Hospital

International Falls Memorial Hospital Association

International Falls Memorial Hospital Association in International Falls, MN publishes cash prices for 333 common procedures listed here, from its own machine-readable price file updated May 6, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Minnesota median for 201 of 329 procedures and below it for 123. By typical cash price it ranks #57 of 79 Minnesota hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1400 US-71, International Falls, Minnesota 56649 Collected Sep 27, 2026 Source price file (218) 283-4481

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 241322 · CMS hospital register

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Ankle X-ray, complete, 3 or more views CPT 73610 RAD EXAM ANKLE MIN 3 VWS	$219.37	$284.89	$62.28–$276.34	at median	23%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 RAD EXAM ANKLE MIN 3 VWS	$219.37	$284.89	$62.28–$276.34	—	23%
Ankle-brachial index (ABI), blood pressure test for leg arteries both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS	$388.62	$504.69	$110.33–$489.55	—	23%
Ankle-brachial index (ABI), blood pressure test for leg arteries one side CPT 93922 UNILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS 52 MOD	$388.62	$504.69	$110.33–$489.55	5% above	23%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient both sides CPT 93922 LIMITED BILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS	$388.62	$504.69	$110.33–$489.55	—	23%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient one side CPT 93922 UNILAT PHYSIOLOGIC STUDIES EXT ART 1-2 LVLS 52 MOD	$388.62	$504.69	$110.33–$489.55	—	23%
Barium swallow (esophagus X-ray with contrast) CPT 74220 RAD EXAM ESOPHAGUS	$467.86	$607.60	$132.82–$589.37	60% above	23%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 RAD EXAM ESOPHAGUS	$467.86	$607.60	$132.82–$589.37	—	23%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY	$1,580.85	$2,053.05	$448.80–$1,991.46	29% above	23%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE AND OR JNT IMG WHOLE BODY	$1,580.85	$2,053.05	$448.80–$1,991.46	—	23%
Breast ultrasound, complete, one breast one side CPT 76641 US UNILATERAL BREAST COMPLETE	$510.59	$663.10	$144.95–$643.21	35% above	23%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US UNILATERAL BREAST COMPLETE	$510.59	$663.10	$144.95–$643.21	—	23%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US UNILATERAL BREAST LIMITED	$401.37	$521.25	$113.95–$505.61	27% above	23%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US UNILATERAL BREAST LIMITED	$401.37	$521.25	$113.95–$505.61	—	23%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST WCONT +WO IF PERF	$1,817.90	$2,360.90	$516.09–$2,290.07	10% above	23%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST WCONT +WO IF PERF	$1,817.90	$2,360.90	$516.09–$2,290.07	—	23%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD PELVIS WO CONTRAST	$2,544.99	$3,305.17	$545.00–$3,206.01	33% above	23%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD PELVIS WO CONTRAST	$2,544.99	$3,305.17	$722.51–$3,206.01	—	23%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PELVIS W CONTRAST	$2,544.99	$3,305.17	$545.00–$3,206.01	3% above	23%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD PELVIS W CONTRAST	$2,544.99	$3,305.17	$722.51–$3,206.01	—	23%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD PELVIS WO THEN W CONT	$3,738.09	$4,854.65	$545.00–$4,709.01	46% above	23%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD PELVIS WO THEN W CONT	$3,738.09	$4,854.65	$1,061.23–$4,709.01	—	23%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	7% below	23%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	16% above	23%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONT	$1,361.90	$1,768.70	$386.64–$1,715.64	9% above	23%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONT	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	8% above	23%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
CT scan of the head without and with contrast CPT 70470 CT HEAD WO THEN W CONTRAST	$1,872.45	$2,431.75	$531.58–$2,358.80	18% above	23%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WO THEN W CONTRAST	$1,872.45	$2,431.75	$531.58–$2,358.80	—	23%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONT	$1,361.90	$1,768.70	$386.64–$1,715.64	at median	23%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONT	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	1% above	23%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,721.86	$2,236.17	$488.83–$2,169.08	17% above	23%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,721.86	$2,236.17	$488.83–$2,169.08	—	23%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 DUP CAROTID BILAT	$1,083.06	$1,406.56	$307.47–$1,364.36	—	23%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 DUP CAROTID BILAT	$1,083.06	$1,406.56	$307.47–$1,364.36	—	23%
Chest X-ray, 2 views CPT 71046 RAD EXAM CHEST 2 VWS	$200.21	$260.01	$56.84–$252.21	13% below	23%
Chest X-ray, 2 views inpatient CPT 71046 RAD EXAM CHEST 2 VWS	$200.21	$260.01	$56.84–$252.21	—	23%
Chest X-ray, single view CPT 71045 RAD EXAM CHEST SINGLE VW	$190.06	$246.83	$53.96–$239.43	7% above	23%
Chest X-ray, single view inpatient CPT 71045 RAD EXAM CHEST SINGLE VW	$190.06	$246.83	$53.96–$239.43	—	23%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEUM	$459.90	$597.27	$130.56–$579.35	12% below	23%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEUM	$459.90	$597.27	$130.56–$579.35	—	23%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE 1+ AXIAL SKELETON	$191.07	$248.14	$54.24–$240.70	39% below	23%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY DEXA AXIAL SKELET	$510.59	$663.10	$144.95–$643.21	63% above	23%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE 1+ AXIAL SKELETON	$191.07	$248.14	$54.24–$240.70	—	23%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY DEXA AXIAL SKELET	$510.59	$663.10	$144.95–$643.21	—	23%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 BONE DENSITY DEXA APPEND SKEL	$255.26	$331.50	$72.47–$321.56	32% above	23%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 BONE DENSITY DEXA APPEND SKEL	$255.26	$331.50	$72.47–$321.56	—	23%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	9% above	23%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DIAGNOSTIC WO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$1,817.90	$2,360.90	$516.09–$2,290.07	22% above	23%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DIAGNOSTIC WITH CONTRAST	$1,817.90	$2,360.90	$516.09–$2,290.07	—	23%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INCL CAD	$385.79	$501.02	$109.52–$485.99	—	23%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INCL CAD	$385.79	$501.02	$109.52–$485.99	—	23%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT INCL CAD	$283.38	$368.02	$80.45–$356.98	9% below	23%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT INCL CAD	$283.38	$368.02	$80.45–$356.98	—	23%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT	$898.58	$1,166.98	$255.10–$1,131.97	—	23%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 DUPLEX VENOUS EXT CMPL BILAT	$898.58	$1,166.98	$255.10–$1,131.97	—	23%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR	$1,002.04	$1,301.35	$284.48–$1,262.31	21% below	23%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO (2D) COMPLETE W DOPPLER & COLOR	$1,002.04	$1,301.35	$284.48–$1,262.31	—	23%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY IMG INCL GALLBLADDER	$1,052.66	$1,367.08	$298.84–$1,326.07	22% below	23%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY IMG INCL GALLBLADDER	$1,052.66	$1,367.08	$298.84–$1,326.07	—	23%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY SLEEP STAGING W4+ ADDL PARAMETERS & CPAP ATTENDED	$393.01	$510.40	$111.57–$495.09	89% below	23%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PF 95811 PSG (SLEEP STAGE)4+W	$393.01	$510.40	$111.57–$495.09	89% below	23%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 PSG CPAP BIPAP 4+ PARAMETERS	$3,755.92	$4,877.81	$1,066.29–$4,731.48	8% above	23%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PF 95811 PSG (SLEEP STAGE)4+W	$393.01	$510.40	$111.57–$495.09	—	23%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY SLEEP STAGING W4+ ADDL PARAMETERS & CPAP ATTENDED	$393.01	$510.40	$111.57–$495.09	—	23%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 PSG CPAP BIPAP 4+ PARAMETERS	$3,755.92	$4,877.81	$1,066.29–$4,731.48	—	23%
Knee X-ray, 3 views CPT 73562 RAD EXAM KNEE 3 VWS	$212.51	$275.98	$60.33–$267.70	8% below	23%
Knee X-ray, 3 views inpatient CPT 73562 RAD EXAM KNEE 3 VWS	$212.51	$275.98	$60.33–$267.70	—	23%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ULTRASOUND ABDOMINAL B-SCAN & OR REAL TIME WIMAGE DOCUMENTATION LTD	$193.99	$251.93	$55.07–$244.37	54% below	23%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABD LIMITED	$362.11	$470.27	$102.80–$456.16	13% below	23%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ULTRASOUND ABDOMINAL B-SCAN & OR REAL TIME WIMAGE DOCUMENTATION LTD	$193.99	$251.93	$55.07–$244.37	—	23%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABD LIMITED	$362.11	$470.27	$102.80–$456.16	—	23%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	136% above	23%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LW DOSE LUNG CA SCR NO CONTRAST	$1,361.90	$1,768.70	$386.64–$1,715.64	—	23%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOWER EXT JT WO CONTRAST	$2,935.24	$3,812.00	$833.30–$3,697.64	65% above	23%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXT JT WO CONTRAST	$2,935.24	$3,812.00	$833.30–$3,697.64	—	23%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOWER EXT JT WO THEN W CONT	$2,853.09	$3,705.30	$809.98–$3,594.14	11% above	23%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXT JT WO THEN W CONT	$2,853.09	$3,705.30	$809.98–$3,594.14	—	23%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$2,621.43	$3,404.45	$744.21–$3,302.32	21% above	23%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$2,621.43	$3,404.45	$744.21–$3,302.32	—	23%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WO THEN W CONT	$2,977.90	$3,867.39	$845.00–$3,751.37	1% above	23%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WO THEN W CONT	$2,977.90	$3,867.39	$845.41–$3,751.37	—	23%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$2,421.31	$3,144.55	$687.40–$3,050.21	19% above	23%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$2,421.31	$3,144.55	$687.40–$3,050.21	—	23%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO THEN W CONT	$3,025.13	$3,928.74	$845.00–$3,810.88	12% above	23%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO THEN W CONT	$3,025.13	$3,928.74	$858.82–$3,810.88	—	23%
MRI of the lower back, no contrast dye CPT 72148 MRI L SPINE WO CONTRAST	$2,867.22	$3,723.65	$813.99–$3,611.94	37% above	23%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L SPINE WO CONTRAST	$2,867.22	$3,723.65	$813.99–$3,611.94	—	23%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L SPINE WO THEN W CONT	$3,025.13	$3,928.74	$845.00–$3,810.88	18% above	23%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L SPINE WO THEN W CONT	$3,025.13	$3,928.74	$858.82–$3,810.88	—	23%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI T SPINE WO CONTRAST	$2,855.20	$3,708.04	$810.58–$3,596.80	34% above	23%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI T SPINE WO CONTRAST	$2,855.20	$3,708.04	$810.58–$3,596.80	—	23%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI C SPINE WO THEN W CONT	$3,025.13	$3,928.74	$845.00–$3,810.88	21% above	23%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI C SPINE WO THEN W CONT	$3,025.13	$3,928.74	$858.82–$3,810.88	—	23%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C SPINE WO CONTRAST	$2,875.89	$3,734.92	$816.45–$3,622.87	36% above	23%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C SPINE WO CONTRAST	$2,875.89	$3,734.92	$816.45–$3,622.87	—	23%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO THEN W CONT	$2,976.76	$3,865.91	$845.00–$3,749.93	12% above	23%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO THEN W CONT	$2,976.76	$3,865.91	$845.09–$3,749.93	—	23%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$2,117.68	$2,750.23	$601.20–$2,667.72	at median	23%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$2,117.68	$2,750.23	$601.20–$2,667.72	—	23%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI UPPER EXT JT WO CONTRAST	$2,280.87	$2,962.16	$647.53–$2,873.30	7% above	23%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXT JT WO CONTRAST	$2,280.87	$2,962.16	$647.53–$2,873.30	—	23%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL SPECT MULT STDY	$2,293.03	$2,977.95	$650.98–$2,888.61	19% below	23%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL SPECT MULT STDY	$2,293.03	$2,977.95	$650.98–$2,888.61	—	23%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT SKULL BASE TO MID THIGH	$4,440.33	$5,766.66	$1,260.59–$5,593.66	74% above	23%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT SKULL BASE TO MID THIGH	$4,440.33	$5,766.66	$1,260.59–$5,593.66	—	23%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC LIMITED	$467.86	$607.60	$132.82–$589.37	53% above	23%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED	$467.86	$607.60	$132.82–$589.37	—	23%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC COMPLETE	$582.57	$756.58	$165.39–$733.88	24% above	23%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC COMPLETE	$582.57	$756.58	$165.39–$733.88	—	23%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PG UTR 2-3TRI SGL 1ST	$467.86	$607.60	$132.82–$589.37	2% below	23%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PG UTR 2-3TRI SGL 1ST	$467.86	$607.60	$132.82–$589.37	—	23%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG UTER 1ST TRI SGL	$467.86	$607.60	$132.82–$589.37	12% above	23%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG UTER 1ST TRI SGL	$467.86	$607.60	$132.82–$589.37	—	23%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB REAL TIME LTD	$246.25	$319.80	$69.91–$310.21	23% below	23%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB REAL TIME LTD	$246.25	$319.80	$69.91–$310.21	—	23%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD	$385.79	$501.02	$109.52–$485.99	—	23%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52	$283.38	$368.02	$80.45–$356.98	16% below	23%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INCL CAD	$385.79	$501.02	$109.52–$485.99	—	23%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT INCL CAD M52	$283.38	$368.02	$80.45–$356.98	—	23%
Shoulder X-ray, complete, 2 or more views CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS	$173.14	$224.85	$49.15–$218.10	23% below	23%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 RAD EXAM SHOULDER COMPL MIN 2 VWS	$173.14	$224.85	$49.15–$218.10	—	23%
Sleep study in a lab (polysomnography) CPT 95810 PF 95810 PSG (SLP STAGE) 4+ PA	$376.69	$489.20	$106.94–$474.52	88% below	23%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY SLEEP STAGING W4+ ADDL PARAMETERS ATTENDED	$376.69	$489.20	$106.94–$474.52	88% below	23%
Sleep study in a lab (polysomnography) CPT 95810 PSG 4+ PARAMETERS	$3,117.17	$4,048.26	$884.95–$3,926.81	1% above	23%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY SLEEP STAGING W4+ ADDL PARAMETERS ATTENDED	$376.69	$489.20	$106.94–$474.52	—	23%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PF 95810 PSG (SLP STAGE) 4+ PA	$376.69	$489.20	$106.94–$474.52	—	23%
Sleep study in a lab (polysomnography) inpatient CPT 95810 PSG 4+ PARAMETERS	$3,117.17	$4,048.26	$884.95–$3,926.81	—	23%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 STRESS TTE WMONITOR	$1,455.22	$1,889.89	$413.13–$1,833.19	18% below	23%
Stress echocardiogram, complete, including the stress test and supervision inpatient CPT 93351 STRESS TTE WMONITOR	$1,455.22	$1,889.89	$413.13–$1,833.19	—	23%
Swallow study (modified barium swallow, video X-ray) CPT 74230 RAD SWALLOWING FUNC W CINERAD OR VIDEORAD	$571.27	$741.90	$162.18–$719.64	92% above	23%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 RAD SWALLOWING FUNC W CINERAD OR VIDEORAD	$571.27	$741.90	$162.18–$719.64	—	23%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL	$332.88	$432.31	$94.50–$419.34	14% below	23%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL	$332.88	$432.31	$94.50–$419.34	—	23%
Transvaginal ultrasound during pregnancy CPT 76817 US PG UTR TRANSVAG	$528.53	$686.39	$150.04–$665.80	58% above	23%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US PG UTR TRANSVAG	$528.53	$686.39	$150.04–$665.80	—	23%
Ultrasound of the abdomen, complete CPT 76700 US ABD COMPLETE	$597.15	$775.51	$169.53–$752.24	2% above	23%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD COMPLETE	$597.15	$775.51	$169.53–$752.24	—	23%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$557.82	$724.44	$158.36–$702.71	22% above	23%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$557.82	$724.44	$158.36–$702.71	—	23%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE HEAD NECK	$429.59	$557.90	$121.96–$541.16	6% below	23%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE HEAD NECK	$429.59	$557.90	$121.96–$541.16	—	23%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 RAD EXAM GI UPPER W WO DELAYED IMG WO KUB	$444.21	$576.89	$126.11–$559.58	39% above	23%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 RAD EXAM GI UPPER W WO DELAYED IMG WO KUB	$444.21	$576.89	$126.11–$559.58	—	23%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT	$455.50	$591.55	$129.31–$573.80	17% below	23%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUPLEX VENOUS EXT LTD UNILAT	$455.50	$591.55	$129.31–$573.80	—	23%
Wrist X-ray, complete, 3 or more views CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS	$163.08	$211.79	$46.30–$205.44	25% below	23%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 RAD EXAM WRIST COMPL MIN 3 VWS	$163.08	$211.79	$46.30–$205.44	—	23%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS	$173.14	$224.85	$49.15–$218.10	37% below	23%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 RAD EXAM HIP UNILAT W PELV WHEN PERF 2 OR 3 VWS	$173.14	$224.85	$49.15–$218.10	—	23%
X-ray of the abdomen, 1 view CPT 74018 RAD EXAM ABDOMEN 1 VW	$158.56	$205.92	$45.01–$199.74	25% below	23%
X-ray of the abdomen, 1 view inpatient CPT 74018 RAD EXAM ABDOMEN 1 VW	$158.56	$205.92	$45.01–$199.74	—	23%
X-ray of the ankle, 2 views CPT 73600 RAD EXAM ANKLE 2 VWS	$151.83	$197.18	$43.10–$191.26	7% below	23%
X-ray of the ankle, 2 views inpatient CPT 73600 RAD EXAM ANKLE 2 VWS	$151.83	$197.18	$43.10–$191.26	—	23%
