Mountain Lakes Medical Center
Listed in its price file as “Professional Resource Mgmt of Rabun LLC”.
Mountain Lakes Medical Center in Clayton, GA publishes cash prices for 247 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Georgia median for 234 of 246 procedures and above it for 12. By typical cash price it ranks #2 of 61 Georgia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.
162 Legacy Point, Clayton, GA 30525-5354 Collected Sep 27, 2026 Source price file (706) 782-3100
Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 111336 · CMS hospital register
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE COMPLETE LT | $104.00 | $260.00 | $182.00 | 60% below | 60% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 XR MODIFIED BARIUM SWALLOW | $225.60 | $564.00 | $394.80 | 28% below | 60% |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 BARIUM SWALLOW (BA) | $225.60 | $564.00 | $394.80 | 28% below | 60% |
| Breast ultrasound, complete, one breast one side CPT 76641 BREAST COMPLETE UNILAT INCLUDE AXILLA | $183.60 | $459.00 | $321.30–$367.20 | 52% below | 60% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED LT INCLUDE AXILLA | $104.00 | $260.00 | $182.00–$208.00 | 73% below | 60% |
| Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED RT INCLUDE AXILLA | $104.00 | $260.00 | $182.00–$208.00 | 73% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W WO CT 70 SEC ABD PEL | $210.00 | $525.00 | $367.50 | 89% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST W WO CTA (BUNDEL CODE) | $897.60 | $2,244.00 | $1,570.80 | 52% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST AORTA W WO CONTRAST | $1,381.60 | $3,454.00 | $2,417.80 | 26% below | 60% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST PULMONARY EMBOLISM PROTOCOL | $1,381.60 | $3,454.00 | $2,417.80 | 26% below | 60% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WITHOUT CONTRAST | $280.00 | $700.00 | $490.00 | 87% below | 60% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS W/O CONTRAST W/ ORAL | $280.00 | $700.00 | $490.00 | 87% below | 60% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ZX A/P WITH IV CONTRAST BUNDEL ONLY | $439.60 | $1,099.00 | $769.30 | 86% below | 60% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD AND PEL WITH IV CONTRAST ONLY | $439.60 | $1,099.00 | $769.30 | 86% below | 60% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD PEL WITH IV CONTRAST ORAL | $439.60 | $1,099.00 | $769.30 | 86% below | 60% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 ABDOMEN & PELVIS WITH & W/OUT CONTRAS | $880.00 | $2,200.00 | $1,540.00 | 72% below | 60% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH CONTRAST | $439.60 | $1,099.00 | $769.30 | 74% below | 60% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WITHOUT CONTRAST | $125.60 | $314.00 | $219.80 | 91% below | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL BONES W/O CONTRAST | $453.20 | $1,133.00 | $793.10 | 62% below | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 SINUSES W/O CONTRAST | $453.20 | $1,133.00 | $793.10 | 62% below | 60% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUSES WITHOUT CONTRAST | $453.20 | $1,133.00 | $793.10 | 62% below | 60% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD W/O CONTRAST | $125.60 | $314.00 | $219.80 | 91% below | 60% |
| CT scan of the head with contrast CPT 70460 CT HEAD W/CONTRAST | $439.60 | $1,099.00 | $769.30 | 72% below | 60% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD W & WO CONTRAST | $790.80 | $1,977.00 | $1,383.90 | 58% below | 60% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST | $439.60 | $1,099.00 | $769.30 | 66% below | 60% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH CONTRAST | $439.60 | $1,099.00 | $769.30 | 73% below | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US EXTRACRANIAL ARTERIES; COMPLETE | $290.80 | $727.00 | $508.90–$811.00 | 62% below | 60% |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US SCREENING CAROTID DOPPLER US BILATERA | $290.80 | $727.00 | $508.90–$811.00 | 62% below | 60% |
| Chest X-ray, single view CPT 71045 XR CHEST (LAT DECUBS)LT | $104.00 | $260.00 | $182.00 | 52% below | 60% |
| Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW | $104.00 | $260.00 | $182.00 | 52% below | 60% |
| Chest X-ray, single view one side CPT 71045 XR CHEST (LAT DECUBS) RT | $104.00 | $260.00 | $182.00 | 52% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL (RENAL AORTA NODES) | $125.60 | $314.00 | $219.80–$251.20 | 79% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US ABDOMINAL AORTA(NON SCREENING) | $125.60 | $314.00 | $219.80–$251.20 | 79% below | 60% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RENAL US | $125.60 | $314.00 | $219.80–$251.20 | 79% below | 60% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST | $125.60 | $314.00 | $219.80 | 90% below | 60% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH CONTRAST | $483.20 | $1,208.00 | $845.60 | 69% below | 60% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US ARTERIAL LOWER BILAT EXTREMITY | $316.80 | $792.00 | $554.40–$811.00 | — | 60% |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US EXTREMITIES ARTERIES BILATERAL ULTRAS | $316.80 | $792.00 | $554.40–$811.00 | — | 60% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 US VENOUS BILATERA DUPLEX SCAN COMPLETE | $316.80 | $792.00 | $554.40–$811.00 | 74% below | 60% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHOCARDIOGRAM COMPLETE | $630.80 | $1,577.00 | $1,067.00–$1,261.60 | 66% below | 60% |
| In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY CPAP | $1,190.80 | $2,977.00 | $542.00–$2,381.60 | 64% below | 60% |
| Knee X-ray, 3 views one side CPT 73562 XR KNEE (3 VIEWS) LT | $104.00 | $260.00 | $182.00 | 61% below | 60% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN ULTRASOUND (LIMITED) | $206.80 | $517.00 | $361.90–$413.60 | 58% below | 60% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT CHEST LOW DOSE | $185.60 | $464.00 | $324.80 | 30% below | 60% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE LUNG WO CONTRAST | $185.60 | $464.00 | $324.80 | 30% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE WO LEFT | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT HIP W/O CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT HIP W/O CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT KNEE W/O CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT KNEE W/O CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI KNEE LT WO CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE WO RIGHT | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI HIP WO RIGHT | $373.63 | $934.08 | $653.86 | 79% below | 60% |
| MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT KNEE W/O | $373.63 | $934.08 | $653.86 | 79% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W / WO LEFT | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE RT WO AND W CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LT HIP W W/O CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE LT WO AND W CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI HIP W W/O CONTRAST RT | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LT KNEE W/ WO | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RT KNEE W/ WO | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE W / WO RIGHT | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN MRCP WO CONTRAST | $373.60 | $934.00 | $653.80 | 80% below | 60% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST | $373.60 | $934.00 | $653.80 | 80% below | 60% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN RENAL WO CONTRAST | $373.60 | $934.00 | $653.80 | 80% below | 60% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD RENAL WO AND W CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 80% below | 60% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN MRCP WO AND W CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 80% below | 60% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W/WO CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 80% below | 60% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST | $373.60 | $934.00 | $653.80 | 78% below | 60% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI IAC WO/W | $589.60 | $1,474.00 | $1,031.80 | 79% below | 60% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 79% below | 60% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE W/WO CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 78% below | 60% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of the pelvis without and with contrast CPT 72197 MRI-PELVIS WO AND W CONTRAST | $589.60 | $1,474.00 | $1,031.80 | 80% below | 60% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI-PELVIS WO CONTRAST | $373.60 | $934.00 | $653.80 | 79% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST RT WO CONTRAST | $373.60 | $934.00 | $653.80 | 76% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW RT W/O CONTRAST | $373.60 | $934.00 | $653.80 | 76% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI ELBOW LT WO CONTRAST | $373.60 | $934.00 | $653.80 | 76% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER RIGHT WO CONTRAST | $373.60 | $934.00 | $653.80 | 76% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SHOULDER LT W/O CONTRAST | $373.60 | $934.00 | $653.80 | 76% below | 60% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI WRIST LT WO CONTRAST | $373.60 | $934.00 | $653.80 | 76% below | 60% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIC ULTRASOUND (LIMITED) | $137.60 | $344.00 | $240.80–$275.20 | 65% below | 60% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC ULTRASOUND (COMPLETE) | $125.60 | $314.00 | $219.80–$251.20 | 79% below | 60% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB ULTRASOUND COMPLETE | $160.80 | $402.00 | $281.40–$321.60 | 72% below | 60% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB ULTRASOUND TRANSVAGI 1ST TRIMESTER | $137.60 | $344.00 | $240.80–$275.20 | 74% below | 60% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB LIMITED ULTRASOUND | $137.60 | $344.00 | $240.80–$275.20 | 60% below | 60% |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR SHOULDER BI LAT MIN 2 VIEWS | $132.40 | $331.00 | $231.70 | — | 60% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER RT MIN 2 VIEWS | $88.40 | $221.00 | $154.70 | 75% below | 60% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR CHIRO SHOULDER RT MIN 2 VIEWS | $88.40 | $221.00 | $154.70 | 75% below | 60% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR CHIRO SHOULDER LT MIN 2 VIEWS | $88.80 | $222.00 | $155.40 | 74% below | 60% |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER LT MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 70% below | 60% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY PSG | $1,161.60 | $2,904.00 | $542.00–$2,323.20 | 62% below | 60% |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 XR OPERATIVE CHOLANGIOGRAM | $225.60 | $564.00 | $394.80 | 69% below | 60% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL ULTRASOUND COMPLETE | $125.60 | $314.00 | $219.80–$251.20 | 75% below | 60% |
| Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL ULTRASOUND | $125.60 | $314.00 | $219.80–$251.20 | 69% below | 60% |
| Ultrasound of the scrotum and testicles CPT 76870 US TESTICULAR SCROTAL ULTRASOUND | $125.60 | $314.00 | $219.80–$251.20 | 77% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID ULTRASOUND | $125.60 | $314.00 | $219.80–$251.20 | 79% below | 60% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUES HEAD AND NECK ULTRASOUND | $125.60 | $314.00 | $219.80–$251.20 | 79% below | 60% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX SCAN RT COMPLETE | $125.60 | $314.00 | $219.80–$811.00 | 80% below | 60% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VENOUS DUPLEX SCAN LT COMPLETE | $125.60 | $314.00 | $219.80–$811.00 | 80% below | 60% |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMPLETE LT | $104.00 | $260.00 | $182.00 | 56% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2V LEFT | $109.60 | $274.00 | $191.80 | 49% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RIGHT WITH PELVIS 2-3 VIEWS | $109.60 | $274.00 | $191.80 | 49% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LEFT WITH PELVIS 2-3 VIEWS | $109.60 | $274.00 | $191.80 | 49% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP RT 2-3 VIEWS | $109.60 | $274.00 | $191.80 | 49% below | 60% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP LT 2-3 VIEWS | $109.60 | $274.00 | $191.80 | 49% below | 60% |
| X-ray of the ankle, 2 views both sides CPT 73600 XR ANKLE BILAT LTD | $104.00 | $260.00 | $182.00 | — | 60% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE LTD LT | $104.00 | $260.00 | $182.00 | 49% below | 60% |
