 — 40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 O .2 L/C POST GLUCOSE DOSE INCL REAGENT $26.80 $44.66 $4.75–$45.10 67% above 40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 .2 L/C POST GLUCOSE DOSE INCL REAGENT ST $26.80 $44.66 $4.75–$45.10 67% above 40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 O GESTATIONAL DIABETES 1 HR SCREEN $26.80 $44.66 $4.75–$45.10 67% above 40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR PP $26.80 $44.66 $4.75–$45.10 67% above 40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GESTATIONAL DIABETES POST 1 HR $26.80 $44.66 $4.75–$45.10 67% above 40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 O GLUCOSE 2 HR PP $26.80 $44.66 $4.75–$45.10 67% above 40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 O GESTATIONAL DIABETES 1 HR SCREEN $26.80 $44.66 $4.75–$45.10 — 40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GESTATIONAL DIABETES POST 1 HR $26.80 $44.66 $4.75–$45.10 — 40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR PP $26.80 $44.66 $4.75–$45.10 — 40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 O GLUCOSE 2 HR PP $26.80 $44.66 $4.75–$45.10 — 40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 .2 L/C POST GLUCOSE DOSE INCL REAGENT ST $26.80 $44.66 $4.75–$45.10 — 40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 O .2 L/C POST GLUCOSE DOSE INCL REAGENT $26.80 $44.66 $4.75–$45.10 — 40%
Glucose tolerance test, 3 samples CPT 82951 GESTATIONAL GLUCOSE 2HR GTT $67.90 $113.17 $12.87–$114.30 51% above 40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 2 HR TOLERANCE TEST $67.90 $113.17 $12.87–$114.30 51% above 40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST 3 HR $67.90 $113.17 $12.87–$114.30 51% above 40%
Glucose tolerance test, 3 samples CPT 82951 O GESTATIONAL GLUCOSE 2HR GTT $67.90 $113.17 $12.87–$114.30 51% above 40%
Glucose tolerance test, 3 samples CPT 82951 O GLUCOSE 2 HR TOLERANCE $67.90 $113.17 $12.87–$114.30 51% above 40%
Glucose tolerance test, 3 samples CPT 82951 O GLUCOSE TOL TEST 3 HR $67.90 $113.17 $12.87–$114.30 51% above 40%
Glucose tolerance test, 3 samples inpatient CPT 82951 O GESTATIONAL GLUCOSE 2HR GTT $67.90 $113.17 $12.87–$114.30 — 40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GESTATIONAL GLUCOSE 2HR GTT $67.90 $113.17 $12.87–$114.30 — 40%
Glucose tolerance test, 3 samples inpatient CPT 82951 O GLUCOSE 2 HR TOLERANCE $67.90 $113.17 $12.87–$114.30 — 40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 2 HR TOLERANCE TEST $67.90 $113.17 $12.87–$114.30 — 40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST 3 HR $67.90 $113.17 $12.87–$114.30 — 40%
Glucose tolerance test, 3 samples inpatient CPT 82951 O GLUCOSE TOL TEST 3 HR $67.90 $113.17 $12.87–$114.30 — 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 .2 NEISSERIA GONORRHOEAE AMP PROBE TECH $123.14 $205.23 $35.09–$207.28 116% above 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC URINE NEISSERIA GONORRHOEAE AMP PR $123.14 $205.23 $35.09–$207.28 116% above 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 O GC URINE NEISSERIA GONORRHOEAE AMP $123.14 $205.23 $35.09–$207.28 116% above 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 O .2 NEISSERIA GONORRHOEAE AMP PROBE TEC $123.14 $205.23 $35.09–$207.28 116% above 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 O GC URINE NEISSERIA GONORRHOEAE AMP $123.14 $205.23 $35.09–$207.28 — 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC URINE NEISSERIA GONORRHOEAE AMP PR $123.14 $205.23 $35.09–$207.28 — 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 .2 NEISSERIA GONORRHOEAE AMP PROBE TECH $123.14 $205.23 $35.09–$207.28 — 40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 O .2 NEISSERIA GONORRHOEAE AMP PROBE TEC $123.14 $205.23 $35.09–$207.28 — 40%
H. pylori antibody blood test CPT 86677 O HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 O HELICOBACTER AB $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 Z/ DELETE.HELICOBACTER PYLORI AB IGG $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 DELETE.R/ HELICOBACTER P $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 O R/ HELICOBACTER PYLORI AB/IgM $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 DELETE.HELICOBACTER AB $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 O R/ HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 R/ HELICOBACTER PYLORI AB/IgM $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 O R/ HELICOBACTER PYLORI AB IGG $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test CPT 86677 R/ HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 110% above 40%
H. pylori antibody blood test inpatient CPT 86677 O R/ HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 R/ HELICOBACTER PYLORI AB/IgM $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 R/ HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 Z/ DELETE.HELICOBACTER PYLORI AB IGG $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 O R/ HELICOBACTER PYLORI AB/IgM $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 O R/ HELICOBACTER PYLORI AB IGG $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 O HELICOBACTER PYLORI AB IGM $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 O HELICOBACTER AB $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 DELETE.R/ HELICOBACTER P $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori antibody blood test inpatient CPT 86677 DELETE.HELICOBACTER AB $96.53 $160.89 $13.56–$162.49 — 40%
H. pylori stool antigen test CPT 87338 O HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 68% above 40%
H. pylori stool antigen test CPT 87338 HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 68% above 40%
H. pylori stool antigen test CPT 87338 Z/ HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 68% above 40%
H. pylori stool antigen test CPT 87338 O Z/ HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 68% above 40%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 — 40%
H. pylori stool antigen test inpatient CPT 87338 O HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 — 40%
H. pylori stool antigen test inpatient CPT 87338 O Z/ HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 — 40%
H. pylori stool antigen test inpatient CPT 87338 Z/ HELICOBACTER PYLORI STOOL Ag $102.25 $170.41 $5.41–$172.11 — 40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA QUANTITATIVE $365.46 $609.10 $85.10–$615.19 112% above 40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Z/ HIV RNA QUANT VIRAL LOAD PCR $365.46 $609.10 $85.10–$615.19 112% above 40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 O Z/ HIV VIRAL LOAD REFLEX TO GENOTYPE $365.46 $609.10 $85.10–$615.19 112% above 40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 O Z/ HIV RNA QUANT VIRAL LOAD $365.46 $609.10 $85.10–$615.19 112% above 40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 DELETE.Z/ HIV RNA QUANT NAAT W/ GENOTYPE $365.46 $609.10 $85.10–$615.19 112% above 40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 O HIV-1 RNA QUANTITATIVE $365.46 $609.10 $85.10–$615.19 112% above 40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 O Z/ HIV VIRAL LOAD REFLEX TO GENOTYPE $365.46 $609.10 $85.10–$615.19 — 40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA QUANTITATIVE $365.46 $609.10 $85.10–$615.19 — 40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 O HIV-1 RNA QUANTITATIVE $365.46 $609.10 $85.10–$615.19 — 40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 Z/ HIV RNA QUANT VIRAL LOAD PCR $365.46 $609.10 $85.10–$615.19 — 40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 DELETE.Z/ HIV RNA QUANT NAAT W/ GENOTYPE $365.46 $609.10 $85.10–$615.19 — 40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 O Z/ HIV RNA QUANT VIRAL LOAD $365.46 $609.10 $85.10–$615.19 — 40%
HIV-1 and HIV-2 antibody test CPT 86703 / HIV PANEL $101.74 $169.57 $12.31–$171.26 197% above 40%
HIV-1 and HIV-2 antibody test CPT 86703 O Z/ HIV 1&2 AG/AB COMBO $101.74 $169.57 $12.31–$171.26 197% above 40%
HIV-1 and HIV-2 antibody test CPT 86703 O R/ HIV PANEL $101.74 $169.57 $12.31–$171.26 197% above 40%
HIV-1 and HIV-2 antibody test CPT 86703 DELETE.Z/ HIV PANEL $101.74 $169.57 $12.31–$171.26 197% above 40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 DELETE.Z/ HIV PANEL $101.74 $169.57 $12.31–$171.26 — 40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 O R/ HIV PANEL $101.74 $169.57 $12.31–$171.26 — 40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 O Z/ HIV 1&2 AG/AB COMBO $101.74 $169.57 $12.31–$171.26 — 40%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 / HIV PANEL $101.74 $169.57 $12.31–$171.26 — 40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Z/ HIV 1&2 (SCREEN) AB/AG p24 W/REFLEX $77.02 $128.36 $24.08–$129.64 66% above 40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 R/ HIV 1/0/2 ANTIGEN/ANTIBODY REACTIVE $77.02 $128.36 $24.08–$129.64 66% above 40%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 O R/ HIV 1/0/2 ANTIGEN/ANTIBODY REACTIVE $77.02 $128.36 $24.08–$129.64 66% above 40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 O R/ HIV 1/0/2 ANTIGEN/ANTIBODY REACTIVE $77.02 $128.36 $24.08–$129.64 — 40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 Z/ HIV 1&2 (SCREEN) AB/AG p24 W/REFLEX $77.02 $128.36 $24.08–$129.64 — 40%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 R/ HIV 1/0/2 ANTIGEN/ANTIBODY REACTIVE $77.02 $128.36 $24.08–$129.64 — 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 R/ HGB-AIC $58.26 $97.10 $9.71–$98.07 64% above 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 O GLYCO HGB A1C $58.26 $97.10 $9.71–$98.07 64% above 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 O R/ HGB-AIC $58.26 $97.10 $9.71–$98.07 64% above 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCO HGB A1C $58.26 $97.10 $9.71–$98.07 64% above 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 O GLYCO HGB A1C $58.26 $97.10 $9.71–$98.07 — 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 R/ HGB-AIC $58.26 $97.10 $9.71–$98.07 — 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCO HGB A1C $58.26 $97.10 $9.71–$98.07 — 40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 O R/ HGB-AIC $58.26 $97.10 $9.71–$98.07 — 40%
Hemoglobin blood test CPT 85018 .HEMOGLOBIN $28.51 $47.51 $2.37–$47.98 174% above 40%
Hemoglobin blood test CPT 85018 .O HEMOGLOBIN $28.51 $47.51 $2.37–$47.98 174% above 40%
Hemoglobin blood test CPT 85018 CLIN GLOBALHEMOGLOBIN LEVEL $28.51 $47.51 $2.37–$47.98 174% above 40%
Hemoglobin blood test CPT 85018 CLIN FAC HEMOGLOBIN LEVEL $28.51 $47.51 $2.37–$47.98 174% above 40%
Hemoglobin blood test inpatient CPT 85018 CLIN GLOBALHEMOGLOBIN LEVEL $28.51 $47.51 $2.37–$47.98 — 40%
Hemoglobin blood test inpatient CPT 85018 CLIN FAC HEMOGLOBIN LEVEL $28.51 $47.51 $2.37–$47.98 — 40%
Hemoglobin blood test inpatient CPT 85018 .HEMOGLOBIN $28.51 $47.51 $2.37–$47.98 — 40%
Hemoglobin blood test inpatient CPT 85018 .O HEMOGLOBIN $28.51 $47.51 $2.37–$47.98 — 40%
Hepatitis B core antibody test (total) CPT 86704 O HEPATITIS A&B PROFILE $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) CPT 86704 O HEPATITIS B CORE ANTIBODY TOTAL $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) CPT 86704 R/ HBV CORE ATB IgG/ IgM DIFF $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) CPT 86704 O Z/ HEPATITIS B CORE TOTAL AB IGG/IGM $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) CPT 86704 O R/ HBV CORE ATB IgG/ IgM DIFF $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) CPT 86704 HEPATITIS A&B PROFILE $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) CPT 86704 Z/ HEPATITIS B CORE TOTAL AB $62.05 $103.42 $12.05–$104.45 119% above 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 O R/ HBV CORE ATB IgG/ IgM DIFF $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 O HEPATITIS A&B PROFILE $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 O HEPATITIS B CORE ANTIBODY TOTAL $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 O Z/ HEPATITIS B CORE TOTAL AB IGG/IGM $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 Z/ HEPATITIS B CORE TOTAL AB $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS A&B PROFILE $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B core antibody test (total) inpatient CPT 86704 R/ HBV CORE ATB IgG/ IgM DIFF $62.05 $103.42 $12.05–$104.45 — 40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ATB QUAL $54.62 $91.03 $10.74–$91.94 82% above 40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 O HEPATITIS B SURFACE ATB QUAL $54.62 $91.03 $10.74–$91.94 82% above 40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 O Z/ HEPATITIS B SURFACE AB $54.62 $91.03 $10.74–$91.94 82% above 40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 O HEPATITIS B SURFACE ATB QUAL $54.62 $91.03 $10.74–$91.94 — 40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ATB QUAL $54.62 $91.03 $10.74–$91.94 — 40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 O Z/ HEPATITIS B SURFACE AB $54.62 $91.03 $10.74–$91.94 — 40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Z/ HEPATITIS B SURFACE AG QUALITATIVE $60.92 $101.53 $10.33–$102.54 71% above 40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG QUAN EIA $65.69 $109.49 $10.33–$110.58 84% above 40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 O HEPATITIS B SURFACE ATG QUAN EIA $65.69 $109.49 $10.33–$110.58 84% above 40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Z/ HEPATITIS B SURFACE AG QUALITATIVE $60.92 $101.53 $10.33–$102.54 — 40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 O HEPATITIS B SURFACE ATG QUAN EIA $65.69 $109.49 $10.33–$110.58 — 40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG QUAN EIA $65.69 $109.49 $10.33–$110.58 — 40%
Hepatitis C antibody blood test (screening) CPT 86803 Z/ HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 62% above 40%
Hepatitis C antibody blood test (screening) CPT 86803 O Z/ HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 62% above 40%
Hepatitis C antibody blood test (screening) CPT 86803 O HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 62% above 40%
Hepatitis C antibody blood test (screening) CPT 86803 O HCV (RIBA) $73.04 $121.74 $14.27–$122.95 62% above 40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 62% above 40%
Hepatitis C antibody blood test (screening) CPT 86803 HCV (RIBA) $73.04 $121.74 $14.27–$122.95 62% above 40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 O Z/ HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 — 40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 — 40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Z/ HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 — 40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HCV (RIBA) $73.04 $121.74 $14.27–$122.95 — 40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 O HCV (RIBA) $73.04 $121.74 $14.27–$122.95 — 40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 O HEPATITIS C AB $73.04 $121.74 $14.27–$122.95 — 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 DELETE.Z/ HCV RNA PCR $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 O INFEC AGENT HEPATITIS C VIRUS QUANTATI $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 O Z/ HEPATITIS C QNT (VIRAL LOAD) $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Z/ HEPATITIS C QNT RNA VL W/R GENOTYPE $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV RNA by PCR QUANTITATIVE $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 DELETE.HEPATITIS QUANTA SURE PLUS $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 DELETE.HEP C NG1 SUPER QUANT $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFEC AGENT HEPATITIS C VIRUS QUANTATIVE $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 O HCV RNA by PCR QUANTITATIVE $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test CPT 87522 Z/ HEPATITIS C QNT (VIRAL LOAD) $468.93 $781.55 $42.84–$789.36 325% above 40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 O HCV RT-PCR QUANT (GRAPH) $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR QUANT (GRAPH) $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT-PCR QUANT (NON GRAPH)(NO REFLEX) $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 DELETE.HCV RT PCR QUANT (NONGRAPH/NO REF $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 O HCV RT-PCR QUANT (NON GRAPH)(NO REFLEX $233.06 $388.43 $42.84–$392.31 111% above 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Z/ HEPATITIS C QNT RNA VL W/R GENOTYPE $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 DELETE.Z/ HCV RNA PCR $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFEC AGENT HEPATITIS C VIRUS QUANTATIVE $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 O HCV RNA by PCR QUANTITATIVE $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 O INFEC AGENT HEPATITIS C VIRUS QUANTATI $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 O Z/ HEPATITIS C QNT (VIRAL LOAD) $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 DELETE.HEP C NG1 SUPER QUANT $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 DELETE.HEPATITIS QUANTA SURE PLUS $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV RNA by PCR QUANTITATIVE $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 Z/ HEPATITIS C QNT (VIRAL LOAD) $468.93 $781.55 $42.84–$789.36 — 40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 O HCV RT-PCR QUANT (NON GRAPH)(NO REFLEX $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 DELETE.HCV RT PCR QUANT (NONGRAPH/NO REF $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR QUANT (GRAPH) $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 O HCV RT-PCR QUANT (GRAPH) $233.06 $388.43 $42.84–$392.31 — 40%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT-PCR QUANT (NON GRAPH)(NO REFLEX) $233.06 $388.43 $42.84–$392.31 — 40%
Herpes blood test, HSV-1 antibody CPT 86695 Z/ HSV TYPE I/II IgG SPECIFIC Abs SERUM $55.58 $92.64 $13.19–$93.56 121% above 40%
Herpes blood test, HSV-1 antibody CPT 86695 O Z/ HSV TYPE I IGG $55.58 $92.64 $13.19–$93.56 121% above 40%
Herpes blood test, HSV-1 antibody CPT 86695 Z/ HSV TYPE I IGG ANTIBODY SERUM $55.58 $92.64 $13.19–$93.56 121% above 40%
Herpes blood test, HSV-1 antibody CPT 86695 .R2 HERPES SMPX VI TYPE 1&2 $55.58 $92.64 $13.19–$93.56 121% above 40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 .R2 HERPES SMPX VI TYPE 1&2 $55.58 $92.64 $13.19–$93.56 — 40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Z/ HSV TYPE I IGG ANTIBODY SERUM $55.58 $92.64 $13.19–$93.56 — 40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 O Z/ HSV TYPE I IGG $55.58 $92.64 $13.19–$93.56 — 40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 Z/ HSV TYPE I/II IgG SPECIFIC Abs SERUM $55.58 $92.64 $13.19–$93.56 — 40%
Herpes blood test, HSV-2 antibody CPT 86696 Z/ HSV TYPE II IGG ANTIBODY SERUM $70.61 $117.68 $19.35–$118.85 63% above 40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX VIRUS TPE I&II IGM $70.61 $117.68 $19.35–$118.85 63% above 40%