X-ray of the finger(s), 2 or more views CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS	$127.11	$165.07	$36.08–$160.12	34% below	23%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 RAD EXAM FINGER(S) MIN 2 VWS	$127.11	$165.07	$36.08–$160.12	—	23%
X-ray of the foot, 2 views CPT 73620 RAD EXAM FOOT 2 VWS	$151.83	$197.18	$43.10–$191.26	9% below	23%
X-ray of the foot, 2 views inpatient CPT 73620 RAD EXAM FOOT 2 VWS	$151.83	$197.18	$43.10–$191.26	—	23%
X-ray of the foot, complete, 3 or more views CPT 73630 RAD EXAM FOOT MIN 3 VWS	$219.37	$284.89	$62.28–$276.34	5% above	23%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 RAD EXAM FOOT MIN 3 VWS	$219.37	$284.89	$62.28–$276.34	—	23%
X-ray of the hand, 3 or more views CPT 73130 RAD EXAM HAND MIN 3 VWS	$163.08	$211.79	$46.30–$205.44	24% below	23%
X-ray of the hand, 3 or more views inpatient CPT 73130 RAD EXAM HAND MIN 3 VWS	$163.08	$211.79	$46.30–$205.44	—	23%
X-ray of the knee, 1 or 2 views CPT 73560 RAD EXAM KNEE 1 OR 2 VWS	$171.00	$222.07	$48.54–$215.41	9% below	23%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 RAD EXAM KNEE 1 OR 2 VWS	$171.00	$222.07	$48.54–$215.41	—	23%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS	$201.30	$261.42	$57.15–$253.58	23% below	23%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 RAD EXAM SPINE LUMB 2 OR 3 VWS	$201.30	$261.42	$57.15–$253.58	—	23%
X-ray of the lower back, 4 or more views CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS	$275.51	$357.80	$78.22–$347.07	20% below	23%
X-ray of the lower back, 4 or more views inpatient CPT 72110 RAD EXAM SPINE LUMB MIN 4 VWS	$275.51	$357.80	$78.22–$347.07	—	23%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 RAD EXAM SPINE THOR 2 VWS	$193.41	$251.18	$54.91–$243.64	22% below	23%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 RAD EXAM SPINE THOR 2 VWS	$193.41	$251.18	$54.91–$243.64	—	23%
X-ray of the nasal bones, 3 or more views CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS	$348.25	$452.27	$98.87–$438.70	59% above	23%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 RAD EXAM NASAL BONES COMPL MIN 3 VWS	$348.25	$452.27	$98.87–$438.70	—	23%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS	$342.35	$444.61	$97.19–$431.27	38% above	23%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 RAD EXAM SPINE CERV 2 OR 3 VWS	$342.35	$444.61	$97.19–$431.27	—	23%
X-ray of the pelvis, 1 or 2 views CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS	$158.56	$205.92	$45.01–$199.74	21% below	23%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 RAD EXAM PELVIS 1 OR 2 VWS	$158.56	$205.92	$45.01–$199.74	—	23%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS	$173.14	$224.85	$49.15–$218.10	24% below	23%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 RAD EXAM SACRUM COCCYX MIN 2 VWS	$173.14	$224.85	$49.15–$218.10	—	23%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460	$97.02	$126.00	$27.54–$122.22	115% above	23%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINOTRANSFERASE	$97.02	$126.00	$27.54–$122.22	115% above	23%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT	$97.02	$126.00	$27.54–$122.22	115% above	23%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT 84460	$97.02	$126.00	$27.54–$122.22	—	23%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINOTRANSFERASE	$97.02	$126.00	$27.54–$122.22	—	23%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALANINE AMINO ALT SGPT	$97.02	$126.00	$27.54–$122.22	—	23%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE ASPARTATE AMINO AST SGOT	$73.66	$95.66	$20.91–$92.79	64% above	23%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST 84450	$73.66	$95.66	$20.91–$92.79	64% above	23%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE ASPARTATE AMINO AST SGOT	$73.66	$95.66	$20.91–$92.79	—	23%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST 84450	$73.66	$95.66	$20.91–$92.79	—	23%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ON PANEL 86003	$7.97	$10.34	$2.26–$10.03	48% below	23%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH 86003	$8.92	$11.58	$2.53–$11.23	41% below	23%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$8.92	$11.58	$2.53–$11.23	41% below	23%
Allergy blood test, specific IgE, per allergen CPT 86003 ALERGEN SPEC IGE QNT SO 86003	$40.00	$51.94	$11.35–$50.38	163% above	23%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERG GALACTOSE-ALPHA-1,3-GALACTOSE IGE SO 86003.903	$95.70	$124.28	$27.17–$120.55	530% above	23%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ON PANEL 86003	$7.97	$10.34	$2.26–$10.03	—	23%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH 86003	$8.92	$11.58	$2.53–$11.23	—	23%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH	$8.92	$11.58	$2.53–$11.23	—	23%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALERGEN SPEC IGE QNT SO 86003	$40.00	$51.94	$11.35–$50.38	—	23%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERG GALACTOSE-ALPHA-1,3-GALACTOSE IGE SO 86003.903	$95.70	$124.28	$27.17–$120.55	—	23%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODIES	$122.49	$159.07	$34.77–$154.30	193% above	23%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITR PEP AB(CCP) 86200	$122.49	$159.07	$34.77–$154.30	193% above	23%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITR PEP AB(CCP) 86200	$122.49	$159.07	$34.77–$154.30	—	23%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODIES	$122.49	$159.07	$34.77–$154.30	—	23%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038	$212.97	$276.58	$60.46–$268.28	373% above	23%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODY SCREEN WITH REFLEX	$212.97	$276.58	$60.46–$268.28	373% above	23%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCREEN WITH REFLEX	$212.97	$276.58	$60.46–$268.28	—	23%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODY SCRE86038	$212.97	$276.58	$60.46–$268.28	—	23%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$294.95	$383.05	$83.73–$371.56	119% above	23%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE 83880	$294.95	$383.05	$83.73–$371.56	119% above	23%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NT-PRO B-TYPE NATRIURETIC PEPTIDE 83880.900	$412.82	$536.12	$117.20–$520.04	206% above	23%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BRAIN NATRIURETIC PEPTIDE	$294.95	$383.05	$83.73–$371.56	—	23%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE 83880	$294.95	$383.05	$83.73–$371.56	—	23%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NT-PRO B-TYPE NATRIURETIC PEPTIDE 83880.900	$412.82	$536.12	$117.20–$520.04	—	23%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$168.39	$218.68	$47.80–$212.12	89% above	23%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL 80048	$168.39	$218.68	$47.80–$212.12	89% above	23%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$168.39	$218.68	$47.80–$212.12	—	23%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL 80048	$168.39	$218.68	$47.80–$212.12	—	23%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV - SURGICAL PATHOLOGY GROSS & MICROSCOPIC EXAM	$319.72	$415.21	$90.76–$402.75	206% above	23%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURGICAL PATH LEVEL IV 88305	$319.72	$415.21	$90.76–$402.75	206% above	23%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURGICAL PATH LEVEL IV 88305	$319.72	$415.21	$90.76–$402.75	—	23%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV - SURGICAL PATHOLOGY GROSS & MICROSCOPIC EXAM	$319.72	$415.21	$90.76–$402.75	—	23%
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES	$190.38	$247.24	$54.05–$239.82	73% above	23%
Blood culture for bacteria CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040	$190.38	$247.24	$54.05–$239.82	73% above	23%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES 87040	$190.38	$247.24	$54.05–$239.82	—	23%
Blood culture for bacteria inpatient CPT 87040 CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES	$190.38	$247.24	$54.05–$239.82	—	23%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE 36415	$26.99	$35.04	$7.66–$33.99	30% above	23%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$26.99	$35.04	$7.66–$33.99	30% above	23%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE 36415	$26.99	$35.04	$7.66–$33.99	—	23%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION VENOUS BLOOD VENIPUNCTURE	$26.99	$35.04	$7.66–$33.99	—	23%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947	$56.29	$73.10	$15.98–$70.91	27% above	23%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP)	$56.29	$73.10	$15.98–$70.91	27% above	23%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP)	$56.29	$73.10	$15.98–$70.91	—	23%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANT BLOOD (EXCEPT REAGENT STRIP) 82947	$56.29	$73.10	$15.98–$70.91	—	23%
Blood lead test CPT 83655 LEAD BLOOD CAPILLARY 83655.905	$23.81	$30.92	$6.76–$29.99	24% below	23%
Blood lead test CPT 83655 HEAVY METAL SCREEN LEAD 83655.902	$64.11	$83.25	$18.20–$80.75	105% above	23%
Blood lead test CPT 83655 LEAD	$66.03	$85.75	$18.74–$83.18	112% above	23%
Blood lead test CPT 83655 LEAD 24 HR URINE 83655.901	$104.42	$135.60	$29.64–$131.53	235% above	23%
Blood lead test CPT 83655 LEAD 83655	$112.94	$146.67	$32.06–$142.27	262% above	23%
Blood lead test CPT 83655 LEAD BLOOD VENOUS 83655.904	$112.94	$146.67	$32.06–$142.27	262% above	23%
Blood lead test inpatient CPT 83655 LEAD BLOOD CAPILLARY 83655.905	$23.81	$30.92	$6.76–$29.99	—	23%
Blood lead test inpatient CPT 83655 HEAVY METAL SCREEN LEAD 83655.902	$64.11	$83.25	$18.20–$80.75	—	23%
Blood lead test inpatient CPT 83655 LEAD	$66.03	$85.75	$18.74–$83.18	—	23%
Blood lead test inpatient CPT 83655 LEAD 24 HR URINE 83655.901	$104.42	$135.60	$29.64–$131.53	—	23%
Blood lead test inpatient CPT 83655 LEAD 83655	$112.94	$146.67	$32.06–$142.27	—	23%
Blood lead test inpatient CPT 83655 LEAD BLOOD VENOUS 83655.904	$112.94	$146.67	$32.06–$142.27	—	23%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL 84703	$93.91	$121.95	$26.66–$118.29	36% above	23%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 GONADOTROPIN CHORIONIC (HCG) QUALITATIVE	$93.91	$121.95	$26.66–$118.29	36% above	23%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG (HUMAN CHORIONIC GONA	$93.91	$121.95	$26.66–$118.29	36% above	23%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 GONADOTROPIN CHORIONIC (HCG) QUALITATIVE	$93.91	$121.95	$26.66–$118.29	—	23%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL 84703	$93.91	$121.95	$26.66–$118.29	—	23%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG (HUMAN CHORIONIC GONA	$93.91	$121.95	$26.66–$118.29	—	23%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$96.56	$125.40	$27.41–$121.64	83% above	23%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900	$96.56	$125.40	$27.41–$121.64	83% above	23%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$96.56	$125.40	$27.41–$121.64	—	23%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO 86900	$96.56	$125.40	$27.41–$121.64	—	23%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN QUANT	$127.89	$166.08	$36.31–$161.10	134% above	23%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN QUANT 86140	$127.89	$166.08	$36.31–$161.10	134% above	23%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN QUANT 86140	$127.89	$166.08	$36.31–$161.10	—	23%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN QUANT	$127.89	$166.08	$36.31–$161.10	—	23%
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$162.91	$211.57	$46.25–$205.22	23% above	23%
C. difficile toxin gene test (stool PCR) CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493	$168.62	$218.98	$47.87–$212.41	27% above	23%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE	$162.91	$211.57	$46.25–$205.22	—	23%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE 87493	$168.62	$218.98	$47.87–$212.41	—	23%
CA 19-9 blood test (tumor marker) CPT 86301 CDMR MMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$160.30	$208.17	$45.51–$201.92	58% above	23%
CA 19-9 blood test (tumor marker) CPT 86301 CDMR CA 19-9PANCREATIC CANCER86301	$160.30	$208.17	$45.51–$201.92	58% above	23%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CDMR MMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9	$160.30	$208.17	$45.51–$201.92	—	23%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CDMR CA 19-9PANCREATIC CANCER86301	$160.30	$208.17	$45.51–$201.92	—	23%
CA-125 blood test (ovarian cancer marker) CPT 86304 CDMR CA125 (OVARIAN CANCER)	$167.89	$218.03	$47.66–$211.49	65% above	23%
CA-125 blood test (ovarian cancer marker) CPT 86304 CDMR CA 125 86304	$167.89	$218.03	$47.66–$211.49	65% above	23%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CDMR CA 125 86304	$167.89	$218.03	$47.66–$211.49	—	23%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CDMR CA125 (OVARIAN CANCER)	$167.89	$218.03	$47.66–$211.49	—	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION	$203.52	$264.30	$57.78–$256.37	117% above	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS OCULAR PERITONEAL NAA 87491.900	$203.52	$264.30	$57.78–$256.37	117% above	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491	$203.52	$264.30	$57.78–$256.37	117% above	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION 87491.901	$203.52	$264.30	$57.78–$256.37	117% above	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACHOMATIS AMPLIF PROBE	$203.52	$264.30	$57.78–$256.37	117% above	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION 87491.901	$203.52	$264.30	$57.78–$256.37	—	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACHOMATIS AMPLIF PROBE	$203.52	$264.30	$57.78–$256.37	—	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS OCULAR PERITONEAL NAA 87491.900	$203.52	$264.30	$57.78–$256.37	—	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 INFECT AGNT NUCLEIC ACID DNA RNA CHLAMYDIA TRACH AMPLIF PROBE 87491	$203.52	$264.30	$57.78–$256.37	—	23%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA NUCLEIC ACID DETECTION	$203.52	$264.30	$57.78–$256.37	—	23%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$145.39	$188.81	$41.27–$183.15	57% above	23%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL 80061	$145.39	$188.81	$41.27–$183.15	57% above	23%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL 80061	$145.39	$188.81	$41.27–$183.15	—	23%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$145.39	$188.81	$41.27–$183.15	—	23%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$135.47	$175.93	$38.46–$170.65	63% above	23%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025	$135.47	$175.93	$38.46–$170.65	63% above	23%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC 85025	$135.47	$175.93	$38.46–$170.65	—	23%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$135.47	$175.93	$38.46–$170.65	—	23%
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027	$116.40	$151.16	$33.04–$146.63	77% above	23%
Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED	$116.40	$151.16	$33.04–$146.63	77% above	23%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED	$116.40	$151.16	$33.04–$146.63	—	23%
Complete blood count (CBC), no differential inpatient CPT 85027 BLOOD COUNT COMPLETE AUTOMATED 85027	$116.40	$151.16	$33.04–$146.63	—	23%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL	$215.99	$280.50	$61.32–$272.09	129% above	23%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053	$215.99	$280.50	$61.32–$272.09	129% above	23%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL	$215.99	$280.50	$61.32–$272.09	—	23%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL 80053	$215.99	$280.50	$61.32–$272.09	—	23%
D-dimer blood test (blood clot marker) CPT 85379 D DIMER PLASMA 85379.901	$71.17	$92.42	$20.20–$89.65	28% below	23%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379	$155.45	$201.88	$44.13–$195.82	57% above	23%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANTITATIVE	$155.45	$201.88	$44.13–$195.82	57% above	23%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D DIMER PLASMA 85379.901	$71.17	$92.42	$20.20–$89.65	—	23%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANTITATIVE	$155.45	$201.88	$44.13–$195.82	—	23%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION PRODUCTS D-DIMER QUANT 85379	$155.45	$201.88	$44.13–$195.82	—	23%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE 82627	$188.70	$245.06	$53.57–$237.71	227% above	23%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE BY IMMUNOASY	$188.70	$245.06	$53.57–$237.71	227% above	23%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE BY IMMUNOASY	$188.70	$245.06	$53.57–$237.71	—	23%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE 82627	$188.70	$245.06	$53.57–$237.71	—	23%
Estradiol blood test CPT 82670 ESTRADIOL (E2) SERUM	$208.61	$270.92	$59.22–$262.79	216% above	23%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL 82670	$208.61	$270.92	$59.22–$262.79	216% above	23%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL 82670	$208.61	$270.92	$59.22–$262.79	—	23%
Estradiol blood test inpatient CPT 82670 ESTRADIOL (E2) SERUM	$208.61	$270.92	$59.22–$262.79	—	23%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001	$202.77	$263.33	$57.56–$255.43	187% above	23%
FSH (follicle-stimulating hormone) test CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH)	$202.77	$263.33	$57.56–$255.43	187% above	23%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH) 83001	$202.77	$263.33	$57.56–$255.43	—	23%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 GONADOTROPIN FOLLICLE STIMULATING HORMONE (FSH)	$202.77	$263.33	$57.56–$255.43	—	23%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN 83993	$381.31	$495.20	$108.25–$480.34	353% above	23%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN STOOL	$381.31	$495.20	$108.25–$480.34	353% above	23%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN 83993	$381.31	$495.20	$108.25–$480.34	—	23%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN STOOL	$381.31	$495.20	$108.25–$480.34	—	23%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN 82728	$188.74	$245.11	$53.58–$237.76	111% above	23%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$188.74	$245.11	$53.58–$237.76	111% above	23%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$188.74	$245.11	$53.58–$237.76	—	23%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN 82728	$188.74	$245.11	$53.58–$237.76	—	23%
Folate (folic acid) blood test CPT 82746 FOLATE 82746	$213.42	$277.16	$60.59–$268.85	167% above	23%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$213.42	$277.16	$60.59–$268.85	167% above	23%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE 82746	$213.42	$277.16	$60.59–$268.85	—	23%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$213.42	$277.16	$60.59–$268.85	—	23%
Free T3 thyroid hormone test CPT 84481 T3 FREE 84481	$174.56	$226.70	$49.56–$219.90	70% above	23%