| X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE LTD RT | $104.00 | $260.00 | $182.00 | 49% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 3RD DIGIT LT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 4TH DIGIT LT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 1ST DIGIT RT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 2ND DIGIT LT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 4TH DIGIT RT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 3RD DIGIT RT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 1ST DIGIT LT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 5TH DIGIT RT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the finger(s), 2 or more views one side CPT 73140 XR 5TH DIGIT LT HAND MIN 2 VIEWS | $104.00 | $260.00 | $182.00 | 43% below | 60% |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR FOOT BILAT COMPLETE | $104.00 | $260.00 | $182.00 | — | 60% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE RT | $104.00 | $260.00 | $182.00 | 60% below | 60% |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMPLETE LT | $104.00 | $260.00 | $182.00 | 60% below | 60% |
| X-ray of the hand, 3 or more views both sides CPT 73130 XR HAND BILAT COMPLETE | $104.00 | $260.00 | $182.00 | — | 60% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMPLETE LT | $104.00 | $260.00 | $182.00 | 61% below | 60% |
| X-ray of the hand, 3 or more views one side CPT 73130 XR HAND COMPLETE RT | $104.00 | $260.00 | $182.00 | 61% below | 60% |
| X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE LTD LT | $104.00 | $260.00 | $182.00 | 44% below | 60% |
| X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE WITH OBLIQUES | $137.60 | $344.00 | $240.80 | 73% below | 60% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE AP LAT | $137.60 | $344.00 | $240.80 | 58% below | 60% |
| X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES MIN 3 VIEWS | $104.00 | $260.00 | $182.00 | 52% below | 60% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CHIRO CPINE LTD | $125.60 | $314.00 | $219.80 | 70% below | 60% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE LTD | $125.60 | $314.00 | $219.80 | 70% below | 60% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 XR AP PELVIS | $137.60 | $344.00 | $240.80 | 43% below | 60% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM COCCYX AP/LAT | $104.00 | $260.00 | $182.00 | 64% below | 60% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 SGPT | $24.80 | $62.00 | $43.40–$49.60 | 44% below | 60% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 AST | $24.80 | $62.00 | $43.40–$49.60 | 31% below | 60% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE | $160.00 | $400.00 | $280.00–$320.00 | 55% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CAT | $13.60 | $34.00 | $23.80–$27.20 | 63% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST CASHEW | $13.60 | $34.00 | $23.80–$27.20 | 63% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BEE VENOM PROFILE PART 1 | $13.60 | $34.00 | $23.80–$27.20 | 63% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST WHEAT | $13.60 | $34.00 | $23.80–$27.20 | 63% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST SOYBEAN | $13.60 | $34.00 | $23.80–$27.20 | 63% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST PEANUT | $13.60 | $34.00 | $23.80–$27.20 | 63% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 RAST BEE VENOM | $35.60 | $89.00 | $62.30–$71.20 | 4% below | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 BEE RAST | $90.40 | $226.00 | $158.20–$180.80 | 144% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY SHELLFISH | $107.60 | $269.00 | $188.30–$215.20 | 190% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY NUTS | $110.00 | $275.00 | $192.50–$220.00 | 197% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY BASIC FOOD | $156.00 | $390.00 | $273.00–$312.00 | 321% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PANEL GENERAL | $204.80 | $512.00 | $358.40–$409.60 | 453% above | 60% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGY ZONE 8 PANEL 1/2 | $468.40 | $1,171.00 | $819.70–$936.80 | 1164% above | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTI-NUCLEAR ANTIBODY REFLEX | $44.00 | $110.00 | $77.00–$88.00 | 53% below | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA ANTI-NUCLEAR ANTIBODIES | $44.00 | $110.00 | $77.00–$88.00 | 53% below | 60% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 SYSTEMIC LUPUS ERYTHEMATOSUS B | $95.60 | $239.00 | $167.30–$191.20 | 2% above | 60% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP TRIAGE | $58.00 | $145.00 | $101.50–$116.00 | 57% below | 60% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BETA NATARETIC PEPTIDE | $64.80 | $162.00 | $113.40–$129.60 | 52% below | 60% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $50.00 | $125.00 | $87.50–$100.00 | 39% below | 60% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL DAILY | $50.00 | $125.00 | $87.50–$100.00 | 39% below | 60% |
| Blood culture for bacteria CPT 87040 CULTURE AFB BLOOD | $42.00 | $105.00 | $73.50–$84.00 | 48% below | 60% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE | $46.40 | $116.00 | $81.20–$92.80 | 42% below | 60% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE | $13.60 | $34.00 | $23.80–$27.20 | 9% above | 60% |
| Blood glucose (sugar) test CPT 82947 GLUCOSE SERUM | $24.80 | $62.00 | $43.40–$49.60 | 32% below | 60% |
| Blood lead test CPT 83655 LEAD BLOOD | $29.20 | $73.00 | $51.10–$58.40 | 58% below | 60% |
| Blood lead test CPT 83655 LEAD URINE | $29.20 | $73.00 | $51.10–$58.40 | 58% below | 60% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREGNANCY TEST SERUM | $54.80 | $137.00 | $95.90–$109.60 | 59% below | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLOOD TYPE-ABO | $139.33 | $348.33 | $243.83–$278.66 | 110% above | 60% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ARC BLOOD TYPE-ABO | $142.40 | $356.00 | $249.20–$284.80 | 114% above | 60% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP QUANTITATIVE | $42.00 | $105.00 | $73.50–$84.00 | 70% below | 60% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF BY PCR | $255.20 | $638.00 | $446.60–$510.40 | 187% above | 60% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125 | $59.60 | $149.00 | $104.30–$119.20 | 58% below | 60% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 HE4 | $463.60 | $1,159.00 | $811.30–$927.20 | 229% above | 60% |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 VRL UPRSPRT A-PROBE | $63.60 | $159.00 | $111.30–$127.20 | 48% below | 60% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA/GC URINE | $71.60 | $179.00 | $125.30–$143.20 | 5% below | 60% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $69.60 | $174.00 | $121.80–$139.20 | 17% below | 60% |
