Hospital

Upper Connecticut Valley Hospital

Listed in its price file as “Upper Connecticut Valley Hospital Association”.

Upper Connecticut Valley Hospital in Colebrook, NH publishes cash prices for 246 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 New Hampshire median for 214 of 243 procedures and above it for 16. By typical cash price it ranks #7 of 19 New Hampshire hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

181 Corliss Lane, Colebrook, NH 03576 Collected Sep 27, 2026 Source price file (603) 237-4971

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 301300 · CMS hospital register NPI 1861489437

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABD 2 VIEWS	$232.55	$419.00	$226.26	11% below	44%
Abdominal X-ray, 2 views inpatient CPT 74019 RADIOLOGIC EXAM ABD 2 VIEWS	$232.55	$419.00	$226.26	—	44%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY RIGHT ANKLE MIN 3 VIEWS	$244.76	$441.00	$354.52–$391.04	7% below	44%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY LEFT ANKLE MIN 3 VIEWS	$244.76	$441.00	$354.52–$391.04	7% below	44%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY RIGHT ANKLE MIN 3 VIEWS	$244.76	$441.00	$354.52–$391.04	—	44%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY LEFT ANKLE MIN 3 VIEWS	$244.76	$441.00	$354.52–$391.04	—	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDEX	$397.38	$716.00	$271.76	6% below	45%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ANKLE BRACHIAL INDEX	$397.38	$716.00	$271.76	—	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT UPPER EXTR WO CONTRAST	$1,296.48	$2,336.00	$970.26–$1,940.52	1% below	45%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT UPPER EXTR WO CONTRAST	$1,296.48	$2,336.00	$970.26–$1,940.52	1% below	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT UPPER EXTR WO CONTRAST	$1,296.48	$2,336.00	$970.26–$1,940.52	—	45%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT UPPER EXTR WO CONTRAST	$1,296.48	$2,336.00	$970.26–$1,940.52	—	45%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND,BREAST UNILAT RIGHT	$418.47	$754.00	$555.21	25% below	45%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST UNILATERAL	$450.11	$811.00	$555.21	19% below	44%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND,BREAST UNILAT LEFT	$480.08	$865.00	$555.21	13% below	44%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND,BREAST UNILAT RIGHT	$418.47	$754.00	$555.21	—	45%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST UNILATERAL	$450.11	$811.00	$555.21	—	44%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND,BREAST UNILAT LEFT	$480.08	$865.00	$555.21	—	44%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,UNILAT,LIMITED,RIGHT	$320.79	$578.00	$457.50–$512.51	17% below	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST, UNILAT,LIMITED,LEFT	$320.79	$578.00	$457.50–$512.51	17% below	45%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED	$342.44	$617.00	$457.50–$512.51	11% below	44%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,UNILAT,LIMITED,RIGHT	$320.79	$578.00	$457.50–$512.51	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST, UNILAT,LIMITED,LEFT	$320.79	$578.00	$457.50–$512.51	—	45%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED	$342.44	$617.00	$457.50–$512.51	—	44%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD/PELVIS W WO CONT	$2,193.36	$3,952.00	$2,000.16	14% below	45%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD/PELVIS W WO CONT	$2,193.36	$3,952.00	$2,000.16	—	45%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W CONTRAST	$1,929.74	$3,477.00	$1,912.35–$3,004.80	2% below	44%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD W CONTRAST	$1,929.74	$3,477.00	$1,912.35–$3,004.80	—	44%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W CONTRAST	$1,929.74	$3,477.00	$956.18–$3,004.80	2% below	44%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK W CONTRAST	$1,929.74	$3,477.00	$956.18–$3,004.80	—	44%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOC & WC	$2,091.80	$3,769.00	$2,072.95–$3,769.00	at median	44%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOC & WC	$2,091.80	$3,769.00	$2,072.95–$3,769.00	—	44%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS WO CONTRAST	$2,462.54	$4,437.00	$3,033.13–$3,934.29	at median	44%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS WO CONTRAST	$2,462.54	$4,437.00	$3,033.13–$3,934.29	—	44%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CONTRST	$2,633.48	$4,745.00	$2,401.38–$4,207.39	1% below	44%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W CONTRST	$2,633.48	$4,745.00	$2,401.38–$4,207.39	—	44%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS 1+ SECT/REGNS	$2,804.42	$5,053.00	$2,779.15–$4,197.53	7% below	44%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS 1+ SECT/REGNS	$2,804.42	$5,053.00	$2,779.15–$4,197.53	—	44%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$1,467.42	$2,644.00	$1,480.64–$2,196.37	12% below	45%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$1,467.42	$2,644.00	$1,480.64–$2,196.37	—	45%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$1,296.48	$2,336.00	$1,182.06–$1,940.52	12% below	45%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$1,296.48	$2,336.00	$1,182.06–$1,940.52	—	45%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONTRAST	$1,296.48	$2,336.00	$970.26–$2,018.26	1% below	45%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO CONTRAST	$1,296.48	$2,336.00	$970.26–$2,018.26	—	45%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,467.42	$2,644.00	$2,091.68	1% below	45%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,467.42	$2,644.00	$2,091.68	—	45%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W & WO CONTRAST	$1,638.36	$2,952.00	$1,641.90	12% below	45%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W & WO CONTRAST	$1,638.36	$2,952.00	$1,641.90	—	45%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$1,296.48	$2,336.00	$1,596.89–$1,985.60	4% below	45%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST	$1,296.48	$2,336.00	$1,596.89–$1,985.60	—	45%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTR	$1,296.48	$2,336.00	$535.82–$2,018.26	9% below	45%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTR	$1,296.48	$2,336.00	$535.82–$2,018.26	—	45%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,467.42	$2,644.00	$1,470.59–$2,196.38	7% below	45%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,467.42	$2,644.00	$1,470.59–$2,196.38	—	45%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 UD CAROTID DUPLEX SCAN BILAT	$779.78	$1,405.00	$724.35–$1,165.17	—	44%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 UD CAROTID DUPLEX SCAN BILAT	$779.78	$1,405.00	$724.35–$1,165.17	—	44%
Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$209.79	$378.00	$206.04–$342.85	12% below	45%
Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$209.79	$378.00	$206.04–$342.85	—	45%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST ONE VIEW	$153.74	$277.00	$152.35–$277.00	25% below	44%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST ONE VIEW	$153.74	$277.00	$152.35–$277.00	—	44%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XRAY LEFT CLAVICLE COMPLETE	$223.67	$403.00	$334.78–$365.52	9% below	44%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XRAY RIGHT CLAVICLE COMPLETE	$223.67	$403.00	$334.78–$365.52	9% below	44%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XRAY RIGHT CLAVICLE COMPLETE	$223.67	$403.00	$334.78–$365.52	—	44%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XRAY LEFT CLAVICLE COMPLETE	$223.67	$403.00	$334.78–$365.52	—	44%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$454.55	$819.00	$450.45–$742.83	25% below	44%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$454.55	$819.00	$450.45–$742.83	—	44%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY AXIAL SKELETON	$415.14	$748.00	$378.54–$663.25	2% below	45%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY AXIAL SKELETON	$415.14	$748.00	$378.54–$663.25	—	45%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX WO CONTRAST	$1,296.48	$2,336.00	$1,284.80–$1,972.29	1% below	45%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX WO CONTRAST	$1,296.48	$2,336.00	$1,284.80–$1,972.29	—	45%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W CONTRAST	$1,467.42	$2,644.00	$1,454.20–$2,196.37	12% below	45%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W CONTRAST	$1,467.42	$2,644.00	$1,454.20–$2,196.37	—	45%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INC CAD	$569.43	$1,026.00	$701.37–$909.75	—	45%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INC CAD	$569.43	$1,026.00	$701.37–$909.75	—	45%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT RT INC CAD	$575.54	$1,037.00	$861.44	1% below	44%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT LT INC CAD	$575.54	$1,037.00	$861.44	1% below	44%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT LT INC CAD	$575.54	$1,037.00	$861.44	—	44%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT RT INC CAD	$575.54	$1,037.00	$861.44	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL	$997.89	$1,798.00	$1,456.38	—	45%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL	$997.89	$1,798.00	$1,456.38	—	45%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,523.48	$2,745.00	