Free T3 thyroid hormone test CPT 84481 FREE T3	$174.56	$226.70	$49.56–$219.90	70% above	23%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE 84481	$174.56	$226.70	$49.56–$219.90	—	23%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$174.56	$226.70	$49.56–$219.90	—	23%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE 84439	$90.53	$117.56	$25.70–$114.03	33% above	23%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$90.53	$117.56	$25.70–$114.03	33% above	23%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE 84439	$90.53	$117.56	$25.70–$114.03	—	23%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$90.53	$117.56	$25.70–$114.03	—	23%
Free testosterone test CPT 84402 TESTOSTERONE FREE MEASURED	$90.53	$117.56	$25.70–$114.03	45% above	23%
Free testosterone test CPT 84402 TESTOSTERONE FREE MEASURED 84402.901	$90.53	$117.56	$25.70–$114.03	45% above	23%
Free testosterone test CPT 84402 TESTOSTERONE FREE 84402.900	$92.80	$120.51	$26.34–$116.89	49% above	23%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE MEASURED	$90.53	$117.56	$25.70–$114.03	—	23%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE MEASURED 84402.901	$90.53	$117.56	$25.70–$114.03	—	23%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE 84402.900	$92.80	$120.51	$26.34–$116.89	—	23%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$460.58	$598.15	$130.76–$580.21	86% above	23%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$460.58	$598.15	$130.76–$580.21	—	23%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950	$56.29	$73.10	$15.98–$70.91	34% above	23%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE GESTATIONAL DIAB	$56.29	$73.10	$15.98–$70.91	34% above	23%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE POST GLUCOSE DOSE	$56.29	$73.10	$15.98–$70.91	34% above	23%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE GESTATIONAL DIAB	$56.29	$73.10	$15.98–$70.91	—	23%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE	$56.29	$73.10	$15.98–$70.91	—	23%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE POST GLUCOSE DOSE 82950	$56.29	$73.10	$15.98–$70.91	—	23%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE 1 HOUR	$76.90	$99.87	$21.83–$96.87	20% below	23%
Glucose tolerance test, 3 samples CPT 82951 LACTOSE TOLERANCE	$97.57	$126.71	$27.70–$122.91	2% above	23%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL 2 HR 82951	$97.57	$126.71	$27.70–$122.91	2% above	23%
Glucose tolerance test, 3 samples CPT 82951 GLUC GEST DIABETES TOL 3HR	$203.08	$263.74	$57.65–$255.83	111% above	23%
Glucose tolerance test, 3 samples CPT 82951 GLUC TOL 3 SPEC & DOSE 82951	$203.08	$263.74	$57.65–$255.83	111% above	23%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE 1 HOUR	$76.90	$99.87	$21.83–$96.87	—	23%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL 2 HR 82951	$97.57	$126.71	$27.70–$122.91	—	23%
Glucose tolerance test, 3 samples inpatient CPT 82951 LACTOSE TOLERANCE	$97.57	$126.71	$27.70–$122.91	—	23%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUC GEST DIABETES TOL 3HR	$203.08	$263.74	$57.65–$255.83	—	23%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUC TOL 3 SPEC & DOSE 82951	$203.08	$263.74	$57.65–$255.83	—	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT 87591.901	$192.39	$249.85	$54.62–$242.35	128% above	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE	$192.39	$249.85	$54.62–$242.35	128% above	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591	$192.39	$249.85	$54.62–$242.35	128% above	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT	$192.39	$249.85	$54.62–$242.35	128% above	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT 87591.901	$192.39	$249.85	$54.62–$242.35	—	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE	$192.39	$249.85	$54.62–$242.35	—	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE NUCLEIC ACID DETECT	$192.39	$249.85	$54.62–$242.35	—	23%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 INFECT AGNT NUCLEIC ACID DNA RNA NEISSERIA GONORRHOEAE AMPLIF PROBE 87591	$192.39	$249.85	$54.62–$242.35	—	23%
H. pylori stool antigen test CPT 87338 H PYLORI ANTIGEN STOOL	$217.08	$281.92	$61.63–$273.46	101% above	23%
H. pylori stool antigen test CPT 87338 H PYLORI AG STOOL 87338	$217.08	$281.92	$61.63–$273.46	101% above	23%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG STOOL 87338	$217.08	$281.92	$61.63–$273.46	—	23%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI ANTIGEN STOOL	$217.08	$281.92	$61.63–$273.46	—	23%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475	$349.44	$453.81	$99.20–$440.20	452% above	23%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 AG WHIV-1 & HIV-2 AB 87389/G0475	$349.44	$453.81	$99.20–$440.20	—	23%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV MRNA E6E7 VAGINAL REFLEX HPV 16/18/45 87624.901	$153.08	$198.80	$43.46–$192.84	19% above	23%
HPV test for high-risk types, one combined (pooled) result CPT 87624 INFECT AGNT DNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$258.73	$336.01	$73.45–$325.93	101% above	23%
HPV test for high-risk types, one combined (pooled) result CPT 87624 INFECT AGNT DNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES 87624	$258.73	$336.01	$73.45–$325.93	101% above	23%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV MRNA E6E7 VAGINAL REFLEX HPV 16/18/45 87624.901	$153.08	$198.80	$43.46–$192.84	—	23%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 INFECT AGNT DNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES 87624	$258.73	$336.01	$73.45–$325.93	—	23%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 INFECT AGNT DNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES	$258.73	$336.01	$73.45–$325.93	—	23%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$145.67	$189.17	$41.35–$183.49	153% above	23%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036	$145.67	$189.17	$41.35–$183.49	153% above	23%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$145.67	$189.17	$41.35–$183.49	—	23%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C 83036	$145.67	$189.17	$41.35–$183.49	—	23%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB)	$106.57	$138.40	$30.25–$134.25	62% above	23%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706	$106.57	$138.40	$30.25–$134.25	62% above	23%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB) 86706	$106.57	$138.40	$30.25–$134.25	—	23%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY (HBSAB)	$106.57	$138.40	$30.25–$134.25	—	23%
Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340	$102.60	$133.24	$29.13–$129.24	92% above	23%
Hepatitis B surface antigen (HBsAg) test CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN	$102.60	$133.24	$29.13–$129.24	92% above	23%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN	$102.60	$133.24	$29.13–$129.24	—	23%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 INFECT AGNT ATGN DETECT IA HEPATITIS B SURFACE ANTIGEN 87340	$102.60	$133.24	$29.13–$129.24	—	23%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$165.98	$215.55	$47.12–$209.08	108% above	23%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY 86803	$165.98	$215.55	$47.12–$209.08	108% above	23%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$165.98	$215.55	$47.12–$209.08	—	23%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY 86803	$165.98	$215.55	$47.12–$209.08	—	23%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522	$307.79	$399.72	$87.38–$387.73	148% above	23%
Hepatitis C viral load (HCV RNA) test CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT	$307.79	$399.72	$87.38–$387.73	148% above	23%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT	$307.79	$399.72	$87.38–$387.73	—	23%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 INFECT AGNT DETECT NUC ACID HEP C QUANT 87522	$307.79	$399.72	$87.38–$387.73	—	23%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES TYPE 1 IGG	$128.83	$167.31	$36.57–$162.29	178% above	23%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLX VIR1 IGG 86695	$128.83	$167.31	$36.57–$162.29	178% above	23%
Herpes blood test, HSV-1 antibody CPT 86695 HSV TYPES 1 AND 2	$128.83	$167.31	$36.57–$162.29	178% above	23%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLX VIR1 IGG 86695	$128.83	$167.31	$36.57–$162.29	—	23%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV TYPES 1 AND 2	$128.83	$167.31	$36.57–$162.29	—	23%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES TYPE 1 IGG	$128.83	$167.31	$36.57–$162.29	—	23%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 IGG	$122.90	$159.60	$34.89–$154.81	113% above	23%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SMPLX VIR 2 IGG 86696	$122.90	$159.60	$34.89–$154.81	113% above	23%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES TYPE 2 IGG	$122.90	$159.60	$34.89–$154.81	113% above	23%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES TYPE 2 IGG	$122.90	$159.60	$34.89–$154.81	—	23%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 IGG	$122.90	$159.60	$34.89–$154.81	—	23%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SMPLX VIR 2 IGG 86696	$122.90	$159.60	$34.89–$154.81	—	23%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HISEN 86141	$124.16	$161.24	$35.25–$156.40	75% above	23%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HISEN 86141	$124.16	$161.24	$35.25–$156.40	—	23%
Homocysteine blood test CPT 83090 CDMR HOMOCYSTINE 83090	$156.46	$203.19	$44.42–$197.09	74% above	23%
Homocysteine blood test CPT 83090 CDMR HOMOCYSTINE	$156.46	$203.19	$44.42–$197.09	74% above	23%
Homocysteine blood test inpatient CPT 83090 CDMR HOMOCYSTINE 83090	$156.46	$203.19	$44.42–$197.09	—	23%
Homocysteine blood test inpatient CPT 83090 CDMR HOMOCYSTINE	$156.46	$203.19	$44.42–$197.09	—	23%
Insulin blood test CPT 83525 INSULIN LEVEL	$58.43	$75.88	$16.59–$73.60	7% above	23%
Insulin blood test CPT 83525 INSULIN LEVEL 83525	$58.43	$75.88	$16.59–$73.60	7% above	23%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL 83525	$58.43	$75.88	$16.59–$73.60	—	23%
Insulin blood test inpatient CPT 83525 INSULIN LEVEL	$58.43	$75.88	$16.59–$73.60	—	23%
Iron blood test (serum iron) CPT 83540 IRON 83540	$84.27	$109.43	$23.92–$106.15	64% above	23%
Iron blood test (serum iron) CPT 83540 IRON	$84.27	$109.43	$23.92–$106.15	64% above	23%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$84.27	$109.43	$23.92–$106.15	—	23%
Iron blood test (serum iron) inpatient CPT 83540 IRON 83540	$84.27	$109.43	$23.92–$106.15	—	23%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$137.17	$178.14	$38.94–$172.80	112% above	23%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY 83550	$137.17	$178.14	$38.94–$172.80	112% above	23%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$137.17	$178.14	$38.94–$172.80	—	23%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY 83550	$137.17	$178.14	$38.94–$172.80	—	23%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL 80069	$152.30	$197.79	$43.24–$191.86	44% above	23%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$152.30	$197.79	$43.24–$191.86	44% above	23%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$152.30	$197.79	$43.24–$191.86	—	23%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL 80069	$152.30	$197.79	$43.24–$191.86	—	23%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH)	$138.86	$180.33	$39.42–$174.92	71% above	23%
LH (luteinizing hormone) test CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002	$138.86	$180.33	$39.42–$174.92	71% above	23%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH) 83002	$138.86	$180.33	$39.42–$174.92	—	23%
LH (luteinizing hormone) test inpatient CPT 83002 GONADOTROPIN LUTEINIZING HORMONE (LH)	$138.86	$180.33	$39.42–$174.92	—	23%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE 83690	$111.75	$145.12	$31.72–$140.77	89% above	23%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$111.75	$145.12	$31.72–$140.77	89% above	23%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE 83690	$111.75	$145.12	$31.72–$140.77	—	23%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$111.75	$145.12	$31.72–$140.77	—	23%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$132.68	$172.31	$37.67–$167.14	30% above	23%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL 80076	$132.68	$172.31	$37.67–$167.14	30% above	23%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$132.68	$172.31	$37.67–$167.14	—	23%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL 80076	$132.68	$172.31	$37.67–$167.14	—	23%
Lyme disease antibody test CPT 86618 LYME DISEASE SEROLOGY SERUM 86618.902	$66.33	$86.13	$18.83–$83.55	3% above	23%
Lyme disease antibody test CPT 86618 LYMES TOTAL 86618	$259.14	$336.54	$73.57–$326.44	301% above	23%
Lyme disease antibody test CPT 86618 LYMES DISEASE ANTIBODY REFLEX TO CONFIRMATION	$259.14	$336.54	$73.57–$326.44	301% above	23%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE SEROLOGY SERUM 86618.902	$66.33	$86.13	$18.83–$83.55	—	23%
Lyme disease antibody test inpatient CPT 86618 LYMES DISEASE ANTIBODY REFLEX TO CONFIRMATION	$259.14	$336.54	$73.57–$326.44	—	23%
Lyme disease antibody test inpatient CPT 86618 LYMES TOTAL 86618	$259.14	$336.54	$73.57–$326.44	—	23%
Magnesium blood test CPT 83735 MAGNESIUM RBC SO 83735.900	$43.66	$56.70	$12.39–$55.00	40% above	23%
Magnesium blood test CPT 83735 MAGNESIUM	$97.02	$126.00	$27.54–$122.22	211% above	23%
Magnesium blood test CPT 83735 MAGNESIUM 83735	$97.02	$126.00	$27.54–$122.22	211% above	23%
Magnesium blood test inpatient CPT 83735 MAGNESIUM RBC SO 83735.900	$43.66	$56.70	$12.39–$55.00	—	23%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 83735	$97.02	$126.00	$27.54–$122.22	—	23%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$97.02	$126.00	$27.54–$122.22	—	23%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA 86765	$38.23	$49.64	$10.85–$48.15	5% above	23%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$38.23	$49.64	$10.85–$48.15	5% above	23%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA 86765	$38.23	$49.64	$10.85–$48.15	—	23%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$38.23	$49.64	$10.85–$48.15	—	23%
Mono test (heterophile antibody, Monospot) CPT 86308 INFECTIOUS MONONUCLEOSIS	$102.60	$133.24	$29.13–$129.24	100% above	23%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOSCREEN 86308	$102.60	$133.24	$29.13–$129.24	100% above	23%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 INFECTIOUS MONONUCLEOSIS	$102.60	$133.24	$29.13–$129.24	—	23%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSCREEN 86308	$102.60	$133.24	$29.13–$129.24	—	23%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE 84154	$92.34	$119.91	$26.21–$116.31	157% above	23%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE 84154	$92.34	$119.91	$26.21–$116.31	—	23%
PSA (prostate-specific antigen) blood test, total CPT 84153 CDMR ASSAY OF PSA TOTAL	$165.98	$215.55	$47.12–$209.08	106% above	23%
PSA (prostate-specific antigen) blood test, total CPT 84153 CDMR ASSAY OF PSA TOTAL 84153	$165.98	$215.55	$47.12–$209.08	106% above	23%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CDMR ASSAY OF PSA TOTAL	$165.98	$215.55	$47.12–$209.08	—	23%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 CDMR ASSAY OF PSA TOTAL 84153	$165.98	$215.55	$47.12–$209.08	—	23%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTO CERV THN AUTO 88175	$188.78	$245.16	$53.59–$237.81	121% above	23%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTO CERV THN AUTO 88175	$188.78	$245.16	$53.59–$237.81	—	23%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTO CERV THN MAN 88142	$188.70	$245.06	$53.57–$237.71	144% above	23%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTO CERV THN MAN 88142	$188.70	$245.06	$53.57–$237.71	—	23%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT 83970	$228.27	$296.45	$64.80–$287.56	95% above	23%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT	$228.27	$296.45	$64.80–$287.56	95% above	23%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT	$228.27	$296.45	$64.80–$287.56	—	23%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT 83970	$228.27	$296.45	$64.80–$287.56	—	23%
Partial thromboplastin time (PTT) clotting test CPT 85730 ACTIVATED PARTIAL THROMBOL TIME, PLASMA 85730.901	$41.87	$54.37	$11.89–$52.74	29% below	23%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730	$114.71	$148.97	$32.56–$144.50	95% above	23%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT)	$114.71	$148.97	$32.56–$144.50	95% above	23%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 ACTIVATED PARTIAL THROMBOL TIME, PLASMA 85730.901	$41.87	$54.37	$11.89–$52.74	—	23%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT)	$114.71	$148.97	$32.56–$144.50	—	23%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730	$114.71	$148.97	$32.56–$144.50	—	23%
Progesterone blood test CPT 84144 PROGESTERONE	$153.81	$199.75	$43.67–$193.76	91% above	23%
Progesterone blood test CPT 84144 PROGESTERONE 84144	$153.81	$199.75	$43.67–$193.76	91% above	23%
Progesterone blood test inpatient CPT 84144 PROGESTERONE 84144	$153.81	$199.75	$43.67–$193.76	—	23%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$153.81	$199.75	$43.67–$193.76	—	23%
Prolactin blood test CPT 84146 MACROPROLACTIN 84146.900	$48.60	$63.11	$13.80–$61.22	26% below	23%
Prolactin blood test CPT 84146 PROLACTIN	$143.44	$186.28	$40.72–$180.69	120% above	23%
Prolactin blood test CPT 84146 PROLACTIN 84146	$143.44	$186.28	$40.72–$180.69	120% above	23%
Prolactin blood test inpatient CPT 84146 MACROPROLACTIN 84146.900	$48.60	$63.11	$13.80–$61.22	—	23%
Prolactin blood test inpatient CPT 84146 PROLACTIN 84146	$143.44	$186.28	$40.72–$180.69	—	23%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$143.44	$186.28	$40.72–$180.69	—	23%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT), PLASMA 85610.901	$29.31	$38.06	$8.32–$36.92	3% below	23%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME - PROTIME CLINIC 85610	$59.49	$77.25	$16.89–$74.93	96% above	23%
Prothrombin time (PT/INR) clotting test CPT 85610 PT INR FINGERSTICK-QW 85610	$92.82	$120.54	$26.35–$116.92	207% above	23%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$92.82	$120.54	$26.35–$116.92	207% above	23%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME (PT)	$92.82	$120.54	$26.35–$116.92	207% above	23%