Herpes blood test, HSV-2 antibody CPT 86696 .R1 HERPES SMPX VI TYPE 1&2 $70.61 $117.68 $19.35–$118.85 63% above 40%
Herpes blood test, HSV-2 antibody CPT 86696 O Z/ HSV TYPE II IGG $70.61 $117.68 $19.35–$118.85 63% above 40%
Herpes blood test, HSV-2 antibody CPT 86696 O HERPES SIMPLEX VIRUS TPE I&II IGM $70.61 $117.68 $19.35–$118.85 63% above 40%
Herpes blood test, HSV-2 antibody CPT 86696 O .R1 HERPES SMPX VI TYPE 1&2 $70.61 $117.68 $19.35–$118.85 63% above 40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 Z/ HSV TYPE II IGG ANTIBODY SERUM $70.61 $117.68 $19.35–$118.85 — 40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 O .R1 HERPES SMPX VI TYPE 1&2 $70.61 $117.68 $19.35–$118.85 — 40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 .R1 HERPES SMPX VI TYPE 1&2 $70.61 $117.68 $19.35–$118.85 — 40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 O Z/ HSV TYPE II IGG $70.61 $117.68 $19.35–$118.85 — 40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 O HERPES SIMPLEX VIRUS TPE I&II IGM $70.61 $117.68 $19.35–$118.85 — 40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX VIRUS TPE I&II IGM $70.61 $117.68 $19.35–$118.85 — 40%
High-sensitivity CRP (hs-CRP) test CPT 86141 O Z/ C-REACTIVE PROTEIN HS CARDIAC $119.70 $199.50 $12.95–$201.49 179% above 40%
High-sensitivity CRP (hs-CRP) test CPT 86141 Z/ C-REACTIVE PROTEIN HS CARDIAC $119.70 $199.50 $12.95–$201.49 179% above 40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 O Z/ C-REACTIVE PROTEIN HS CARDIAC $119.70 $199.50 $12.95–$201.49 — 40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 Z/ C-REACTIVE PROTEIN HS CARDIAC $119.70 $199.50 $12.95–$201.49 — 40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 146% above 40%
Homocysteine blood test CPT 83090 .HOMOCYSTINE $139.97 $233.29 $17.92–$235.62 146% above 40%
Homocysteine blood test CPT 83090 O HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 146% above 40%
Homocysteine blood test CPT 83090 O Z/ HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 146% above 40%
Homocysteine blood test CPT 83090 Z/ HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 146% above 40%
Homocysteine blood test inpatient CPT 83090 O HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 — 40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 — 40%
Homocysteine blood test inpatient CPT 83090 Z/ HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 — 40%
Homocysteine blood test inpatient CPT 83090 O Z/ HOMOCYSTEINE QUANTITATIVE $139.97 $233.29 $17.92–$235.62 — 40%
Homocysteine blood test inpatient CPT 83090 .HOMOCYSTINE $139.97 $233.29 $17.92–$235.62 — 40%
Insulin blood test CPT 83525 O .1 INSULIN & PEPTIDE SERUM $65.92 $109.86 $11.43–$110.95 131% above 40%
Insulin blood test CPT 83525 O INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 131% above 40%
Insulin blood test CPT 83525 O Z/ INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 131% above 40%
Insulin blood test CPT 83525 .1 INSULIN & PEPTIDE SERUM $65.92 $109.86 $11.43–$110.95 131% above 40%
Insulin blood test CPT 83525 Z/ INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 131% above 40%
Insulin blood test CPT 83525 INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 131% above 40%
Insulin blood test inpatient CPT 83525 O INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 — 40%
Insulin blood test inpatient CPT 83525 O Z/ INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 — 40%
Insulin blood test inpatient CPT 83525 INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 — 40%
Insulin blood test inpatient CPT 83525 O .1 INSULIN & PEPTIDE SERUM $65.92 $109.86 $11.43–$110.95 — 40%
Insulin blood test inpatient CPT 83525 .1 INSULIN & PEPTIDE SERUM $65.92 $109.86 $11.43–$110.95 — 40%
Insulin blood test inpatient CPT 83525 Z/ INSULIN TOTAL $65.92 $109.86 $11.43–$110.95 — 40%
Iron blood test (serum iron) CPT 83540 O Z/ IRON(FE) $46.15 $76.91 $6.26–$77.67 112% above 40%
Iron blood test (serum iron) CPT 83540 .2 IRON $46.15 $76.91 $6.26–$77.67 112% above 40%
Iron blood test (serum iron) CPT 83540 Z/ IRON(FE) $46.15 $76.91 $6.26–$77.67 112% above 40%
Iron blood test (serum iron) CPT 83540 O .2 IRON $46.15 $76.91 $6.26–$77.67 112% above 40%
Iron blood test (serum iron) CPT 83540 DELETE.IRON(FE) $46.15 $76.91 $6.26–$77.67 112% above 40%
Iron blood test (serum iron) CPT 83540 O IRON(FE) $46.15 $76.91 $6.26–$77.67 112% above 40%
Iron blood test (serum iron) inpatient CPT 83540 O IRON(FE) $46.15 $76.91 $6.26–$77.67 — 40%
Iron blood test (serum iron) inpatient CPT 83540 DELETE.IRON(FE) $46.15 $76.91 $6.26–$77.67 — 40%
Iron blood test (serum iron) inpatient CPT 83540 Z/ IRON(FE) $46.15 $76.91 $6.26–$77.67 — 40%
Iron blood test (serum iron) inpatient CPT 83540 .2 IRON $46.15 $76.91 $6.26–$77.67 — 40%
Iron blood test (serum iron) inpatient CPT 83540 O .2 IRON $46.15 $76.91 $6.26–$77.67 — 40%
Iron blood test (serum iron) inpatient CPT 83540 O Z/ IRON(FE) $46.15 $76.91 $6.26–$77.67 — 40%
Iron-binding capacity (TIBC) test CPT 83550 .1 TOTAL IRON BINDING CAPACITY $51.54 $85.90 $8.74–$86.75 60% above 40%
Iron-binding capacity (TIBC) test CPT 83550 DELETE.IRON BINDNG CAPACITY-TOTAL $51.54 $85.90 $8.74–$86.75 60% above 40%
Iron-binding capacity (TIBC) test CPT 83550 O .1 TOTAL IRON BINDING CAPACITY $51.54 $85.90 $8.74–$86.75 60% above 40%
Iron-binding capacity (TIBC) test CPT 83550 O IRON BINDNG CAPACITY-TOTAL $51.54 $85.90 $8.74–$86.75 60% above 40%
Iron-binding capacity (TIBC) test CPT 83550 DELETE.Z/ TIBC (IRON) $51.54 $85.90 $8.74–$86.75 60% above 40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 DELETE.IRON BINDNG CAPACITY-TOTAL $51.54 $85.90 $8.74–$86.75 — 40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 DELETE.Z/ TIBC (IRON) $51.54 $85.90 $8.74–$86.75 — 40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 O IRON BINDNG CAPACITY-TOTAL $51.54 $85.90 $8.74–$86.75 — 40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 .1 TOTAL IRON BINDING CAPACITY $51.54 $85.90 $8.74–$86.75 — 40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 O .1 TOTAL IRON BINDING CAPACITY $51.54 $85.90 $8.74–$86.75 — 40%
Kidney function blood test panel CPT 80069 O RENAL PANEL $91.85 $153.08 $8.68–$154.61 83% above 40%
Kidney function blood test panel CPT 80069 RENAL PANEL $91.85 $153.08 $8.68–$154.61 83% above 40%
Kidney function blood test panel inpatient CPT 80069 O RENAL PANEL $91.85 $153.08 $8.68–$154.61 — 40%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL $91.85 $153.08 $8.68–$154.61 — 40%
LH (luteinizing hormone) test CPT 83002 Z/ LH $105.18 $175.30 $18.52–$177.05 95% above 40%
LH (luteinizing hormone) test CPT 83002 O Z/ LH $105.18 $175.30 $18.52–$177.05 95% above 40%
LH (luteinizing hormone) test CPT 83002 LH $105.18 $175.30 $18.52–$177.05 95% above 40%
LH (luteinizing hormone) test CPT 83002 O LH $105.18 $175.30 $18.52–$177.05 95% above 40%
LH (luteinizing hormone) test inpatient CPT 83002 LH $105.18 $175.30 $18.52–$177.05 — 40%
LH (luteinizing hormone) test inpatient CPT 83002 Z/ LH $105.18 $175.30 $18.52–$177.05 — 40%
LH (luteinizing hormone) test inpatient CPT 83002 O Z/ LH $105.18 $175.30 $18.52–$177.05 — 40%
LH (luteinizing hormone) test inpatient CPT 83002 O LH $105.18 $175.30 $18.52–$177.05 — 40%
Lactate (lactic acid) blood test CPT 83605 O LACTIC ACID $94.96 $158.26 $11.57–$159.84 241% above 40%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID $94.96 $158.26 $11.57–$159.84 241% above 40%
Lactate (lactic acid) blood test CPT 83605 O R/ LACTATE (LACTIC ACID) $94.96 $158.26 $11.57–$159.84 241% above 40%
Lactate (lactic acid) blood test CPT 83605 R/ LACTATE (LACTIC ACID) $94.96 $158.26 $11.57–$159.84 241% above 40%
Lactate (lactic acid) blood test inpatient CPT 83605 R/ LACTATE (LACTIC ACID) $94.96 $158.26 $11.57–$159.84 — 40%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID $94.96 $158.26 $11.57–$159.84 — 40%
Lactate (lactic acid) blood test inpatient CPT 83605 O R/ LACTATE (LACTIC ACID) $94.96 $158.26 $11.57–$159.84 — 40%
Lactate (lactic acid) blood test inpatient CPT 83605 O LACTIC ACID $94.96 $158.26 $11.57–$159.84 — 40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Z/ LDH, BODY FLUID $49.16 $81.94 $6.04–$82.75 141% above 40%
Lactate dehydrogenase (LDH) blood test CPT 83615 O Z/ LDH, BODY FLUID $49.16 $81.94 $6.04–$82.75 141% above 40%
Lactate dehydrogenase (LDH) blood test CPT 83615 O Z/ LDH $49.16 $81.94 $6.04–$82.75 141% above 40%
Lactate dehydrogenase (LDH) blood test CPT 83615 Z/ LDH $49.16 $81.94 $6.04–$82.75 141% above 40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 O Z/ LDH $49.16 $81.94 $6.04–$82.75 — 40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 O Z/ LDH, BODY FLUID $49.16 $81.94 $6.04–$82.75 — 40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Z/ LDH, BODY FLUID $49.16 $81.94 $6.04–$82.75 — 40%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 Z/ LDH $49.16 $81.94 $6.04–$82.75 — 40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $85.90 $143.16 $6.89–$144.59 242% above 40%
Lipase blood test (pancreas enzyme) CPT 83690 R/ LIPASE $85.90 $143.16 $6.89–$144.59 242% above 40%
Lipase blood test (pancreas enzyme) CPT 83690 O LIPASE $85.90 $143.16 $6.89–$144.59 242% above 40%
Lipase blood test (pancreas enzyme) CPT 83690 O R/ LIPASE $85.90 $143.16 $6.89–$144.59 242% above 40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 O R/ LIPASE $85.90 $143.16 $6.89–$144.59 — 40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 R/ LIPASE $85.90 $143.16 $6.89–$144.59 — 40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 O LIPASE $85.90 $143.16 $6.89–$144.59 — 40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $85.90 $143.16 $6.89–$144.59 — 40%
Liver function blood test panel CPT 80076 Z/ LIVER PANEL $98.42 $164.03 $8.17–$165.67 96% above 40%
Liver function blood test panel CPT 80076 O LIVER PROFILE $98.42 $164.03 $8.17–$165.67 96% above 40%
Liver function blood test panel CPT 80076 LIVER PROFILE $98.42 $164.03 $8.17–$165.67 96% above 40%
Liver function blood test panel inpatient CPT 80076 O LIVER PROFILE $98.42 $164.03 $8.17–$165.67 — 40%
Liver function blood test panel inpatient CPT 80076 LIVER PROFILE $98.42 $164.03 $8.17–$165.67 — 40%
Liver function blood test panel inpatient CPT 80076 Z/ LIVER PANEL $98.42 $164.03 $8.17–$165.67 — 40%
Lyme disease antibody test CPT 86618 O Z/ LYME DISEASE IGG & IGM CONFIRMATION $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O Z/ LYME AB TOTAL (screen) $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 DELETE.LYME DISEASE AB Igm $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 DELETE.LYME DISEASE ANTIBODY $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O LYME DISEASE AB QUANT Igm $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 DELETE.LYME DISEASE ATB (B BURG $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 DELETE.LYME TOTAL AB W/REF $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 DELETE.Z/ LYME DISEASE IGM CONFIRM $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O Z/ LYME DISEASE IGG CONFIRMATION $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O LYME DISEASE ANTIBODY (TITER) $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 LYME DISEASE/SYPHILIS ANTIBODY DIFF PROF $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 Z/ LYME AB TOTAL $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 .LYME DISEASE TOTAL ANTIBODY $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O Z/ LYME DISEASE IGM CONFIRMATION $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O LYME DISEASE/SYPHILIS ANTIBODY DIFF PR $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O LYME TOTAL AB W/REFLEX $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 DISEASE.Z/ LYME DISEASE IGG CONFIRM $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test CPT 86618 O LYME DISEASE ATB (B BURGDORFERI) $92.27 $153.78 $17.03–$155.31 83% above 40%
Lyme disease antibody test inpatient CPT 86618 O LYME TOTAL AB W/REFLEX $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 DELETE.LYME DISEASE AB Igm $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 DELETE.LYME DISEASE ANTIBODY $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 DELETE.LYME DISEASE ATB (B BURG $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 DELETE.LYME TOTAL AB W/REF $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 DELETE.Z/ LYME DISEASE IGM CONFIRM $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 DISEASE.Z/ LYME DISEASE IGG CONFIRM $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O LYME DISEASE AB QUANT Igm $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O LYME DISEASE ANTIBODY (TITER) $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O LYME DISEASE ATB (B BURGDORFERI) $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O LYME DISEASE/SYPHILIS ANTIBODY DIFF PR $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O Z/ LYME AB TOTAL (screen) $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O Z/ LYME DISEASE IGG & IGM CONFIRMATION $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O Z/ LYME DISEASE IGG CONFIRMATION $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 O Z/ LYME DISEASE IGM CONFIRMATION $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 .LYME DISEASE TOTAL ANTIBODY $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 Z/ LYME AB TOTAL $92.27 $153.78 $17.03–$155.31 — 40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE/SYPHILIS ANTIBODY DIFF PROF $92.27 $153.78 $17.03–$155.31 — 40%
Magnesium blood test CPT 83735 MAGNESIUM SERUM ASSAY $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 O MAGNESIUM SERUM $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 O MAGNESIUM URINE $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 O R/ MAGNESIUM SERUM $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 O Z/ MAGNESIUM RBC $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 O Z/ MAGNESIUM URINE 24HR $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 .MAGNESIUM URINE $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 Z/ MAGNESIUM RBC $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 Z/ MAGNESIUM URINE 24HR $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 MAGNESIUM URINE $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test CPT 83735 R/ MAGNESIUM SERUM $66.24 $110.40 $6.70–$111.50 209% above 40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM ASSAY $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 O Z/ MAGNESIUM URINE 24HR $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 .MAGNESIUM URINE $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 O MAGNESIUM URINE $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 O MAGNESIUM SERUM $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 Z/ MAGNESIUM RBC $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 R/ MAGNESIUM SERUM $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 Z/ MAGNESIUM URINE 24HR $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 O R/ MAGNESIUM SERUM $66.24 $110.40 $6.70–$111.50 — 40%
Magnesium blood test inpatient CPT 83735 O Z/ MAGNESIUM RBC $66.24 $110.40 $6.70–$111.50 — 40%
Measles (rubeola) antibody test CPT 86765 .RUBEOLA VIRUS IgG $38.77 $64.61 $12.88–$65.25 33% above 40%
Measles (rubeola) antibody test CPT 86765 O Z/ RUBEOLA IgG Ab $38.77 $64.61 $12.88–$65.25 33% above 40%
Measles (rubeola) antibody test CPT 86765 Z/ RUBEOLA IgG Ab $38.77 $64.61 $12.88–$65.25 33% above 40%
Measles (rubeola) antibody test CPT 86765 Z/ RUBEOLA ANTIBODY IGM $38.77 $64.61 $12.88–$65.25 33% above 40%
Measles (rubeola) antibody test CPT 86765 O R/ RUBEOLA ANTIBODY IGM $38.77 $64.61 $12.88–$65.25 33% above 40%
Measles (rubeola) antibody test CPT 86765 O RUBEOLA VIRUS IgG $38.77 $64.61 $12.88–$65.25 33% above 40%
Measles (rubeola) antibody test inpatient CPT 86765 Z/ RUBEOLA ANTIBODY IGM $38.77 $64.61 $12.88–$65.25 — 40%
Measles (rubeola) antibody test inpatient CPT 86765 O R/ RUBEOLA ANTIBODY IGM $38.77 $64.61 $12.88–$65.25 — 40%
Measles (rubeola) antibody test inpatient CPT 86765 O Z/ RUBEOLA IgG Ab $38.77 $64.61 $12.88–$65.25 — 40%
Measles (rubeola) antibody test inpatient CPT 86765 .RUBEOLA VIRUS IgG $38.77 $64.61 $12.88–$65.25 — 40%
Measles (rubeola) antibody test inpatient CPT 86765 Z/ RUBEOLA IgG Ab $38.77 $64.61 $12.88–$65.25 — 40%
Measles (rubeola) antibody test inpatient CPT 86765 O RUBEOLA VIRUS IgG $38.77 $64.61 $12.88–$65.25 — 40%
Mono test (heterophile antibody, Monospot) CPT 86308 Z/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST SCREEN (IN-HOUSE) $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 O MONO TEST SCREEN $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 O MONONUCLEOSIS QUAL W/REFLEX $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS QUAL W/REFLEX $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 O R/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 R/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) CPT 86308 O Z/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 117% above 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 O MONO TEST SCREEN $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Z/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS QUAL W/REFLEX $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 R/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST SCREEN (IN-HOUSE) $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 O Z/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 O MONONUCLEOSIS QUAL W/REFLEX $52.43 $87.38 $5.18–$88.25 — 40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 O R/ MONONUCLEOSIS TEST QUAL $52.43 $87.38 $5.18–$88.25 — 40%
Mumps immunity blood test CPT 86735 Z/ MUMPS IgM $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 MUMPS ANTIBODY TITER $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 MUMPS IGM $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 Z/ MUMPS IgG $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 O Z/ MUMPS IgM $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 O Z/ MUMPS IgG $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 .MUMPS ANTIBODIES IGM $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 MUMPS IgG $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 O MUMPS IgG $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 O MUMPS IGM $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 O MUMPS ANTIBODIES IGM $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test CPT 86735 O ANTIBODY MUMPS $41.11 $68.51 $13.05–$69.19 39% above 40%
Mumps immunity blood test inpatient CPT 86735 MUMPS ANTIBODY TITER $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 O MUMPS ANTIBODIES IGM $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 O MUMPS IGM $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 Z/ MUMPS IgM $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 MUMPS IgG $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 O ANTIBODY MUMPS $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 O MUMPS IgG $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 .MUMPS ANTIBODIES IGM $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 O Z/ MUMPS IgG $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 O Z/ MUMPS IgM $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 Z/ MUMPS IgG $41.11 $68.51 $13.05–$69.19 — 40%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGM $41.11 $68.51 $13.05–$69.19 — 40%