$1,509.75–$2,433.99	1% below	44%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$1,523.48	$2,745.00	$1,509.75–$2,433.99	—	44%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY LT ELBOW (MIN 3 VIEWS)	$244.76	$441.00	$251.37–$391.03	12% below	44%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY RT ELBOW (MIN 3 VIEWS)	$244.76	$441.00	$251.37–$391.03	12% below	44%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY LT ELBOW (MIN 3 VIEWS)	$244.76	$441.00	$251.37–$391.03	—	44%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY RT ELBOW (MIN 3 VIEWS)	$244.76	$441.00	$251.37–$391.03	—	44%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY LEFT FOREARM (2 VIEWS)	$215.90	$389.00	$217.84–$365.00	12% below	44%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY RIGHT FOREARM (2 VIEWS)	$215.90	$389.00	$217.84–$365.00	12% below	44%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY LEFT FOREARM (2 VIEWS)	$215.90	$389.00	$217.84–$365.00	—	44%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY RIGHT FOREARM (2 VIEWS)	$215.90	$389.00	$217.84–$365.00	—	44%
Knee X-ray, 3 views one side CPT 73562 X-RAY LEFT KNEE (3 VIEWS)	$342.99	$618.00	$333.72–$547.98	at median	45%
Knee X-ray, 3 views one side CPT 73562 X-RAY RIGHT KNEE (3 VIEWS)	$342.99	$618.00	$333.72–$547.98	at median	45%
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY RIGHT KNEE (3 VIEWS)	$342.99	$618.00	$333.72–$547.98	—	45%
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY LEFT KNEE (3 VIEWS)	$342.99	$618.00	$333.72–$547.98	—	45%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY RT KNEE (4 OR MORE VIEW)	$305.81	$551.00	$415.43–$487.89	4% below	44%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY LT KNEE (4 OR MORE VIEW)	$305.81	$551.00	$415.43–$487.89	4% below	44%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY LT KNEE (4 OR MORE VIEW)	$305.81	$551.00	$415.43–$487.89	—	44%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY RT KNEE (4 OR MORE VIEW)	$305.81	$551.00	$415.43–$487.89	—	44%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT LOWER EXTR WO CONTRAST	$1,296.48	$2,336.00	$1,847.73–$2,071.34	1% below	45%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT LOWER EXTR WO CONTRAST	$1,296.48	$2,336.00	$1,847.73–$2,071.34	1% below	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT LOWER EXTR WO CONTRAST	$1,296.48	$2,336.00	$1,847.73–$2,071.34	—	45%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT LOWER EXTR WO CONTRAST	$1,296.48	$2,336.00	$1,847.73–$2,071.34	—	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD SINGLE ORGAN	$420.69	$758.00	$390.50–$654.62	16% below	45%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LMTD SINGLE ORGAN	$420.69	$758.00	$390.50–$654.62	—	45%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US XTR LT NON-VASCULAR LMTD	$263.63	$475.00	$360.45–$375.62	20% below	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US XTR RT NON-VASCULAR LMTD	$263.63	$475.00	$360.45–$375.62	20% below	44%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US XTR LT NON-VASCULAR LMTD	$263.63	$475.00	$360.45–$375.62	—	44%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US XTR RT NON-VASCULAR LMTD	$263.63	$475.00	$360.45–$375.62	—	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT FOR LUNG CANCER SCREENING	$630.48	$1,136.00	$575.10–$1,030.35	19% below	45%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT FOR LUNG CANCER SCREENING	$630.48	$1,136.00	$575.10–$1,030.35	—	45%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY RT LOWER LEG (2 VIEWS)	$218.12	$393.00	$318.33–$326.47	19% below	44%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY LT LOWER LEG (2 VIEWS)	$218.12	$393.00	$318.33–$326.47	19% below	44%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY LT LOWER LEG (2 VIEWS)	$218.12	$393.00	$318.33–$326.47	—	44%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY RT LOWER LEG (2 VIEWS)	$218.12	$393.00	$318.33–$326.47	—	44%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST	$1,944.17	$3,503.00	$2,837.43	1% below	44%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST	$1,944.17	$3,503.00	$2,837.43	—	44%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT LOW EXT JNT WO CONTRAST	$2,040.18	$3,676.00	$2,095.32–$3,334.13	1% below	45%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT LOW EXTR JNT WO CONTR	$2,040.18	$3,676.00	$2,095.32–$3,334.13	1% below	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LT LOW EXT JNT WO CONTRAST	$2,040.18	$3,676.00	$2,095.32–$3,334.13	—	45%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RT LOW EXTR JNT WO CONTR	$2,040.18	$3,676.00	$2,095.32–$3,334.13	—	45%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & WO