Prothrombin time (PT/INR) clotting test CPT 85610 AD PROTIME INR	$92.82	$120.54	$26.35–$116.92	207% above	23%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME 85610	$92.82	$120.54	$26.35–$116.92	207% above	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT), PLASMA 85610.901	$29.31	$38.06	$8.32–$36.92	—	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME - PROTIME CLINIC 85610	$59.49	$77.25	$16.89–$74.93	—	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$92.82	$120.54	$26.35–$116.92	—	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 AD PROTIME INR	$92.82	$120.54	$26.35–$116.92	—	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME (PT)	$92.82	$120.54	$26.35–$116.92	—	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT INR FINGERSTICK-QW 85610	$92.82	$120.54	$26.35–$116.92	—	23%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME 85610	$92.82	$120.54	$26.35–$116.92	—	23%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305	$68.96	$89.55	$19.58–$86.86	18% above	23%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS	$77.59	$100.76	$22.03–$97.74	33% above	23%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS 80305	$68.96	$89.55	$19.58–$86.86	—	23%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCR PRESUMP DIRECT OPTICAL OBS	$77.59	$100.76	$22.03–$97.74	—	23%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 INFECTIOUS AGENT IMMUNOASSAY DIRECT OBSERVATION STREPOCOCCUS GROUP A	$72.28	$93.86	$20.52–$91.04	35% above	23%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RPD GROUP A STREP SCREEN 87880	$72.28	$93.86	$20.52–$91.04	35% above	23%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RPD GROUP A STREP SCREEN 87880	$72.28	$93.86	$20.52–$91.04	—	23%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 INFECTIOUS AGENT IMMUNOASSAY DIRECT OBSERVATION STREPOCOCCUS GROUP A	$72.28	$93.86	$20.52–$91.04	—	23%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR PANEL SERUM 86431.900	$58.69	$76.22	$16.66–$73.93	21% above	23%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANTITATIVE	$85.45	$110.97	$24.26–$107.64	76% above	23%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT 86431	$85.45	$110.97	$24.26–$107.64	76% above	23%
Rheumatoid factor (RF) test CPT 86431 RA FACTOR QUANT 86431	$85.45	$110.97	$24.26–$107.64	76% above	23%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR PANEL SERUM 86431.900	$58.69	$76.22	$16.66–$73.93	—	23%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANT 86431	$85.45	$110.97	$24.26–$107.64	—	23%
Rheumatoid factor (RF) test inpatient CPT 86431 RA FACTOR QUANTITATIVE	$85.45	$110.97	$24.26–$107.64	—	23%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT 86431	$85.45	$110.97	$24.26–$107.64	—	23%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA 86762	$110.25	$143.17	$31.30–$138.87	133% above	23%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB	$110.25	$143.17	$31.30–$138.87	133% above	23%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$110.25	$143.17	$31.30–$138.87	133% above	23%
Rubella antibody test (immunity check) CPT 86762 RUBELLA IGM AB 86762.903	$110.25	$143.17	$31.30–$138.87	133% above	23%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM AB	$110.25	$143.17	$31.30–$138.87	—	23%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA 86762	$110.25	$143.17	$31.30–$138.87	—	23%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$110.25	$143.17	$31.30–$138.87	—	23%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IGM AB 86762.903	$110.25	$143.17	$31.30–$138.87	—	23%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE RBC AUTOMATED	$98.94	$128.49	$28.09–$124.64	161% above	23%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SEDIMENTATION RATE RBC AUTOMATED 85652	$98.94	$128.49	$28.09–$124.64	161% above	23%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE RBC AUTOMATED 85652	$98.94	$128.49	$28.09–$124.64	—	23%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SEDIMENTATION RATE RBC AUTOMATED	$98.94	$128.49	$28.09–$124.64	—	23%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES	$140.59	$182.58	$39.91–$177.10	299% above	23%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES 87177	$140.59	$182.58	$39.91–$177.10	299% above	23%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES	$140.59	$182.58	$39.91–$177.10	—	23%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES 87177	$140.59	$182.58	$39.91–$177.10	—	23%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER 82270	$78.45	$101.88	$22.27–$98.82	122% above	23%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER 82270	$78.45	$101.88	$22.27–$98.82	—	23%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$106.53	$138.35	$30.24–$134.20	85% above	23%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274	$106.53	$138.35	$30.24–$134.20	85% above	23%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3	$106.53	$138.35	$30.24–$134.20	—	23%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 CDMR BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3 82274	$106.53	$138.35	$30.24–$134.20	—	23%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF 86592.903	$23.03	$29.90	$6.54–$29.00	22% below	23%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$78.45	$101.88	$22.27–$98.82	165% above	23%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592	$78.45	$101.88	$22.27–$98.82	165% above	23%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL CSF 86592.903	$23.03	$29.90	$6.54–$29.00	—	23%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL	$78.45	$101.88	$22.27–$98.82	—	23%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL 86592	$78.45	$101.88	$22.27–$98.82	—	23%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL MEDIATED IMMUNITY 86480	$69.25	$89.93	$19.66–$87.23	44% below	23%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL MEDIATED IMMUNITY 86480	$69.25	$89.93	$19.66–$87.23	—	23%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 84403.900	$74.99	$97.38	$21.29–$94.46	20% above	23%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 84403.901	$92.80	$120.51	$26.34–$116.89	48% above	23%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902	$174.39	$226.47	$49.51–$219.68	179% above	23%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TESTOSTERONE TOTAL	$174.39	$226.47	$49.51–$219.68	179% above	23%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL MEASURED	$174.39	$226.47	$49.51–$219.68	179% above	23%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403	$174.39	$226.47	$49.51–$219.68	179% above	23%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL 84403.904	$435.95	$566.16	$123.76–$549.18	597% above	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 84403.900	$74.99	$97.38	$21.29–$94.46	—	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 84403.901	$92.80	$120.51	$26.34–$116.89	—	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TESTOSTERONE TOTAL	$174.39	$226.47	$49.51–$219.68	—	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TESTOSTERONE TOTAL 84403	$174.39	$226.47	$49.51–$219.68	—	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL MEASURED 84403.902	$174.39	$226.47	$49.51–$219.68	—	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL MEASURED	$174.39	$226.47	$49.51–$219.68	—	23%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL 84403.904	$435.95	$566.16	$123.76–$549.18	—	23%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOME T1 AB SERUM 86376.900	$34.48	$44.77	$9.79–$43.43	35% below	23%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI-THYROID PEROX ABY	$117.88	$153.08	$33.46–$148.49	123% above	23%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTITHYROID AB ANTI TPO 86376	$117.88	$153.08	$33.46–$148.49	123% above	23%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER KIDNEY MICROSOME T1 AB SERUM 86376.900	$34.48	$44.77	$9.79–$43.43	—	23%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI-THYROID PEROX ABY	$117.88	$153.08	$33.46–$148.49	—	23%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTITHYROID AB ANTI TPO 86376	$117.88	$153.08	$33.46–$148.49	—	23%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH)	$122.24	$158.75	$34.70–$153.99	30% above	23%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443	$125.91	$163.51	$35.74–$158.60	34% above	23%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH)	$122.24	$158.75	$34.70–$153.99	—	23%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) 84443	$125.91	$163.51	$35.74–$158.60	—	23%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661	$146.81	$190.66	$41.68–$184.94	193% above	23%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION	$146.81	$190.66	$41.68–$184.94	193% above	23%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION 87661	$146.81	$190.66	$41.68–$184.94	—	23%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID DETECTION	$146.81	$190.66	$41.68–$184.94	—	23%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID 84550	$66.93	$86.92	$19.00–$84.31	54% above	23%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$66.93	$86.92	$19.00–$84.31	54% above	23%
Uric acid blood test CPT 84550 URIC ACID SERUM	$66.93	$86.92	$19.00–$84.31	54% above	23%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$66.93	$86.92	$19.00–$84.31	—	23%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID 84550	$66.93	$86.92	$19.00–$84.31	—	23%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM	$66.93	$86.92	$19.00–$84.31	—	23%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$61.67	$80.09	$17.51–$77.69	24% above	23%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE 81001	$61.67	$80.09	$17.51–$77.69	24% above	23%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$61.67	$80.09	$17.51–$77.69	—	23%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE 81001	$61.67	$80.09	$17.51–$77.69	—	23%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS DIP STICK TABLET REAGENT AUTOMATED WO MICROSCOPY	$35.99	$46.73	$10.22–$45.33	41% above	23%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS-DIPSTICK ONLY 81003	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated CPT 81003 URINE AUTO NO MICRO SGL ANALYT	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated CPT 81003 URINE PH	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS REFLEX MICRO	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS MACROSCOPIC	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated CPT 81003 SP GRAVITY U	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated CPT 81003 URINE KETONE	$55.83	$72.50	$15.85–$70.33	118% above	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS DIP STICK TABLET REAGENT AUTOMATED WO MICROSCOPY	$35.99	$46.73	$10.22–$45.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS MACROSCOPIC	$55.83	$72.50	$15.85–$70.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 SP GRAVITY U	$55.83	$72.50	$15.85–$70.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS-DIPSTICK ONLY 81003	$55.83	$72.50	$15.85–$70.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE AUTO NO MICRO SGL ANALYT	$55.83	$72.50	$15.85–$70.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS REFLEX MICRO	$55.83	$72.50	$15.85–$70.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE KETONE	$55.83	$72.50	$15.85–$70.33	—	23%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINE PH	$55.83	$72.50	$15.85–$70.33	—	23%
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086	$112.79	$146.48	$32.02–$142.09	105% above	23%
Urine culture for bacteria, with colony count CPT 87086 CULTURE BACTERIAL QUANTITATIVE COLONY COUNT URINE	$112.79	$146.48	$32.02–$142.09	105% above	23%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE 87086	$112.79	$146.48	$32.02–$142.09	—	23%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE BACTERIAL QUANTITATIVE COLONY COUNT URINE	$112.79	$146.48	$32.02–$142.09	—	23%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST 81025	$92.82	$120.54	$26.35–$116.92	139% above	23%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$92.82	$120.54	$26.35–$116.92	139% above	23%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$92.82	$120.54	$26.35–$116.92	—	23%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST 81025	$92.82	$120.54	$26.35–$116.92	—	23%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607	$211.09	$274.14	$59.93–$265.92	138% above	23%
Vitamin B12 (cobalamin) blood test CPT 82607 CYANOCOBALAMIN VITAMIN B-12	$211.09	$274.14	$59.93–$265.92	138% above	23%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN VITAMIN B-12 82607	$211.09	$274.14	$59.93–$265.92	—	23%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 CYANOCOBALAMIN VITAMIN B-12	$211.09	$274.14	$59.93–$265.92	—	23%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CALCIFEDIOL (25-OH VITAMIN D-3) 82306.900	$157.28	$204.25	$44.65–$198.12	62% above	23%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CDMR VITAMIN D 25 HYDROXY 82306	$236.73	$307.44	$67.21–$298.22	144% above	23%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 CDMR VITAMIN D 25 HYDROXY	$236.73	$307.44	$67.21–$298.22	144% above	23%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CALCIFEDIOL (25-OH VITAMIN D-3) 82306.900	$157.28	$204.25	$44.65–$198.12	—	23%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CDMR VITAMIN D 25 HYDROXY 82306	$236.73	$307.44	$67.21–$298.22	—	23%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 CDMR VITAMIN D 25 HYDROXY	$236.73	$307.44	$67.21–$298.22	—	23%
Zinc blood test CPT 84630 ZINC	$147.04	$190.95	$41.74–$185.22	389% above	23%
Zinc blood test CPT 84630 ZINC 84630.900	$147.04	$190.95	$41.74–$185.22	389% above	23%
Zinc blood test inpatient CPT 84630 ZINC	$147.04	$190.95	$41.74–$185.22	—	23%
Zinc blood test inpatient CPT 84630 ZINC 84630.900	$147.04	$190.95	$41.74–$185.22	—	23%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE SERUM 84702.900	$24.11	$31.31	$6.84–$30.37	74% below	23%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE	$181.73	$236.01	$51.59–$228.93	97% above	23%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702	$181.73	$236.01	$51.59–$228.93	97% above	23%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG QUANTITATIVE SERUM 84702.900	$24.11	$31.31	$6.84–$30.37	—	23%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE 84702	$181.73	$236.01	$51.59–$228.93	—	23%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC HCG QUANTITATIVE	$181.73	$236.01	$51.59–$228.93	—	23%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY RUPTURED APPENDIX WABSCESS GENERALIZED PERITONITIS	$3,001.00	$3,897.39	$851.97–$3,780.47	84% above	23%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY RUPTURED APPENDIX WABSCESS GENERALIZED PERITONITIS	$3,001.00	$3,897.39	$851.97–$3,780.47	—	23%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$2,103.10	$2,731.29	$597.06–$2,649.35	69% above	23%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$2,103.10	$2,731.29	$597.06–$2,649.35	—	23%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY SHLDR SURGICAL WROTATOR CUFF RPR	$5,596.32	$7,267.94	$1,588.77–$7,049.90	118% above	23%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY SHLDR SURGICAL WROTATOR CUFF RPR	$5,596.32	$7,267.94	$1,588.77–$7,049.90	—	23%
Botox injections for chronic migraine CPT 64615 CHEMODENERV MUSC MIGRAINE	$668.97	$868.79	$189.92–$842.73	10% above	23%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERV MUSC MIGRAINE	$668.97	$868.79	$189.92–$842.73	—	23%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 ED 27786 CLSD TX ANKLE FX WO MANIP	$290.83	$377.69	$82.56–$366.36	38% below	23%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLOSED TREAT DISTAL FIBULAR FX (LAT MALLEOLUS) WO MANIP	$678.57	$881.25	$192.64–$854.81	45% above	23%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 ED 27786 CLSD TX ANKLE FX WO MANIP	$290.83	$377.69	$82.56–$366.36	—	23%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLOSED TREAT DISTAL FIBULAR FX (LAT MALLEOLUS) WO MANIP	$678.57	$881.25	$192.64–$854.81	—	23%
Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 CORRECT HALLUX VALGUS W BUNION SESAMOID DIST METATAR OSTEO	$2,199.71	$2,856.76	$624.49–$2,771.06	34% above	23%
Bunion correction with a bone cut near the head of the first metatarsal inpatient CPT 28296 CORRECT HALLUX VALGUS W BUNION SESAMOID DIST METATAR OSTEO	$2,199.71	$2,856.76	$624.49–$2,771.06	—	23%
Bunion correction with removal of part of the big toe joint CPT 28292 CORRECT HALLUX VALGUS W BUNION SESAMOID PROX PHAL BASE	$2,830.24	$3,675.63	$803.49–$3,565.36	94% above	23%
Bunion correction with removal of part of the big toe joint inpatient CPT 28292 CORRECT HALLUX VALGUS W BUNION SESAMOID PROX PHAL BASE	$2,830.24	$3,675.63	$803.49–$3,565.36	—	23%
Cardioversion, elective (restoring heart rhythm) CPT 92960 ED 92960 CARDIOVERSION	$191.30	$248.44	$54.31–$240.99	81% below	23%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE EXTERNAL	$446.31	$579.62	$126.70–$562.23	57% below	23%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 ED 92960 CARDIOVERSION	$191.30	$248.44	$54.31–$240.99	—	23%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE EXTERNAL	$446.31	$579.62	$126.70–$562.23	—	23%
Carpal tunnel release, open surgery CPT 64721 NEUROPLASTY & OR TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL	$2,572.41	$3,340.79	$730.30–$3,240.57	76% above	23%
Carpal tunnel release, open surgery inpatient CPT 64721 NEUROPLASTY & OR TRANSPOSITION MEDIAN NERVE AT CARPAL TUNNEL	$2,572.41	$3,340.79	$730.30–$3,240.57	—	23%
Cervical biopsy CPT 57500 BX EXC CERVIX LESN WWO FULGURATION (SEP PROC)	$430.13	$558.61	$122.11–$541.85	at median	23%
Cervical biopsy inpatient CPT 57500 BX EXC CERVIX LESN WWO FULGURATION (SEP PROC)	$430.13	$558.61	$122.11–$541.85	—	23%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION SURGICAL EXC OTHR THN CLAMP DEVICE DORSL SLIT EXCPT NWBRN	$879.65	$1,142.40	$249.73–$1,108.13	36% below	23%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION SURGICAL EXC OTHR THN CLAMP DEVICE DORSL SLIT EXCPT NWBRN	$879.65	$1,142.40	$249.73–$1,108.13	—	23%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION W REGIONAL BLOCK	$150.65	$195.64	$42.77–$189.77	38% below	23%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION USING CLAMP OTHER DEVICE NEWBORN	$502.19	$652.19	$142.57–$632.62	106% above	23%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION W REGIONAL BLOCK	$150.65	$195.64	$42.77–$189.77	—	23%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION USING CLAMP OTHER DEVICE NEWBORN	$502.19	$652.19	$142.57–$632.62	—	23%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX	$293.21	$380.78	$83.24–$369.36	41% below	23%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLOSED TREAT DISTAL RADIAL FX EPIPHYSEAL SEPARATION WO MANIP	$684.07	$888.39	$194.20–$861.74	39% above	23%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 ED 25600 CLSD TX DISTAL RADIAL FX	$293.21	$380.78	$83.24–$369.36	—	23%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLOSED TREAT DISTAL RADIAL FX EPIPHYSEAL SEPARATION WO MANIP	$684.07	$888.39	$194.20–$861.74	—	23%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY FLEXIBLE WREMVL LESN SNARE	$1,808.34	$2,348.49	$513.38–$2,278.04	45% above	23%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY FLEXIBLE WREMVL LESN SNARE	$1,808.34	$2,348.49	$513.38–$2,278.04	—	23%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE WBX SNGL MULTIPLE	$1,561.79	$2,028.29	$443.38–$1,967.44	24% above	23%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE WBX SNGL MULTIPLE	$1,561.79	$2,028.29	$443.38–$1,967.44	—	23%