Obstetric blood test panel CPT 80055 O R/ PRENATAL PROFILE I $258.08 $430.13 $24.12–$434.43 242% above 40%
Obstetric blood test panel inpatient CPT 80055 O R/ PRENATAL PROFILE I $258.08 $430.13 $24.12–$434.43 — 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 DELETE.Z/ PSA FREE & TOTAL $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 O R/ PSA SCREENING $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 .2 PSA FREE $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 O Z/ PSA FREE $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 O Z/ PSA FREE & TOTAL $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 R/ PSA SCREENING $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 O .2 PSA FREE $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free CPT 84154 DELETE.O Z/ PSA FREE $70.51 $117.52 $18.39–$118.69 45% above 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 DELETE.O Z/ PSA FREE $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 R/ PSA SCREENING $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 O .2 PSA FREE $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 O Z/ PSA FREE & TOTAL $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 O Z/ PSA FREE $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 .2 PSA FREE $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 O R/ PSA SCREENING $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 DELETE.Z/ PSA FREE & TOTAL $70.51 $117.52 $18.39–$118.69 — 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 O .1 PSA TOTAL $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 R/ PSA TOTAL $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 Z/ PROSTATE HEALTH INDEX $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL SCREENING $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 .1 PSA TOTAL $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DELETE.PSA :TOTAL W/REFLX FREE $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 O R/ PSA TOTAL $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DELETE.O Z/ PSA TOTAL (DX) $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 O PSA TOTAL DX $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA TOTAL (DX) $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total CPT 84153 DELETE.PSA TOTAL DX $84.59 $140.99 $18.39–$142.39 92% above 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 R/ PSA TOTAL $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL SCREENING $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DELETE.PSA TOTAL DX $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA TOTAL (DX) $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 O .1 PSA TOTAL $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Z/ PROSTATE HEALTH INDEX $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 .1 PSA TOTAL $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 O R/ PSA TOTAL $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 O PSA TOTAL DX $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DELETE.O Z/ PSA TOTAL (DX) $84.59 $140.99 $18.39–$142.39 — 40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 DELETE.PSA :TOTAL W/REFLX FREE $84.59 $140.99 $18.39–$142.39 — 40%
Pap test (liquid-based, automated screening with review) CPT 88175 O GYNECOLOGIC PAP TEST W/REFLEX TO H $121.21 $202.01 $25.04–$204.03 183% above 40%
Pap test (liquid-based, automated screening with review) CPT 88175 O PAP IG GUIDED $121.21 $202.01 $25.04–$204.03 183% above 40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP IG GUIDED $121.21 $202.01 $25.04–$204.03 183% above 40%
Pap test (liquid-based, automated screening with review) CPT 88175 GYNECOLOGIC PAP TEST W/REFLEX TO HPV $121.21 $202.01 $25.04–$204.03 183% above 40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP IG GUIDED $121.21 $202.01 $25.04–$204.03 — 40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 O GYNECOLOGIC PAP TEST W/REFLEX TO H $121.21 $202.01 $25.04–$204.03 — 40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 GYNECOLOGIC PAP TEST W/REFLEX TO HPV $121.21 $202.01 $25.04–$204.03 — 40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 O PAP IG GUIDED $121.21 $202.01 $25.04–$204.03 — 40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CLIN GLOBAL CYTOPATH CERV/VAG THIN LAYER $48.05 $80.08 $20.26–$80.88 73% above 40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CLIN GLOBAL CYTOPATH CERV/VAG THIN LAYER $48.05 $80.08 $20.26–$80.88 — 40%
Parathyroid hormone (PTH) blood test CPT 83970 O PARATHYROID HORMONE $171.79 $286.32 $41.28–$289.18 89% above 40%
Parathyroid hormone (PTH) blood test CPT 83970 O R/ PARATHYROID HORMONE $171.79 $286.32 $41.28–$289.18 89% above 40%
Parathyroid hormone (PTH) blood test CPT 83970 O Z/ PARATHYROID HORMONE (INTACT) $171.79 $286.32 $41.28–$289.18 89% above 40%
Parathyroid hormone (PTH) blood test CPT 83970 Z/ PARATHYROID HORMONE INTACT $171.79 $286.32 $41.28–$289.18 89% above 40%
Parathyroid hormone (PTH) blood test CPT 83970 Z/ PTH INTACT + CA $171.79 $286.32 $41.28–$289.18 89% above 40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 O R/ PARATHYROID HORMONE $171.79 $286.32 $41.28–$289.18 — 40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 O PARATHYROID HORMONE $171.79 $286.32 $41.28–$289.18 — 40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Z/ PARATHYROID HORMONE INTACT $171.79 $286.32 $41.28–$289.18 — 40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 O Z/ PARATHYROID HORMONE (INTACT) $171.79 $286.32 $41.28–$289.18 — 40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Z/ PTH INTACT + CA $171.79 $286.32 $41.28–$289.18 — 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 O R/ PTT ACTIVATED $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 R/ PTT ACTIVATED $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 O PARTIAL THROMBOPLAST $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 Z/ PTT MIXING STUDY $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 O Z/ PTT MIXING STUDY $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test CPT 85730 O Z/ LUPUS ANTICOAGULANT PANEL $66.65 $111.09 $6.01–$112.20 227% above 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 O Z/ LUPUS ANTICOAGULANT PANEL $66.65 $111.09 $6.01–$112.20 — 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 O Z/ PTT MIXING STUDY $66.65 $111.09 $6.01–$112.20 — 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 O PARTIAL THROMBOPLAST $66.65 $111.09 $6.01–$112.20 — 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 R/ PTT ACTIVATED $66.65 $111.09 $6.01–$112.20 — 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME $66.65 $111.09 $6.01–$112.20 — 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Z/ PTT MIXING STUDY $66.65 $111.09 $6.01–$112.20 — 40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 O R/ PTT ACTIVATED $66.65 $111.09 $6.01–$112.20 — 40%
Phosphorus (phosphate) blood test CPT 84100 O R/ PHOSPHORUS $50.68 $84.47 $4.74–$85.31 202% above 40%
Phosphorus (phosphate) blood test CPT 84100 O PHOSPHORUS (INORGANIC) $50.68 $84.47 $4.74–$85.31 202% above 40%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS (INORGANIC) $50.68 $84.47 $4.74–$85.31 202% above 40%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS (INORGANIC) $50.68 $84.47 $4.74–$85.31 — 40%
Phosphorus (phosphate) blood test inpatient CPT 84100 O R/ PHOSPHORUS $50.68 $84.47 $4.74–$85.31 — 40%
Phosphorus (phosphate) blood test inpatient CPT 84100 O PHOSPHORUS (INORGANIC) $50.68 $84.47 $4.74–$85.31 — 40%
Potassium blood test CPT 84132 POTASSIUM (K+) SERUM $40.40 $67.34 $4.76–$68.01 130% above 40%
Potassium blood test CPT 84132 O POTASSIUM (K+) SERUM $40.40 $67.34 $4.76–$68.01 130% above 40%
Potassium blood test inpatient CPT 84132 POTASSIUM (K+) SERUM $40.40 $67.34 $4.76–$68.01 — 40%
Potassium blood test inpatient CPT 84132 O POTASSIUM (K+) SERUM $40.40 $67.34 $4.76–$68.01 — 40%
Progesterone blood test CPT 84144 O Z/ PROGESTERONE $97.77 $162.95 $20.86–$164.57 79% above 40%
Progesterone blood test CPT 84144 Z/ PROGESTERONE $97.77 $162.95 $20.86–$164.57 79% above 40%
Progesterone blood test inpatient CPT 84144 O Z/ PROGESTERONE $97.77 $162.95 $20.86–$164.57 — 40%
Progesterone blood test inpatient CPT 84144 Z/ PROGESTERONE $97.77 $162.95 $20.86–$164.57 — 40%
Prolactin blood test CPT 84146 Z/ PROLACTIN, PITUITARY MACROADENOMA $101.15 $168.58 $19.38–$170.26 58% above 40%
Prolactin blood test CPT 84146 Z/ PROLACTIN $101.15 $168.58 $19.38–$170.26 58% above 40%
Prolactin blood test CPT 84146 O Z/ MACROPROLACTIN $101.15 $168.58 $19.38–$170.26 58% above 40%
Prolactin blood test CPT 84146 O Z/ PROLACTIN $101.15 $168.58 $19.38–$170.26 58% above 40%
Prolactin blood test inpatient CPT 84146 Z/ PROLACTIN $101.15 $168.58 $19.38–$170.26 — 40%
Prolactin blood test inpatient CPT 84146 O Z/ PROLACTIN $101.15 $168.58 $19.38–$170.26 — 40%
Prolactin blood test inpatient CPT 84146 Z/ PROLACTIN, PITUITARY MACROADENOMA $101.15 $168.58 $19.38–$170.26 — 40%
Prolactin blood test inpatient CPT 84146 O Z/ MACROPROLACTIN $101.15 $168.58 $19.38–$170.26 — 40%
Prothrombin time (PT/INR) clotting test CPT 85610 O R/ PT AND PTT $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 O R/ PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 O PROTHROMBIN TIME FINGER STICK $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 O PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 .R3 FACTOR V INH PROFILE COMP $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 O .1 PROTIME MIXING STUDY $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 O .R3 FACTOR V INH PROFILE COMP $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME FINGER STICK $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 R/ PT AND PTT $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test CPT 85610 R/ PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 215% above 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 O PROTHROMBIN TIME FINGER STICK $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 R/ PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 O PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 .R3 FACTOR V INH PROFILE COMP $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 O .1 PROTIME MIXING STUDY $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 O .R3 FACTOR V INH PROFILE COMP $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 O R/ PROTHROMBIN TIME $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME FINGER STICK $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 R/ PT AND PTT $45.62 $76.03 $4.29–$76.79 — 40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 O R/ PT AND PTT $45.62 $76.03 $4.29–$76.79 — 40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 .2 R/ DRUG SCREEN PRSMPTV $129.88 $216.46 $12.60–$218.62 471% above 40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 O .2 R/ DRUG SCREEN PRSMPTV $129.88 $216.46 $12.60–$218.62 471% above 40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 O .URINALYSIS ROUTINE AUTO W MICRO $129.88 $216.46 $12.60–$218.62 471% above 40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 .URINALYSIS ROUTINE AUTO W MICRO $129.88 $216.46 $12.60–$218.62 471% above 40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 CLIN FAC URINE DRUG SCREEN $206.24 $343.73 $12.60–$347.16 807% above 40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 O .2 R/ DRUG SCREEN PRSMPTV $129.88 $216.46 $12.60–$218.62 — 40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 .2 R/ DRUG SCREEN PRSMPTV $129.88 $216.46 $12.60–$218.62 — 40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 .URINALYSIS ROUTINE AUTO W MICRO $129.88 $216.46 $12.60–$218.62 — 40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 O .URINALYSIS ROUTINE AUTO W MICRO $129.88 $216.46 $12.60–$218.62 — 40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 CLIN FAC URINE DRUG SCREEN $206.24 $343.73 $12.60–$347.16 — 40%
Rapid flu test (influenza antigen) CPT 87804 CLIN GLOBAL FLU SCREEN A/B $68.49 $114.15 $13.97–$115.29 204% above 40%
Rapid flu test (influenza antigen) inpatient CPT 87804 CLIN GLOBAL FLU SCREEN A/B $68.49 $114.15 $13.97–$115.29 — 40%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 CLIN GLOBAL STREP SCREEN $53.58 $89.30 $13.97–$90.19 141% above 40%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 CLIN GLOBAL STREP SCREEN $53.58 $89.30 $13.97–$90.19 — 40%
Renin blood test CPT 84244 O .R2 RENIN ACT $119.38 $198.96 $21.99–$200.94 100% above 40%
Renin blood test CPT 84244 Z/ RENIN $119.38 $198.96 $21.99–$200.94 100% above 40%
Renin blood test CPT 84244 DELETE.RENIN PLASMA LEVEL $119.38 $198.96 $21.99–$200.94 100% above 40%
Renin blood test CPT 84244 O RENIN PLASMA LEVEL $119.38 $198.96 $21.99–$200.94 100% above 40%
Renin blood test CPT 84244 .R2 RENIN ACT $119.38 $198.96 $21.99–$200.94 100% above 40%
Renin blood test CPT 84244 O Z/ RENIN PLASMA $119.38 $198.96 $21.99–$200.94 100% above 40%
Renin blood test inpatient CPT 84244 O .R2 RENIN ACT $119.38 $198.96 $21.99–$200.94 — 40%
Renin blood test inpatient CPT 84244 Z/ RENIN $119.38 $198.96 $21.99–$200.94 — 40%
Renin blood test inpatient CPT 84244 O Z/ RENIN PLASMA $119.38 $198.96 $21.99–$200.94 — 40%
Renin blood test inpatient CPT 84244 DELETE.RENIN PLASMA LEVEL $119.38 $198.96 $21.99–$200.94 — 40%
Renin blood test inpatient CPT 84244 O RENIN PLASMA LEVEL $119.38 $198.96 $21.99–$200.94 — 40%
Renin blood test inpatient CPT 84244 .R2 RENIN ACT $119.38 $198.96 $21.99–$200.94 — 40%
Rh blood typing CPT 86901 BB BLOOD TYPE RH $45.11 $75.18 $2.99–$75.93 111% above 40%
Rh blood typing CPT 86901 .BB BLOOD TYPE RH $45.11 $75.18 $2.99–$75.93 111% above 40%
Rh blood typing CPT 86901 DELETE.BB BLOOD TYPE RH (D) UBS $45.11 $75.18 $2.99–$75.93 111% above 40%
Rh blood typing CPT 86901 O BB BLOOD TYPE RH $45.11 $75.18 $2.99–$75.93 111% above 40%
Rh blood typing inpatient CPT 86901 O BB BLOOD TYPE RH $45.11 $75.18 $2.99–$75.93 — 40%
Rh blood typing inpatient CPT 86901 BB BLOOD TYPE RH $45.11 $75.18 $2.99–$75.93 — 40%
Rh blood typing inpatient CPT 86901 .BB BLOOD TYPE RH $45.11 $75.18 $2.99–$75.93 — 40%
Rh blood typing inpatient CPT 86901 DELETE.BB BLOOD TYPE RH (D) UBS $45.11 $75.18 $2.99–$75.93 — 40%
Rheumatoid factor (RF) test CPT 86431 .Z/ RHEUMATOID FACTOR QUANTITATIVE $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test CPT 86431 .4 ANA/ENA/RA PROFILE $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test CPT 86431 O Z/ RHEUMATOID FACTOR QUANT $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test CPT 86431 Z/ RHEUMATOID FACTOR $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test CPT 86431 O .4 ANA/ENA/RA PROFILE $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test CPT 86431 .Z/ RHEUMATOID FACTOR PANEL REFLEX G/A/M $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test CPT 86431 O RHEUMATOID FACTOR QUANT $39.53 $65.89 $5.67–$66.54 68% above 40%
Rheumatoid factor (RF) test inpatient CPT 86431 .Z/ RHEUMATOID FACTOR PANEL REFLEX G/A/M $39.53 $65.89 $5.67–$66.54 — 40%
Rheumatoid factor (RF) test inpatient CPT 86431 O .4 ANA/ENA/RA PROFILE $39.53 $65.89 $5.67–$66.54 — 40%
Rheumatoid factor (RF) test inpatient CPT 86431 O RHEUMATOID FACTOR QUANT $39.53 $65.89 $5.67–$66.54 — 40%
Rheumatoid factor (RF) test inpatient CPT 86431 Z/ RHEUMATOID FACTOR $39.53 $65.89 $5.67–$66.54 — 40%
Rheumatoid factor (RF) test inpatient CPT 86431 O Z/ RHEUMATOID FACTOR QUANT $39.53 $65.89 $5.67–$66.54 — 40%
Rheumatoid factor (RF) test inpatient CPT 86431 .4 ANA/ENA/RA PROFILE $39.53 $65.89 $5.67–$66.54 — 40%
Rheumatoid factor (RF) test inpatient CPT 86431 .Z/ RHEUMATOID FACTOR QUANTITATIVE $39.53 $65.89 $5.67–$66.54 — 40%
Rubella antibody test (immunity check) CPT 86762 R/ RUBELLA ANTIBODY $56.41 $94.02 $14.39–$94.96 70% above 40%
Rubella antibody test (immunity check) CPT 86762 O R/ RUBELLA ANTIBODY $56.41 $94.02 $14.39–$94.96 70% above 40%
Rubella antibody test (immunity check) CPT 86762 O RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 70% above 40%
Rubella antibody test (immunity check) CPT 86762 .RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 70% above 40%
Rubella antibody test (immunity check) CPT 86762 O Z/ RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 70% above 40%
Rubella antibody test (immunity check) CPT 86762 Z/ RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 70% above 40%
Rubella antibody test (immunity check) inpatient CPT 86762 Z/ RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 — 40%
Rubella antibody test (immunity check) inpatient CPT 86762 O R/ RUBELLA ANTIBODY $56.41 $94.02 $14.39–$94.96 — 40%
Rubella antibody test (immunity check) inpatient CPT 86762 .RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 — 40%
Rubella antibody test (immunity check) inpatient CPT 86762 O Z/ RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 — 40%
Rubella antibody test (immunity check) inpatient CPT 86762 O RUBELLA IgG Ab $56.41 $94.02 $14.39–$94.96 — 40%
Rubella antibody test (immunity check) inpatient CPT 86762 R/ RUBELLA ANTIBODY $56.41 $94.02 $14.39–$94.96 — 40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 O Z/ SEDIMENTATION RATE WESTERGREN $30.06 $50.10 $2.70–$50.60 24% above 40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Z/ SEDIMENTATION RATE WESTERGREN $30.06 $50.10 $2.70–$50.60 24% above 40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 Z/ SEDIMENTATION RATE WESTERGREN $30.06 $50.10 $2.70–$50.60 — 40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 O Z/ SEDIMENTATION RATE WESTERGREN $30.06 $50.10 $2.70–$50.60 — 40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 O SEMEN ANALYSIS $18.60 $31.00 $14.05–$44.76 48% below 40%
Semen analysis: volume, sperm count, motility and morphology CPT 89320 SEMEN ANALYSIS $18.60 $31.00 $14.05–$44.76 48% below 40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 O SEMEN ANALYSIS $18.60 $31.00 $14.05–$44.76 — 40%
Semen analysis: volume, sperm count, motility and morphology inpatient CPT 89320 SEMEN ANALYSIS $18.60 $31.00 $14.05–$44.76 — 40%
Sodium blood test CPT 84295 SODIUM (NA+) SERUM $58.41 $97.35 $4.81–$98.32 242% above 40%
Sodium blood test CPT 84295 O SODIUM (NA+) SERUM $58.41 $97.35 $4.81–$98.32 242% above 40%
Sodium blood test inpatient CPT 84295 SODIUM (NA+) SERUM $58.41 $97.35 $4.81–$98.32 — 40%
Sodium blood test inpatient CPT 84295 O SODIUM (NA+) SERUM $58.41 $97.35 $4.81–$98.32 — 40%
Stool ova and parasites exam CPT 87177 OCP STOOL $48.84 $81.40 $8.90–$82.21 63% above 40%
Stool ova and parasites exam CPT 87177 Z/ OCP STOOL $48.84 $81.40 $8.90–$82.21 63% above 40%
Stool ova and parasites exam CPT 87177 O Z/ OCP STOOL $48.84 $81.40 $8.90–$82.21 63% above 40%
Stool ova and parasites exam CPT 87177 O OCP STOOL $48.84 $81.40 $8.90–$82.21 63% above 40%