CONTRAST	$3,398.82	$6,124.00	$3,099.06–$5,291.36	5% below	45%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & WO CONTRAST	$3,398.82	$6,124.00	$3,099.06–$5,291.36	—	45%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$2,260.52	$4,073.00	$2,240.15–$3,323.57	1% below	44%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$2,260.52	$4,073.00	$2,240.15–$3,323.57	—	44%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & WO CONTRAST	$3,359.97	$6,054.00	$3,097.26–$5,490.98	4% below	45%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & WO CONTRAST	$3,359.97	$6,054.00	$3,097.26–$5,490.98	—	45%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO CONTRAST	$2,425.91	$4,371.00	$1,202.03–$3,630.99	1% below	44%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO CONTRAST	$2,425.91	$4,371.00	$1,202.03–$3,630.99	—	44%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,425.91	$4,371.00	$1,202.03–$3,875.77	1% below	44%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,425.91	$4,371.00	$1,202.03–$3,875.77	—	44%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERV SPINE W & WO CONTRAST	$3,058.61	$5,511.00	$1,883.66–$4,577.99	12% below	44%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERV SPINE W & WO CONTRAST	$3,058.61	$5,511.00	$1,883.66–$4,577.99	—	44%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,425.91	$4,371.00	$2,491.47–$3,540.51	1% below	44%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,425.91	$4,371.00	$2,491.47–$3,540.51	—	44%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/C&W/C	$3,054.17	$5,503.00	$4,571.34	12% below	44%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/C&W/C	$3,054.17	$5,503.00	$4,571.34	—	44%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$2,471.97	$4,454.00	$2,857.52–$3,699.94	1% below	45%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$2,471.97	$4,454.00	$2,857.52–$3,699.94	—	45%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI U EXTR ANY JNT WO CONTRAST	$1,944.17	$3,503.00	$1,197.33–$2,977.55	1% below	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI U EXTR ANY JNT WO CONTRAST	$1,944.17	$3,503.00	$1,197.33–$2,977.55	—	44%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$316.35	$570.00	$389.65–$473.50	22% below	45%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$316.35	$570.00	$389.65–$473.50	—	45%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST	$1,467.42	$2,644.00	$251.14–$1,807.44	2% below	45%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST	$1,467.42	$2,644.00	$251.14–$1,807.44	—	45%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO/C	$1,296.48	$2,336.00	$1,331.52	2% below	45%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO/C	$1,296.48	$2,336.00	$1,331.52	—	45%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED NON OB	$315.80	$569.00	$324.33–$457.42	12% below	44%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED NON OB	$315.80	$569.00	$324.33–$457.42	—	44%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC (NON-OB) COMPLETE	$450.11	$811.00	$418.00–$651.96	15% below	44%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC (NON-OB) COMPLETE	$450.11	$811.00	$418.00–$651.96	—	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$437.90	$789.00	$655.42	26% below	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$437.90	$789.00	$655.42	—	44%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY LEFT RIBS (2 VIEWS)	$236.43	$426.00	$233.20–$426.00	1% below	45%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY RIGHT RIBS (2 VIEWS)	$236.43	$426.00	$233.20–$426.00	1% below	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIGHT RIBS (2 VIEWS)	$236.43	$426.00	$233.20–$426.00	—	45%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY LEFT RIBS (2 VIEWS)	$236.43	$426.00	$233.20–$426.00	—	45%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INC CAD	$534.47	$963.00	$128.46–$873.44	—	44%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT LT INC CAD	$466.76	$841.00	$128.46–$873.44	2% below	44%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT RT INC CAD	$466.76	$841.00	$128.46–$873.44	2% below	44%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INC CAD	$534.47	$963.00	$128.46–$873.44	—	44%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT LT INC CAD	$466.76	$841.00	$128.46–$873.44	—	44%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT RT INC CAD	$466.76	$841.00	$128.46–$873.44	—	44%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY LT SHOULDER (MIN 2 VIEW)	$229.22	$413.00	$227.15–$374.59	12% below	44%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XRAY RT SHOULDER (MIN 2 VIEWS)	$229.22	$413.00	$227.15–$374.59	12% below	44%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X-RAY LT SHOULDER (MIN 2 VIEW)	$229.22	$413.00	$227.15–$374.59	—	44%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XRAY RT SHOULDER (MIN 2 VIEWS)	$229.22	$413.00	$227.15–$374.59	—	44%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY SINUSES (MIN 3 VIEWS)	$266.40	$480.00	$264.00–$266.98	21% below	45%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY SINUSES (MIN 3 VIEWS)	$266.40	$480.00	$264.00–$266.98	—	45%