Colonoscopy, diagnostic CPT 45378 COLONOSCPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE DX WWO SPECIMENS COLO	$1,359.07	$1,765.02	$385.83–$1,712.07	13% above	23%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCPY FLEXIBLE PROXIMAL TO SPLENIC FLEXURE DX WWO SPECIMENS COLO	$1,359.07	$1,765.02	$385.83–$1,712.07	—	23%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 COLPOSCPY CERVIX WUPR ADJ VAGINA WBIOPSY CERVIX & ENDOCERVIC CURETT	$569.13	$739.12	$161.57–$716.95	4% above	23%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454 COLPOSCPY CERVIX WUPR ADJ VAGINA WBIOPSY CERVIX & ENDOCERVIC CURETT	$569.13	$739.12	$161.57–$716.95	—	23%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURETTAGE DX & OR THERAPEUTIC (NONOBSTETRICAL)	$959.23	$1,245.75	$272.32–$1,208.38	34% below	23%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURETTAGE DX & OR THERAPEUTIC (NONOBSTETRICAL)	$959.23	$1,245.75	$272.32–$1,208.38	—	23%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCT PREMALIG LESNS EXCPT SKIN TAGS CUTANEOUS VASC PROLIFERAT LESN	$250.82	$325.74	$71.21–$315.97	39% above	23%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCT PREMALIG LESNS EXCPT SKIN TAGS CUTANEOUS VASC PROLIFERAT LESN	$250.82	$325.74	$71.21–$315.97	—	23%
Earwax removal by irrigation (rinsing), one ear CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI	$29.99	$38.94	$8.51–$37.77	61% below	23%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL	$29.99	$38.94	$8.51–$37.77	61% below	23%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 PF 69209 RMVL IMPACTED CERUMEN IRR LAVAGE UNILATERAL	$29.99	$38.94	$8.51–$37.77	61% below	23%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 ED 69209 RMVL IMPACTED CERUMEN IRRIGATION LAVAGE UNI	$29.99	$38.94	$8.51–$37.77	—	23%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 PF 69209 RMVL IMPACTED CERUMEN IRR LAVAGE UNILATERAL	$29.99	$38.94	$8.51–$37.77	—	23%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVAL IMPACTED CERUMEN USING IRRIGATION/LAVAGE, UNILATERAL	$29.99	$38.94	$8.51–$37.77	—	23%
Earwax removal with instruments, one ear CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI	$23.77	$30.87	$6.75–$29.94	81% below	23%
Earwax removal with instruments, one ear one side CPT 69210 REMVL IMPACTED CERUMEN (SEP PROC) UNILATERAL	$79.28	$102.96	$22.51–$99.87	36% below	23%
Earwax removal with instruments, one ear inpatient CPT 69210 ED 69210 REMV IMPACTED EAR WAX INSTRUMENT UNI	$23.77	$30.87	$6.75–$29.94	—	23%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMVL IMPACTED CERUMEN (SEP PROC) UNILATERAL	$79.28	$102.96	$22.51–$99.87	—	23%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BX WWO ENDOCERVICAL BX WO DILATION ANY METH (SEP PROC)	$344.19	$446.99	$97.71–$433.58	39% above	23%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BX WWO ENDOCERVICAL BX WO DILATION ANY METH (SEP PROC)	$344.19	$446.99	$97.71–$433.58	—	23%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 TX RM 62321 INJ IL NDL CATH CERV THOR W GUID	$1,391.10	$1,806.62	$394.93–$1,752.42	41% above	23%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 SURG 62321 INJ IL NDL CATH CERV THOR W GUID	$2,298.34	$2,984.85	$652.49–$2,895.30	132% above	23%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 TX RM 62321 INJ IL NDL CATH CERV THOR W GUID	$1,391.10	$1,806.62	$394.93–$1,752.42	—	23%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 SURG 62321 INJ IL NDL CATH CERV THOR W GUID	$2,298.34	$2,984.85	$652.49–$2,895.30	—	23%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 TX RM 64493 INJ FACET JNT LUM SACRAL 1 LVL	$947.76	$1,230.85	$269.06–$1,193.92	32% below	23%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 SURG 64493 INJ DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$2,231.40	$2,897.92	$633.49–$2,810.98	61% above	23%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 TX RM 64493 INJ FACET JNT LUM SACRAL 1 LVL	$947.76	$1,230.85	$269.06–$1,193.92	—	23%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 SURG 64493 INJ DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL	$2,231.40	$2,897.92	$633.49–$2,810.98	—	23%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$1,754.83	$2,279.00	$498.19–$2,210.63	13% above	23%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 RPR AA HERNIA 1ST 3-10 CM REDUCIBLE	$1,754.83	$2,279.00	$498.19–$2,210.63	—	23%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$5,343.80	$6,939.99	$1,517.08–$6,731.79	249% above	23%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 RPR AA HERNIA 1ST < 3 CM REDUCIBLE	$5,343.80	$6,939.99	$1,517.08–$6,731.79	—	23%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX WWO SPECIMENS BRUSHING WASHING(SEP PROC)	$441.98	$574.00	$125.48–$556.78	48% below	23%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 SIGMOIDOSCOPY FLEXIBLE DX WWO SPECIMENS BRUSHING WASHING(SEP PROC)	$441.98	$574.00	$125.48–$556.78	—	23%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$3,563.03	$4,627.31	$1,011.53–$4,488.49	115% above	23%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY	$3,563.03	$4,627.31	$1,011.53–$4,488.49	—	23%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY WCHOLANGIOGRAPHY	$2,107.23	$2,736.65	$598.23–$2,654.55	5% above	23%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAPAROSCOPY SURGICAL CHOLECYSTECTOMY WCHOLANGIOGRAPHY	$2,107.23	$2,736.65	$598.23–$2,654.55	—	23%
Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE	$2,272.72	$2,951.58	$645.22–$2,863.03	3% below	23%
Hammertoe correction surgery inpatient CPT 28285 CORRECTION HAMMERTOE	$2,272.72	$2,951.58	$645.22–$2,863.03	—	23%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOIDECTOMY SMPL LIGATURE	$1,179.12	$1,531.32	$334.75–$1,485.38	45% above	23%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOIDECTOMY SMPL LIGATURE	$1,179.12	$1,531.32	$334.75–$1,485.38	—	23%
Hysterectomy through an abdominal incision (total) CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY WWO REMVL TUBE(S) OVARY(S)	$3,331.76	$4,326.96	$945.87–$4,197.15	52% above	23%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 TOTAL ABDOMINAL HYSTERECTOMY WWO REMVL TUBE(S) OVARY(S)	$3,331.76	$4,326.96	$945.87–$4,197.15	—	23%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 CATHIZATION & INTRODUCTION SALINE INFUSION SONOHYSTEROGRAPHY HYSTEROSA	$448.05	$581.88	$127.20–$564.42	48% above	23%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 SURG 58340 HYSTERO INJ CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$1,427.07	$1,853.33	$405.14–$1,797.73	371% above	23%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 CATHIZATION & INTRODUCTION SALINE INFUSION SONOHYSTEROGRAPHY HYSTEROSA	$448.05	$581.88	$127.20–$564.42	—	23%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 SURG 58340 HYSTERO INJ CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI	$1,427.07	$1,853.33	$405.14–$1,797.73	—	23%
Hysteroscopy with endometrial ablation CPT 58563 HYSTEROSCOPY SURGICAL WENDOMETRIAL ABLATION	$2,003.43	$2,601.85	$568.76–$2,523.79	40% below	23%
Hysteroscopy with endometrial ablation inpatient CPT 58563 HYSTEROSCOPY SURGICAL WENDOMETRIAL ABLATION	$2,003.43	$2,601.85	$568.76–$2,523.79	—	23%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY SURGICAL WENDOMETRIAL BX & OR POLYPECTOMY WWO D&C	$582.57	$756.58	$165.39–$733.88	74% below	23%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558 HYSTEROSCOPY SURGICAL WENDOMETRIAL BX & OR POLYPECTOMY WWO D&C	$582.57	$756.58	$165.39–$733.88	—	23%
IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE	$355.34	$461.47	$100.88–$447.63	40% above	23%
IUD insertion (the device itself billed separately) inpatient CPT 58300 INSERT INTRAUTERINE DEVICE	$355.34	$461.47	$100.88–$447.63	—	23%
Incision and drainage of a simple or single skin abscess CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL	$104.61	$135.85	$29.70–$131.77	64% below	23%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION & DRAINAGE ABSCESS SMPL SNGL	$348.61	$452.74	$98.97–$439.16	21% above	23%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ED 10060 I&D SKIN ABSCESS SMPL	$104.61	$135.85	$29.70–$131.77	—	23%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION & DRAINAGE ABSCESS SMPL SNGL	$348.61	$452.74	$98.97–$439.16	—	23%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR INITIAL INGUINAL HERNIA AGE 5+ REDUCIBLE	$2,019.81	$2,623.12	$573.41–$2,544.43	16% above	23%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR INITIAL INGUINAL HERNIA AGE 5+ REDUCIBLE	$2,019.81	$2,623.12	$573.41–$2,544.43	—	23%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ(S) SNGL TENDON SHEATH LIG APONEUROSIS	$246.67	$320.34	$70.03–$310.73	33% below	23%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ(S) SNGL TENDON SHEATH LIG APONEUROSIS	$246.67	$320.34	$70.03–$310.73	—	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID	$64.79	$84.14	$18.39–$81.62	82% below	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENT ASP INJ MAJOR JOINT BURSA WO US GUID	$215.94	$280.44	$61.30–$272.03	41% below	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 TX RM 20610 ARTHROCENT ASP INJ JOINT BURSA MAJOR WO US GUID	$338.66	$439.81	$96.14–$426.62	7% below	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 SURG 20610 ARTHROCENTESIS ASP INJ MJR JNT BURSA WO US GUID	$590.34	$766.67	$167.59–$743.67	62% above	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ED 20610 ASP INJ JOINT BURSA MAJOR WO US GUID	$64.79	$84.14	$18.39–$81.62	—	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENT ASP INJ MAJOR JOINT BURSA WO US GUID	$215.94	$280.44	$61.30–$272.03	—	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 TX RM 20610 ARTHROCENT ASP INJ JOINT BURSA MAJOR WO US GUID	$338.66	$439.81	$96.14–$426.62	—	23%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 SURG 20610 ARTHROCENTESIS ASP INJ MJR JNT BURSA WO US GUID	$590.34	$766.67	$167.59–$743.67	—	23%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERT DRUG DELIVERY IMPLANT	$147.41	$191.43	$41.85–$185.69	46% below	23%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERT DRUG DELIVERY IMPLANT	$147.41	$191.43	$41.85–$185.69	—	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ED 20605 ASP INJ JOINT BURSA INTERMED WO US GUID	$52.99	$68.81	$15.04–$66.75	83% below	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENT ASP INJ INTMDTE JOINT BURSA WO US GUID	$176.57	$229.31	$50.13–$222.43	42% below	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 TX RM 20605 ARTHRO ASP INJ JOINT BURSA INTERMED WO US GUID	$288.69	$374.92	$81.96–$363.67	5% below	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 SURG 20605 ARTHROCENTESIS ASP INJ INTRM JNT BURSA WO US GUID	$1,004.13	$1,304.06	$285.07–$1,264.94	229% above	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ED 20605 ASP INJ JOINT BURSA INTERMED WO US GUID	$52.99	$68.81	$15.04–$66.75	—	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENT ASP INJ INTMDTE JOINT BURSA WO US GUID	$176.57	$229.31	$50.13–$222.43	—	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 TX RM 20605 ARTHRO ASP INJ JOINT BURSA INTERMED WO US GUID	$288.69	$374.92	$81.96–$363.67	—	23%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 SURG 20605 ARTHROCENTESIS ASP INJ INTRM JNT BURSA WO US GUID	$1,004.13	$1,304.06	$285.07–$1,264.94	—	23%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ED 20600 ASP INJ JOINT BURSA SMALL WO US GUID	$50.29	$65.31	$14.28–$63.35	84% below	23%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ARTHROCENTESIS ASP INJ SMALL JOINT BURSA WO US GUID	$167.61	$217.67	$47.58–$211.14	48% below	23%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 SURG 20600 ARTHROCENTESIS ASP INJ SM JNT BURSA WO US GUID	$167.61	$217.67	$47.58–$211.14	48% below	23%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ED 20600 ASP INJ JOINT BURSA SMALL WO US GUID	$50.29	$65.31	$14.28–$63.35	—	23%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ARTHROCENTESIS ASP INJ SMALL JOINT BURSA WO US GUID	$167.61	$217.67	$47.58–$211.14	—	23%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 SURG 20600 ARTHROCENTESIS ASP INJ SM JNT BURSA WO US GUID	$167.61	$217.67	$47.58–$211.14	—	23%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL LAT WSHAVING	$3,275.54	$4,253.94	$929.91–$4,126.32	69% above	23%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL LAT WSHAVING	$3,275.54	$4,253.94	$929.91–$4,126.32	—	23%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL & LAT WSHAVING	$3,386.90	$4,398.57	$961.53–$4,266.61	42% above	23%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY KNEE SURGICAL WMENISCECTOMY MEDIAL & LAT WSHAVING	$3,386.90	$4,398.57	$961.53–$4,266.61	—	23%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) CPT 29877 ARTHROSCPY KNEE SURGICAL DEBRIDEMENT SHAVING ARTICULAR CARTILAGE(CHOND	$3,635.90	$4,721.94	$1,032.22–$4,580.28	103% above	23%
Knee arthroscopy with smoothing of damaged cartilage (chondroplasty) inpatient CPT 29877 ARTHROSCPY KNEE SURGICAL DEBRIDEMENT SHAVING ARTICULAR CARTILAGE(CHOND	$3,635.90	$4,721.94	$1,032.22–$4,580.28	—	23%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,201.07	$1,559.82	$340.98–$1,513.03	8% below	23%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY SURGICAL APPENDECTOMY	$1,201.07	$1,559.82	$340.98–$1,513.03	—	23%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAPAROSCOPY SURGICAL WREMVL ADNEXAL STRUCTURES	$3,854.16	$5,005.39	$1,094.18–$4,855.23	124% above	23%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAPAROSCOPY SURGICAL WREMVL ADNEXAL STRUCTURES	$3,854.16	$5,005.39	$1,094.18–$4,855.23	—	23%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR <	$217.95	$283.04	$61.87–$274.55	52% below	23%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE WNDS SCALP AXILLAE TRUNK EXTREM 2.5 CM <	$726.49	$943.49	$206.25–$915.19	60% above	23%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 ED 12031 LYR CLSR OF WND 2.5CM OR <	$217.95	$283.04	$61.87–$274.55	—	23%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE WNDS SCALP AXILLAE TRUNK EXTREM 2.5 CM <	$726.49	$943.49	$206.25–$915.19	—	23%
Lower-back epidural injection, with imaging guidance CPT 62323 TX RM 62323 TR RM INJ INTERLAMINAR LUMBR SAC W IMAG GUID	$1,368.90	$1,777.78	$388.62–$1,724.45	44% above	23%
Lower-back epidural injection, with imaging guidance CPT 62323 SURG 62323 INJ IL NDL CATH LUMB SACR W GUID	$1,463.03	$1,900.03	$415.35–$1,843.03	54% above	23%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 TX RM 62323 TR RM INJ INTERLAMINAR LUMBR SAC W IMAG GUID	$1,368.90	$1,777.78	$388.62–$1,724.45	—	23%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 SURG 62323 INJ IL NDL CATH LUMB SACR W GUID	$1,463.03	$1,900.03	$415.35–$1,843.03	—	23%
Lower-back epidural injection, without imaging guidance CPT 62322 TX RM 62322 INJ IL NDL CATH LUMB SACR WO GUID	$696.35	$904.34	$197.69–$877.21	28% below	23%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 TX RM 62322 INJ IL NDL CATH LUMB SACR WO GUID	$696.35	$904.34	$197.69–$877.21	—	23%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TX RM 64483 INJ TRNFRM EPID LUM SNGL 1LVL	$1,309.41	$1,700.53	$371.74–$1,649.51	2% above	23%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 SURG 64483 INJ TRNFRM EPID LUM SNGL 1LVL	$2,298.34	$2,984.85	$652.49–$2,895.30	79% above	23%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TX RM 64483 INJ TRNFRM EPID LUM SNGL 1LVL	$1,309.41	$1,700.53	$371.74–$1,649.51	—	23%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 SURG 64483 INJ TRNFRM EPID LUM SNGL 1LVL	$2,298.34	$2,984.85	$652.49–$2,895.30	—	23%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL LUMPECTOMY	$1,978.10	$2,568.96	$561.57–$2,491.89	34% above	23%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL LUMPECTOMY	$1,978.10	$2,568.96	$561.57–$2,491.89	—	23%
Miscarriage treatment with D&C, first trimester CPT 59820 TREAT MISSED ABORTION COMPD SURGICALLY 1ST TRIMESTER	$655.07	$850.74	$185.97–$825.22	18% below	23%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 TREAT MISSED ABORTION COMPD SURGICALLY 1ST TRIMESTER	$655.07	$850.74	$185.97–$825.22	—	23%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BENGN SKN LESN INC MARGIN NO SKN TAG TRNK ARM LEG EXC DIA 0.5 CM <	$375.59	$487.77	$106.63–$473.14	7% below	23%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BENGN SKN LESN INC MARGIN NO SKN TAG TRNK ARM LEG EXC DIA 0.5 CM <	$375.59	$487.77	$106.63–$473.14	—	23%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 ED 11440 EXC BGN LSN FACE/EAR/LIP < 5CM	$123.49	$160.37	$35.06–$155.56	77% below	23%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC BENIGN SKIN LESN INCL MARGINS FACE EXC DIAM 0.5 CM <	$411.62	$534.56	$116.85–$518.52	22% below	23%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 ED 11440 EXC BGN LSN FACE/EAR/LIP < 5CM	$123.49	$160.37	$35.06–$155.56	—	23%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC BENIGN SKIN LESN INCL MARGINS FACE EXC DIAM 0.5 CM <	$411.62	$534.56	$116.85–$518.52	—	23%
Nail removal (partial or complete), one nail CPT 11730 ED 11730 REMV OF NAIL PLATE	$89.07	$115.67	$25.29–$112.20	68% below	23%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE PARTIAL COMP SMPL SNGL	$296.86	$385.53	$84.28–$373.96	6% above	23%
Nail removal (partial or complete), one nail inpatient CPT 11730 ED 11730 REMV OF NAIL PLATE	$89.07	$115.67	$25.29–$112.20	—	23%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE PARTIAL COMP SMPL SNGL	$296.86	$385.53	$84.28–$373.96	—	23%
Occipital nerve block (injection for headaches) CPT 64405 ED 64405 INJ NERVE BLOCK GR OCCPTAL	$142.02	$184.43	$40.32–$178.90	77% below	23%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANESTHETIC AGENT GREATER OCCIPITAL NERVE	$331.43	$430.42	$94.09–$417.51	45% below	23%
Occipital nerve block (injection for headaches) CPT 64405 TX RM 64405 INJ ANES NRV GREAT OCCIPITAL	$383.07	$497.49	$108.75–$482.57	37% below	23%
Occipital nerve block (injection for headaches) inpatient CPT 64405 ED 64405 INJ NERVE BLOCK GR OCCPTAL	$142.02	$184.43	$40.32–$178.90	—	23%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANESTHETIC AGENT GREATER OCCIPITAL NERVE	$331.43	$430.42	$94.09–$417.51	—	23%
Occipital nerve block (injection for headaches) inpatient CPT 64405 TX RM 64405 INJ ANES NRV GREAT OCCIPITAL	$383.07	$497.49	$108.75–$482.57	—	23%
Paracentesis with imaging guidance CPT 49083 ED 49083 ABD PARACNTSIS WIMAG GUID	$286.77	$372.42	$81.41–$361.25	67% below	23%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS WIMAGING	$955.87	$1,241.38	$271.37–$1,204.14	10% above	23%