| Complete blood count (CBC) with differential CPT 85025 CHARGE CBC/ AUTO DIFF | $25.60 | $64.00 | $44.80–$51.20 | 61% below | 60% |
| Complete blood count (CBC), no differential CPT 85027 CHARGE CBC W/O DIFF | $28.80 | $72.00 | $50.40–$57.60 | 39% below | 60% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL DAILY | $67.20 | $168.00 | $117.60–$134.40 | 36% below | 60% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $67.20 | $168.00 | $117.60–$134.40 | 36% below | 60% |
| D-dimer blood test (blood clot marker) CPT 85379 D DIMER TRIAGE | $67.20 | $168.00 | $117.60–$134.40 | 37% below | 60% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE | $64.00 | $160.00 | $112.00–$128.00 | 63% below | 60% |
| Estradiol blood test CPT 82670 ESTRADIOL | $71.60 | $179.00 | $125.30–$143.20 | 33% below | 60% |
| FSH (follicle-stimulating hormone) test CPT 83001 FSH | $60.00 | $150.00 | $105.00–$120.00 | 61% below | 60% |
| Ferritin blood test (iron stores) CPT 82728 FERRITIN | $55.60 | $139.00 | $97.30–$111.20 | 62% below | 60% |
| Folate (folic acid) blood test CPT 82746 FOLATE SERUM | $53.60 | $134.00 | $93.80–$107.20 | 68% below | 60% |
| Free T3 thyroid hormone test CPT 84481 T-3 FREE | $54.00 | $135.00 | $94.50–$108.00 | 70% below | 60% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T-4 FREE | $43.60 | $109.00 | $76.30–$87.20 | 68% below | 60% |
| Free testosterone test CPT 84402 TESTOSTERONE FREE | $49.60 | $124.00 | $86.80–$99.20 | 79% below | 60% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GTT GLUCOSE TOLERANCE 1 HOUR MOD | $24.00 | $60.00 | $42.00–$48.00 | 69% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 GTT GLUCOSE TOLERANCE 2 HOUR | $57.20 | $143.00 | $100.10–$114.40 | 43% below | 60% |
| Glucose tolerance test, 3 samples CPT 82951 GTT-GLUCOSE TOLERANCE 3 HOUR | $69.20 | $173.00 | $121.10–$138.40 | 32% below | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 URINE GC AMPLIFICATION | $54.80 | $137.00 | $95.90–$109.60 | 27% below | 60% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC/CHLAMYDIA AMPLIFICATION | $86.40 | $216.00 | $151.20–$172.80 | 15% above | 60% |
| H. pylori antibody blood test CPT 86677 H PYLORI QUAL SERUM | $56.40 | $141.00 | $98.70–$112.80 | 37% below | 60% |
| H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY PANEL | $82.40 | $206.00 | $144.20–$164.80 | 8% below | 60% |
| H. pylori stool antigen test CPT 87338 STOOL FOR H-PYLORI | $176.80 | $442.00 | $309.40–$353.60 | 3% above | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV VIRAL LOAD QUANT BY PCR | $136.40 | $341.00 | $238.70–$272.80 | 47% below | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV QT PCR RNA | $146.00 | $365.00 | $255.50–$292.00 | 44% below | 60% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV RNA (BDNA) | $156.00 | $390.00 | $273.00–$312.00 | 40% below | 60% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 A1C HGB | $40.80 | $102.00 | $71.40–$81.60 | 59% below | 60% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE AB | $46.80 | $117.00 | $81.90–$93.60 | 42% below | 60% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB | $56.00 | $140.00 | $98.00–$112.00 | 60% below | 60% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HCV PCR RNA QT | $172.40 | $431.00 | $301.70–$344.80 | 13% below | 60% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C PCR QUANT | $198.80 | $497.00 | $347.90–$397.60 | 1% above | 60% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY | $48.40 | $121.00 | $84.70–$96.80 | 47% below | 60% |
| Insulin blood test CPT 83525 INSULIN | $52.00 | $130.00 | $91.00–$104.00 | 20% below | 60% |
| Iron blood test (serum iron) CPT 83540 IRON | $28.00 | $70.00 | $49.00–$56.00 | 40% below | 60% |
| Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY | $34.00 | $85.00 | $59.50–$68.00 | 75% below | 60% |
| Kidney function blood test panel CPT 80069 RENAL PROFILE | $56.40 | $141.00 | $98.70–$112.80 | 55% below | 60% |
| LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE | $65.20 | $163.00 | $114.10–$130.40 | 23% below | 60% |
| Lipase blood test (pancreas enzyme) CPT 83690 LIPASE | $50.80 | $127.00 | $88.90–$101.60 | 59% below | 60% |
| Liver function blood test panel CPT 80076 HEPATIC PANEL | $57.20 | $143.00 | $100.10–$114.40 | 46% below | 60% |
| Lyme disease antibody test CPT 86618 LYME TEST | $56.40 | $141.00 | $98.70–$112.80 | 28% below | 60% |
| Magnesium blood test CPT 83735 LITU 24 HOUR BILLING 10 | $8.04 | $20.10 | $14.07–$16.08 | 87% below | 60% |
| Magnesium blood test CPT 83735 URINE MAGNESIUM RANDOM | $21.20 | $53.00 | $37.10–$42.40 | 67% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE | $29.60 | $74.00 | $51.80–$59.20 | 53% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM RBC | $29.60 | $74.00 | $51.80–$59.20 | 53% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM URINE 24 HOUR | $33.20 | $83.00 | $58.10–$66.40 | 48% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM SERUM | $43.60 | $109.00 | $76.30–$87.20 | 31% below | 60% |
| Magnesium blood test CPT 83735 MAGNESIUM SERUM DAILY | $43.60 | $109.00 | $76.30–$87.20 | 31% below | 60% |
| Measles (rubeola) antibody test CPT 86765 MEASLES IGM | $40.80 | $102.00 | $71.40–$81.60 | 33% below | 60% |
| Measles (rubeola) antibody test CPT 86765 MEASLES IGG (RUBEOLA) | $46.40 | $116.00 | $81.20–$92.80 | 24% below | 60% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $50.00 | $125.00 | $87.50–$100.00 | 62% below | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-DIAGNOSTIC | $58.80 | $147.00 | $102.90–$117.60 | 66% below | 60% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA-ENHANCED (POST PROSTATECTOMY) | $95.60 | $239.00 | $167.30–$191.20 | 44% below | 60% |
| Parathyroid hormone (PTH) blood test CPT 83970 PARATHYROID HORMONE INTACT | $112.80 | $282.00 | $197.40–$225.60 | 50% below | 60% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $46.80 | $117.00 | $81.90–$93.60 | 6% above | 60% |
| Progesterone blood test CPT 84144 PROGESTERONE | $52.80 | $132.00 | $92.40–$105.60 | 68% below | 60% |