Toe X-ray, 2 or more views one side CPT 73660 XRAY TOE(S) MIN 2 VIEW LT	$232.55	$419.00	$318.33–$387.45	8% above	44%
Toe X-ray, 2 or more views one side CPT 73660 XRAY TOE(S) MIN 2 VIEW RT	$232.55	$419.00	$318.33–$387.45	8% above	44%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XRAY TOE(S) MIN 2 VIEW LT	$232.55	$419.00	$318.33–$387.45	—	44%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XRAY TOE(S) MIN 2 VIEW RT	$232.55	$419.00	$318.33–$387.45	—	44%
Transvaginal pelvic ultrasound CPT 76830 NON-OB TRANSVAGINAL US	$519.48	$936.00	$482.35–$829.95	1% below	45%
Transvaginal pelvic ultrasound inpatient CPT 76830 NON-OB TRANSVAGINAL US	$519.48	$936.00	$482.35–$829.95	—	45%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$400.71	$722.00	$299.89	8% below	45%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$400.71	$722.00	$299.89	—	45%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOMEN COMPLETE	$555.56	$1,001.00	$570.57–$887.59	15% below	44%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOMEN COMPLETE	$555.56	$1,001.00	$570.57–$887.59	—	44%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CONTENTS	$407.93	$735.00	$372.06–$610.56	20% below	44%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM AND CONTENTS	$407.93	$735.00	$372.06–$610.56	—	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$475.64	$857.00	$488.49–$728.45	6% below	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$475.64	$857.00	$488.49–$728.45	—	44%
Upper arm X-ray (humerus), 2 views one side CPT 73060 LEFT HUMERUS MIN 2 VIEWS	$221.45	$399.00	$227.43–$272.76	16% below	44%
Upper arm X-ray (humerus), 2 views one side CPT 73060 RIGHT HUMERUS MIN 2 VIEWS	$221.45	$399.00	$227.43–$272.76	16% below	44%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RIGHT HUMERUS MIN 2 VIEWS	$221.45	$399.00	$227.43–$272.76	—	44%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 LEFT HUMERUS MIN 2 VIEWS	$221.45	$399.00	$227.43–$272.76	—	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXT VEINS LT LMTD	$820.29	$1,478.00	$747.90–$1,310.54	at median	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXT VEINS RT LMTD	$820.29	$1,478.00	$747.90–$1,310.54	at median	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXT VEINS LT LMTD	$820.29	$1,478.00	$747.90–$1,310.54	—	45%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXT VEINS RT LMTD	$820.29	$1,478.00	$747.90–$1,310.54	—	45%
Wrist X-ray, 2 views one side CPT 73100 X-RAY RIGHT WRIST (2 VIEWS)	$224.22	$404.00	$259.46–$335.61	12% below	45%
Wrist X-ray, 2 views one side CPT 73100 X-RAY LEFT WRIST (2 VIEWS)	$224.22	$404.00	$259.46–$335.61	12% below	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY LEFT WRIST (2 VIEWS)	$224.22	$404.00	$259.46–$335.61	—	45%
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY RIGHT WRIST (2 VIEWS)	$224.22	$404.00	$259.46–$335.61	—	45%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY RIGHT WRIST (MIN 3 VIEW)	$221.45	$399.00	$201.96–$331.45	17% below	44%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XRAY LEFT WRIST (MIN 3 VIEWS)	$221.45	$399.00	$201.96–$331.45	17% below	44%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X-RAY RIGHT WRIST (MIN 3 VIEW)	$221.45	$399.00	$201.96–$331.45	—	44%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XRAY LEFT WRIST (MIN 3 VIEWS)	$221.45	$399.00	$201.96–$331.45	—	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY RIGHT HIP (2-3 VIEWS)	$324.12	$584.00	$124.58–$485.13	at median	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY LEFT HIP (2-3 VIEWS)	$324.12	$584.00	$124.58–$485.13	at median	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY LEFT HIP (2-3 VIEWS)	$324.12	$584.00	$124.58–$485.13	—	45%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY RIGHT HIP (2-3 VIEWS)	$324.12	$584.00	$124.58–$485.13	—	45%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABD ONE VIEW	$194.81	$351.00	$177.66–$291.58	13% below	44%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABD ONE VIEW	$194.81	$351.00	$177.66–$291.58	—	44%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY LEFT ANKLE (2 VIEWS)	$228.66	$412.00	$331.21–$347.79	at median	45%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY RIGHT ANKLE (2 VIEWS)	$228.66	$412.00	$331.21–$347.79	at median	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY LEFT ANKLE (2 VIEWS)	$228.66	$412.00	$331.21–$347.79	—	45%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY RIGHT ANKLE (2 VIEWS)	$228.66	$412.00	$331.21–$347.79	—	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW LT	$205.35	$370.00	$51.71–$314.50	1% below	45%