Paracentesis with imaging guidance CPT 49083 SURG 49083 ABD PARACENTESIS W IMAGING	$1,292.08	$1,678.02	$366.82–$1,627.68	48% above	23%
Paracentesis with imaging guidance inpatient CPT 49083 ED 49083 ABD PARACNTSIS WIMAG GUID	$286.77	$372.42	$81.41–$361.25	—	23%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS WIMAGING	$955.87	$1,241.38	$271.37–$1,204.14	—	23%
Paracentesis with imaging guidance inpatient CPT 49083 SURG 49083 ABD PARACENTESIS W IMAGING	$1,292.08	$1,678.02	$366.82–$1,627.68	—	23%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ED 11750 REMV OF NAIL BED	$324.30	$421.16	$92.07–$408.53	35% below	23%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL NAIL MATRIX PERM REMVL	$1,080.95	$1,403.83	$306.88–$1,361.72	115% above	23%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ED 11750 REMV OF NAIL BED	$324.30	$421.16	$92.07–$408.53	—	23%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL NAIL MATRIX PERM REMVL	$1,080.95	$1,403.83	$306.88–$1,361.72	—	23%
Removal of a breast lump, open surgery CPT 19120 EXC BREAST LESN(S) OPEN MALE FEMALE 1 OR MORE	$1,728.25	$2,244.47	$490.64–$2,177.14	17% above	23%
Removal of a breast lump, open surgery inpatient CPT 19120 EXC BREAST LESN(S) OPEN MALE FEMALE 1 OR MORE	$1,728.25	$2,244.47	$490.64–$2,177.14	—	23%
Removal of a foreign object under the skin, simple CPT 10120 ED 10120 INC&REMV FB SMPL	$129.22	$167.81	$36.68–$162.78	68% below	23%
Removal of a foreign object under the skin, simple CPT 10120 INCISION & REMVL FB SUBQ TISSUES SMPL	$430.74	$559.39	$122.28–$542.61	8% above	23%
Removal of a foreign object under the skin, simple inpatient CPT 10120 ED 10120 INC&REMV FB SMPL	$129.22	$167.81	$36.68–$162.78	—	23%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION & REMVL FB SUBQ TISSUES SMPL	$430.74	$559.39	$122.28–$542.61	—	23%
Short arm cast (elbow to hand) CPT 29075 ED 29075 APPL CAST FOREARM ARM	$82.98	$107.76	$23.56–$104.53	65% below	23%
Short arm cast (elbow to hand) CPT 29075 APPLN CAST ELBOW TO FINGER (SHORT ARM)	$276.66	$359.29	$78.54–$348.51	17% above	23%
Short arm cast (elbow to hand) inpatient CPT 29075 ED 29075 APPL CAST FOREARM ARM	$82.98	$107.76	$23.56–$104.53	—	23%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLN CAST ELBOW TO FINGER (SHORT ARM)	$276.66	$359.29	$78.54–$348.51	—	23%
Short arm splint (forearm and hand) CPT 29125 ED 29125 APPL SPLINT FOREARM	$59.40	$77.14	$16.86–$74.83	70% below	23%
Short arm splint (forearm and hand) CPT 29125 APPLN SHORT ARM SPLINT (FOREARM TO HAND) STATIC	$197.93	$257.04	$56.19–$249.33	at median	23%
Short arm splint (forearm and hand) inpatient CPT 29125 ED 29125 APPL SPLINT FOREARM	$59.40	$77.14	$16.86–$74.83	—	23%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLN SHORT ARM SPLINT (FOREARM TO HAND) STATIC	$197.93	$257.04	$56.19–$249.33	—	23%
Short leg cast (below the knee) CPT 29405 ED 29405 APPL CAST SHORT LEG	$75.90	$98.56	$21.55–$95.60	72% below	23%
Short leg cast (below the knee) CPT 29405 APPLN SHORT LEG CAST (BELOW KNEE TO TOES)	$253.06	$328.64	$71.84–$318.78	7% below	23%
Short leg cast (below the knee) inpatient CPT 29405 ED 29405 APPL CAST SHORT LEG	$75.90	$98.56	$21.55–$95.60	—	23%
Short leg cast (below the knee) inpatient CPT 29405 APPLN SHORT LEG CAST (BELOW KNEE TO TOES)	$253.06	$328.64	$71.84–$318.78	—	23%
Short leg splint (calf to foot) CPT 29515 ED 29515 APPL SPLINT SHORT LEG	$65.48	$85.03	$18.59–$82.48	71% below	23%
Short leg splint (calf to foot) CPT 29515 APPLN SHORT LEG SPLINT (CALF TO FOOT)	$218.13	$283.28	$61.93–$274.78	2% below	23%
Short leg splint (calf to foot) inpatient CPT 29515 ED 29515 APPL SPLINT SHORT LEG	$65.48	$85.03	$18.59–$82.48	—	23%
Short leg splint (calf to foot) inpatient CPT 29515 APPLN SHORT LEG SPLINT (CALF TO FOOT)	$218.13	$283.28	$61.93–$274.78	—	23%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) CPT 29824 ARTHROSCOPY SHLDR SURGICAL DISTAL CLAVICULECTOMY WARTICULAR SURFACE	$3,541.25	$4,599.02	$1,005.35–$4,461.05	66% above	23%
Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle) inpatient CPT 29824 ARTHROSCOPY SHLDR SURGICAL DISTAL CLAVICULECTOMY WARTICULAR SURFACE	$3,541.25	$4,599.02	$1,005.35–$4,461.05	—	23%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCPY SHLDR SURGICAL DECOMPRESSION SUBACROMIAL SPACE WPARTIAL AC	$902.28	$1,171.78	$256.15–$1,136.63	18% below	23%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCPY SHLDR SURGICAL DECOMPRESSION SUBACROMIAL SPACE WPARTIAL AC	$902.28	$1,171.78	$256.15–$1,136.63	—	23%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR<	$86.74	$112.64	$24.62–$109.26	68% below	23%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITALIA TRNK EXTREM 2.5 CM <	$289.09	$375.44	$82.07–$364.18	7% above	23%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ED 12001 RPR SUPERFCL WND 2.5CM OR<	$86.74	$112.64	$24.62–$109.26	—	23%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITALIA TRNK EXTREM 2.5 CM <	$289.09	$375.44	$82.07–$364.18	—	23%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN; SINGLE LESION	$240.71	$312.61	$68.34–$303.23	17% below	23%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN; SINGLE LESION	$240.71	$312.61	$68.34–$303.23	—	23%
Skin tag removal, up to 15 tags CPT 11200 ED 11200 SKIN TAG RMV <16	$79.96	$103.84	$22.70–$100.72	59% below	23%
Skin tag removal, up to 15 tags CPT 11200 REMVL SKIN TAGS MULT FIBROCUTANEOUS TAGS ANY AREA UP TO & INCL 15 LESN	$266.50	$346.10	$75.66–$335.72	36% above	23%
Skin tag removal, up to 15 tags inpatient CPT 11200 ED 11200 SKIN TAG RMV <16	$79.96	$103.84	$22.70–$100.72	—	23%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMVL SKIN TAGS MULT FIBROCUTANEOUS TAGS ANY AREA UP TO & INCL 15 LESN	$266.50	$346.10	$75.66–$335.72	—	23%
Spinal tap (lumbar puncture), diagnostic CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG	$145.43	$188.87	$41.29–$183.20	80% below	23%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DX	$484.73	$629.51	$137.61–$610.62	33% below	23%
Spinal tap (lumbar puncture), diagnostic CPT 62270 TX RM 62270 LUMBAR PUNCTURE DIAGNOSTIC	$761.38	$988.80	$216.15–$959.14	5% above	23%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 ED 62270 SPINAL TAP LUMBAR DIAG	$145.43	$188.87	$41.29–$183.20	—	23%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DX	$484.73	$629.51	$137.61–$610.62	—	23%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 TX RM 62270 LUMBAR PUNCTURE DIAGNOSTIC	$761.38	$988.80	$216.15–$959.14	—	23%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM	$103.57	$134.50	$29.40–$130.47	66% below	23%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITAL TRNK EXTREM 2.6-7.5 CM	$345.24	$448.36	$98.01–$434.91	12% above	23%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ED 12002 RPR SUPERFCL WND 2.6-7.5CM	$103.57	$134.50	$29.40–$130.47	—	23%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SMPL RPR SUPERL WNDS SCALP NECK AXILLAE GENITAL TRNK EXTREM 2.6-7.5 CM	$345.24	$448.36	$98.01–$434.91	—	23%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR<	$104.24	$135.37	$29.59–$131.31	62% below	23%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SMPL RPR SUPERL WNDS FACEUS MEMBRANES 2.5 CM <	$347.52	$451.32	$98.66–$437.78	27% above	23%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ED 12011 RPR SUPERFCL WND 2.5CM OR<	$104.24	$135.37	$29.59–$131.31	—	23%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SMPL RPR SUPERL WNDS FACEUS MEMBRANES 2.5 CM <	$347.52	$451.32	$98.66–$437.78	—	23%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 ED 11102 TANGENTIAL BX SKIN SINGLE LESION	$57.42	$74.57	$16.30–$72.33	77% below	23%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$191.47	$248.66	$54.36–$241.20	22% below	23%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 ED 11102 TANGENTIAL BX SKIN SINGLE LESION	$57.42	$74.57	$16.30–$72.33	—	23%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN; SINGLE LESION	$191.47	$248.66	$54.36–$241.20	—	23%
Thoracentesis with imaging guidance CPT 32555 ED 32555 THORACENTESIS W IMAGING	$298.14	$387.19	$84.64–$375.57	67% below	23%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W IMAGING	$695.65	$903.43	$197.49–$876.33	22% below	23%
Thoracentesis with imaging guidance CPT 32555 SURG 32555 THORACENTESIS W IMAGING	$1,330.45	$1,727.85	$377.71–$1,676.01	49% above	23%
Thoracentesis with imaging guidance inpatient CPT 32555 ED 32555 THORACENTESIS W IMAGING	$298.14	$387.19	$84.64–$375.57	—	23%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W IMAGING	$695.65	$903.43	$197.49–$876.33	—	23%
Thoracentesis with imaging guidance inpatient CPT 32555 SURG 32555 THORACENTESIS W IMAGING	$1,330.45	$1,727.85	$377.71–$1,676.01	—	23%
Total hip replacement CPT 27130 ARTHROPLASTY ACETABULAR PROXIMAL FEMORAL PROSTHETIC REPLACE WWO AUTOG	$5,688.56	$7,387.73	$1,614.96–$7,166.10	46% above	23%
Total hip replacement inpatient CPT 27130 ARTHROPLASTY ACETABULAR PROXIMAL FEMORAL PROSTHETIC REPLACE WWO AUTOG	$5,688.56	$7,387.73	$1,614.96–$7,166.10	—	23%
Total knee replacement CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL & LAT COMPARTMENTS WWO PAT	$8,085.05	$10,500.06	$2,295.31–$10,185.06	116% above	23%
Total knee replacement inpatient CPT 27447 ARTHROPLASTY KNEE CONDYLE & PLATEAU MEDIAL & LAT COMPARTMENTS WWO PAT	$8,085.05	$10,500.06	$2,295.31–$10,185.06	—	23%
Total shoulder replacement CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHLDR	$5,321.76	$6,911.37	$1,510.83–$6,704.03	30% above	23%
Total shoulder replacement inpatient CPT 23472 ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHLDR	$5,321.76	$6,911.37	$1,510.83–$6,704.03	—	23%
Trigger finger release surgery CPT 26055 TENDON SHEATH INCISION	$1,883.42	$2,446.00	$534.70–$2,372.62	45% above	23%
Trigger finger release surgery inpatient CPT 26055 TENDON SHEATH INCISION	$1,883.42	$2,446.00	$534.70–$2,372.62	—	23%
Trigger point injections, 1 or 2 muscles CPT 20552 ED 20552 INJ 1-2 MUSC GRPS	$49.94	$64.85	$14.18–$62.90	84% below	23%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ(S) SNGL MULTIPLE TRIGGER POINT(S) 1-2 MUSCLES	$166.42	$216.12	$47.24–$209.64	46% below	23%
Trigger point injections, 1 or 2 muscles CPT 20552 TX RM 20552 INJ TRIGGER PT 1-2 MUSCLE(S)	$276.00	$358.44	$78.35–$347.69	11% below	23%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 ED 20552 INJ 1-2 MUSC GRPS	$49.94	$64.85	$14.18–$62.90	—	23%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ(S) SNGL MULTIPLE TRIGGER POINT(S) 1-2 MUSCLES	$166.42	$216.12	$47.24–$209.64	—	23%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TX RM 20552 INJ TRIGGER PT 1-2 MUSCLE(S)	$276.00	$358.44	$78.35–$347.69	—	23%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 SURG 19083 BX BREAST W DVC US GUIDE 1ST LSN	$1,314.58	$1,707.24	$373.20–$1,656.02	20% below	23%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 SURG 19083 BX BREAST W DVC US GUIDE 1ST LSN	$1,314.58	$1,707.24	$373.20–$1,656.02	—	23%
Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY WBX SNGL MULTIPLE	$1,104.86	$1,434.88	$313.66–$1,391.83	5% above	23%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UPPER GI ENDOSCOPY WBX SNGL MULTIPLE	$1,104.86	$1,434.88	$313.66–$1,391.83	—	23%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UPPER GI ENDOSCOPY WREMVL LESN SNARE	$1,114.09	$1,446.87	$316.29–$1,403.46	37% below	23%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UPPER GI ENDOSCOPY WREMVL LESN SNARE	$1,114.09	$1,446.87	$316.29–$1,403.46	—	23%
Upper endoscopy (EGD), diagnostic CPT 43235 UPR GI ENDOSCOPY DX WWO SPECIMEN COLLECTION BRUSH WASH(SEP PROC)	$953.72	$1,238.59	$270.76–$1,201.43	1% below	23%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPR GI ENDOSCOPY DX WWO SPECIMEN COLLECTION BRUSH WASH(SEP PROC)	$953.72	$1,238.59	$270.76–$1,201.43	—	23%
Vasectomy, one or both sides, including follow-up semen testing both sides CPT 55250 VASECTOMY UNILAT BILAT WPOSTOPERATIVE SEMEN EXAM (SEP PROC)	$1,342.69	$1,743.75	$381.18–$1,691.44	—	23%
Vasectomy, one or both sides, including follow-up semen testing inpatient both sides CPT 55250 VASECTOMY UNILAT BILAT WPOSTOPERATIVE SEMEN EXAM (SEP PROC)	$1,342.69	$1,743.75	$381.18–$1,691.44	—	23%
Wart removal, up to 14 warts CPT 17110 DESTRUCTION BENIGN LESIONS 1 TO 14	$342.94	$445.37	$97.36–$432.01	75% above	23%
Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCTION BENIGN LESIONS 1 TO 14	$342.94	$445.37	$97.36–$432.01	—	23%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ED 11042 DEBR SKN SUBQ TISS 20 CM <	$157.23	$204.19	$44.64–$198.06	65% below	23%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN & SUBQ TISSUE	$524.14	$680.70	$148.80–$660.28	17% above	23%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ED 11042 DEBR SKN SUBQ TISS 20 CM <	$157.23	$204.19	$44.64–$198.06	—	23%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN & SUBQ TISSUE	$524.14	$680.70	$148.80–$660.28	—	23%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 FX W INTERNAL FIXN	$4,076.63	$5,294.32	$1,157.34–$5,135.49	71% above	23%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 FX W INTERNAL FIXN	$4,076.63	$5,294.32	$1,157.34–$5,135.49	—	23%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 BLOOD ADMIN 1HR	$281.19	$365.17	$79.83–$354.21	61% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 1 HR	$281.19	$365.17	$79.83–$354.21	61% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 2HR	$373.35	$484.87	$105.99–$470.32	48% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 BLOOD ADMIN 2HR	$373.35	$484.87	$105.99–$470.32	48% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 BLOOD ADMIN 3HR	$467.86	$607.60	$132.82–$589.37	34% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 3HR	$467.86	$607.60	$132.82–$589.37	34% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 4HR	$561.11	$728.71	$159.30–$706.85	21% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 ED 36430 BLOOD ADMIN 4HR	$561.11	$728.71	$159.30–$706.85	21% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 5HR	$630.94	$819.39	$179.12–$794.81	12% below	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 6HR	$720.87	$936.19	$204.65–$908.10	1% above	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 7HR	$810.80	$1,052.98	$230.18–$1,021.39	14% above	23%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADM 8HR	$900.73	$1,169.77	$255.71–$1,134.68	26% above	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 1 HR	$281.19	$365.17	$79.83–$354.21	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 BLOOD ADMIN 1HR	$281.19	$365.17	$79.83–$354.21	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 BLOOD ADMIN 2HR	$373.35	$484.87	$105.99–$470.32	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 2HR	$373.35	$484.87	$105.99–$470.32	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 3HR	$467.86	$607.60	$132.82–$589.37	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 BLOOD ADMIN 3HR	$467.86	$607.60	$132.82–$589.37	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 4HR	$561.11	$728.71	$159.30–$706.85	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ED 36430 BLOOD ADMIN 4HR	$561.11	$728.71	$159.30–$706.85	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 5HR	$630.94	$819.39	$179.12–$794.81	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 6HR	$720.87	$936.19	$204.65–$908.10	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 7HR	$810.80	$1,052.98	$230.18–$1,021.39	—	23%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADM 8HR	$900.73	$1,169.77	$255.71–$1,134.68	—	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB INITIAL TX	$165.49	$214.92	$46.98–$208.47	41% above	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PRESSURIZED NONPRESSURIZED INHALATION RX AIRWAY OBSTRUCTION DX SPUTUM	$165.49	$214.92	$46.98–$208.47	41% above	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 PF 94640 NEBULIZER TREATMENT	$165.49	$214.92	$46.98–$208.47	41% above	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB SUBSEQ TX	$165.49	$214.92	$46.98–$208.47	41% above	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB SUBSEQ TX	$165.49	$214.92	$46.98–$208.47	—	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PRESSURIZED NONPRESSURIZED INHALATION RX AIRWAY OBSTRUCTION DX SPUTUM	$165.49	$214.92	$46.98–$208.47	—	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 PF 94640 NEBULIZER TREATMENT	$165.49	$214.92	$46.98–$208.47	—	23%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB INITIAL TX	$165.49	$214.92	$46.98–$208.47	—	23%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO INFUSION 1ST HR	$590.10	$766.36	$167.53–$743.37	15% above	23%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO INFUSION 1ST HR	$590.10	$766.36	$167.53–$743.37	—	23%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE E&M 30-74 MIN	$656.48	$852.57	$186.37–$1,198.00	57% below	23%
Critical care, first 30 to 74 minutes CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN	$1,746.90	$2,268.69	$495.94–$2,200.63	13% above	23%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE E&M 30-74 MIN	$656.48	$852.57	$186.37–$826.99	—	23%