Stool ova and parasites exam inpatient CPT 87177 OCP STOOL $48.84 $81.40 $8.90–$82.21 — 40%
Stool ova and parasites exam inpatient CPT 87177 O OCP STOOL $48.84 $81.40 $8.90–$82.21 — 40%
Stool ova and parasites exam inpatient CPT 87177 Z/ OCP STOOL $48.84 $81.40 $8.90–$82.21 — 40%
Stool ova and parasites exam inpatient CPT 87177 O Z/ OCP STOOL $48.84 $81.40 $8.90–$82.21 — 40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 CLIN GLOBAL BLOOD OCC FECES-COL SCREEN $34.06 $56.76 $3.79–$57.32 152% above 40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 CLIN FAC BLOOD OCCULT FECES-COL SCREEN $34.06 $56.76 $4.38–$57.32 152% above 40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 CLIN FAC BLOOD OCCULT FECES-COL SCREEN $34.06 $56.76 $4.38–$57.32 — 40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 CLIN GLOBAL BLOOD OCC FECES-COL SCREEN $34.06 $56.76 $3.79–$57.32 — 40%
Syphilis antibody test (Treponema pallidum) CPT 86780 O Z/ FTA-ABS $119.52 $199.20 $13.24–$201.19 366% above 40%
Syphilis antibody test (Treponema pallidum) CPT 86780 Z/ FTA-ABS $119.52 $199.20 $13.24–$201.19 366% above 40%
Syphilis antibody test (Treponema pallidum) CPT 86780 .Z/ TREPONEMA PALLIDIUM AB $119.52 $199.20 $13.24–$201.19 366% above 40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 Z/ FTA-ABS $119.52 $199.20 $13.24–$201.19 — 40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 .Z/ TREPONEMA PALLIDIUM AB $119.52 $199.20 $13.24–$201.19 — 40%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 O Z/ FTA-ABS $119.52 $199.20 $13.24–$201.19 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 O Z/ RPR WITH TITER $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Z/ RPR W/REFLEX TITER & TREP ABS $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 R/ RPR (VDRL) $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 O R/ RPR (VDRL) $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 R/ RPR-FTA-ABS QUANT $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 DELETE.Z/ RPR WITH TITER $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 O R/ RPR-FTA-ABS QUANT $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 O Z/ RPR W/REFLEX FTA & TITER $40.85 $68.08 $4.27–$68.76 183% above 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 O R/ RPR-FTA-ABS QUANT $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 R/ RPR-FTA-ABS QUANT $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 DELETE.Z/ RPR WITH TITER $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 R/ RPR (VDRL) $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 O R/ RPR (VDRL) $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Z/ RPR W/REFLEX TITER & TREP ABS $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 O Z/ RPR WITH TITER $40.85 $68.08 $4.27–$68.76 — 40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 O Z/ RPR W/REFLEX FTA & TITER $40.85 $68.08 $4.27–$68.76 — 40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 O Z/ TB GOLD/QUANTIFERON $213.82 $356.37 $61.98–$359.93 81% above 40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Z/ TB GOLD/QUANTIFERON $213.82 $356.37 $61.98–$359.93 81% above 40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 O Z/ TB GOLD/QUANTIFERON $213.82 $356.37 $61.98–$359.93 — 40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 Z/ TB GOLD/QUANTIFERON $213.82 $356.37 $61.98–$359.93 — 40%
Testosterone blood test, total (not free testosterone) CPT 84403 Z/ TESTOSTERONE TOTAL $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 O Z/ TESTOSTERONE TOTAL-MALE $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 Z/ TESTOST LC/MS FEM,CHILD,HYPOGONADAL M $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 O .2 TESTOSTERONE WEAKLY $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 DELETE.Z/ TESTOS FREE/TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 DELETE.Z/ TESTOSTERONE TOTAL-FEMAL $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 .O Z/ TESTOSTERONE TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 .O Z/ TESTOSTERONE TOTAL-MALE $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 .Z/ TESTOSTERONE TOTAL $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 .Z/ TESTOSTERONE TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 .1 FREE ANDROGEN INDEX TOTAL $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 DELETE.Z/ TESTO FREE/TOTAL-MALE $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 DELETE.O Z/ TESTO FREE/TOTAL-MALE $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 DELETE.O Z/ TESTO FREE/TOTAL-FEMALE/CHIL $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 O Z/ TESTOSTERONE TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) CPT 84403 .2 TESTOSTERONE WEAKLY $122.32 $203.87 $25.81–$205.90 109% above 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .Z/ TESTOSTERONE TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .1 FREE ANDROGEN INDEX TOTAL $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 DELETE.Z/ TESTO FREE/TOTAL-MALE $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 DELETE.O Z/ TESTO FREE/TOTAL-MALE $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 O .2 TESTOSTERONE WEAKLY $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 O Z/ TESTOSTERONE TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .Z/ TESTOSTERONE TOTAL $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 DELETE.O Z/ TESTO FREE/TOTAL-FEMALE/CHIL $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .2 TESTOSTERONE WEAKLY $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 DELETE.Z/ TESTOS FREE/TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Z/ TESTOSTERONE TOTAL $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 DELETE.Z/ TESTOSTERONE TOTAL-FEMAL $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Z/ TESTOST LC/MS FEM,CHILD,HYPOGONADAL M $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .O Z/ TESTOSTERONE TOTAL-FEMALE/CHILD $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 O Z/ TESTOSTERONE TOTAL-MALE $122.32 $203.87 $25.81–$205.90 — 40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 .O Z/ TESTOSTERONE TOTAL-MALE $122.32 $203.87 $25.81–$205.90 — 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI MICROSOMAL-HEMAGGLUTINATION $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE (ANTI-MICROSOMAL) ATB $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 O ANTI MICROSOMAL-HEMAGGLUTINATION $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Z/ THYROID PEROXIDASE (ANTI-MICROSOMAL) $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Z/ THYROID ANTIBODIES $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Z/ RABIES ANTIBODY SCREEN $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 Z/ LIVER KIDNEY MICROSOMAL ANTIBODY $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 O Z/ RABIES ANTIBODY SCREEN $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 O Z/ THYROID PEROXIDASE (ANTI-MICROSOMA $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 O Z/ THYROID ANTIBODIES $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 O THYROID PEROXIDASE (ANTI-MICROSOMAL) A $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test CPT 86376 O Z/ LIVER KIDNEY MICROSOMAL ANTIBODY $73.48 $122.46 $14.55–$123.68 104% above 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 O Z/ THYROID PEROXIDASE (ANTI-MICROSOMA $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 O THYROID PEROXIDASE (ANTI-MICROSOMAL) A $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 O Z/ THYROID ANTIBODIES $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI MICROSOMAL-HEMAGGLUTINATION $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Z/ THYROID ANTIBODIES $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Z/ THYROID PEROXIDASE (ANTI-MICROSOMAL) $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Z/ RABIES ANTIBODY SCREEN $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 O ANTI MICROSOMAL-HEMAGGLUTINATION $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Z/ LIVER KIDNEY MICROSOMAL ANTIBODY $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE (ANTI-MICROSOMAL) ATB $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 O Z/ RABIES ANTIBODY SCREEN $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 O Z/ LIVER KIDNEY MICROSOMAL ANTIBODY $73.48 $122.46 $14.55–$123.68 — 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 O THYROID PROFILE (TSH) $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 O R/ THYROID CASCADE PROFILE $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 O TSH ULTRASENSITIVITIES $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 O Z/ TSH $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Z/ TSH $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 INACTIVATE $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 R/ THYROID CASCADE PROFILE $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 R/ TSH $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID PROFILE (TSH) $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH ULTRASENSITIVITIES $87.58 $145.96 $16.80–$147.41 113% above 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 O Z/ TSH $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 O THYROID PROFILE (TSH) $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH ULTRASENSITIVITIES $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 R/ THYROID CASCADE PROFILE $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 O TSH ULTRASENSITIVITIES $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 O R/ THYROID CASCADE PROFILE $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 R/ TSH $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID PROFILE (TSH) $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 INACTIVATE $87.58 $145.96 $16.80–$147.41 — 40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Z/ TSH $87.58 $145.96 $16.80–$147.41 — 40%
Total IgE blood test CPT 82785 O IMMUNOCAP IGE PEDIATRIC FOOD PANEL $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 O IMMUNOCAP RESPIRATORY PANEL $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 O R/ ALLERGEN PROFILE W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 O Z/ ALLERGEN PROFILE W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 O Z/ IGE $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 .IGE $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 Z/ IGE $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 Z/ DELETE.ALLERGEN PROF W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 IMMUNOCAP IGE PEDIATRIC FOOD PANEL $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 IMMUNOCAP RESPIRATORY PANEL $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 O IGE $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test CPT 82785 DELETE.R/ ALLERGEN PROFILE W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 129% above 40%
Total IgE blood test inpatient CPT 82785 DELETE.R/ ALLERGEN PROFILE W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 O IGE $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 O IMMUNOCAP RESPIRATORY PANEL $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 O IMMUNOCAP IGE PEDIATRIC FOOD PANEL $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 IMMUNOCAP RESPIRATORY PANEL $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 IMMUNOCAP IGE PEDIATRIC FOOD PANEL $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 Z/ DELETE.ALLERGEN PROF W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 Z/ IGE $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 .IGE $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 O Z/ ALLERGEN PROFILE W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 O R/ ALLERGEN PROFILE W/ IGE RESP 6 $87.59 $145.99 $16.46–$147.44 — 40%
Total IgE blood test inpatient CPT 82785 O Z/ IGE $87.59 $145.99 $16.46–$147.44 — 40%
Total cholesterol blood test CPT 82465 O CHOLESTEROL SERUM TOTAL $46.30 $77.16 $4.35–$77.93 209% above 40%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM TOTAL $46.30 $77.16 $4.35–$77.93 209% above 40%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM TOTAL $46.30 $77.16 $4.35–$77.93 — 40%
Total cholesterol blood test inpatient CPT 82465 O CHOLESTEROL SERUM TOTAL $46.30 $77.16 $4.35–$77.93 — 40%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL $39.47 $65.78 $5.64–$66.43 69% above 40%
Total thyroxine (T4) blood test CPT 84436 O THYROXINE TOTAL $39.47 $65.78 $5.64–$66.43 69% above 40%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL $39.47 $65.78 $5.64–$66.43 — 40%
Total thyroxine (T4) blood test inpatient CPT 84436 O THYROXINE TOTAL $39.47 $65.78 $5.64–$66.43 — 40%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL $70.50 $117.50 $7.48–$118.67 47% above 40%
Total triiodothyronine (T3) blood test CPT 84480 O T3 TOTAL $70.50 $117.50 $7.48–$118.67 47% above 40%
Total triiodothyronine (T3) blood test CPT 84480 O Z/ T3 TOTAL $70.50 $117.50 $7.48–$118.67 47% above 40%
Total triiodothyronine (T3) blood test CPT 84480 Z/ T3 $70.50 $117.50 $7.48–$118.67 47% above 40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 O T3 TOTAL $70.50 $117.50 $7.48–$118.67 — 40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL $70.50 $117.50 $7.48–$118.67 — 40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 Z/ T3 $70.50 $117.50 $7.48–$118.67 — 40%
Total triiodothyronine (T3) blood test inpatient CPT 84480 O Z/ T3 TOTAL $70.50 $117.50 $7.48–$118.67 — 40%
Transferrin blood test CPT 84466 O Z/ TRANSFERRIN $78.37 $130.62 $12.76–$131.92 103% above 40%
Transferrin blood test CPT 84466 .TRANSFERRIN $78.37 $130.62 $12.76–$131.92 103% above 40%
Transferrin blood test CPT 84466 Z/ TRANSFERRIN $78.37 $130.62 $12.76–$131.92 103% above 40%
Transferrin blood test CPT 84466 O .TRANSFERRIN $78.37 $130.62 $12.76–$131.92 103% above 40%
Transferrin blood test inpatient CPT 84466 O .TRANSFERRIN $78.37 $130.62 $12.76–$131.92 — 40%
Transferrin blood test inpatient CPT 84466 .TRANSFERRIN $78.37 $130.62 $12.76–$131.92 — 40%
Transferrin blood test inpatient CPT 84466 O Z/ TRANSFERRIN $78.37 $130.62 $12.76–$131.92 — 40%
Transferrin blood test inpatient CPT 84466 Z/ TRANSFERRIN $78.37 $130.62 $12.76–$131.92 — 40%
Trichomonas test (NAAT) CPT 87661 O R/ TRICHOMONAS VAGINALIS $115.68 $192.80 $35.09–$194.72 136% above 40%
Trichomonas test (NAAT) CPT 87661 Z/ TRICHOMONAS VAGINALIS $115.68 $192.80 $35.09–$194.72 136% above 40%
Trichomonas test (NAAT) CPT 87661 O Z/ TRICHOMONAS VAGINALIS $115.68 $192.80 $35.09–$194.72 136% above 40%
Trichomonas test (NAAT) inpatient CPT 87661 O Z/ TRICHOMONAS VAGINALIS $115.68 $192.80 $35.09–$194.72 — 40%
Trichomonas test (NAAT) inpatient CPT 87661 Z/ TRICHOMONAS VAGINALIS $115.68 $192.80 $35.09–$194.72 — 40%
Trichomonas test (NAAT) inpatient CPT 87661 O R/ TRICHOMONAS VAGINALIS $115.68 $192.80 $35.09–$194.72 — 40%
Triglycerides blood test CPT 84478 O TRIGLYCERIDES $38.75 $64.59 $5.74–$65.23 62% above 40%
Triglycerides blood test CPT 84478 TRIGLYCERIDES $38.75 $64.59 $5.74–$65.23 62% above 40%
Triglycerides blood test inpatient CPT 84478 O TRIGLYCERIDES $38.75 $64.59 $5.74–$65.23 — 40%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES $38.75 $64.59 $5.74–$65.23 — 40%
Troponin test, quantitative CPT 84484 TROPONIN I $133.79 $222.99 $11.48–$225.21 253% above 40%
Troponin test, quantitative CPT 84484 ISTAT TROPONIN $133.79 $222.99 $11.48–$225.21 253% above 40%
Troponin test, quantitative CPT 84484 DELETE.TROPONIN I HIGH SENSITIVITY $133.79 $222.99 $11.48–$225.21 253% above 40%
Troponin test, quantitative CPT 84484 DELETE.TROPONIN QUANTATIVE (R) $133.79 $222.99 $11.48–$225.21 253% above 40%
Troponin test, quantitative CPT 84484 O ISTAT TROPONIN $133.79 $222.99 $11.48–$225.21 253% above 40%
Troponin test, quantitative CPT 84484 O TROPONIN I $133.79 $222.99 $11.48–$225.21 253% above 40%
Troponin test, quantitative inpatient CPT 84484 O TROPONIN I $133.79 $222.99 $11.48–$225.21 — 40%
Troponin test, quantitative inpatient CPT 84484 DELETE.TROPONIN I HIGH SENSITIVITY $133.79 $222.99 $11.48–$225.21 — 40%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I $133.79 $222.99 $11.48–$225.21 — 40%
Troponin test, quantitative inpatient CPT 84484 DELETE.TROPONIN QUANTATIVE (R) $133.79 $222.99 $11.48–$225.21 — 40%
Troponin test, quantitative inpatient CPT 84484 ISTAT TROPONIN $133.79 $222.99 $11.48–$225.21 — 40%
Troponin test, quantitative inpatient CPT 84484 O ISTAT TROPONIN $133.79 $222.99 $11.48–$225.21 — 40%
Uric acid blood test CPT 84550 URIC ACID SERUM $40.07 $66.78 $4.52–$67.44 129% above 40%
Uric acid blood test CPT 84550 O URIC ACID SERUM $40.07 $66.78 $4.52–$67.44 129% above 40%
Uric acid blood test CPT 84550 Z/ URIC ACID SER PLASMA $40.07 $66.78 $4.52–$67.44 129% above 40%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM $40.07 $66.78 $4.52–$67.44 — 40%
Uric acid blood test inpatient CPT 84550 O URIC ACID SERUM $40.07 $66.78 $4.52–$67.44 — 40%
Uric acid blood test inpatient CPT 84550 Z/ URIC ACID SER PLASMA $40.07 $66.78 $4.52–$67.44 — 40%
Urinalysis with microscope exam, automated CPT 81001 O R/ URINALYSIS $45.75 $76.25 $3.17–$77.01 83% above 40%
Urinalysis with microscope exam, automated CPT 81001 R/ URINALYSIS $45.75 $76.25 $3.17–$77.01 83% above 40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS UA-AUTO W/MICRO $45.75 $76.25 $3.17–$77.01 83% above 40%
Urinalysis with microscope exam, automated CPT 81001 O URINALYSIS UA-AUTO W/MICRO $45.75 $76.25 $3.17–$77.01 83% above 40%
Urinalysis with microscope exam, automated inpatient CPT 81001 O URINALYSIS UA-AUTO W/MICRO $45.75 $76.25 $3.17–$77.01 — 40%
Urinalysis with microscope exam, automated inpatient CPT 81001 O R/ URINALYSIS $45.75 $76.25 $3.17–$77.01 — 40%
Urinalysis with microscope exam, automated inpatient CPT 81001 R/ URINALYSIS $45.75 $76.25 $3.17–$77.01 — 40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS UA-AUTO W/MICRO $45.75 $76.25 $3.17–$77.01 — 40%
Urinalysis with microscope exam, manual CPT 81000 DELETE.U/A GLUCOSE DIPSTICK/TAB RGT $10.85 $18.08 $3.70–$18.26 65% above 40%
Urinalysis with microscope exam, manual CPT 81000 CLIN GLOBAL URINALYSIS W/MICRO $10.85 $18.08 $3.70–$18.26 65% above 40%
Urinalysis with microscope exam, manual inpatient CPT 81000 DELETE.U/A GLUCOSE DIPSTICK/TAB RGT $10.85 $18.08 $3.70–$18.26 — 40%
Urinalysis with microscope exam, manual inpatient CPT 81000 CLIN GLOBAL URINALYSIS W/MICRO $10.85 $18.08 $3.70–$18.26 — 40%
Urinalysis without microscope exam, automated CPT 81003 Z/ PH (URINE) AUTOMATED $28.33 $47.22 $2.25–$47.69 220% above 40%
Urinalysis without microscope exam, automated CPT 81003 O Z/ PH (URINE) $28.33 $47.22 $2.25–$47.69 220% above 40%
Urinalysis without microscope exam, automated inpatient CPT 81003 Z/ PH (URINE) AUTOMATED $28.33 $47.22 $2.25–$47.69 — 40%
Urinalysis without microscope exam, automated inpatient CPT 81003 O Z/ PH (URINE) $28.33 $47.22 $2.25–$47.69 — 40%
Urinalysis without microscope exam, manual CPT 81002 CLIN FAC URINALYSIS W/MICRO $11.54 $19.23 $2.98–$19.42 67% above 40%
Urinalysis without microscope exam, manual CPT 81002 O UA DIPSTICK NON-AUTO W/O /MICRO $11.54 $19.23 $2.98–$19.42 67% above 40%