| Prolactin blood test CPT 84146 PROLACTIN | $69.20 | $173.00 | $121.10–$138.40 | 64% below | 60% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PT PROTIME | $32.80 | $82.00 | $57.40–$65.60 | 14% below | 60% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP SCREEN | $33.20 | $83.00 | $58.10–$66.40 | 56% below | 60% |
| Stool ova and parasites exam CPT 87177 OVA & PARASITE (O&P) | $32.40 | $81.00 | $56.70–$64.80 | 67% below | 60% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREENING | $20.40 | $51.00 | $35.70–$40.80 | 45% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL CSF | $17.60 | $44.00 | $30.80–$35.20 | 52% below | 60% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR | $26.80 | $67.00 | $46.90–$53.60 | 28% below | 60% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIRFERON GOLD TB TEST-INCUBATED | $102.40 | $256.00 | $179.20–$204.80 | 42% below | 60% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE | $56.80 | $142.00 | $99.40–$113.60 | 67% below | 60% |
| Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE WEAKLY BOUND | $70.40 | $176.00 | $123.20–$140.80 | 60% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE | $24.40 | $61.00 | $42.70–$48.80 | 77% below | 60% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER KIDNEY MICROSOMAL AB | $46.80 | $117.00 | $81.90–$93.60 | 55% below | 60% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH | $56.80 | $142.00 | $99.40–$113.60 | 64% below | 60% |
| Uric acid blood test CPT 84550 URIC ACID SERUM | $23.20 | $58.00 | $40.60–$46.40 | 69% below | 60% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS | $23.60 | $59.00 | $41.30–$47.20 | 43% below | 60% |
| Urinalysis without microscope exam, automated CPT 81003 URINE DIPSTICK | $18.40 | $46.00 | $32.20–$36.80 | 48% below | 60% |
| Urine pregnancy test, read by color change CPT 81025 PREGNANCY TEST URINE | $42.00 | $105.00 | $73.50–$84.00 | 46% below | 60% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $61.20 | $153.00 | $107.10–$122.40 | 47% below | 60% |
| Vitamin B12 (cobalamin) blood test CPT 82607 PERNICIOUS ANEMIA CASCADE | $78.00 | $195.00 | $136.50–$156.00 | 33% below | 60% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D25 (OH 25) | $86.40 | $216.00 | $151.20–$172.80 | 64% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 DRUG SCREEN AMERITOX | $18.80 | $47.00 | $32.90–$37.60 | 88% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG QUANTITATIVE PREGNANCY | $52.00 | $130.00 | $91.00–$104.00 | 67% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QUAD MATERNAL AFP PANEL 2/3 | $75.20 | $188.00 | $131.60–$150.40 | 53% below | 60% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG SUB UNIT QT | $79.60 | $199.00 | $139.30–$159.20 | 50% below | 60% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Adenoid removal (adenoidectomy), child under 12 CPT 42830 REMOVAL OF ADENOIDS | $3,516.80 | $8,792.00 | $6,154.40–$7,473.20 | 57% below | 60% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 BUNIONECTOMY | $3,679.20 | $9,198.00 | $6,438.60–$7,818.30 | 45% below | 60% |
| Bunion correction with a bone cut near the head of the first metatarsal CPT 28296 INCISION OF METATARSAL | $3,679.20 | $9,198.00 | $6,438.60–$7,818.30 | 45% below | 60% |
| Bunion correction with removal of part of the big toe joint CPT 28292 CORRECTION HALLUX VALGUS | $3,679.20 | $9,198.00 | $6,438.60–$7,818.30 | 37% below | 60% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 ER CARDIOVERSION ELECTIVE EXTERNAL | $709.20 | $1,773.00 | $750.00–$1,241.10 | 71% below | 60% |
| Cataract surgery with lens implant CPT 66984 EXTRACAPSULAR CATARACT REMOVAL | $2,669.20 | $6,673.00 | $4,671.10–$5,672.05 | 75% below | 60% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 FAC REDUCTION DISTAL RADIAL FX W/ POS | $248.41 | $621.03 | $434.72–$750.00 | 65% below | 60% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/REMOVAL BY SNARE TECHNIQUE | $1,338.80 | $3,347.00 | $2,342.90–$2,844.95 | 66% below | 60% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY | $1,338.80 | $3,347.00 | $2,342.90–$2,844.95 | 66% below | 60% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY DIAGNOSTIC | $1,094.00 | $2,735.00 | $1,914.50–$2,324.75 | 73% below | 60% |
| Complex cataract surgery with lens implant CPT 66982 EXTRACAPSULAR CATARACT REMOVAL | $2,669.20 | $6,673.00 | $4,671.10–$5,672.05 | 75% below | 60% |
| Ear tube placement (tympanostomy) under general anesthesia, one ear CPT 69436 TYMPANOSTOMY GENERAL ANESTHESIA | $1,716.00 | $4,290.00 | $3,003.00–$3,646.50 | 14% below | 60% |
| Ear tube placement (tympanostomy) with local anesthesia, one ear CPT 69433 OP FACILITY TYMPANOSTOMY LOC OR TOP ANES | $564.80 | $1,412.00 | $988.40–$1,129.60 | 38% below | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 OP FAC CERUMEN REM EAR IRRIGATE | $19.60 | $49.00 | $34.30–$39.20 | 87% below | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 OP CL CERUMEN REM EAR IRRIGATE | $19.60 | $49.00 | $34.30–$39.20 | 87% below | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 CERUMEN REMOVAL IRRIGATION/LAVAGE | $68.98 | $172.44 | $120.71–$750.00 | 54% below | 60% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 OP FACILITY CERUMEN REM EAR IRRIGATE | $71.20 | $178.00 | $124.60–$142.40 | 52% below | 60% |
| Earwax removal with instruments, one ear CPT 69210 CERUMEN REMOVAL INSTRUMENTATION | $68.98 | $172.44 | $120.71–$750.00 | 79% below | 60% |
| Earwax removal with instruments, one ear CPT 69210 OP CL EAR INSTRUMENT | $70.00 | $175.00 | $122.50–$140.00 | 79% below | 60% |
| Endoscopic sinus surgery: full ethmoid sinus opening CPT 31255 OP FACILITY NASAL SINUS | $7,424.40 | $18,561.00 | $12,992.70–$15,776.85 | 21% below | 60% |
| Endoscopic sinus surgery: opening the frontal sinus CPT 31276 FAC NASAL/SINUS ENDOSCOPY | $7,647.20 | $19,118.00 | $13,382.60–$16,250.30 | 14% above | 60% |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus CPT 31256 EXPLORATION MAXILLARY SINUS | $4,200.40 | $10,501.00 | $7,350.70–$8,925.85 | 37% below | 60% |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue CPT 31267 ENDOSCOPY MAXILLARY SINUS | $7,647.20 | $19,118.00 | $13,382.60–$16,250.30 | 14% above | 60% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 TRANSLAMIBAR EPIDURAL INJ C OR T SPINE | $796.40 | $1,991.00 | $1,393.70–$1,692.35 | 76% below | 60% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FAC CL INJ THER AGENT PARA FACET JOINT W | $1,022.62 | $2,556.54 | $1,789.58–$2,045.23 | 66% below | 60% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 FACET MEDIAL NERVE BLOCK L SPINE | $1,053.60 | $2,634.00 | $1,843.80–$2,238.90 | 65% below | 60% |
| Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 SIGMOIDOSCOPY / FLEX SIG | $1,027.20 | $2,568.00 | $1,797.60–$2,182.80 | 53% below | 60% |
| Hammertoe correction surgery CPT 28285 CORRECTION HAMMERTOE | $3,679.20 | $9,198.00 | $6,438.60–$7,818.30 | 45% below | 60% |
| Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558 HYSTEROSCOPY BIOPSY | $3,562.40 | $8,906.00 | $6,234.20–$7,570.10 | 59% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 ER I&D OF ABSCESS SIMPLE | $122.40 | $306.00 | $214.20–$750.00 | 80% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 OP FAC I&D SIM | $130.07 | $325.17 | $227.62–$260.14 | 78% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 OP CL I&D SIMPLE | $146.80 | $367.00 | $256.90–$293.60 | 76% below | 60% |
| Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAIN | $154.32 | $385.80 | $270.06–$308.64 | 74% below | 60% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 OP CL INJ TENDON SHEATH LIGAMENT | $330.00 | $825.00 | $577.50–$660.00 | 74% below | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OR FAC HIP INJECTION | $326.27 | $815.67 | $570.97–$693.32 | 64% below | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OP JOINT ASPIRATION | $326.40 | $816.00 | $571.20–$652.80 | 64% below | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER ARTHROCENTSIS ASPIRATION/INJ MAJOR JO | $330.00 | $825.00 | $577.50–$750.00 | 64% below | 60% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 OP CL ARTHROCENTSIS ASPIRATION/LG JOINT | $330.00 | $825.00 | $577.50–$660.00 | 64% below | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ER ARTHROCENTSIS ASPIRATION/INJ INTERMED | $330.00 | $825.00 | $577.50–$750.00 | 56% below | 60% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 OP CL ARTHROCENTSIS ASPIRATION/LG JOINT | $330.00 | $825.00 | $577.50–$660.00 | 56% below | 60% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 OP CL ARTHROCENTSIS ASPIRATION/SM JOINT | $330.00 | $825.00 | $577.50–$660.00 | 45% below | 60% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSUREOF SCALP AXILLAE TRUNK AND/ | $436.40 | $1,091.00 | $750.00–$763.70 | 41% below | 60% |
| Lower-back epidural injection, with imaging guidance CPT 62323 CL LUMBAR EPIDURAL CONTINUOUS | $509.60 | $1,274.00 | $891.80–$1,019.20 | 71% below | 60% |
| Lower-back epidural injection, with imaging guidance CPT 62323 OR FAC INJ OR DRAIN ON SPINE | $773.21 | $1,933.02 | $1,353.11–$1,643.07 | 56% below | 60% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 OR FAC TRANSFORAMINAL EPID INJ L SPINE | $1,053.60 | $2,634.00 | $1,843.80–$2,238.90 | 69% below | 60% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 FAC EPIDU W IMAGE LUMBAR OR SACRAL | $1,053.60 | $2,634.00 | $1,843.80–$2,107.20 | 69% below | 60% |
| Lumbar spinal fusion (posterior), one level CPT 22612 POSTERIOR SPINAL FUSION | $27,065.60 | $67,664.00 | $47,364.80–$57,514.40 | 126% above | 60% |
| Nail removal (partial or complete), one nail CPT 11730 OP CL AVULSION NAILPLATE SIMPLE O | $216.70 | $541.74 | $379.22–$433.39 | 58% below | 60% |
| Occipital nerve block (injection for headaches) CPT 64405 FAC CLINIC OCCIPITAL NERVE INJECTION | $326.27 | $815.67 | $570.97–$652.54 | 58% below | 60% |
| Occipital nerve block (injection for headaches) CPT 64405 OCCIPITAL NERVE BLOCK | $336.40 | $841.00 | $588.70–$714.85 | 57% below | 60% |
| Occipital nerve block (injection for headaches) CPT 64405 ER INJECTION(S), ANESTHETIC AGENT(S) OPT | $342.40 | $856.00 | $599.20–$750.00 | 56% below | 60% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 FAC EXC NAIL MATRIX REMOVAL | $447.60 | $1,119.00 | $750.00–$783.30 | 41% below | 60% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 OP CL PERM REMOVAL NAIL PARTIAL OR COMPL | $447.68 | $1,119.21 | $783.45–$895.37 | 41% below | 60% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 RADIOFREQUENCY THERMAL ABLATION RFTA L S | $2,222.00 | $5,555.00 | $3,888.50–$4,721.75 | 46% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 ER I&R FOREIGN BODY SIMPLE | $120.80 | $302.00 | $211.40–$750.00 | 88% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 RHC REM FB SIMPLE INCISION | $190.00 | $475.00 | $332.50–$380.00 | 80% below | 60% |
| Removal of a foreign object under the skin, simple CPT 10120 FAC INCISION AND REMOVAL FOREIGN BODY TI | $479.60 | $1,199.00 | $839.30–$959.20 | 50% below | 60% |
| Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 COLORECTAL CANCER SCREENING | $1,020.40 | $2,551.00 | $1,785.70–$2,168.35 | 51% below | 60% |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 COLORECTAL CANCER SCREENING HIGH RISK | $1,027.20 | $2,568.00 | $1,797.60–$2,182.80 | 35% below | 60% |
| Septoplasty to straighten the nasal septum CPT 30520 SEPTOPLASTY OR SUBMUCOUS RESECTION | $3,516.80 | $8,792.00 | $6,154.40–$7,473.20 | 57% below | 60% |
| Short arm cast (elbow to hand) CPT 29075 OP CL APPLICATION OF FOREARM CAST | $109.60 | $274.00 | $191.80–$219.20 | 90% below | 60% |
| Short arm splint (forearm and hand) CPT 29125 OP CL APPLICATION OF SPLINT | $139.20 | $348.00 | $243.60–$278.40 | 64% below | 60% |
| Short arm splint (forearm and hand) CPT 29125 ER APPLICATION SHORT ARM SPLINT | $142.40 | $356.00 | $249.20–$750.00 | 63% below | 60% |
| Short leg cast (below the knee) CPT 29405 OP CL APPLICATION OF SHORT LEG CAST | $87.20 | $218.00 | $152.60–$174.40 | 89% below | 60% |
| Short leg cast (below the knee) CPT 29405 ER APPLICATION SHORT LEG CAST | $302.40 | $756.00 | $529.20–$750.00 | 63% below | 60% |
| Short leg splint (calf to foot) CPT 29515 ER APPLICATION SHORT LEG SPLINT | $178.40 | $446.00 | $312.20–$750.00 | 54% below | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 OP CL LAC REPAIR 2.5 OR LESS | $112.00 | $280.00 | $196.00–$224.00 | 67% below | 60% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE REPAIR-2.5 OR LESS | $226.80 | $567.00 | $396.90–$750.00 | 34% below | 60% |
| Skin biopsy, punch, one lesion CPT 11104 PRO PUNCH BIOPSY OF SKIN SINGLE | $61.20 | $153.00 | $107.10–$122.40 | 89% below | 60% |