Critical care, first 30 to 74 minutes inpatient CPT 99291 ED 99291 CRITICAL CARE E&M 30-74 MIN	$1,746.90	$2,268.69	$495.94–$2,200.63	—	23%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS WINTERP & REPORT	$244.98	$318.15	$69.55–$308.61	87% above	23%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS WINTERP & REPORT	$244.98	$318.15	$69.55–$308.61	—	23%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ECG TRACING WO INTERP	$178.64	$231.99	$50.71–$225.03	4% above	23%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS TRACING ONLY WO INTERP	$178.64	$231.99	$50.71–$225.03	4% above	23%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ECG TRACING WO INTERP	$178.64	$231.99	$50.71–$225.03	—	23%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM ROUTINE WAT LEAST 12 LEADS TRACING ONLY WO INTERP	$178.64	$231.99	$50.71–$225.03	—	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 UC 99281 EMERGENCY DEPT VISIT LEVEL I	$42.71	$55.46	$12.12–$163.00	78% below	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 URGENT CARE DEPT VISIT LVL I	$50.93	$66.14	$14.46–$163.00	74% below	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMERGENCY DEPT VISIT LVL I	$100.09	$129.98	$28.41–$163.00	48% below	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED 99281 EMER CASE LEVEL I	$234.92	$305.09	$66.69–$295.94	22% above	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 UC 99281 EMERGENCY DEPT VISIT LEVEL I	$42.71	$55.46	$12.12–$53.80	—	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 URGENT CARE DEPT VISIT LVL I	$50.93	$66.14	$14.46–$64.16	—	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMERGENCY DEPT VISIT LVL I	$100.09	$129.98	$28.41–$126.08	—	23%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED 99281 EMER CASE LEVEL I	$234.92	$305.09	$66.69–$295.94	—	23%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 UC 99282 EMERGENCY DEPT VISIT LEVEL II	$51.73	$67.17	$14.68–$299.00	79% below	23%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 URGENT CARE DEPT VISIT LVL II	$109.92	$142.75	$31.21–$299.00	56% below	23%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT LVL II	$149.83	$194.58	$42.54–$299.00	40% below	23%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED 99282 EMER CASE LEVEL II	$320.27	$415.93	$90.92–$403.45	29% above	23%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 UC 99282 EMERGENCY DEPT VISIT LEVEL II	$51.73	$67.17	$14.68–$65.15	—	23%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 URGENT CARE DEPT VISIT LVL II	$109.92	$142.75	$31.21–$138.47	—	23%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT LVL II	$149.83	$194.58	$42.54–$188.74	—	23%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED 99282 EMER CASE LEVEL II	$320.27	$415.93	$90.92–$403.45	—	23%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 UC 99283 EMERGENCY DEPT VISIT LEVEL III	$64.05	$83.18	$18.18–$463.00	84% below	23%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 URGENT CARE DEPT VISIT LVL III	$191.16	$248.25	$54.27–$463.00	52% below	23%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LVL III	$291.56	$378.64	$82.77–$463.00	26% below	23%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED 99283 EMER CASE LEVEL III	$522.81	$678.97	$148.42–$658.60	32% above	23%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 UC 99283 EMERGENCY DEPT VISIT LEVEL III	$64.05	$83.18	$18.18–$80.68	—	23%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 URGENT CARE DEPT VISIT LVL III	$191.16	$248.25	$54.27–$240.80	—	23%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LVL III	$291.56	$378.64	$82.77–$367.28	—	23%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED 99283 EMER CASE LEVEL III	$522.81	$678.97	$148.42–$658.60	—	23%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 URGENT CARE DEPT VISIT LVL IV	$222.71	$289.23	$63.23–$545.00	65% below	23%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT LVL IV	$432.74	$561.99	$122.85–$545.13	32% below	23%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED 99284 EMER CASE LEVEL IV	$850.71	$1,104.81	$241.51–$1,071.67	34% above	23%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 URGENT CARE DEPT VISIT LVL IV	$222.71	$289.23	$63.23–$280.55	—	23%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT LVL IV	$432.74	$561.99	$122.85–$545.13	—	23%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED 99284 EMER CASE LEVEL IV	$850.71	$1,104.81	$241.51–$1,071.67	—	23%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 URGENT CARE DEPT VISIT LVL V	$247.44	$321.34	$70.24–$1,198.00	74% below	23%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT LVL V	$641.59	$833.23	$182.14–$1,198.00	32% below	23%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED 99285 EMER CASE LEVEL V	$1,133.86	$1,472.54	$321.90–$1,428.36	20% above	23%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 URGENT CARE DEPT VISIT LVL V	$247.44	$321.34	$70.24–$311.70	—	23%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT LVL V	$641.59	$833.23	$182.14–$808.23	—	23%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED 99285 EMER CASE LEVEL V	$1,133.86	$1,472.54	$321.90–$1,428.36	—	23%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST TRACING PERSANTINE	$113.53	$147.43	$32.23–$143.01	84% below	23%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST TRACING	$370.33	$480.94	$105.13–$466.51	49% below	23%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST TRACING PERSANTINE	$113.53	$147.43	$32.23–$143.01	—	23%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST TRACING	$370.33	$480.94	$105.13–$466.51	—	23%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 PF 96360 IV HYDRAT INIT 31-60M	$330.05	$428.63	$93.70–$415.77	21% above	23%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRAT INITIAL 31-60MINS	$330.05	$428.63	$93.70–$415.77	21% above	23%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR	$330.05	$428.63	$93.70–$415.77	21% above	23%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$330.05	$428.63	$93.70–$415.77	21% above	23%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$330.05	$428.63	$93.70–$415.77	—	23%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRAT INITIAL 31-60MINS	$330.05	$428.63	$93.70–$415.77	—	23%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ED 96360 IV INFUS THERAPY HYDRATION FLUIDS INITIAL 31 MIN-1HR	$330.05	$428.63	$93.70–$415.77	—	23%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 PF 96360 IV HYDRAT INIT 31-60M	$330.05	$428.63	$93.70–$415.77	—	23%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR	$315.94	$410.30	$89.69–$397.99	4% below	23%
IV infusion of a medicine, first hour CPT 96365 THER PROPH DIAG IV INF INTL	$315.94	$410.30	$89.69–$397.99	4% below	23%
IV infusion of a medicine, first hour CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR	$315.94	$410.30	$89.69–$397.99	4% below	23%
IV infusion of a medicine, first hour CPT 96365 PF 96365 IV INF THPY PRO DX UP	$315.94	$410.30	$89.69–$397.99	4% below	23%
IV infusion of a medicine, first hour inpatient CPT 96365 THER PROPH DIAG IV INF INTL	$315.94	$410.30	$89.69–$397.99	—	23%
IV infusion of a medicine, first hour inpatient CPT 96365 ED 96365 IV INFUS THER PROPH DIAG INITIAL UP TO 1HR	$315.94	$410.30	$89.69–$397.99	—	23%
IV infusion of a medicine, first hour inpatient CPT 96365 PF 96365 IV INF THPY PRO DX UP	$315.94	$410.30	$89.69–$397.99	—	23%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION TX PROPH DX INIT TO 1HR	$315.94	$410.30	$89.69–$397.99	—	23%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 SC IM INJECTION	$87.74	$113.94	$24.91–$110.52	14% above	23%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER PROPHY DIAG INJ SC IM	$87.74	$113.94	$24.91–$110.52	14% above	23%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM	$87.74	$113.94	$24.91–$110.52	14% above	23%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PF 96372 THER PRO DX INJ SQ IM	$87.74	$113.94	$24.91–$110.52	14% above	23%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 SC IM INJECTION	$87.74	$113.94	$24.91–$110.52	—	23%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER PROPHY DIAG INJ SC IM	$87.74	$113.94	$24.91–$110.52	—	23%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PF 96372 THER PRO DX INJ SQ IM	$87.74	$113.94	$24.91–$110.52	—	23%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ED 96372 THER PROPH DIAG INJECTION SQ IM	$87.74	$113.94	$24.91–$110.52	—	23%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 PF 95910 NERVE CONDUCTION STUDY 7-8	$142.78	$185.42	$40.53–$179.86	67% below	23%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 MOTOR&SENS 7-8 NRV CNDJ TEST	$475.90	$618.04	$135.10–$599.50	11% above	23%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 PF 95910 NERVE CONDUCTION STUDY 7-8	$142.78	$185.42	$40.53–$179.86	—	23%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 MOTOR&SENS 7-8 NRV CNDJ TEST	$475.90	$618.04	$135.10–$599.50	—	23%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSC RE ED EA 15MIN 97112	$106.80	$138.70	$30.32–$134.54	47% above	23%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE ED EA 15MIN 97112	$106.80	$138.70	$30.32–$134.54	—	23%
New patient office visit, about 30 minutes CPT 99203 PF 99203 FAC OFFICE OP VISIT NEW PT LEVEL III	$86.65	$112.52	$24.60–$109.14	26% below	23%
New patient office visit, about 30 minutes CPT 99203 OFFICE OP VISIT NEW PT LEVEL III	$288.72	$374.96	$81.97–$363.71	147% above	23%
New patient office visit, about 30 minutes inpatient CPT 99203 PF 99203 FAC OFFICE OP VISIT NEW PT LEVEL III	$86.65	$112.52	$24.60–$109.14	—	23%
New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE OP VISIT NEW PT LEVEL III	$288.72	$374.96	$81.97–$363.71	—	23%
New patient office visit, about 45 minutes CPT 99204 PF 99204 FAC OFFICE OP VISIT NEW PT LEVEL IV	$115.03	$149.38	$32.65–$144.90	33% below	23%
New patient office visit, about 45 minutes CPT 99204 OFFICE OP VISIT NEW PT LEVEL IV	$383.50	$498.05	$108.87–$483.11	123% above	23%
New patient office visit, about 45 minutes inpatient CPT 99204 PF 99204 FAC OFFICE OP VISIT NEW PT LEVEL IV	$115.03	$149.38	$32.65–$144.90	—	23%
New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE OP VISIT NEW PT LEVEL IV	$383.50	$498.05	$108.87–$483.11	—	23%
New patient office visit, about 60 minutes CPT 99205 PF 99205 FAC OFFICE OP VISIT NEW PT LEVEL V	$143.06	$185.78	$40.61–$180.21	39% below	23%
New patient office visit, about 60 minutes CPT 99205 OFFICE OP VISIT NEW PT LEVEL V	$476.81	$619.23	$135.36–$600.65	103% above	23%
New patient office visit, about 60 minutes inpatient CPT 99205 PF 99205 FAC OFFICE OP VISIT NEW PT LEVEL V	$143.06	$185.78	$40.61–$180.21	—	23%
New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE OP VISIT NEW PT LEVEL V	$476.81	$619.23	$135.36–$600.65	—	23%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 PF 99202 FAC OFFICE OP VISIT NEW PT LEVEL II	$55.37	$71.90	$15.72–$69.74	27% below	23%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE OP VISIT NEW PT LEVEL II	$184.48	$239.58	$52.37–$232.39	142% above	23%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 PF 99202 FAC OFFICE OP VISIT NEW PT LEVEL II	$55.37	$71.90	$15.72–$69.74	—	23%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OFFICE OP VISIT NEW PT LEVEL II	$184.48	$239.58	$52.37–$232.39	—	23%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEXITY 97165	$176.99	$229.85	$50.25–$222.95	5% above	23%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEXITY 97165	$176.99	$229.85	$50.25–$222.95	—	23%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEXITY 97163	$398.26	$517.22	$113.06–$501.70	99% above	23%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEXITY 97163	$398.26	$517.22	$113.06–$501.70	—	23%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEXITY 97161	$176.99	$229.85	$50.25–$222.95	5% above	23%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$176.99	$229.85	$50.25–$222.95	5% above	23%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PF 97161 PT EVAL LOW COMPLEX 20 MIN	$176.99	$229.85	$50.25–$222.95	5% above	23%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PF 97161 PT EVAL LOW COMPLEX 20 MIN	$176.99	$229.85	$50.25–$222.95	—	23%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$176.99	$229.85	$50.25–$222.95	—	23%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEXITY 97161	$176.99	$229.85	$50.25–$222.95	—	23%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MODERATE COMPLEXITY 97162	$265.49	$344.79	$75.37–$334.45	44% above	23%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MODERATE COMPLEXITY 97162	$265.49	$344.79	$75.37–$334.45	—	23%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN 97140	$103.46	$134.36	$29.37–$130.33	25% above	23%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN 97140	$103.46	$134.36	$29.37–$130.33	—	23%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXERCISE EA 15 MIN 97110	$116.86	$151.76	$33.17–$147.21	29% above	23%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERCISE EA 15 MIN 97110	$116.86	$151.76	$33.17–$147.21	—	23%
Preventive checkup, new patient aged 18–39 CPT 99385 PF 99385 FAC PREVENT MED NEW18-39Y	$92.12	$119.63	$26.15–$116.04	43% below	23%
Preventive checkup, new patient aged 18–39 CPT 99385 DOT PX NEW PT 18-39YR	$144.11	$187.15	$40.91–$181.54	12% below	23%
Preventive checkup, new patient aged 18–39 CPT 99385 PREV MED E&M NEW 18-39 Y O	$307.05	$398.76	$87.17–$386.80	88% above	23%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PF 99385 FAC PREVENT MED NEW18-39Y	$92.12	$119.63	$26.15–$116.04	—	23%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 DOT PX NEW PT 18-39YR	$144.11	$187.15	$40.91–$181.54	—	23%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PREV MED E&M NEW 18-39 Y O	$307.05	$398.76	$87.17–$386.80	—	23%
Preventive checkup, new patient aged 40–64 CPT 99386 PF 99386 FAC PREVENT MED NEW40-64Y	$106.63	$138.47	$30.27–$134.32	52% below	23%
Preventive checkup, new patient aged 40–64 CPT 99386 DOT PX NEW PT 40-64YR	$144.11	$187.15	$40.91–$181.54	34% below	23%
Preventive checkup, new patient aged 40–64 CPT 99386 PREV MED E&M NEW 40-64 Y O	$355.34	$461.47	$100.88–$447.63	62% above	23%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PF 99386 FAC PREVENT MED NEW40-64Y	$106.63	$138.47	$30.27–$134.32	—	23%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 DOT PX NEW PT 40-64YR	$144.11	$187.15	$40.91–$181.54	—	23%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PREV MED E&M NEW 40-64 Y O	$355.34	$461.47	$100.88–$447.63	—	23%
Preventive checkup, new patient aged 65 or older CPT 99387 PF 99387 FAC PREVENT MED NEW>65YR	$115.72	$150.28	$32.85–$145.77	56% below	23%
Preventive checkup, new patient aged 65 or older CPT 99387 DOT PX NEW PT 65+YR	$144.11	$187.15	$40.91–$181.54	45% below	23%
Preventive checkup, new patient aged 65 or older CPT 99387 PREV MED E&M NEW 65 AND OVER	$385.79	$501.02	$109.52–$485.99	47% above	23%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PF 99387 FAC PREVENT MED NEW>65YR	$115.72	$150.28	$32.85–$145.77	—	23%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 DOT PX NEW PT 65+YR	$144.11	$187.15	$40.91–$181.54	—	23%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PREV MED E&M NEW 65 AND OVER	$385.79	$501.02	$109.52–$485.99	—	23%
Preventive checkup, returning patient aged 18–39 CPT 99395 PF 99395 FAC PREVENT MED EST18-39Y	$81.99	$106.47	$23.27–$103.28	37% below	23%
Preventive checkup, returning patient aged 18–39 CPT 99395 DOT PX EST PT 18-39YR	$144.11	$187.15	$40.91–$181.54	11% above	23%
Preventive checkup, returning patient aged 18–39 CPT 99395 PREV MED E&M EST 18-39 Y O	$273.27	$354.89	$77.58–$344.24	110% above	23%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PF 99395 FAC PREVENT MED EST18-39Y	$81.99	$106.47	$23.27–$103.28	—	23%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 DOT PX EST PT 18-39YR	$144.11	$187.15	$40.91–$181.54	—	23%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PREV MED E&M EST 18-39 Y O	$273.27	$354.89	$77.58–$344.24	—	23%
Preventive checkup, returning patient aged 40–64 CPT 99396 PF 99396 FAC PREVENT MED EST40-64Y	$87.74	$113.94	$24.91–$110.52	40% below	23%
Preventive checkup, returning patient aged 40–64 CPT 99396 DOT PX EST PT 40-64YR	$144.11	$187.15	$40.91–$181.54	1% below	23%
Preventive checkup, returning patient aged 40–64 CPT 99396 PREV MED E&M EST 40-64 Y O	$292.42	$379.76	$83.02–$368.37	101% above	23%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PF 99396 FAC PREVENT MED EST40-64Y	$87.74	$113.94	$24.91–$110.52	—	23%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 DOT PX EST PT 40-64YR	$144.11	$187.15	$40.91–$181.54	—	23%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PREV MED E&M EST 40-64 Y O	$292.42	$379.76	$83.02–$368.37	—	23%
Preventive checkup, returning patient aged 65 or older CPT 99397 PF 99397 FAC PREVENT MED EST >65YR	$94.82	$123.14	$26.92–$119.45	56% below	23%
Preventive checkup, returning patient aged 65 or older CPT 99397 DOT PX EST PT 65+YR	$144.11	$187.15	$40.91–$181.54	33% below	23%
Preventive checkup, returning patient aged 65 or older CPT 99397 PREV MED E&M EST 65 AND OVER	$316.01	$410.40	$89.71–$398.09	47% above	23%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PF 99397 FAC PREVENT MED EST >65YR	$94.82	$123.14	$26.92–$119.45	—	23%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 DOT PX EST PT 65+YR	$144.11	$187.15	$40.91–$181.54	—	23%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PREV MED E&M EST 65 AND OVER	$316.01	$410.40	$89.71–$398.09	—	23%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 TOBACCO CONSULT 3-10 MIN	$36.03	$46.79	$10.23–$45.39	9% above	23%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$36.03	$46.79	$10.23–$45.39	9% above	23%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 TOBACCO CONSULT 3-10 MIN	$36.03	$46.79	$10.23–$45.39	—	23%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN	$36.03	$46.79	$10.23–$45.39	—	23%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 PF 99215 FAC OFFICE OP VISIT EST PT LEVEL V	$100.22	$130.15	$28.45–$126.25	41% below	23%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OFFICE OP VISIT EST PT LEVEL V	$334.08	$433.86	$94.84–$420.84	97% above	23%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 PF 99215 FAC OFFICE OP VISIT EST PT LEVEL V	$100.22	$130.15	$28.45–$126.25	—	23%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE OP VISIT EST PT LEVEL V	$334.08	$433.86	$94.84–$420.84	—	23%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 PF 99213 FAC OFFICE OP VISIT EST PT LEVEL III	$54.54	$70.83	$15.48–$68.71	42% below	23%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OFFICE OP VISIT EST PT LEVEL III	$181.83	$236.14	$51.62–$229.06	93% above	23%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 PF 99213 FAC OFFICE OP VISIT EST PT LEVEL III	$54.54	$70.83	$15.48–$68.71	—	23%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OFFICE OP VISIT EST PT LEVEL III	$181.83	$236.14	$51.62–$229.06	—	23%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 PF 99214 FAC OFFICE OP VISIT EST PT LEVEL IV	$80.43	$104.45	$22.83–$101.32	33% below	23%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OFFICE OP VISIT EST PT LEVEL IV	$268.15	$348.24	$76.13–$337.79	123% above	23%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 PF 99214 FAC OFFICE OP VISIT EST PT LEVEL IV	$80.43	$104.45	$22.83–$101.32	—	23%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OFFICE OP VISIT EST PT LEVEL IV	$268.15	$348.24	$76.13–$337.79	—	23%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PF 99212 FAC OFFICE OP VISIT EST PT LEVEL II	$32.92	$42.75	$9.35–$41.47	60% below	23%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE OP VISIT EST PT LEVEL II	$109.78	$142.56	$31.16–$138.28	35% above	23%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PF 99212 FAC OFFICE OP VISIT EST PT LEVEL II	$32.92	$42.75	$9.35–$41.47	—	23%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OFFICE OP VISIT EST PT LEVEL II	$109.78	$142.56	$31.16–$138.28	—	23%
Specialist consultation, low complexity or 30+ minutes CPT 99243 PF 99243 FAC OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$75.08	$97.50	$21.31–$94.58	59% below	23%
Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$250.32	$325.08	$71.06–$315.33	37% above	23%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 PF 99243 FAC OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$75.08	$97.50	$21.31–$94.58	—	23%
Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE OP CONSULT NEW/EST LOW MDM 30 MIN	$250.32	$325.08	$71.06–$315.33	—	23%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 PF 99244 FAC OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$112.35	$145.90	$31.89–$141.52	46% below	23%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$374.45	$486.29	$106.30–$471.70	81% above	23%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 PF 99244 FAC OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$112.35	$145.90	$31.89–$141.52	—	23%
Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE OP CONSULT NEW/EST MOD MDM 40 MIN	$374.45	$486.29	$106.30–$471.70	—	23%
Speech and language evaluation CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523	$300.25	$389.93	$85.24–$378.23	6% below	23%
Speech and language evaluation inpatient CPT 92523 SPEECH EVAL LANG COMP EXPRESSION 92523	$300.25	$389.93	$85.24–$378.23	—	23%
Speech therapy session, individual CPT 92507 SPEECH THERAPY TX 92507	$295.76	$384.10	$83.96–$372.58	40% above	23%
Speech therapy session, individual inpatient CPT 92507 SPEECH THERAPY TX 92507	$295.76	$384.10	$83.96–$372.58	—	23%
Spirometry (breathing test) CPT 94010 PFT SCREEN SPIROMETRY (NO BD)	$158.83	$206.27	$45.09–$200.08	at median	23%
Spirometry (breathing test) inpatient CPT 94010 PFT SCREEN SPIROMETRY (NO BD)	$158.83	$206.27	$45.09–$200.08	—	23%
Spirometry before and after a bronchodilator CPT 94060 PF 94060 SPIRO PFT PRE&POST B	$77.00	$99.99	$21.86–$96.99	74% below	23%
Spirometry before and after a bronchodilator CPT 94060 BRONCHODILAT RESPONSE SPIROMETRY PRE POST BRONCHODILATOR ADMIN	$256.72	$333.40	$72.88–$323.40	12% below	23%
Spirometry before and after a bronchodilator CPT 94060 PFT SCREEN SPIROMETRY (WITH BD)	$256.72	$333.40	$72.88–$323.40	12% below	23%
Spirometry before and after a bronchodilator inpatient CPT 94060 PF 94060 SPIRO PFT PRE&POST B	$77.00	$99.99	$21.86–$96.99	—	23%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT SCREEN SPIROMETRY (WITH BD)	$256.72	$333.40	$72.88–$323.40	—	23%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHODILAT RESPONSE SPIROMETRY PRE POST BRONCHODILATOR ADMIN	$256.72	$333.40	$72.88–$323.40	—	23%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTIVITIES EA15 MIN 97530	$119.33	$154.97	$33.88–$150.32	54% above	23%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTIVITIES EA15 MIN 97530	$119.33	$154.97	$33.88–$150.32	—	23%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 LV THERAPEUTIC PHLEBOTOMY	$198.43	$257.70	$56.33–$249.97	6% below	23%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$198.43	$257.70	$56.33–$249.97	6% below	23%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$198.43	$257.70	$56.33–$249.97	—	23%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 LV THERAPEUTIC PHLEBOTOMY	$198.43	$257.70	$56.33–$249.97	—	23%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 Influenza Vac Type A&B Surface Ant Adj Susp Pref Syr 0.5 ML	$77.00	$100.00	$21.86–$97.00	at median	23%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CDMR FLU VACCINE ADJUVANT IM	$79.31	$103.00	$22.52–$99.91	3% above	23%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CDMR PF 90653 FLU VACCINE ADJUVANT IM	$79.31	$103.00	$22.52–$99.91	3% above	23%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 Influenza Vac Type A&B Surface Ant Adj Susp Pref Syr 0.5 ML	$77.00	$100.00	$21.86–$97.00	—	23%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 CDMR FLU VACCINE ADJUVANT IM	$79.31	$103.00	$22.52–$99.91	—	23%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 CDMR PF 90653 FLU VACCINE ADJUVANT IM	$79.31	$103.00	$22.52–$99.91	—	23%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CDMR PF 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$241.34	$313.42	$68.51–$304.02	32% above	23%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 CDMR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$241.34	$313.42	$68.51–$304.02	32% above	23%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CDMR PF 91322 SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$241.34	$313.42	$68.51–$304.02	—	23%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 CDMR SARSCOV2 VACCINE 50 MCG/0.5 ML FOR IM USE	$241.34	$313.42	$68.51–$304.02	—	23%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 PF 90716 VARICELLA VACC SQ	$260.57	$338.40	$73.97–$328.25	9% above	23%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VIRUS VACCINE LIVE SUBQ USE	$260.57	$338.40	$73.97–$328.25	9% above	23%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 Varicella Virus Vac Live For Inj 1350 PFU/0.5ML	$330.32	$428.98	$93.78–$416.11	38% above	23%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VIRUS VACCINE LIVE SUBQ USE	$260.57	$338.40	$73.97–$328.25	—	23%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 PF 90716 VARICELLA VACC SQ	$260.57	$338.40	$73.97–$328.25	—	23%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 Varicella Virus Vac Live For Inj 1350 PFU/0.5ML	$330.32	$428.98	$93.78–$416.11	—	23%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CDMR INFLUENZA VACCINE TRIVALENT PRESER FREE 0.5 ML DOSAGE IM	$79.31	$103.00	$22.52–$99.91	258% above	23%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CDMR PF 90656 FLU VACC TRIVALENT SPLT PF 0.5 ML DOSAGE IM	$79.31	$103.00	$22.52–$99.91	258% above	23%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CDMR INFLUENZA VACCINE TRIVALENT PRESER FREE 0.5 ML DOSAGE IM	$79.31	$103.00	$22.52–$99.91	—	23%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CDMR PF 90656 FLU VACC TRIVALENT SPLT PF 0.5 ML DOSAGE IM	$79.31	$103.00	$22.52–$99.91	—	23%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 PF 90651 HPV VIRUS VACCINE 9 VAL IM	$422.67	$548.91	$119.99–$532.44	11% above	23%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 HUMAN PAPILLOMAVIRUS 6 11 16 18 31 33 45 52 58 NONAVALENT 3 DOSE IM	$422.67	$548.91	$119.99–$532.44	11% above	23%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Human Papillomavirus (HPV) 9-Valent Recomb Vac Susp Pref Syr	$492.76	$639.94	$139.89–$620.74	30% above	23%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 PF 90651 HPV VIRUS VACCINE 9 VAL IM	$422.67	$548.91	$119.99–$532.44	—	23%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HUMAN PAPILLOMAVIRUS 6 11 16 18 31 33 45 52 58 NONAVALENT 3 DOSE IM	$422.67	$548.91	$119.99–$532.44	—	23%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 Human Papillomavirus (HPV) 9-Valent Recomb Vac Susp Pref Syr	$492.76	$639.94	$139.89–$620.74	—	23%
Hepatitis A vaccine, adult dose CPT 90632 Hepatitis A Vaccine Susp Prefilled Syr 1440 EL Unit/ML	$141.24	$183.42	$40.10–$177.92	35% above	23%
Hepatitis A vaccine, adult dose CPT 90632 HEPATITIS A VACCINE ADULT DOSAGE IM USE	$144.27	$187.36	$40.96–$181.74	38% above	23%
Hepatitis A vaccine, adult dose CPT 90632 PF 90632 HEPAT A VACC ADULT	$144.27	$187.36	$40.96–$181.74	38% above	23%
Hepatitis A vaccine, adult dose inpatient CPT 90632 Hepatitis A Vaccine Susp Prefilled Syr 1440 EL Unit/ML	$141.24	$183.42	$40.10–$177.92	—	23%
Hepatitis A vaccine, adult dose inpatient CPT 90632 PF 90632 HEPAT A VACC ADULT	$144.27	$187.36	$40.96–$181.74	—	23%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEPATITIS A VACCINE ADULT DOSAGE IM USE	$144.27	$187.36	$40.96–$181.74	—	23%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 PF 90746 HEPAT B VACC ADULT IM	$130.72	$169.76	$37.11–$164.67	17% above	23%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VACCINE ADULT DOSAGE IM USE	$130.72	$169.76	$37.11–$164.67	17% above	23%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 20 MCG/ML	$132.12	$171.58	$37.51–$166.43	18% above	23%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEPATITIS B VACCINE ADULT DOSAGE IM USE	$130.72	$169.76	$37.11–$164.67	—	23%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 PF 90746 HEPAT B VACC ADULT IM	$130.72	$169.76	$37.11–$164.67	—	23%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hepatitis B Vaccine (Recombinant) Susp Pref Syr 20 MCG/ML	$132.12	$171.58	$37.51–$166.43	—	23%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CDMR FLU VACC PRSV FREE INC ANTIG	$48.83	$63.41	$13.86–$61.51	35% below	23%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CDMR PF 90662 INFLU VACC PF ANTIGEN	$48.83	$63.41	$13.86–$61.51	35% below	23%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CDMR FLU VACC PRSV FREE INC ANTIG	$48.83	$63.41	$13.86–$61.51	—	23%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CDMR PF 90662 INFLU VACC PF ANTIGEN	$48.83	$63.41	$13.86–$61.51	—	23%
MMR vaccine (measles, mumps and rubella), live CPT 90707 Measles-Mumps-Rubella Virus Vaccines For Inj Soln	$146.02	$189.63	$41.45–$183.94	17% above	23%
MMR vaccine (measles, mumps and rubella), live CPT 90707 PF 90707 MMR VIRUS VAC LIVE SQ	$159.85	$207.59	$45.38–$201.36	28% above	23%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES MUMPS AND RUBELLA VIRUS VACCINE (MMR) LIVE SUB-Q USE	$159.85	$207.59	$45.38–$201.36	28% above	23%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 Measles-Mumps-Rubella Virus Vaccines For Inj Soln	$146.02	$189.63	$41.45–$183.94	—	23%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES MUMPS AND RUBELLA VIRUS VACCINE (MMR) LIVE SUB-Q USE	$159.85	$207.59	$45.38–$201.36	—	23%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 PF 90707 MMR VIRUS VAC LIVE SQ	$159.85	$207.59	$45.38–$201.36	—	23%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE SEROGROUPS A C Y & W-135(4-VALENT) IM	$244.13	$317.05	$69.31–$307.54	25% above	23%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 PF 90734 MENING CONJ VACC-QUADRIVALENT IM	$244.13	$317.05	$69.31–$307.54	25% above	23%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 PF 90734 MENING CONJ VACC-QUADRIVALENT IM	$244.13	$317.05	$69.31–$307.54	—	23%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL CONJUGATE VACCINE SEROGROUPS A C Y & W-135(4-VALENT) IM	$244.13	$317.05	$69.31–$307.54	—	23%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENINGOCOCCAL RECOMB PROTEIN&OUTER MEMBRN VESICAL SEROGRP B 2 DOSE IM	$322.14	$418.36	$91.45–$405.81	7% above	23%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 PF 90620 MENINGOCOCCAL RECOMB PROTEIN OMV SEROGRP B 2 DOSE IM	$322.14	$418.36	$91.45–$405.81	7% above	23%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 Meningococcal Vac B (Recomb OMV Adjuv) Inj Prefilled Syringe	$374.77	$486.71	$106.39–$472.11	24% above	23%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 PF 90620 MENINGOCOCCAL RECOMB PROTEIN OMV SEROGRP B 2 DOSE IM	$322.14	$418.36	$91.45–$405.81	—	23%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 MENINGOCOCCAL RECOMB PROTEIN&OUTER MEMBRN VESICAL SEROGRP B 2 DOSE IM	$322.14	$418.36	$91.45–$405.81	—	23%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 Meningococcal Vac B (Recomb OMV Adjuv) Inj Prefilled Syringe	$374.77	$486.71	$106.39–$472.11	—	23%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$314.80	$408.83	$89.37–$396.57	22% below	23%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PF 90677 PNEUMO VACC 20 VAL IM	$314.80	$408.83	$89.37–$396.57	22% below	23%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PCV20 VACCINE FOR INTRAMUSCULAR USE	$314.80	$408.83	$89.37–$396.57	—	23%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PF 90677 PNEUMO VACC 20 VAL IM	$314.80	$408.83	$89.37–$396.57	—	23%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 Pneumococcal Vaccine Polyvalent Soln Pref Syr 25 MCG/0.5ML	$198.63	$257.96	$56.39–$250.22	50% above	23%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PF 90732 IMM PNEUMOCOCCAL VACC	$207.07	$268.92	$58.79–$260.85	57% above	23%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE 23-VALENT ADULT IMMUNOSUPPRESSED P	$207.07	$268.92	$58.79–$260.85	57% above	23%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pneumococcal Vaccine Polyvalent Soln Pref Syr 25 MCG/0.5ML	$198.63	$257.96	$56.39–$250.22	—	23%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL POLYSACCHARIDE VACCINE 23-VALENT ADULT IMMUNOSUPPRESSED P	$207.07	$268.92	$58.79–$260.85	—	23%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PF 90732 IMM PNEUMOCOCCAL VACC	$207.07	$268.92	$58.79–$260.85	—	23%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$738.78	$959.45	$209.74–$930.67	41% above	23%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 PF 90380 RSV MONOC ANTB SEASN .5ML IM	$738.78	$959.45	$209.74–$930.67	41% above	23%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 PF 90380 RSV MONOC ANTB SEASN .5ML IM	$738.78	$959.45	$209.74–$930.67	—	23%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV MONOC ANTB SEASN .5ML IM	$738.78	$959.45	$209.74–$930.67	—	23%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$474.05	$615.64	$134.58–$597.17	115% above	23%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678 RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE	$474.05	$615.64	$134.58–$597.17	—	23%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM USE	$648.61	$842.34	$184.14–$817.07	18% above	23%
Rabies vaccine, one dose CPT 90675 PF 90675 RABIES VACC IM VL 1ML	$648.61	$842.34	$184.14–$817.07	18% above	23%
Rabies vaccine, one dose CPT 90675 Rabies Vaccine, PCEC For Inj	$652.28	$847.11	$185.18–$821.70	18% above	23%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM USE	$648.61	$842.34	$184.14–$817.07	—	23%
Rabies vaccine, one dose inpatient CPT 90675 PF 90675 RABIES VACC IM VL 1ML	$648.61	$842.34	$184.14–$817.07	—	23%
Rabies vaccine, one dose inpatient CPT 90675 Rabies Vaccine, PCEC For Inj	$652.28	$847.11	$185.18–$821.70	—	23%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 PF 90750 ZOSTER VAC HZV RECOMBINANT SUBUNIT ADJUVANTED IM	$288.52	$374.70	$81.91–$363.46	26% above	23%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER VACCINE HZV, RECOMBINANT, SUBUNIT, ADJUVANTED, INTRAMUSCULAR	$288.52	$374.70	$81.91–$363.46	26% above	23%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 Zoster Vac Recombinant Adjuvanted for IM Inj 50 MCG/0.5ML	$362.15	$470.32	$102.81–$456.21	58% above	23%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER VACCINE HZV, RECOMBINANT, SUBUNIT, ADJUVANTED, INTRAMUSCULAR	$288.52	$374.70	$81.91–$363.46	—	23%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 PF 90750 ZOSTER VAC HZV RECOMBINANT SUBUNIT ADJUVANTED IM	$288.52	$374.70	$81.91–$363.46	—	23%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 Zoster Vac Recombinant Adjuvanted for IM Inj 50 MCG/0.5ML	$362.15	$470.32	$102.81–$456.21	—	23%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 Tetanus-Diphtheria Toxoids (Td) Inj 5-2 LF/0.5ML	$75.82	$98.46	$21.52–$95.51	21% above	23%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 PF 90714 DIP TET PF >7YR IM DO	$79.59	$103.36	$22.59–$100.26	28% above	23%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD TOXOIDS ABSORBED PRESERVATIVE FREE	$79.59	$103.36	$22.59–$100.26	28% above	23%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 Tetanus-Diphtheria Toxoids (Td) Inj 5-2 LF/0.5ML	$75.82	$98.46	$21.52–$95.51	—	23%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD TOXOIDS ABSORBED PRESERVATIVE FREE	$79.59	$103.36	$22.59–$100.26	—	23%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 PF 90714 DIP TET PF >7YR IM DO	$79.59	$103.36	$22.59–$100.26	—	23%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2-15.5 LF-MCG/0.5ML	$102.37	$132.94	$29.06–$128.95	31% above	23%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP 7 YRS OR OLDER IM	$103.88	$134.90	$29.49–$130.85	32% above	23%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 PF 90715 TDAP VACC >7 YR IM	$103.88	$134.90	$29.49–$130.85	32% above	23%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 Tet-Diph-Acell Pertuss Ad Pref Syr 5-2-15.5 LF-MCG/0.5ML	$102.37	$132.94	$29.06–$128.95	—	23%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 PF 90715 TDAP VACC >7 YR IM	$103.88	$134.90	$29.49–$130.85	—	23%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP 7 YRS OR OLDER IM	$103.88	$134.90	$29.49–$130.85	—	23%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 PF 90691 TYPHOID VACC VI CAP	$198.60	$257.91	$56.38–$250.17	36% above	23%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE (VICPS) IM USE	$198.60	$257.91	$56.38–$250.17	36% above	23%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE (VICPS) IM USE	$198.60	$257.91	$56.38–$250.17	—	23%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 PF 90691 TYPHOID VACC VI CAP	$198.60	$257.91	$56.38–$250.17	—	23%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE	$53.99	$70.11	$15.33–$68.01	32% above	23%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN INFLUENZA VIR VAC	$53.99	$70.11	$15.33–$68.01	32% above	23%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION 1 SNGL COMBINATION VACCINE TOXOID	$53.99	$70.11	$15.33–$68.01	32% above	23%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATON	$53.99	$70.11	$15.33–$68.01	32% above	23%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN 1 VACCINE	$53.99	$70.11	$15.33–$68.01	32% above	23%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PF 90471 IMMUN ADM 1 VACC IM	$53.99	$70.11	$15.33–$68.01	32% above	23%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION 1 SNGL COMBINATION VACCINE TOXOID	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PF 90471 IMMUN ADM 1 VACC IM	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ED 90471 IMMUNE ADMIN 1 VACCINE	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN INFLUENZA VIR VAC	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN 1 VACCINE	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATON	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 PF 90472 IMMUN ADM ADD VAC IM	$53.99	$70.11	$15.33–$68.01	114% above	23%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDL VACCINE	$53.99	$70.11	$15.33–$68.01	114% above	23%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE	$53.99	$70.11	$15.33–$68.01	114% above	23%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDL SNGL COMBINATION VACCINE TOXOID	$53.99	$70.11	$15.33–$68.01	114% above	23%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ED 90472 IMMUN ADMIN EA ADDL VACCINE	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EACH ADDL SNGL COMBINATION VACCINE TOXOID	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 PF 90472 IMMUN ADM ADD VAC IM	$53.99	$70.11	$15.33–$68.01	—	23%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADDL VACCINE	$53.99	$70.11	$15.33–$68.01	—	23%

Source file: https://sthpiprd.blob.core.windows.net/machine-readable-files/8047/410726171_international-falls-memorial-hospital-association_standardcharges.csv