Urinalysis without microscope exam, manual CPT 81002 UA DIPSTICK NON-AUTO W/O /MICRO $11.54 $19.23 $2.98–$19.42 67% above 40%
Urinalysis without microscope exam, manual inpatient CPT 81002 CLIN FAC URINALYSIS W/MICRO $11.54 $19.23 $2.98–$19.42 — 40%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA DIPSTICK NON-AUTO W/O /MICRO $11.54 $19.23 $2.98–$19.42 — 40%
Urinalysis without microscope exam, manual inpatient CPT 81002 O UA DIPSTICK NON-AUTO W/O /MICRO $11.54 $19.23 $2.98–$19.42 — 40%
Urine culture for bacteria, with colony count CPT 87086 DELETE.Z/ CULTURE URINE QUANT COLONY CT $65.63 $109.39 $8.07–$110.48 75% above 40%
Urine culture for bacteria, with colony count CPT 87086 Z/ CULTURE URINE QUANT COLONY CT $65.63 $109.39 $8.07–$110.48 75% above 40%
Urine culture for bacteria, with colony count CPT 87086 O Z/ CULTURE URINE QUANT COLONY CT $65.63 $109.39 $8.07–$110.48 75% above 40%
Urine culture for bacteria, with colony count inpatient CPT 87086 O Z/ CULTURE URINE QUANT COLONY CT $65.63 $109.39 $8.07–$110.48 — 40%
Urine culture for bacteria, with colony count inpatient CPT 87086 Z/ CULTURE URINE QUANT COLONY CT $65.63 $109.39 $8.07–$110.48 — 40%
Urine culture for bacteria, with colony count inpatient CPT 87086 DELETE.Z/ CULTURE URINE QUANT COLONY CT $65.63 $109.39 $8.07–$110.48 — 40%
Urine microalbumin (albumin) test CPT 82043 O Z/ MICROALBUMIN/CREATININE RATIO RAND $54.02 $90.03 $5.78–$90.93 210% above 40%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN 24 HR URINE QUANT $54.02 $90.03 $5.78–$90.93 210% above 40%
Urine microalbumin (albumin) test CPT 82043 .ALBUMIN URINE QUANTITATIVE $54.02 $90.03 $5.78–$90.93 210% above 40%
Urine microalbumin (albumin) test CPT 82043 O MICROALBUMIN/CREATININE RATIO RAND QUA $54.02 $90.03 $5.78–$90.93 210% above 40%
Urine microalbumin (albumin) test CPT 82043 O MICROALBUMIN 24 HR URINE QUANT $54.02 $90.03 $5.78–$90.93 210% above 40%
Urine microalbumin (albumin) test inpatient CPT 82043 .ALBUMIN URINE QUANTITATIVE $54.02 $90.03 $5.78–$90.93 — 40%
Urine microalbumin (albumin) test inpatient CPT 82043 O MICROALBUMIN 24 HR URINE QUANT $54.02 $90.03 $5.78–$90.93 — 40%
Urine microalbumin (albumin) test inpatient CPT 82043 O Z/ MICROALBUMIN/CREATININE RATIO RAND $54.02 $90.03 $5.78–$90.93 — 40%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN 24 HR URINE QUANT $54.02 $90.03 $5.78–$90.93 — 40%
Urine microalbumin (albumin) test inpatient CPT 82043 O MICROALBUMIN/CREATININE RATIO RAND QUA $54.02 $90.03 $5.78–$90.93 — 40%
Urine pregnancy test, read by color change CPT 81025 CLIN GLOBAL UPT $51.47 $85.79 $7.37–$86.64 145% above 40%
Urine pregnancy test, read by color change CPT 81025 UC PREGNANCY URINE QUALITATIVE $51.47 $85.79 $7.37–$86.64 145% above 40%
Urine pregnancy test, read by color change inpatient CPT 81025 UC PREGNANCY URINE QUALITATIVE $51.47 $85.79 $7.37–$86.64 — 40%
Urine pregnancy test, read by color change inpatient CPT 81025 CLIN GLOBAL UPT $51.47 $85.79 $7.37–$86.64 — 40%
Vitamin B12 (cobalamin) blood test CPT 82607 Z/ VITAMIN B-12 LEVEL $94.15 $156.91 $15.08–$158.47 137% above 40%
Vitamin B12 (cobalamin) blood test CPT 82607 O VITAMIN B-12 LEVEL $94.15 $156.91 $15.08–$158.47 137% above 40%
Vitamin B12 (cobalamin) blood test CPT 82607 O R/ VIT B-12 BINDING DEFICIENCY CAS $94.15 $156.91 $15.08–$158.47 137% above 40%
Vitamin B12 (cobalamin) blood test CPT 82607 .VIT B-12 $94.15 $156.91 $15.08–$158.47 137% above 40%
Vitamin B12 (cobalamin) blood test CPT 82607 O Z/ VITAMIN B-12 LEVEL $94.15 $156.91 $15.08–$158.47 137% above 40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 O Z/ VITAMIN B-12 LEVEL $94.15 $156.91 $15.08–$158.47 — 40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 O VITAMIN B-12 LEVEL $94.15 $156.91 $15.08–$158.47 — 40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 .VIT B-12 $94.15 $156.91 $15.08–$158.47 — 40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Z/ VITAMIN B-12 LEVEL $94.15 $156.91 $15.08–$158.47 — 40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 O R/ VIT B-12 BINDING DEFICIENCY CAS $94.15 $156.91 $15.08–$158.47 — 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Z/ VITAMIN D 25 FRACTIONATED D2/D3 $134.89 $224.82 $29.60–$227.06 76% above 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Z/ VITAMIN D 25 HYDROXY $134.89 $224.82 $29.60–$227.06 76% above 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 O Z/ VITAMIN D 25-HYDROXY $134.89 $224.82 $29.60–$227.06 76% above 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 O VITAMIN D 25 FRACTIONATED D2/D3 $134.89 $224.82 $29.60–$227.06 76% above 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Z/ VITAMIN D 25 FRACTIONATED D2/D3 $134.89 $224.82 $29.60–$227.06 — 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 O Z/ VITAMIN D 25-HYDROXY $134.89 $224.82 $29.60–$227.06 — 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Z/ VITAMIN D 25 HYDROXY $134.89 $224.82 $29.60–$227.06 — 40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 O VITAMIN D 25 FRACTIONATED D2/D3 $134.89 $224.82 $29.60–$227.06 — 40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VITAMIN D 1 25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 77% above 40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 O VITAMIN D 1 25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 77% above 40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Z/ VITAMIN D 1,25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 77% above 40%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 O Z/ VITAMIN D 1 25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 77% above 40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 Z/ VITAMIN D 1,25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 — 40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VITAMIN D 1 25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 — 40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 O Z/ VITAMIN D 1 25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 — 40%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 O VITAMIN D 1 25 DIHYDROXY $157.67 $262.79 $38.50–$265.41 — 40%
Zinc blood test CPT 84630 Z/ ZINC WHOLE BLOOD $61.84 $103.06 $11.39–$104.09 98% above 40%
Zinc blood test CPT 84630 Z/ ZINC SERUM/PLASMA $61.84 $103.06 $11.39–$104.09 98% above 40%
Zinc blood test CPT 84630 Z/ ZINC RBC $61.84 $103.06 $11.39–$104.09 98% above 40%
Zinc blood test CPT 84630 O Z/ ZINC WHOLE BLOOD $61.84 $103.06 $11.39–$104.09 98% above 40%
Zinc blood test CPT 84630 O Z/ ZINC SERUM/PLASMA $61.84 $103.06 $11.39–$104.09 98% above 40%
Zinc blood test CPT 84630 O Z/ ZINC RBC $61.84 $103.06 $11.39–$104.09 98% above 40%
Zinc blood test inpatient CPT 84630 O Z/ ZINC SERUM/PLASMA $61.84 $103.06 $11.39–$104.09 — 40%
Zinc blood test inpatient CPT 84630 O Z/ ZINC RBC $61.84 $103.06 $11.39–$104.09 — 40%
Zinc blood test inpatient CPT 84630 Z/ ZINC SERUM/PLASMA $61.84 $103.06 $11.39–$104.09 — 40%
Zinc blood test inpatient CPT 84630 Z/ ZINC WHOLE BLOOD $61.84 $103.06 $11.39–$104.09 — 40%
Zinc blood test inpatient CPT 84630 O Z/ ZINC WHOLE BLOOD $61.84 $103.06 $11.39–$104.09 — 40%
Zinc blood test inpatient CPT 84630 Z/ ZINC RBC $61.84 $103.06 $11.39–$104.09 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 O BETA HCG QUANTITATIVE $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 O .3 R/ GONADOTROPIN CHORIONIC hCG QUANT $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Z/ BETA HCG TUMOR MARKER (FEMALES) $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 .3 R/ GONADOTROPIN CHORIONIC hCG QUANT $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 O Z/ BETA HCG TUMOR MARKER $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 DELETE.Z/ BETA HCG QUANT $108.98 $181.64 $15.05–$183.45 124% above 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 O .3 R/ GONADOTROPIN CHORIONIC hCG QUANT $108.98 $181.64 $15.05–$183.45 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 O Z/ BETA HCG TUMOR MARKER $108.98 $181.64 $15.05–$183.45 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE $108.98 $181.64 $15.05–$183.45 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 O BETA HCG QUANTITATIVE $108.98 $181.64 $15.05–$183.45 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 Z/ BETA HCG TUMOR MARKER (FEMALES) $108.98 $181.64 $15.05–$183.45 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 DELETE.Z/ BETA HCG QUANT $108.98 $181.64 $15.05–$183.45 — 40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 .3 R/ GONADOTROPIN CHORIONIC hCG QUANT $108.98 $181.64 $15.05–$183.45 — 40%

Surgery and procedures

ProcedureCash price List priceInsurers payvs LouisianaOff list
Botox injections for chronic migraine CPT 64615 PHY CHEMO DENERVE MUSCLE MIGRAINE $91.20 $152.00 $86.26–$611.75 42% below 40%
Botox injections for chronic migraine CPT 64615 CHEMO DENERVE MUSCLE MIGRAINE $843.60 $1,406.00 $481.30–$1,546.60 434% above 40%
Botox injections for chronic migraine inpatient CPT 64615 PHY CHEMO DENERVE MUSCLE MIGRAINE $91.20 $152.00 $86.26–$611.75 — 40%
Botox injections for chronic migraine inpatient CPT 64615 CHEMO DENERVE MUSCLE MIGRAINE $843.60 $1,406.00 $481.30–$1,546.60 — 40%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TRT FIBULAR FX W/O MANIPULATION $503.70 $839.50 $151.13–$847.89 141% above 40%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TRT FIBULAR FX W/O MANIPULATION $503.70 $839.50 $151.13–$847.89 — 40%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLO TX METATARSAL FX W/O MANIPULATION $623.78 $1,039.64 $151.13–$1,143.60 212% above 40%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLO TX METATARSAL FX W/O MANIPULATION $623.78 $1,039.64 $151.13–$1,143.60 — 40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 FAC/ CARDIOVERSION ELECT EXTERNAL $1,463.84 $2,439.74 $862.54–$2,683.71 169% above 40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 FAC/ CARDIOVERSION ELECT EXTERNAL $1,463.84 $2,439.74 $862.54–$2,683.71 — 40%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 TREAT DISTAL RADIUS FX $739.72 $1,232.86 $151.13–$1,356.14 219% above 40%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 TREAT DISTAL RADIUS FX $739.72 $1,232.86 $151.13–$1,356.14 — 40%
Colonoscopy with polyp removal CPT 45385 COLONO WITH POLYECTOMY FLEX BY SNARE TE $2,435.58 $4,059.30 $468.30–$4,099.89 188% above 40%
Colonoscopy with polyp removal inpatient CPT 45385 COLONO WITH POLYECTOMY FLEX BY SNARE TE $2,435.58 $4,059.30 $468.30–$4,099.89 — 40%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY FLEX SNGL/MULTI $2,489.31 $4,148.85 $468.30–$4,190.33 191% above 40%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY FLEX SNGL/MULTI $2,489.31 $4,148.85 $468.30–$4,190.33 — 40%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLEX,DX W/WO SPEC $1,880.40 $3,134.00 $468.30–$3,165.34 152% above 40%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLEX,DX W/WO SPEC $1,880.40 $3,134.00 $468.30–$3,165.34 — 40%
Earwax removal with instruments, one ear CPT 69210 CLIN FAC REM CERUMEN 1 OR 2 EARS UNLATER $163.20 $272.00 $96.25–$299.20 153% above 40%
Earwax removal with instruments, one ear one side CPT 69210 FAC/ REMOVE CERIMEN W/INSTR UNILATERAL $217.41 $362.35 $96.25–$398.58 237% above 40%
Earwax removal with instruments, one ear inpatient CPT 69210 CLIN FAC REM CERUMEN 1 OR 2 EARS UNLATER $163.20 $272.00 $96.25–$299.20 — 40%
Earwax removal with instruments, one ear inpatient one side CPT 69210 FAC/ REMOVE CERIMEN W/INSTR UNILATERAL $217.41 $362.35 $96.25–$398.58 — 40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 FAC ESI TRANLAMINAR THORACIC/CERVICAL $1,853.20 $3,088.67 $349.65–$3,119.55 141% above 40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 ESI CERVICAL TRANSLAMINAR $2,316.50 $3,860.84 $349.65–$3,899.44 202% above 40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 FAC ESI TRANLAMINAR THORACIC/CERVICAL $1,853.20 $3,088.67 $349.65–$3,119.55 — 40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 ESI CERVICAL TRANSLAMINAR $2,316.50 $3,860.84 $349.65–$3,899.44 — 40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 MEDIAL BRNCH BLCK, LUMB/SACR, SGL LVL-LT $2,143.67 $3,572.78 — 322% above 40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 FACET JOINT INJ LUMBAR/SCR SGL LEV RT $2,143.67 $3,572.78 — 322% above 40%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493 MEDIAL BRNCH BLCK, LUMB/SACR, SGL LVL-RT $2,143.67 $3,572.78 — 322% above 40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 FACET JOINT INJ LUMBAR/SCR SGL LEV RT $2,143.67 $3,572.78 — — 40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 MEDIAL BRNCH BLCK, LUMB/SACR, SGL LVL-RT $2,143.67 $3,572.78 — — 40%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493 MEDIAL BRNCH BLCK, LUMB/SACR, SGL LVL-LT $2,143.67 $3,572.78 — — 40%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDSCOPY FLEX,DX W/WO SPEC $1,492.20 $2,487.00 $187.11–$2,511.87 235% above 40%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDSCOPY FLEX,DX W/WO SPEC $1,492.20 $2,487.00 $187.11–$2,511.87 — 40%
Incision and drainage of a simple or single skin abscess CPT 10060 CLIN FAC I&D OF ABCESS SIMPLE $486.60 $811.00 $310.56–$819.11 150% above 40%
Incision and drainage of a simple or single skin abscess CPT 10060 OBS I&D ABCESS SIMPLE OR SINGLE $649.11 $1,081.85 $98.66–$1,092.66 233% above 40%
Incision and drainage of a simple or single skin abscess CPT 10060 WC I&D ABSCESS SIMPLE $649.11 $1,081.85 $98.66–$1,092.66 233% above 40%
Incision and drainage of a simple or single skin abscess CPT 10060 FAC I&D OF ABSCESS SIMPLE/SINGLE $649.11 $1,081.85 $310.56–$1,092.66 233% above 40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 CLIN FAC I&D OF ABCESS SIMPLE $486.60 $811.00 $310.56–$819.11 — 40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 OBS I&D ABCESS SIMPLE OR SINGLE $649.11 $1,081.85 $98.66–$1,092.66 — 40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 WC I&D ABSCESS SIMPLE $649.11 $1,081.85 $98.66–$1,092.66 — 40%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 FAC I&D OF ABSCESS SIMPLE/SINGLE $649.11 $1,081.85 $310.56–$1,092.66 — 40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 FAC INJECTION 1 TENDON SHEATH/LIGAMENT $435.00 $725.00 $32.56–$797.50 203% above 40%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 FAC INJ TENDON/LIGAMENT PLANTAR 'FASCIA'"" $466.72 $777.86 $32.56–$855.64 225% above 40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION PIRIFORMIS LT $466.72 $777.86 — 225% above 40%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550 INJECTION PIRIFORMIS RT $466.72 $777.86 — 225% above 40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 FAC INJECTION 1 TENDON SHEATH/LIGAMENT $435.00 $725.00 $32.56–$797.50 — 40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 FAC INJ TENDON/LIGAMENT PLANTAR 'FASCIA'"" $466.72 $777.86 $32.56–$855.64 — 40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJECTION PIRIFORMIS LT $466.72 $777.86 — — 40%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550 INJECTION PIRIFORMIS RT $466.72 $777.86 — — 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CLIN FAC ARTHRO JOINT BURSA MAJOR $407.40 $679.00 $355.52–$746.90 64% above 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHRO JOINT BURSA-MAJOR-LT $543.29 $905.48 — 119% above 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 INJECTION HIP LT $543.29 $905.48 — 119% above 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHRO JOINT BURSA-MAJOR-RT $543.29 $905.48 $39.37–$996.02 119% above 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 ARTHRO JOINT BURSA-MAJOR-LT $543.29 $905.48 $39.37–$996.02 119% above 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CLIN FAC ARTHRO JOINT BURSA MAJOR $407.40 $679.00 $355.52–$746.90 — 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHRO JOINT BURSA-MAJOR-LT $543.29 $905.48 $39.37–$996.02 — 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHRO JOINT BURSA-MAJOR-RT $543.29 $905.48 $39.37–$996.02 — 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 ARTHRO JOINT BURSA-MAJOR-LT $543.29 $905.48 — — 40%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 INJECTION HIP LT $543.29 $905.48 — — 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 CLIN FAC ARTHRO JOINT BURSA INTERM $373.80 $623.00 $353.55–$685.30 76% above 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 FAC ARTHROCENTESIS JOINT BURSA INTER $498.46 $830.77 $33.05–$913.84 134% above 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHRO JOINT BURSA-INTERM-LT $498.46 $830.77 — 134% above 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605 ARTHRO JOINT BURSA-INTERM-RT $498.46 $830.77 — 134% above 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 CLIN FAC ARTHRO JOINT BURSA INTERM $373.80 $623.00 $353.55–$685.30 — 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 FAC ARTHROCENTESIS JOINT BURSA INTER $498.46 $830.77 $33.05–$913.84 — 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHRO JOINT BURSA-INTERM-LT $498.46 $830.77 — — 40%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605 ARTHRO JOINT BURSA-INTERM-RT $498.46 $830.77 — — 40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 CLIN FAC ARTHRO JOINT BURSA SMALL $401.40 $669.00 $355.52–$735.90 75% above 40%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 FAC ARTHROCENTESIS JOINT BURSA SMALL $535.43 $892.39 $31.10–$981.62 134% above 40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHRO JOINT BURSA-SMALL-LT $535.43 $892.39 — 134% above 40%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600 ARTHRO JOINT BURSA-SMALL-RT $535.43 $892.39 — 134% above 40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 CLIN FAC ARTHRO JOINT BURSA SMALL $401.40 $669.00 $355.52–$735.90 — 40%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 FAC ARTHROCENTESIS JOINT BURSA SMALL $535.43 $892.39 $31.10–$981.62 — 40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 ARTHRO JOINT BURSA-SMALL-RT $535.43 $892.39 — — 40%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600 ARTHRO JOINT BURSA-SMALL-LT $535.43 $892.39 — — 40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTER W/D RPR SC/AX/TR/EX 205CM OR< $1,294.57 $2,157.61 $217.73–$2,179.18 294% above 40%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTER W/D RPR SC/AX/TR/EX 205CM OR< $1,294.57 $2,157.61 $217.73–$2,179.18 — 40%
Lower-back epidural injection, with imaging guidance CPT 62323 FAC ESI TRANSLAMINAR LUMBAR/SACRAL $1,792.28 $2,987.13 $349.65–$3,017.00 131% above 40%
Lower-back epidural injection, with imaging guidance CPT 62323 ESI CAUDAL BLOCK $2,240.35 $3,733.91 $349.65–$3,771.24 189% above 40%