| Skin tag removal, up to 15 tags CPT 11200 OP CL REM SKIN TAGS | $31.20 | $78.00 | $54.60–$62.40 | 92% below | 60% |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 ER DIAGNOSTIC LUMBAR PUNCTURE | $812.00 | $2,030.00 | $750.00–$1,421.00 | 60% below | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 OP CL LAC REPAIR 2.6 TO 7.5 | $137.20 | $343.00 | $240.10–$274.40 | 64% below | 60% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER SIMP REP SU WOUND SCALP/NECK/ACIL12.6 | $226.80 | $567.00 | $396.90–$750.00 | 41% below | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR OF SUPERFICIAL 2.5CM< | $64.00 | $160.00 | $112.00–$128.00 | 83% below | 60% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER SIMP REP SU WOUND FACE/EAR/EYELID2.6 | $226.80 | $567.00 | $396.90–$750.00 | 40% below | 60% |
| Tangential (shave-style) skin biopsy, one lesion CPT 11102 PRO TANGENTIAL BIOPSY OF SKIN SINGLE LES | $49.60 | $124.00 | $86.80–$99.20 | 91% below | 60% |
| Tonsil and adenoid removal, age 12 or older CPT 42821 TONSILLECTOMY AND ADENOIDECTOMY OVER 12 | $3,516.80 | $8,792.00 | $6,154.40–$7,473.20 | 68% below | 60% |
| Tonsil and adenoid removal, child under 12 CPT 42820 FAC TONSILL AND ADENOIDECTOMY >5 | $6,600.00 | $16,500.00 | $11,550.00–$14,025.00 | 17% below | 60% |
| Tonsil removal (tonsillectomy) only, age 12 or older CPT 42826 FAC TONSILLECTOMY | $3,681.20 | $9,203.00 | $6,442.10–$7,822.55 | 62% below | 60% |
| Tonsil removal (tonsillectomy) only, child under 12 CPT 42825 REMOVAL OF TONSILS | $6,600.00 | $16,500.00 | $11,550.00–$14,025.00 | 33% below | 60% |
| Trigger finger release surgery CPT 26055 INCISE TENDON FINGER SHEATH | $1,807.60 | $4,519.00 | $3,163.30–$3,841.15 | 59% below | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 FAC INJECT SINGLE/ MULT 1 OR 2 MUSCLES | $47.02 | $117.54 | $82.28–$94.03 | 96% below | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 OR FAC INJECT SING/MULTI 1-2 MUSC | $326.27 | $815.67 | $570.97–$693.32 | 71% below | 60% |
| Trigger point injections, 1 or 2 muscles CPT 20552 OP CL TRIGGER POINT | $326.40 | $816.00 | $571.20–$652.80 | 71% below | 60% |
| Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UPPER GI ENDOSCOPY W/BALLOON DIALATION | $2,152.80 | $5,382.00 | $3,767.40–$4,574.70 | 53% below | 60% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY W/BIOPSY | $1,020.40 | $2,551.00 | $1,785.70–$2,168.35 | 27% below | 60% |
| Upper endoscopy (EGD) with polyp removal by snare CPT 43251 ESOPHA. W/ REMOVAL OF TUMOR POLOP OR LES | $2,089.91 | $5,224.77 | $3,657.34–$4,441.05 | 54% below | 60% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY | $1,125.20 | $2,813.00 | $1,969.10–$2,391.05 | at median | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 REM DEBR <20 SQ CM | $75.34 | $188.34 | $131.84–$150.67 | 92% below | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 FAC DEBRID SUB TIS; 20SQ CM OR LESS | $447.68 | $1,119.21 | $750.00–$783.45 | 52% below | 60% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/TISSUE | $470.00 | $1,175.00 | $822.50–$998.75 | 49% below | 60% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION/TRANSFUSION | $501.20 | $1,253.00 | $877.10–$1,002.40 | 35% below | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INITIAL NEBULIZER TREATMENT | $237.60 | $594.00 | $109.00–$475.20 | 26% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INITIAL MDI TREATMENT | $237.60 | $594.00 | $109.00–$475.20 | 26% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT SUBSEQUENT | $237.60 | $594.00 | $109.00–$475.20 | 26% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 OUTPATIENT INHALATION NEBULIZER | $237.60 | $594.00 | $109.00–$475.20 | 26% above | 60% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AEROSOL NEBULIZER | $244.00 | $610.00 | $109.00–$488.00 | 29% above | 60% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INF 1 HOUR | $419.20 | $1,048.00 | $125.00–$838.40 | 40% below | 60% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 PRO COMPREHENSIVE HEARING TEST | $36.80 | $92.00 | $64.40–$144.00 | 91% below | 60% |
| Comprehensive hearing test: tone and speech audiometry, both ears CPT 92557 COMPREHENSIVE HEARING TEST | $178.00 | $445.00 | $144.00–$356.00 | 55% below | 60% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE IN ED 30-74 MINUTES | $940.40 | $2,351.00 | $750.00–$1,645.70 | 59% below | 60% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 OP CL EKG COMPLETE | $16.00 | $40.00 | $28.00–$32.00 | 36% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NUC MED EKG | $70.40 | $176.00 | $123.20–$375.00 | 74% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG PERFORMED BY MEDSURG NURSING STAFF | $70.40 | $176.00 | $123.20–$375.00 | 74% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG PERFORMED BY ER NURSING STAFF | $70.40 | $176.00 | $123.20–$375.00 | 74% below | 60% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG | $70.40 | $176.00 | $123.20–$375.00 | 74% below | 60% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER NON URGENT LEVEL 1 | $91.60 | $229.00 | $160.30–$750.00 | 59% below | 60% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER SEMI URGENT LEVEL 2 | $166.00 | $415.00 | $290.50–$750.00 | 51% below | 60% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER URGENT LEVEL 3 | $292.40 | $731.00 | $511.70–$750.00 | 55% below | 60% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER EMERGENT LEVEL 4 | $459.20 | $1,148.00 | $750.00–$803.60 | 48% below | 60% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER IMMINENT LEVEL 5 | $659.20 | $1,648.00 | $750.00–$1,153.60 | 45% below | 60% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST TREADMILL | $334.40 | $836.00 | $258.00–$668.80 | 50% below | 60% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 EKG EKG STRESS SPV | $336.00 | $840.00 | $258.00–$672.00 | 50% below | 60% |
| Family therapy with the patient, 50 minutes CPT 90847 LCSW FAMILY PSYCHOANALYSIS SRVS W/ PT | $33.60 | $84.00 | $58.80–$1,100.00 | 84% below | 60% |
| Family therapy without the patient, 50 minutes CPT 90846 LCSW FAMILY PSYCHOANALYSIS SRVS W/O PT | $117.60 | $294.00 | $205.80–$1,100.00 | 36% below | 60% |
| Group psychotherapy session CPT 90853 LCSW GROUP PSYCHOTHERAPY SESSIONS | $28.00 | $70.00 | $49.00–$1,100.00 | 92% below | 60% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INITIAL IV HYDRATION 31 MIN-1 HR | $258.40 | $646.00 | $125.00–$516.80 | 16% below | 60% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INITIAL IV HYDRATION 31MIN-1 HR | $258.40 | $646.00 | $125.00–$516.80 | 16% below | 60% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP CL HYDRATION 31 TO 60 MINUTES | $258.40 | $646.00 | $452.20–$516.80 | 16% below | 60% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION IV HYDRATION 31 MIN-1 HR | $258.40 | $646.00 | $125.00–$516.80 | 16% below | 60% |