Lower-back epidural injection, with imaging guidance CPT 62323 CAUDAL HYPERTONIC SINGLE SHOT $2,240.35 $3,733.91 $349.65–$3,771.24 189% above 40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 FAC ESI TRANSLAMINAR LUMBAR/SACRAL $1,792.28 $2,987.13 $349.65–$3,017.00 — 40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 ESI CAUDAL BLOCK $2,240.35 $3,733.91 $349.65–$3,771.24 — 40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CAUDAL HYPERTONIC SINGLE SHOT $2,240.35 $3,733.91 $349.65–$3,771.24 — 40%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 ESI TRANSFORAMINAL LUMB/SACR SGL LEV BIL $1,920.87 $3,201.45 $472.70–$3,521.59 321% above 40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 FAC ESI TRNSFRAMNL LUMB/SACR SGL LEV RT $1,536.70 $2,561.16 — 237% above 40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 BLOCK SELECT NERVE ROOT, LUM/SAC LT $1,920.87 $3,201.45 — 321% above 40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 BLOCK SELECT NERVE ROOT, LUM/SAC RT $1,920.87 $3,201.45 — 321% above 40%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483 ESI TRANSFORAMINAL LUMB/SACR SGL LEV LT $1,920.87 $3,201.45 — 321% above 40%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 ESI TRANSFORAMINAL LUMB/SACR SGL LEV BIL $1,920.87 $3,201.45 $472.70–$3,521.59 — 40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 FAC ESI TRNSFRAMNL LUMB/SACR SGL LEV RT $1,536.70 $2,561.16 — — 40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 ESI TRANSFORAMINAL LUMB/SACR SGL LEV LT $1,920.87 $3,201.45 — — 40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 BLOCK SELECT NERVE ROOT, LUM/SAC RT $1,920.87 $3,201.45 — — 40%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483 BLOCK SELECT NERVE ROOT, LUM/SAC LT $1,920.87 $3,201.45 — — 40%
Nail removal (partial or complete), one nail CPT 11730 CLIN FAC AVULSION OF NAIL PLATE-SMPL SGL $767.40 $1,279.00 $166.30–$1,406.90 467% above 40%
Nail removal (partial or complete), one nail CPT 11730 AVULSION OF NAIL PLATE-SMPL SGL $1,023.18 $1,705.30 $166.30–$1,875.83 657% above 40%
Nail removal (partial or complete), one nail inpatient CPT 11730 CLIN FAC AVULSION OF NAIL PLATE-SMPL SGL $767.40 $1,279.00 $166.30–$1,406.90 — 40%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION OF NAIL PLATE-SMPL SGL $1,023.18 $1,705.30 $166.30–$1,875.83 — 40%
Occipital nerve block (injection for headaches) one side CPT 64405 BLOCK OCCIPITAL NERVE-RT $248.35 $413.91 — 4% below 40%
Occipital nerve block (injection for headaches) one side CPT 64405 BLOCK OCCIPITAL NERVE-LT $248.35 $413.91 — 4% below 40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 BLOCK OCCIPITAL NERVE-LT $248.35 $413.91 — — 40%
Occipital nerve block (injection for headaches) inpatient one side CPT 64405 BLOCK OCCIPITAL NERVE-RT $248.35 $413.91 — — 40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 CLIN FAC REMOVAL OF NAIL BED $1,120.80 $1,868.00 $349.65–$1,886.68 214% above 40%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION OF NAILS PERMANENT REM $1,494.32 $2,490.53 $129.76–$2,515.43 319% above 40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 CLIN FAC REMOVAL OF NAIL BED $1,120.80 $1,868.00 $349.65–$1,886.68 — 40%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION OF NAILS PERMANENT REM $1,494.32 $2,490.53 $129.76–$2,515.43 — 40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 RF DEST, FACET JOINT, LUMB/SAC, SGL-RT $3,687.71 $6,146.18 — 265% above 40%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635 RF DEST, FACET JOINT, LUMBAR/SAC, SGL-LT $3,687.71 $6,146.18 — 265% above 40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 RF DEST, FACET JOINT, LUMBAR/SAC, SGL-LT $3,687.71 $6,146.18 — — 40%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635 RF DEST, FACET JOINT, LUMB/SAC, SGL-RT $3,687.71 $6,146.18 — — 40%
Removal of a foreign object under the skin, simple CPT 10120 CLIN FAC REM FB SUBQ TISSUE SIMPLE $798.00 $1,330.00 $349.65–$1,343.30 242% above 40%
Removal of a foreign object under the skin, simple CPT 10120 INACTIVATE $1,064.14 $1,773.57 $349.65–$1,791.30 356% above 40%
Removal of a foreign object under the skin, simple CPT 10120 I&D & REMOVAL F B SUB TISSUE SIMPLE $1,064.14 $1,773.57 $146.77–$1,791.30 356% above 40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 CLIN FAC REM FB SUBQ TISSUE SIMPLE $798.00 $1,330.00 $349.65–$1,343.30 — 40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 I&D & REMOVAL F B SUB TISSUE SIMPLE $1,064.14 $1,773.57 $146.77–$1,791.30 — 40%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INACTIVATE $1,064.14 $1,773.57 $349.65–$1,791.30 — 40%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CA SCR COLO NO CRIT/HIGH RISK $1,987.20 $3,312.00 $499.28–$3,643.20 217% above 40%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 COLORECTAL CA SCR COLO NO CRIT/HIGH RISK $1,987.20 $3,312.00 $499.28–$3,643.20 — 40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CA SCR COLON CRIT/HIGH RISK $1,781.40 $2,969.00 $499.28–$3,265.90 193% above 40%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 COLORECTAL CA SCR COLON CRIT/HIGH RISK $1,781.40 $2,969.00 $499.28–$3,265.90 — 40%
Short arm cast (elbow to hand) CPT 29075 FAC APPL CAST SHORT ARM $337.17 $561.95 $71.45–$618.14 99% above 40%
Short arm cast (elbow to hand) inpatient CPT 29075 FAC APPL CAST SHORT ARM $337.17 $561.95 $71.45–$618.14 — 40%
Short arm splint (forearm and hand) CPT 29125 FAC/ APPLICATION STATIC SHORT ARM SPLINT $253.57 $422.61 $239.83–$464.87 110% above 40%
Short arm splint (forearm and hand) one side CPT 29125 SPLINT WRIST CARPAL TUNNEL RT LG $253.57 $422.61 $239.83–$464.87 110% above 40%
Short arm splint (forearm and hand) inpatient CPT 29125 FAC/ APPLICATION STATIC SHORT ARM SPLINT $253.57 $422.61 $239.83–$464.87 — 40%
Short arm splint (forearm and hand) inpatient one side CPT 29125 SPLINT WRIST CARPAL TUNNEL RT LG $253.57 $422.61 $239.83–$464.87 — 40%
Short leg cast (below the knee) CPT 29405 FAC CAST SHORT LEG $658.88 $1,098.14 $68.53–$1,207.95 261% above 40%
Short leg cast (below the knee) inpatient CPT 29405 FAC CAST SHORT LEG $658.88 $1,098.14 $68.53–$1,207.95 — 40%
Short leg splint (calf to foot) CPT 29515 FAC/ APPLICATION SH LEG SPLINT CALF-FOOT $282.73 $471.21 $267.41–$518.33 98% above 40%
Short leg splint (calf to foot) inpatient CPT 29515 FAC/ APPLICATION SH LEG SPLINT CALF-FOOT $282.73 $471.21 $267.41–$518.33 — 40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 CLIN FAC REP WOUND SCALP/NECK/TRK <2.5CM $286.20 $477.00 $270.69–$481.77 53% above 40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 FAC/ RPR WOUND SCALP/NECK/TRK < 2.5CM $358.27 $597.12 $310.56–$603.09 91% above 40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 CLIN FAC REP WOUND SCALP/NECK/TRK <2.5CM $286.20 $477.00 $270.69–$481.77 — 40%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 FAC/ RPR WOUND SCALP/NECK/TRK < 2.5CM $358.27 $597.12 $310.56–$603.09 — 40%
Skin biopsy, punch, one lesion CPT 11104 WC TANGENTIAL BIOPSY SQ- SGL LESION $891.35 $1,485.58 $153.39–$1,634.13 228% above 40%
Skin biopsy, punch, one lesion inpatient CPT 11104 WC TANGENTIAL BIOPSY SQ- SGL LESION $891.35 $1,485.58 $153.39–$1,634.13 — 40%
Skin tag removal, up to 15 tags CPT 11200 CLIN FAC REMOVE SKIN TAGSUP TO 15 LESION $1,009.80 $1,683.00 $166.30–$1,851.30 658% above 40%
Skin tag removal, up to 15 tags CPT 11200 REMOVE SKIN TAGS UP TO & INCL15 LESIONS $1,346.78 $2,244.63 $166.30–$2,469.09 911% above 40%
Skin tag removal, up to 15 tags inpatient CPT 11200 CLIN FAC REMOVE SKIN TAGSUP TO 15 LESION $1,009.80 $1,683.00 $166.30–$1,851.30 — 40%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS UP TO & INCL15 LESIONS $1,346.78 $2,244.63 $166.30–$2,469.09 — 40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 OBS LUMBAR PUNCTURE $2,043.37 $3,405.62 $349.65–$3,439.67 381% above 40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 FAC SPINAL PUNCTURE LUMBAR DIAGN $2,043.37 $3,405.62 $349.65–$3,439.67 381% above 40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 FAC SPINAL PUNCTURE LUMBAR DIAGN $2,043.37 $3,405.62 $349.65–$3,439.67 — 40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 OBS LUMBAR PUNCTURE $2,043.37 $3,405.62 $349.65–$3,439.67 — 40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 CLIN FAC REP WOUND SCALP/NK/TR2.6-7.5CM $291.00 $485.00 $275.23–$489.85 58% above 40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 FAC RPR WOUND SCALP/NECK TRK 2.6- 7.5C $388.04 $646.74 $310.56–$653.20 111% above 40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 CLIN FAC REP WOUND SCALP/NK/TR2.6-7.5CM $291.00 $485.00 $275.23–$489.85 — 40%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 FAC RPR WOUND SCALP/NECK TRK 2.6- 7.5C $388.04 $646.74 $310.56–$653.20 — 40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 CLIN FAC REP WOUND FACE =<2.5CM $396.05 $660.09 $310.56–$666.69 117% above 40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 FAC RPR WOUND FACE <= 2.5CM $396.05 $660.09 $310.56–$666.69 117% above 40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 CLIN FAC REP WOUND FACE =<2.5CM $396.05 $660.09 $310.56–$666.69 — 40%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 FAC RPR WOUND FACE <= 2.5CM $396.05 $660.09 $310.56–$666.69 — 40%
Thoracentesis with imaging guidance CPT 32555 FAC/ THORACENTESIS W INSERTION OF TUBE $1,754.48 $2,924.13 $349.65–$2,953.37 171% above 40%
Thoracentesis with imaging guidance inpatient CPT 32555 FAC/ THORACENTESIS W INSERTION OF TUBE $1,754.48 $2,924.13 $349.65–$2,953.37 — 40%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGER PNTS INJ-SGL/MULT- 1 OR 2 MUS BIL $520.62 $867.70 $40.82–$954.47 294% above 40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 TRIGGER PT INJ- SGL/MTL- 1-2 MUSC-LT $520.62 $867.70 $40.82–$954.47 294% above 40%
Trigger point injections, 1 or 2 muscles one side CPT 20552 TRIGER PNTS INJ- SGL/MULT- 1 OR 2 MUS RT $520.62 $867.70 $40.82–$954.47 294% above 40%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGER PNTS INJ-SGL/MULT- 1 OR 2 MUS BIL $520.62 $867.70 $40.82–$954.47 — 40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 TRIGER PNTS INJ- SGL/MULT- 1 OR 2 MUS RT $520.62 $867.70 $40.82–$954.47 — 40%
Trigger point injections, 1 or 2 muscles inpatient one side CPT 20552 TRIGGER PT INJ- SGL/MTL- 1-2 MUSC-LT $520.62 $867.70 $40.82–$954.47 — 40%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 EGD ESOP DIL W/ TRANSENDO BALLO <30MM $2,704.07 $4,506.79 $468.30–$4,551.85 217% above 40%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 EGD ESOP DIL W/ TRANSENDO BALLO <30MM $2,704.07 $4,506.79 $468.30–$4,551.85 — 40%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD WITH BIOPSY SNG/MULTI $1,766.40 $2,944.00 $468.30–$2,973.44 138% above 40%
Upper endoscopy (EGD) with biopsy CPT 43239 GASTRO W/BIOPSY SNGL/MULTI $2,208.29 $3,680.48 $468.30–$3,717.28 198% above 40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD WITH BIOPSY SNG/MULTI $1,766.40 $2,944.00 $468.30–$2,973.44 — 40%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 GASTRO W/BIOPSY SNGL/MULTI $2,208.29 $3,680.48 $468.30–$3,717.28 — 40%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 EGD WITH POLYECTOMY SNARE TECH $2,016.00 $3,360.00 $468.30–$3,393.60 144% above 40%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 EGD WITH POLYECTOMY SNARE TECH $2,016.00 $3,360.00 $468.30–$3,393.60 — 40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 EGD WIRE GUIDED ESOPHAGEAL DILATION $1,324.20 $2,207.00 $468.30–$2,229.07 100% above 40%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 EGD WIRE GUIDED ESOPHAGEAL DILATION $1,324.20 $2,207.00 $468.30–$2,229.07 — 40%
Upper endoscopy (EGD), diagnostic CPT 43235 FAC EGD FLEXIBLE $1,660.20 $2,767.00 $349.65–$2,794.67 105% above 40%
Upper endoscopy (EGD), diagnostic CPT 43235 GASTROSCOPY $2,074.90 $3,458.17 $349.65–$3,492.75 156% above 40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 FAC EGD FLEXIBLE $1,660.20 $2,767.00 $349.65–$2,794.67 — 40%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 GASTROSCOPY $2,074.90 $3,458.17 $349.65–$3,492.75 — 40%
Wart removal, up to 14 warts CPT 17110 CLIN FAC DESTRUC BENIGN/WART 1-14 $217.20 $362.00 $166.30–$398.20 62% above 40%
Wart removal, up to 14 warts inpatient CPT 17110 CLIN FAC DESTRUC BENIGN/WART 1-14 $217.20 $362.00 $166.30–$398.20 — 40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 CLIN FAC DEBRIDE SQ TIS 1st 20SQCM $709.80 $1,183.00 $468.30–$1,194.83 81% above 40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER FAC DEBRID SQ TISSUE 1st 20SQCM OR $946.03 $1,576.72 $218.57–$1,592.48 141% above 40%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC DEBRIDE-SQ SKIN 1st 20 SQCM<0 $946.03 $1,576.72 $218.57–$1,592.48 141% above 40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 CLIN FAC DEBRIDE SQ TIS 1st 20SQCM $709.80 $1,183.00 $468.30–$1,194.83 — 40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ER FAC DEBRID SQ TISSUE 1st 20SQCM OR $946.03 $1,576.72 $218.57–$1,592.48 — 40%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC DEBRIDE-SQ SKIN 1st 20 SQCM<0 $946.03 $1,576.72 $218.57–$1,592.48 — 40%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 TREAT PHALANGEAL FX OPEN W/INT FIX $9,543.89 $15,906.48 $752.85–$16,065.54 25% above 40%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 TREAT PHALANGEAL FX OPEN W/INT FIX $9,543.89 $15,906.48 $752.85–$16,065.54 — 40%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs LouisianaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSIOIN BLOOD OR BLOOD COMPONENTS $906.83 $1,511.38 $571.22–$1,662.51 91% above 40%
Blood transfusion (giving blood or blood components) CPT 36430 BB BLOOD ADMINISTRATION $906.83 $1,511.38 $571.22–$1,662.51 91% above 40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BB BLOOD ADMINISTRATION $906.83 $1,511.38 $571.22–$1,662.51 — 40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSIOIN BLOOD OR BLOOD COMPONENTS $906.83 $1,511.38 $571.22–$1,662.51 — 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT $34.20 $57.00 $28.50–$62.70 61% below 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 CLIN FAC NEB TRT PRESSURIZED/NON PRESSUR $275.95 $459.91 $43.29–$505.90 216% above 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBUL INIT TX $275.95 $459.91 $43.29–$505.90 216% above 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT INITIAL $275.95 $459.91 $43.29–$505.90 216% above 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 CLIN FAC NEB TRT PRESSURIZED/NON PRESS $275.95 $459.91 $43.29–$505.90 216% above 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBUL INIT TX $275.95 $459.91 $43.29–$505.90 — 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 CLIN FAC NEB TRT PRESSURIZED/NON PRESSUR $275.95 $459.91 $43.29–$505.90 — 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 CLIN FAC NEB TRT PRESSURIZED/NON PRESS $275.95 $459.91 $43.29–$505.90 — 40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENT INITIAL $275.95 $459.91 $43.29–$505.90 — 40%
Comprehensive eye exam by an eye doctor, new patient CPT 92004 CLINIC FAC NEW PAT, COMPREHENSIVE EXAM $167.40 $279.00 $139.50–$306.90 173% above 40%
Comprehensive eye exam by an eye doctor, new patient inpatient CPT 92004 CLINIC FAC NEW PAT, COMPREHENSIVE EXAM $167.40 $279.00 $139.50–$306.90 — 40%
Comprehensive eye exam, returning patient CPT 92014 CLINIC FAC EST PAT, COMPREHENSIVE EXAM $154.80 $258.00 $129.00–$283.80 186% above 40%
Comprehensive eye exam, returning patient CPT 92014 CLIN GLOBAL EST, COMPREHENSIVE EXAM $206.44 $344.06 $172.03–$378.46 281% above 40%
Comprehensive eye exam, returning patient inpatient CPT 92014 CLINIC FAC EST PAT, COMPREHENSIVE EXAM $154.80 $258.00 $129.00–$283.80 — 40%
Comprehensive eye exam, returning patient inpatient CPT 92014 CLIN GLOBAL EST, COMPREHENSIVE EXAM $206.44 $344.06 $172.03–$378.46 — 40%
Critical care, first 30 to 74 minutes CPT 99291 ER ROOM/NURSING CRIT CARE 1ST 30-74 MIN $1,616.87 $2,694.79 $1,013.71–$2,964.26 115% above 40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ER ROOM/NURSING CRIT CARE 1ST 30-74 MIN $1,616.87 $2,694.79 $1,013.71–$2,964.26 — 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 FAC ED EKG INITIAL $158.32 $263.87 $47.60–$290.25 92% above 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CLIN FAC ECG ROUT W/ATLEAST 12 LEADS $158.32 $263.87 $47.60–$290.25 92% above 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12-LEAD TRACING ONLY $158.32 $263.87 $47.60–$290.25 92% above 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CLIN FAC ECG ROUTINE W/ AT LEAST 12 LEAD $158.32 $263.87 $47.60–$290.25 92% above 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12-LEAD TRACING ONLY $158.32 $263.87 $47.60–$290.25 — 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 FAC ED EKG INITIAL $158.32 $263.87 $47.60–$290.25 — 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CLIN FAC ECG ROUTINE W/ AT LEAST 12 LEAD $158.32 $263.87 $47.60–$290.25 — 40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CLIN FAC ECG ROUT W/ATLEAST 12 LEADS $158.32 $263.87 $47.60–$290.25 — 40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 FAC ER- PHY/HC PROF NOT REQUIRED @ VISIT $191.91 $319.85 $156.58–$351.83 105% above 40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 FAC ER- PHY/HC PROF NOT REQUIRED @ VISIT $191.91 $319.85 $156.58–$351.83 — 40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 FAC ER- HIS/EXAM & STRAGHT FORWARD MDM $217.92 $363.20 $156.58–$399.52 37% above 40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 FAC ER- HIS/EXAM & STRAGHT FORWARD MDM $217.92 $363.20 $156.58–$399.52 — 40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 FAC ER- HIS/EXAM & LOW LEVEL MDM $368.22 $613.70 $274.11–$675.07 48% above 40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 FAC ER- HIS/EXAM & LOW LEVEL MDM $368.22 $613.70 $274.11–$675.07 — 40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 FAC ER- HIS/EXAM & MODERATE LEVEL MDM $631.82 $1,053.04 $476.96–$1,158.34 58% above 40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 FAC ER- HIS/EXAM & MODERATE LEVEL MDM $631.82 $1,053.04 $476.96–$1,158.34 — 40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 FAC ER- HIS/EXAM & HIGH LEVEL MDM $881.28 $1,468.80 $476.96–$1,615.68 70% above 40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 FAC ER- HIS/EXAM & HIGH LEVEL MDM $881.28 $1,468.80 $476.96–$1,615.68 — 40%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST $751.84 $1,253.07 $313.58–$1,378.37 121% above 40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST $751.84 $1,253.07 $313.58–$1,378.37 — 40%
Eye exam, returning patient, intermediate CPT 92012 CLINIC FAC EST PATIENT INTERMEDIATE $89.40 $149.00 $74.50–$312.46 44% above 40%
Eye exam, returning patient, intermediate CPT 92012 CLIN GLOBAL EST PATIENT, INTERMEDIATE $119.46 $199.10 $99.55–$312.46 93% above 40%
Eye exam, returning patient, intermediate inpatient CPT 92012 CLINIC FAC EST PATIENT INTERMEDIATE $89.40 $149.00 $74.50–$312.46 — 40%
Eye exam, returning patient, intermediate inpatient CPT 92012 CLIN GLOBAL EST PATIENT, INTERMEDIATE $119.46 $199.10 $99.55–$312.46 — 40%
Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY WITH PATIENT 50 MIN $240.51 $400.85 $200.42–$440.93 123% above 40%
Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY WITH PATIENT 50 MIN $240.51 $400.85 $200.42–$440.93 — 40%
Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN $212.40 $354.00 $177.00–$389.40 75% above 40%
Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT 50 MIN $212.40 $354.00 $177.00–$389.40 — 40%
Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY $140.53 $234.21 $117.10–$257.63 50% above 40%
Group psychotherapy session CPT 90853 GOAL SETTING GRP THERAPY $140.53 $234.21 $117.10–$257.63 50% above 40%
Group psychotherapy session inpatient CPT 90853 GOAL SETTING GRP THERAPY $140.53 $234.21 $117.10–$257.63 — 40%
Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY $140.53 $234.21 $117.10–$257.63 — 40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OBS IV INF HYDRA 31 MIN-1 HR $321.92 $536.54 $129.19–$590.19 117% above 40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 FAC/ HYDRATION INITIAL 31-60 MIN $321.92 $536.54 $129.19–$590.19 117% above 40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 FAC IV INF HYDRATION INITIAL 31-60 MIN $321.92 $536.54 $129.19–$590.19 117% above 40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION INITIAL 31-60 MIN $321.92 $536.54 $129.19–$590.19 117% above 40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 FAC IV INF HYDRATION INITIAL 31-60 MIN $321.92 $536.54 $129.19–$590.19 — 40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OBS IV INF HYDRA 31 MIN-1 HR $321.92 $536.54 $129.19–$590.19 — 40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 FAC/ HYDRATION INITIAL 31-60 MIN $321.92 $536.54 $129.19–$590.19 — 40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION INITIAL 31-60 MIN $321.92 $536.54 $129.19–$590.19 — 40%
IV infusion of a medicine, first hour CPT 96365 MEDICINAL INF 16-60 MIN INITIAL $357.43 $595.72 $101.47–$655.29 85% above 40%
IV infusion of a medicine, first hour CPT 96365 FAC THER/PROPH/DIAG IV INF INIT HOUR $357.43 $595.72 $101.47–$655.29 85% above 40%
IV infusion of a medicine, first hour CPT 96365 OBS IV INF THERAPY 1HR/IV PIGGYBACK $357.43 $595.72 $101.47–$655.29 85% above 40%
IV infusion of a medicine, first hour CPT 96365 FAC/ IV INF 0-60MIN INITIAL $357.43 $595.72 $101.47–$655.29 85% above 40%
IV infusion of a medicine, first hour inpatient CPT 96365 FAC THER/PROPH/DIAG IV INF INIT HOUR $357.43 $595.72 $101.47–$655.29 — 40%
IV infusion of a medicine, first hour inpatient CPT 96365 OBS IV INF THERAPY 1HR/IV PIGGYBACK $357.43 $595.72 $101.47–$655.29 — 40%
IV infusion of a medicine, first hour inpatient CPT 96365 FAC/ IV INF 0-60MIN INITIAL $357.43 $595.72 $101.47–$655.29 — 40%
IV infusion of a medicine, first hour inpatient CPT 96365 MEDICINAL INF 16-60 MIN INITIAL $357.43 $595.72 $101.47–$655.29 — 40%
IV push of a medicine, first drug CPT 96374 FAC/ IVP INITIAL < 15 MIN $220.51 $367.51 $101.47–$404.26 127% above 40%
IV push of a medicine, first drug CPT 96374 IVP INITIAL PUSH SINGLE OR INITIAL DRUG $220.51 $367.51 $101.47–$404.26 127% above 40%
IV push of a medicine, first drug CPT 96374 FAC IVP SINGLE OR INITIAL DRUG $220.51 $367.51 $101.47–$404.26 127% above 40%
IV push of a medicine, first drug CPT 96374 INACTIVATE $220.51 $367.51 $101.47–$404.26 127% above 40%
IV push of a medicine, first drug CPT 96374 OBS IV PUSH SINGLE OR INITIAL DRUG $220.51 $367.51 $101.47–$404.26 127% above 40%
IV push of a medicine, first drug inpatient CPT 96374 INACTIVATE $220.51 $367.51 $101.47–$404.26 — 40%
IV push of a medicine, first drug inpatient CPT 96374 IVP INITIAL PUSH SINGLE OR INITIAL DRUG $220.51 $367.51 $101.47–$404.26 — 40%
IV push of a medicine, first drug inpatient CPT 96374 OBS IV PUSH SINGLE OR INITIAL DRUG $220.51 $367.51 $101.47–$404.26 — 40%
IV push of a medicine, first drug inpatient CPT 96374 FAC IVP SINGLE OR INITIAL DRUG $220.51 $367.51 $101.47–$404.26 — 40%
IV push of a medicine, first drug inpatient CPT 96374 FAC/ IVP INITIAL < 15 MIN $220.51 $367.51 $101.47–$404.26 — 40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 CLIN FAC ADMIN OF THERAPEUTIC INJ $99.17 $165.28 $49.46–$181.80 87% above 40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 FAC/ THER/PROPH/DIAG INJ SC/IM $99.17 $165.28 $49.46–$181.80 87% above 40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OBS INJECTION IM OR SUBQ $99.17 $165.28 $49.46–$181.80 87% above 40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM $99.17 $165.28 $49.46–$181.80 87% above 40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM $99.17 $165.28 $49.46–$181.80 — 40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 FAC/ THER/PROPH/DIAG INJ SC/IM $99.17 $165.28 $49.46–$181.80 — 40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 CLIN FAC ADMIN OF THERAPEUTIC INJ $99.17 $165.28 $49.46–$181.80 — 40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OBS INJECTION IM OR SUBQ $99.17 $165.28 $49.46–$181.80 — 40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NERVE CNDJ TEST 7-8 STUDIES $510.00 $850.00 $91.48–$935.00 281% above 40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NERVE CNDJ TEST 7-8 STUDIES $510.00 $850.00 $91.48–$935.00 — 40%
New patient office visit, about 30 minutes CPT 99203 CLINIC FAC NEW PATIENT LEVEL 3 $79.20 $132.00 $38.00–$162.50 11% above 40%
New patient office visit, about 30 minutes CPT 99203 CLINIC FAC NEW PATIENT E&M =/>30 MINS $93.60 $156.00 $38.00–$162.50 31% above 40%
New patient office visit, about 30 minutes CPT 99203 WC NEW PT VISIT LV 3 =/>30 MINS $105.95 $176.59 $38.00–$178.35 48% above 40%
New patient office visit, about 30 minutes CPT 99203 NEW PATIENT VISIT E&M IF TIME 30-44 MIN $105.95 $176.59 $38.00–$178.35 48% above 40%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC FAC NEW PATIENT LEVEL 3 $79.20 $132.00 $38.00–$162.50 — 40%
New patient office visit, about 30 minutes inpatient CPT 99203 CLINIC FAC NEW PATIENT E&M =/>30 MINS $93.60 $156.00 $38.00–$162.50 — 40%
New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT VISIT E&M IF TIME 30-44 MIN $105.95 $176.59 $38.00–$178.35 — 40%
New patient office visit, about 30 minutes inpatient CPT 99203 WC NEW PT VISIT LV 3 =/>30 MINS $105.95 $176.59 $38.00–$178.35 — 40%
New patient office visit, about 45 minutes CPT 99204 CLINIC FAC NEW PAT E&M =/>45 MINS $121.80 $203.00 $57.00–$236.45 55% above 40%
New patient office visit, about 45 minutes CPT 99204 CLINIC FAC NEW PATIENT LEVEL 4 $121.80 $203.00 $57.00–$236.45 55% above 40%
New patient office visit, about 45 minutes CPT 99204 NEW PATIENT VISIT E&M IF TIME 45 MIN $162.40 $270.67 $57.00–$273.37 106% above 40%
New patient office visit, about 45 minutes CPT 99204 WC NEW PT VISIT LV 4 =/>45 MINS $162.40 $270.67 $57.00–$273.37 106% above 40%
New patient office visit, about 45 minutes inpatient CPT 99204 CLINIC FAC NEW PATIENT LEVEL 4 $121.80 $203.00 $57.00–$236.45 — 40%
New patient office visit, about 45 minutes inpatient CPT 99204 CLINIC FAC NEW PAT E&M =/>45 MINS $121.80 $203.00 $57.00–$236.45 — 40%
New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT VISIT E&M IF TIME 45 MIN $162.40 $270.67 $57.00–$273.37 — 40%
New patient office visit, about 45 minutes inpatient CPT 99204 WC NEW PT VISIT LV 4 =/>45 MINS $162.40 $270.67 $57.00–$273.37 — 40%
New patient office visit, about 60 minutes CPT 99205 CLINIC FAC NEW PAT E&M =/> 60 MINS $193.80 $323.00 $57.00–$326.23 99% above 40%
New patient office visit, about 60 minutes CPT 99205 CLINIC FAC NEW PATIENT LEVEL 5 $193.80 $323.00 $57.00–$326.23 99% above 40%
New patient office visit, about 60 minutes CPT 99205 NEW PATIENT VISIT E&M IF TIME 60-74 MN $258.15 $430.25 $57.00–$434.55 165% above 40%
New patient office visit, about 60 minutes CPT 99205 WC NEW PT VISIT LV5 =/> 60 MINS $258.15 $430.25 $57.00–$434.55 165% above 40%
New patient office visit, about 60 minutes inpatient CPT 99205 CLINIC FAC NEW PATIENT LEVEL 5 $193.80 $323.00 $57.00–$326.23 — 40%
New patient office visit, about 60 minutes inpatient CPT 99205 CLINIC FAC NEW PAT E&M =/> 60 MINS $193.80 $323.00 $57.00–$326.23 — 40%
New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT VISIT E&M IF TIME 60-74 MN $258.15 $430.25 $57.00–$434.55 — 40%
New patient office visit, about 60 minutes inpatient CPT 99205 WC NEW PT VISIT LV5 =/> 60 MINS $258.15 $430.25 $57.00–$434.55 — 40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CLINIC FAC NEW PAT IF TIME =/>15 MINS $79.20 $132.00 $33.00–$141.24 44% above 40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CLINIC FAC NEW PATIENT LEVEL 2 $93.60 $156.00 $33.00–$157.56 70% above 40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 CLINIC FACILITY NEW PT LVL 2 =/>15 MINS $124.72 $207.86 $33.00–$209.93 127% above 40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OUTPATIENT E&M VISIT IF TIM 15-29 MIN $124.72 $207.86 $33.00–$209.93 127% above 40%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC NEW PT VISIT LV2 =/>15 MINS $124.72 $207.86 $33.00–$209.93 127% above 40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CLINIC FAC NEW PAT IF TIME =/>15 MINS $79.20 $132.00 $33.00–$141.24 — 40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CLINIC FAC NEW PATIENT LEVEL 2 $93.60 $156.00 $33.00–$157.56 — 40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 CLINIC FACILITY NEW PT LVL 2 =/>15 MINS $124.72 $207.86 $33.00–$209.93 — 40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OUTPATIENT E&M VISIT IF TIM 15-29 MIN $124.72 $207.86 $33.00–$209.93 — 40%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC NEW PT VISIT LV2 =/>15 MINS $124.72 $207.86 $33.00–$209.93 — 40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT-INTIAL ASSE &INTERVEN INDIV EA 15 MN $91.61 $152.69 $66.25–$167.95 208% above 40%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT-INTIAL ASSE &INTERVEN INDIV EA 15 MN $91.61 $152.69 $66.25–$167.95 — 40%
Preventive checkup, new patient aged 18–39 CPT 99385 CLINIC FAC NEW PATIENT 18-39 YRS $100.20 $167.00 $83.50–$183.70 26% below 40%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 CLINIC FAC NEW PATIENT 18-39 YRS $100.20 $167.00 $83.50–$183.70 — 40%
Preventive checkup, new patient aged 40–64 CPT 99386 CLINIC FAC NEW PATIENT 40-64 YRS $130.80 $218.00 $109.00–$239.80 6% below 40%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 CLINIC FAC NEW PATIENT 40-64 YRS $130.80 $218.00 $109.00–$239.80 — 40%
Preventive checkup, new patient aged 65 or older CPT 99387 CLINIC FAC NEW PATIENT 65+ YRS $117.00 $195.00 $97.50–$214.50 13% below 40%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 CLINIC FAC NEW PATIENT 65+ YRS $117.00 $195.00 $97.50–$214.50 — 40%
Preventive checkup, returning patient aged 18–39 CPT 99395 CLINIC FAC EST PATIENT 18-39 YRS $89.40 $149.00 $74.50–$163.90 2% above 40%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 CLINIC FAC EST PATIENT 18-39 YRS $89.40 $149.00 $74.50–$163.90 — 40%
Preventive checkup, returning patient aged 40–64 CPT 99396 CLINIC FAC EST PATIENT 40-64 YRS $73.80 $123.00 $61.50–$135.30 35% below 40%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 CLINIC FAC EST PATIENT 40-64 YRS $73.80 $123.00 $61.50–$135.30 — 40%
Preventive checkup, returning patient aged 65 or older CPT 99397 CLINIC FAC EST PATIENT 65+YRS $58.80 $98.00 $49.00–$107.80 51% below 40%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 CLINIC FAC EST PATIENT 65+YRS $58.80 $98.00 $49.00–$107.80 — 40%
Psychotherapy session, 30 minutes CPT 90832 HOSP IND PSYCHOTHERAPY 20-30 MINUTES $124.52 $207.53 $103.76–$228.28 64% above 40%
Psychotherapy session, 30 minutes CPT 90832 INDIVIDUAL SESSION 16-37 MIN $124.52 $207.53 $103.76–$228.28 64% above 40%
Psychotherapy session, 30 minutes inpatient CPT 90832 HOSP IND PSYCHOTHERAPY 20-30 MINUTES $124.52 $207.53 $103.76–$228.28 — 40%
Psychotherapy session, 30 minutes inpatient CPT 90832 INDIVIDUAL SESSION 16-37 MIN $124.52 $207.53 $103.76–$228.28 — 40%
Psychotherapy session, 45 minutes CPT 90834 INDIVIDUAL THERAPY 38-52 $295.71 $492.85 $246.42–$542.13 203% above 40%
Psychotherapy session, 45 minutes inpatient CPT 90834 INDIVIDUAL THERAPY 38-52 $295.71 $492.85 $246.42–$542.13 — 40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 CLINIC FAC SMOKING/TOBACCO USE CES 3-10 $36.60 $61.00 $22.28–$67.10 87% above 40%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 CLIN GLOBAL SMOKING/TOBACCO CESS 3-10 $49.08 $81.80 $22.28–$89.98 150% above 40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 CLINIC FAC SMOKING/TOBACCO USE CES 3-10 $36.60 $61.00 $22.28–$67.10 — 40%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 CLIN GLOBAL SMOKING/TOBACCO CESS 3-10 $49.08 $81.80 $22.28–$89.98 — 40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 CLINIC FAC EST PAT LEVEL 5 =/> 40 MINS $165.60 $276.00 $57.00–$278.76 141% above 40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 UC FAC EST PATIENT LEVEL 5 $165.60 $276.00 $57.00–$278.76 141% above 40%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC EST PT VISIT LV 5 =/> 40 MINS $220.83 $368.05 $57.00–$371.73 222% above 40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 UC FAC EST PATIENT LEVEL 5 $165.60 $276.00 $57.00–$278.76 — 40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 CLINIC FAC EST PAT LEVEL 5 =/> 40 MINS $165.60 $276.00 $57.00–$278.76 — 40%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC EST PT VISIT LV 5 =/> 40 MINS $220.83 $368.05 $57.00–$371.73 — 40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 CLINIC FAC EST PAT LEVEL 3 =/> 20 MINS $62.40 $104.00 $38.00–$162.50 12% above 40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 UC FAC EST PATIENT LEVEL 3 $62.40 $104.00 $38.00–$162.50 12% above 40%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC EST PT VISIT LV 3 =/> 20 MINS $83.19 $138.65 $38.00–$162.50 49% above 40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 CLINIC FAC EST PAT LEVEL 3 =/> 20 MINS $62.40 $104.00 $38.00–$162.50 — 40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 UC FAC EST PATIENT LEVEL 3 $62.40 $104.00 $38.00–$162.50 — 40%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC EST PT VISIT LV 3 =/> 20 MINS $83.19 $138.65 $38.00–$162.50 — 40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 CLINIC FAC EST PT LVL 4 =/> 30 MINS $118.80 $198.00 $57.00–$236.45 86% above 40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 UC FAC EST PATIENT LEVEL 4 $118.80 $198.00 $57.00–$236.45 86% above 40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 UC FAC EST PT LVL 4 =/> 30 MINS $158.47 $264.12 $57.00–$266.76 148% above 40%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC EST PT VISIT LV 4 =/> 30 MINS $158.47 $264.12 $57.00–$266.76 148% above 40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 UC FAC EST PATIENT LEVEL 4 $118.80 $198.00 $57.00–$236.45 — 40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 CLINIC FAC EST PT LVL 4 =/> 30 MINS $118.80 $198.00 $57.00–$236.45 — 40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 UC FAC EST PT LVL 4 =/> 30 MINS $158.47 $264.12 $57.00–$266.76 — 40%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC EST PT VISIT LV 4 =/> 30 MINS $158.47 $264.12 $57.00–$266.76 — 40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 UC FAC EST PATIENT LEVEL 2 $62.40 $104.00 $33.00–$141.24 26% above 40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CLINIC FAC EST PATIENT LV 2 =/> 10 MINS $62.58 $104.30 $33.00–$141.24 27% above 40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC EST PT VISIT LV 2 =/> 10 MINS $83.58 $139.30 $33.00–$141.24 69% above 40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 INACTIVATE $83.58 $139.30 $33.00–$141.24 69% above 40%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 CLIN GLOBAL EST PATIENT LV2 =/> 10 MINS $83.58 $139.30 $33.00–$141.24 69% above 40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 UC FAC EST PATIENT LEVEL 2 $62.40 $104.00 $33.00–$141.24 — 40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CLINIC FAC EST PATIENT LV 2 =/> 10 MINS $62.58 $104.30 $33.00–$141.24 — 40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC EST PT VISIT LV 2 =/> 10 MINS $83.58 $139.30 $33.00–$141.24 — 40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 CLIN GLOBAL EST PATIENT LV2 =/> 10 MINS $83.58 $139.30 $33.00–$141.24 — 40%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 INACTIVATE $83.58 $139.30 $33.00–$141.24 — 40%
Spirometry (breathing test) CPT 94010 PULMONARY FUNCTION W/INTERPRETATION $266.30 $443.83 $120.83–$488.21 109% above 40%
Spirometry (breathing test) inpatient CPT 94010 PULMONARY FUNCTION W/INTERPRETATION $266.30 $443.83 $120.83–$488.21 — 40%
Spirometry before and after a bronchodilator CPT 94060 PULMONARY FUNC W/BRONCHODILATOR & INTERP $535.41 $892.35 $120.83–$981.58 147% above 40%
Spirometry before and after a bronchodilator CPT 94060 PFT without Bronchodilator $535.41 $892.35 $120.83–$981.58 147% above 40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT without Bronchodilator $535.41 $892.35 $120.83–$981.58 — 40%
Spirometry before and after a bronchodilator inpatient CPT 94060 PULMONARY FUNC W/BRONCHODILATOR & INTERP $535.41 $892.35 $120.83–$981.58 — 40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY $177.18 $295.30 $70.47–$324.83 81% above 40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 FAC THERAPEUTIC PHLEBOTOMY $177.18 $295.30 $70.47–$324.83 81% above 40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY $177.18 $295.30 $70.47–$324.83 — 40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 FAC THERAPEUTIC PHLEBOTOMY $177.18 $295.30 $70.47–$324.83 — 40%

Vaccines

ProcedureCash price List priceInsurers payvs LouisianaOff list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CLIN FAC VARIVAX-VFC $217.46 $362.43 $79.10–$398.67 7% above 40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CLIN FAC VARIVAX $217.46 $362.43 $79.10–$398.67 7% above 40%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CLIN GLOBAL VARIVAX $217.46 $362.43 $79.10–$398.67 7% above 40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 CLIN FAC VARIVAX $217.46 $362.43 $79.10–$398.67 — 40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 CLIN FAC VARIVAX-VFC $217.46 $362.43 $79.10–$398.67 — 40%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 CLIN GLOBAL VARIVAX $217.46 $362.43 $79.10–$398.67 — 40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 CLIN GLOBAL KINRIX AGE 4-6 $426.53 $710.89 $69.07–$781.97 511% above 40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 CLIN FAC KINRIX AGE 4-6 VFCR $426.53 $710.89 $69.07–$781.97 511% above 40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 CLIN FAC KINRIX AGE 4-6 $426.53 $710.89 $69.07–$781.97 511% above 40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 CLIN FAC KINRIX AGE 4-6 $426.53 $710.89 $69.07–$781.97 — 40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 CLIN GLOBAL KINRIX AGE 4-6 $426.53 $710.89 $69.07–$781.97 — 40%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 CLIN FAC KINRIX AGE 4-6 VFCR $426.53 $710.89 $69.07–$781.97 — 40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 CLIN FAC DTAP-UNDER 7 YRS-VFC $35.40 $59.00 $32.40–$64.90 8% above 40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 CLIN FAC DTAP-UNDER 7YRS $35.40 $59.00 $32.40–$64.90 8% above 40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 CLIN GLOBAL DTAP-UNDER 7 YRS $35.40 $59.00 $32.40–$64.90 8% above 40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 CLIN FAC DTAP-UNDER 7YRS $35.40 $59.00 $32.40–$64.90 — 40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 CLIN FAC DTAP-UNDER 7 YRS-VFC $35.40 $59.00 $32.40–$64.90 — 40%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 CLIN GLOBAL DTAP-UNDER 7 YRS $35.40 $59.00 $32.40–$64.90 — 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 INACTIVE $45.00 $75.00 $42.56–$117.41 58% below 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 CLIN FAC PEDIARIX (3) VFC $120.29 $200.49 $53.03–$220.53 12% above 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 CLIN FAC PEDIARX (3) $120.29 $200.49 $53.03–$220.53 12% above 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 CLIN GLOBAL REDIARIX (3) $120.29 $200.49 $53.03–$220.53 12% above 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 INACTIVE $45.00 $75.00 $42.56–$117.41 — 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 CLIN FAC PEDIARX (3) $120.29 $200.49 $53.03–$220.53 — 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 CLIN FAC PEDIARIX (3) VFC $120.29 $200.49 $53.03–$220.53 — 40%
DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 CLIN GLOBAL REDIARIX (3) $120.29 $200.49 $53.03–$220.53 — 40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 CLIN FAC PENTACEL $138.00 $230.00 $129.85–$253.00 79% above 40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 CLIN FAC PENTACEL VFC $138.00 $230.00 $129.85–$253.00 79% above 40%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 CLIN GLOBAL PENTACEL $138.00 $230.00 $129.85–$253.00 79% above 40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 CLIN GLOBAL PENTACEL $138.00 $230.00 $129.85–$253.00 — 40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 CLIN FAC PENTACEL $138.00 $230.00 $129.85–$253.00 — 40%
DTaP, polio and Hib combination vaccine (Pentacel) inpatient CPT 90698 CLIN FAC PENTACEL VFC $138.00 $230.00 $129.85–$253.00 — 40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CLIN FAC FLU PF 3 YR & OLDER $173.26 $288.76 $18.60–$317.63 459% above 40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CLIN FAC FLU PF 3 YR OR OLDER-VFC $173.26 $288.76 $18.60–$317.63 459% above 40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CLIN GLOBAL FLU PF 3 YRS & OLDER $173.26 $288.76 $18.60–$317.63 459% above 40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CLIN FAC FLU PF 3 YR & OLDER $173.26 $288.76 $18.60–$317.63 — 40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CLIN GLOBAL FLU PF 3 YRS & OLDER $173.26 $288.76 $18.60–$317.63 — 40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CLIN FAC FLU PF 3 YR OR OLDER-VFC $173.26 $288.76 $18.60–$317.63 — 40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 CLIN GLOBAL HPV 9 $325.40 $542.33 $130.61–$596.56 24% above 40%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 CLIN FAC HPV 9 $325.40 $542.33 $130.61–$596.56 24% above 40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 CLIN GLOBAL HPV 9 $325.40 $542.33 $130.61–$596.56 — 40%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 CLIN FAC HPV 9 $325.40 $542.33 $130.61–$596.56 — 40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 CLIN FAC HEPATITIS A-2 DOSE ADULT VFC $145.80 $243.00 $137.90–$267.30 78% above 40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 CLIN FAC HEPATITIS A-2 DOSE ADULT $145.80 $243.00 $137.90–$267.30 78% above 40%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 CLIN GLOBAL HEP A-2 DOSE ADULT $145.80 $243.00 $137.90–$267.30 78% above 40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 CLIN FAC HEPATITIS A-2 DOSE ADULT VFC $145.80 $243.00 $137.90–$267.30 — 40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 CLIN FAC HEPATITIS A-2 DOSE ADULT $145.80 $243.00 $137.90–$267.30 — 40%
Hepatitis A and B combination vaccine, adult (Twinrix) inpatient CPT 90636 CLIN GLOBAL HEP A-2 DOSE ADULT $145.80 $243.00 $137.90–$267.30 — 40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 CLIN FAC HEPATITIS A-2 DOSE/PED $42.00 $70.00 $39.72–$77.00 4% below 40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 CLIN GLOBAL HEP A-2 DOSE/PEDS $42.00 $70.00 $39.72–$77.00 4% below 40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 CLIN FAC HEP A-2 DOSE-VFC $42.00 $70.00 $39.72–$77.00 4% below 40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 CLIN GLOBAL HEP A-2 DOSE/PEDS $42.00 $70.00 $39.72–$77.00 — 40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 CLIN FAC HEP A-2 DOSE-VFC $42.00 $70.00 $39.72–$77.00 — 40%
Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 CLIN FAC HEPATITIS A-2 DOSE/PED $42.00 $70.00 $39.72–$77.00 — 40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CLIN GLOBAL HEPATITIS B INJ ADULT $110.71 $184.51 $64.55–$202.96 57% above 40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CLIN GLOBAL HEP B-3 DOSE ADULT $110.71 $184.51 $64.55–$202.96 57% above 40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CLIN FAC HEP B-3 DOSE ADULT $110.71 $184.51 $64.55–$202.96 57% above 40%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CLIN FAC HEPATITIS B INJ ADULT $110.71 $184.51 $64.55–$202.96 57% above 40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CLIN GLOBAL HEP B-3 DOSE ADULT $110.71 $184.51 $64.55–$202.96 — 40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CLIN GLOBAL HEPATITIS B INJ ADULT $110.71 $184.51 $64.55–$202.96 — 40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CLIN FAC HEPATITIS B INJ ADULT $110.71 $184.51 $64.55–$202.96 — 40%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CLIN FAC HEP B-3 DOSE ADULT $110.71 $184.51 $64.55–$202.96 — 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 CLIN FAC HEP B-3 DOSE/PEDS $49.35 $82.25 $26.66–$90.47 25% above 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 CLIN GLOBAL HEP B-3 DOSE/PEDS MCV4 $49.35 $82.25 $26.66–$90.47 25% above 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 CLIN FAC HEP B-3 DOSE-VFC $49.35 $82.25 $26.66–$90.47 25% above 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPATITIS B 10 MCG/0.5 ML INJ $115.80 $193.00 $26.66–$212.30 192% above 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 CLIN FAC HEP B-3 DOSE-VFC $49.35 $82.25 $26.66–$90.47 — 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 CLIN FAC HEP B-3 DOSE/PEDS $49.35 $82.25 $26.66–$90.47 — 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 CLIN GLOBAL HEP B-3 DOSE/PEDS MCV4 $49.35 $82.25 $26.66–$90.47 — 40%
Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 HEPATITIS B 10 MCG/0.5 ML INJ $115.80 $193.00 $26.66–$212.30 — 40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 CLIN FAC HIB-VFC $31.81 $53.01 $14.45–$58.31 41% above 40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 CLIN GLOBAL HIB $31.81 $53.01 $14.45–$58.31 41% above 40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 CLIN FAC HIB $31.81 $53.01 $14.45–$58.31 41% above 40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 CLIN FAC HIB-VFC $31.81 $53.01 $14.45–$58.31 — 40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 CLIN FAC HIB $31.81 $53.01 $14.45–$58.31 — 40%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) inpatient CPT 90648 CLIN GLOBAL HIB $31.81 $53.01 $14.45–$58.31 — 40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CLIN GLOBAL FLUZONE 65 YRS& OLDER $119.96 $199.93 $75.04–$219.92 97% above 40%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CLIN FAC FLUZONE 65YRS & OLDER $119.96 $199.93 $75.04–$219.92 97% above 40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CLIN FAC FLUZONE 65YRS & OLDER $119.96 $199.93 $75.04–$219.92 — 40%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CLIN GLOBAL FLUZONE 65 YRS& OLDER $119.96 $199.93 $75.04–$219.92 — 40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CLIN FAC MMR $108.55 $180.92 $102.67–$199.01 48% above 40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CLIN FAC MMR-VFC $108.55 $180.92 $102.67–$199.01 48% above 40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CLIN GLOBAL MMR $108.55 $180.92 $102.67–$199.01 48% above 40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 CLIN GLOBAL MMR $108.55 $180.92 $102.67–$199.01 — 40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 CLIN FAC MMR $108.55 $180.92 $102.67–$199.01 — 40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 CLIN FAC MMR-VFC $108.55 $180.92 $102.67–$199.01 — 40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 CLIN FAC MMRV-VFC $194.93 $324.88 $184.36–$357.36 29% above 40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 CLIN GLOBAL MMRV $194.93 $324.88 $184.36–$357.36 29% above 40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 CLIN FAC MMRV $194.93 $324.88 $184.36–$357.36 29% above 40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 CLIN GLOBAL MMRV $194.93 $324.88 $184.36–$357.36 — 40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 CLIN FAC MMRV-VFC $194.93 $324.88 $184.36–$357.36 — 40%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710 CLIN FAC MMRV $194.93 $324.88 $184.36–$357.36 — 40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CLIN GLOBAL MENACTRA $25.92 $43.20 $24.51–$189.95 84% below 40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CLIN FAC MENACTRA-VFC $25.92 $43.20 $24.51–$189.95 84% below 40%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CLIN FAC MENACTRA $25.92 $43.20 $24.51–$189.95 84% below 40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 CLIN FAC MENACTRA $25.92 $43.20 $24.51–$189.95 — 40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 CLIN FAC MENACTRA-VFC $25.92 $43.20 $24.51–$189.95 — 40%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 CLIN GLOBAL MENACTRA $25.92 $43.20 $24.51–$189.95 — 40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 CLIN GLOBAL BEXSERO (MEN B) 1 $206.50 $344.17 $189.68–$378.58 4% below 40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 CLIN FAC BEXSERO (MEN B) 1 VFC $206.50 $344.17 $189.68–$378.58 4% below 40%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 CLIN FAC BEXSERO (MEN B) 1 $206.50 $344.17 $189.68–$378.58 4% below 40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 CLIN FAC BEXSERO (MEN B) 1 $206.50 $344.17 $189.68–$378.58 — 40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 CLIN GLOBAL BEXSERO (MEN B) 1 $206.50 $344.17 $189.68–$378.58 — 40%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 CLIN FAC BEXSERO (MEN B) 1 VFC $206.50 $344.17 $189.68–$378.58 — 40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 CLIN FAC FLUMIST $63.00 $105.00 $15.14–$115.50 400% above 40%
Nasal spray flu vaccine, live (FluMist) CPT 90660 CLIN GLOBAL FLUMIST $63.00 $105.00 $15.14–$115.50 400% above 40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 CLIN GLOBAL FLUMIST $63.00 $105.00 $15.14–$115.50 — 40%
Nasal spray flu vaccine, live (FluMist) inpatient CPT 90660 CLIN FAC FLUMIST $63.00 $105.00 $15.14–$115.50 — 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 CLIN FAC PNEUM CONJ VAC 13 VAL IM-VFC $307.75 $512.92 $190.11–$564.21 46% above 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 CLIN GLOBAL PNEUM CONJ VAC 13 VALENT IM $307.75 $512.92 $190.11–$564.21 46% above 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 CLIN FAC PNEUMO CONJ VAC 13 VALENT IM $307.75 $512.92 $190.11–$564.21 46% above 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMOCOCCAL -13 PCV $407.40 $679.00 $190.11–$746.90 93% above 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 CLIN GLOBAL PNEUM CONJ VAC 13 VALENT IM $307.75 $512.92 $190.11–$564.21 — 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 CLIN FAC PNEUM CONJ VAC 13 VAL IM-VFC $307.75 $512.92 $190.11–$564.21 — 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 CLIN FAC PNEUMO CONJ VAC 13 VALENT IM $307.75 $512.92 $190.11–$564.21 — 40%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL -13 PCV $407.40 $679.00 $190.11–$746.90 — 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CLIN FAC HPV-9 VFC $206.89 $344.81 $94.44–$379.29 48% above 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CLIN GLOBAL PNEUMOCOCCAL-23 $206.89 $344.81 $94.44–$379.29 48% above 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CLIN FAC HPV-9 $206.89 $344.81 $94.44–$379.29 48% above 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CLIN FAC PNEUMOCOCCAL-23 $206.89 $344.81 $94.44–$379.29 48% above 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CLIN FAC PREVNAR 13-VFC $206.89 $344.81 $94.44–$379.29 48% above 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL -23 $211.20 $352.00 $94.44–$387.20 51% above 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CLIN FAC HPV-9 $206.89 $344.81 $94.44–$379.29 — 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CLIN GLOBAL PNEUMOCOCCAL-23 $206.89 $344.81 $94.44–$379.29 — 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CLIN FAC HPV-9 VFC $206.89 $344.81 $94.44–$379.29 — 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CLIN FAC PNEUMOCOCCAL-23 $206.89 $344.81 $94.44–$379.29 — 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CLIN FAC PREVNAR 13-VFC $206.89 $344.81 $94.44–$379.29 — 40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL -23 $211.20 $352.00 $94.44–$387.20 — 40%
Polio vaccine, inactivated (IPV) CPT 90713 CLIN FAC IPV $68.44 $114.07 $48.47–$125.47 64% above 40%
Polio vaccine, inactivated (IPV) CPT 90713 CLIN FAC IPV-VFC $68.44 $114.07 $48.47–$125.47 64% above 40%
Polio vaccine, inactivated (IPV) CPT 90713 CLIN GLOBAL IPV $68.44 $114.07 $48.47–$125.47 64% above 40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 CLIN FAC IPV $68.44 $114.07 $48.47–$125.47 — 40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 CLIN GLOBAL IPV $68.44 $114.07 $48.47–$125.47 — 40%
Polio vaccine, inactivated (IPV) inpatient CPT 90713 CLIN FAC IPV-VFC $68.44 $114.07 $48.47–$125.47 — 40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE SYRINGE KIT 1ML (2.5IU) $782.40 $1,304.00 $276.13–$1,434.40 8% above 40%
Rabies vaccine, one dose CPT 90675 RABIES IMMUNE GLOBULIN (HUMAN) 150IU/ML $6,126.00 $10,210.00 $276.13–$11,231.00 746% above 40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE SYRINGE KIT 1ML (2.5IU) $782.40 $1,304.00 $276.13–$1,434.40 — 40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES IMMUNE GLOBULIN (HUMAN) 150IU/ML $6,126.00 $10,210.00 $276.13–$11,231.00 — 40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 CLIN GLOBAL ROTAVIRUS LIVE ORAL $87.57 $145.95 $82.82–$160.54 8% below 40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 CLIN FAC ROTAVIRUS LIVE ORAL $87.57 $145.95 $82.82–$160.54 8% below 40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 CLIN FAC ROTAVIRUS LIVE ORAL $87.57 $145.95 $82.82–$160.54 — 40%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 CLIN GLOBAL ROTAVIRUS LIVE ORAL $87.57 $145.95 $82.82–$160.54 — 40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TETANUS/DIPTHERIA TOXOIDS (Td) 0.5ML PFS $66.60 $111.00 $26.37–$122.10 42% above 40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TETANUS/DIPTHERIA TOXOIDS (Td) 0.5ML PFS $66.60 $111.00 $26.37–$122.10 — 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS/DIPTHERIA/PERTUSSIS 0.5 ML SYR $67.50 $112.50 $35.32–$123.75 at median 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS/DIPHT/PERTUSSIS VAC 0.5 ML $90.60 $151.00 $35.32–$166.10 34% above 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CLIN FAC TDAP-7 YRS OR OLDER $182.40 $304.00 $35.32–$334.40 169% above 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CLIN GLOBAL TDAP-7 YRS OR OLDER $182.40 $304.00 $35.32–$334.40 169% above 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CLIN FAC TDAP-7 YRS OR OLDER-VFC $182.40 $304.00 $35.32–$334.40 169% above 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS/DIPTHERIA/PERTUSSIS 0.5 ML SYR $67.50 $112.50 $35.32–$123.75 — 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS/DIPHT/PERTUSSIS VAC 0.5 ML $90.60 $151.00 $35.32–$166.10 — 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CLIN FAC TDAP-7 YRS OR OLDER $182.40 $304.00 $35.32–$334.40 — 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CLIN FAC TDAP-7 YRS OR OLDER-VFC $182.40 $304.00 $35.32–$334.40 — 40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CLIN GLOBAL TDAP-7 YRS OR OLDER $182.40 $304.00 $35.32–$334.40 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CLIN FAC IMMUNIZATION ADMIN 1 VACCINE $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADM ONE VACCINE CHILD $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INACTIVATE $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OBS VACCINE ADMIN 1 VACCINE $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN 1ST VACCINE $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 CLIN GLOBAL IMMUNIZATION ADMIN 1 VACCINE $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FAC VACCINE ADMIN 1 VACCINE > 18 years $71.26 $118.76 $19.31–$130.63 76% above 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INACTIVATE $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CLIN GLOBAL IMMUNIZATION ADMIN 1 VACCINE $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADM ONE VACCINE CHILD $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 CLIN FAC IMMUNIZATION ADMIN 1 VACCINE $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN 1ST VACCINE $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 OBS VACCINE ADMIN 1 VACCINE $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FAC VACCINE ADMIN 1 VACCINE > 18 years $71.26 $118.76 $19.31–$130.63 — 40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CLIN FAC IMMUNIZATION ADM EA ADD VACCINE $33.99 $56.65 $14.92–$62.31 21% above 40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 FAC EA ADD'L VACCINE $33.99 $56.65 $14.92–$62.31 21% above 40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 OBS EA ADDL VACCINE $33.99 $56.65 $14.92–$62.31 21% above 40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN VACCINE EA ADD'L VACCINE $33.99 $56.65 $14.92–$62.31 21% above 40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 CLIN GLOBAL EACH ADDL VACCINE $33.99 $56.65 $14.92–$62.31 21% above 40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN VACCINE EA ADD'L VACCINE $33.99 $56.65 $14.92–$62.31 — 40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 CLIN GLOBAL EACH ADDL VACCINE $33.99 $56.65 $14.92–$62.31 — 40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 CLIN FAC IMMUNIZATION ADM EA ADD VACCINE $33.99 $56.65 $14.92–$62.31 — 40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 FAC EA ADD'L VACCINE $33.99 $56.65 $14.92–$62.31 — 40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 OBS EA ADDL VACCINE $33.99 $56.65 $14.92–$62.31 — 40%

Source file: https://mrfs.hyvehealthcare.com/WestFelicianaParish/720683078_the-hospital-service-district-of-west-feliciana-parish-louisiana_standardcharges.csv