| IV infusion of a medicine, first hour CPT 96365 INITIAL IV INFUSION 16MIN-1HR | $258.40 | $646.00 | $125.00–$516.80 | 15% below | 60% |
| IV infusion of a medicine, first hour CPT 96365 INITIAL INFUSION IV THERAPY 1 HR | $258.40 | $646.00 | $125.00–$516.80 | 15% below | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SQ OR IM | $78.40 | $196.00 | $125.00–$156.80 | at median | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 WCC INJECTION ADMINISTRATON | $78.40 | $196.00 | $125.00–$156.80 | at median | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IV PUSH SUBCUTANEOUS OR INTRAM | $78.40 | $196.00 | $125.00–$156.80 | at median | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION THERAPEUTIC SQ OR IM | $78.40 | $196.00 | $125.00–$156.80 | at median | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 INFUSION SUBCUTANEOUS INIT 1 HR INC PUMP | $78.40 | $196.00 | $125.00–$156.80 | at median | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP CL INJECTION SQ OR IM | $78.40 | $196.00 | $137.20–$156.80 | at median | 60% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 SPEC CLINIC INJECTION ADMIN | $85.60 | $214.00 | $149.80–$171.20 | 9% above | 60% |
| Mental health diagnostic evaluation (intake), without medical services CPT 90791 PSYCHIATRIC DIAGNOSTIC EVALUATION | $171.60 | $429.00 | $300.30–$1,100.00 | 68% below | 60% |
| New patient office visit, about 30 minutes CPT 99203 RHC NEW LEVEL 3, 30 MIN | $95.20 | $238.00 | $166.60–$190.40 | 59% below | 60% |
| New patient office visit, about 30 minutes CPT 99203 OP FACILITY NEW LEVEL 3 | $109.60 | $274.00 | $191.80–$219.20 | 52% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 RHC NEW VISIT LEVEL 4, 40 MIN | $154.80 | $387.00 | $270.90–$309.60 | 26% below | 60% |
| New patient office visit, about 45 minutes CPT 99204 OP FACILITY NEW VISIT LEVEL 4 | $177.20 | $443.00 | $310.10–$354.40 | 15% below | 60% |
| New patient office visit, about 60 minutes CPT 99205 RHC NEW VISIT LEVEL 5, 50 MIN | $210.40 | $526.00 | $368.20–$420.80 | 22% below | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 RHC NEW VISIT LEV 2, 20 MIN | $55.20 | $138.00 | $96.60–$110.40 | 70% below | 60% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP FACILITY NEW VISIT LEV 2 | $64.40 | $161.00 | $112.70–$128.80 | 65% below | 60% |
| Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 FAC MNT INITIAL ASSESSMENT EA 15 MIN | $47.60 | $119.00 | $83.30–$236.00 | 11% above | 60% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT INITIAL EVALUATION HIGH COMPLEXITY | $149.20 | $373.00 | $125.00–$2,058.00 | 20% below | 60% |
| Preventive checkup, new patient aged 18–39 CPT 99385 OP CL PREV VISIT NEW AGE 18-39 | $106.80 | $267.00 | $186.90–$213.60 | 81% below | 60% |
| Preventive checkup, new patient aged 40–64 CPT 99386 OP CL PREV VISIT NEW AGE 40-64 | $129.20 | $323.00 | $226.10–$258.40 | 80% below | 60% |
| Preventive checkup, new patient aged 65 or older CPT 99387 OP CL PREV VISIT NEW AGE 65+ | $138.80 | $347.00 | $242.90–$277.60 | 80% below | 60% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 OP CL PREV VISIT EST AGE 18-39 | $132.34 | $330.84 | $231.59–$264.67 | 74% below | 60% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 OP CL PREV VISIT EST AGE 40-64 | $106.00 | $265.00 | $185.50–$212.00 | 80% below | 60% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 OP CL PREV VISIT EST AGE 65+ | $111.20 | $278.00 | $194.60–$222.40 | 81% below | 60% |
| Psychotherapy for crisis, first 60 minutes CPT 90839 LCSW CRISIS PSYT 1ST 60 MIN | $148.00 | $370.00 | $259.00–$1,100.00 | 72% below | 60% |
| Psychotherapy session, 30 minutes CPT 90832 LCSW PSYT 16-37 MIN | $78.80 | $197.00 | $137.90–$1,100.00 | 74% below | 60% |
| Psychotherapy session, 45 minutes CPT 90834 LCSW PSYT 38-52 MIN | $104.40 | $261.00 | $182.70–$1,100.00 | 73% below | 60% |
| Psychotherapy session, 60 minutes CPT 90837 LCSW PSYT >53 MIN | $153.60 | $384.00 | $268.80–$1,100.00 | 76% below | 60% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION COUNSELING > 3 <10 | $33.20 | $83.00 | $58.10–$109.00 | 36% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 RHC EST LEVEL 5, 50 MIN | $166.80 | $417.00 | $291.90–$333.60 | 37% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP FACILITY EST LEVEL 5 | $230.40 | $576.00 | $403.20–$460.80 | 13% below | 60% |
| Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP FACILITY NEW LEVEL 5 | $284.00 | $710.00 | $497.00–$568.00 | 7% above | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 RHC EST LEVEL 3, 30 MIN | $76.40 | $191.00 | $133.70–$152.80 | 64% below | 60% |
| Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP FACILITY EST LEVEL 3 | $87.60 | $219.00 | $153.30–$175.20 | 59% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 RHC EST LEVEL 4, 40 MIN | $112.40 | $281.00 | $196.70–$224.80 | 33% below | 60% |
| Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP FACILITY EST LEVEL 4 | $128.80 | $322.00 | $225.40–$257.60 | 23% below | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RHC EST LEVEL 2, 20 MIN | $41.20 | $103.00 | $72.10–$82.40 | 68% below | 60% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP FACILITY EST LEVEL 2 | $47.60 | $119.00 | $83.30–$95.20 | 63% below | 60% |
| Spirometry (breathing test) CPT 94010 PFT SPIROMETRY | $178.80 | $447.00 | $220.00–$357.60 | 57% below | 60% |
| Spirometry before and after a bronchodilator CPT 94060 PFT PRE & POST BRON | $358.80 | $897.00 | $220.00–$717.60 | 50% below | 60% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY | $142.40 | $356.00 | $249.20–$284.80 | 6% below | 60% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs Georgia | Off list |
|---|---|---|---|---|---|
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE | $78.40 | $196.00 | $137.20–$312.00 | 26% above | 60% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OP CL INTL IMM ADMIN ADULT | $78.40 | $196.00 | $137.20–$312.00 | 26% above | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 EA ADDTL ADMIN ADULT | $16.00 | $40.00 | $28.00–$312.00 | 57% below | 60% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDTL VACCINE | $16.40 | $41.00 | $28.70–$312.00 | 56% below | 60% |