X-ray of the finger(s), 2 or more views one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW RT	$205.35	$370.00	$51.71–$314.50	1% below	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW RT	$205.35	$370.00	$51.71–$314.50	—	45%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW LT	$205.35	$370.00	$51.71–$314.50	—	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS	$277.50	$500.00	$275.00–$415.35	6% below	45%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY LEFT FOOT MIN 3 VIEWS	$277.50	$500.00	$275.00–$415.35	6% below	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY LEFT FOOT MIN 3 VIEWS	$277.50	$500.00	$275.00–$415.35	—	45%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS	$277.50	$500.00	$275.00–$415.35	—	45%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY RIGHT HAND MIN 3 VIEWS	$248.09	$447.00	$226.26–$405.43	9% below	44%
X-ray of the hand, 3 or more views one side CPT 73130 XRAY LEFT HAND (MIN 3 VIEWS)	$248.09	$447.00	$226.26–$405.43	9% below	44%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XRAY LEFT HAND (MIN 3 VIEWS)	$248.09	$447.00	$226.26–$405.43	—	44%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X-RAY RIGHT HAND MIN 3 VIEWS	$248.09	$447.00	$226.26–$405.43	—	44%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY RIGHT KNEE 1 - 2 VIEWS	$244.76	$441.00	$229.71–$374.85	1% below	44%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY LEFT KNEE 1 - 2 VIEWS	$244.76	$441.00	$229.71–$374.85	1% below	44%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY RIGHT KNEE 1 - 2 VIEWS	$244.76	$441.00	$229.71–$374.85	—	44%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY LEFT KNEE 1 - 2 VIEWS	$244.76	$441.00	$229.71–$374.85	—	44%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY LOWER SPINE 2-3 VWS	$255.86	$461.00	$253.55–$418.13	12% below	44%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY LOWER SPINE 2-3 VWS	$255.86	$461.00	$253.55–$418.13	—	44%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY LOWER SPINE (MIN 4 VIEW)	$354.65	$639.00	$436.82–$530.82	8% below	44%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY LOWER SPINE (MIN 4 VIEW)	$354.65	$639.00	$436.82–$530.82	—	44%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM SPINE CERV 2-3 VWS	$236.43	$426.00	$230.04–$353.88	14% below	45%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM SPINE CERV 2-3 VWS	$236.43	$426.00	$230.04–$353.88	—	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY TAILBONE (MIN 2 VIEWS)	$209.79	$378.00	$210.24–$314.00	12% below	45%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY TAILBONE (MIN 2 VIEWS)	$209.79	$378.00	$210.24–$314.00	—	45%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$17.21	$31.00	$17.36–$19.85	74% below	44%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$17.21	$31.00	$17.36–$19.85	—	44%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$16.65	$30.00	$16.80–$19.17	75% below	45%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$16.65	$30.00	$16.80–$19.17	—	45%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PROFILE	$312.47	$563.00	$290.40–$315.28	8% below	44%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PROFILE	$312.47	$563.00	$290.40–$315.28	—	44%
Albumin blood test CPT 82040 ALBUMIN SERUM	$38.85	$70.00	$39.20	18% below	45%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$38.85	$70.00	$39.20	—	45%
Aldosterone blood test CPT 82088 ALDOSTERONE	$226.44	$408.00	$228.48–$261.52	5% below	45%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$226.44	$408.00	$228.48–$261.52	—	45%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE EA ALLERGEN	$29.97	$54.00	$41.31	6% below	45%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE EA ALLERGEN	$29.97	$54.00	$41.31	—	45%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$53.28	$96.00	$50.06–$65.63	53% below	45%
Alpha-fetoprotein (AFP) blood test CPT 82105 PLACENTAL ALPHA MICROGLOB-1	$311.36	$561.00	$50.06–$65.63	172% above	44%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$53.28	$96.00	$50.06–$65.63	—	45%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 PLACENTAL ALPHA MICROGLOB-1	$311.36	$561.00	$50.06–$65.63	—	44%
Ammonia blood test CPT 82140 AMMONIA	$46.62	$84.00	$42.66–$43.94	47% below	45%
Ammonia blood test inpatient CPT 82140 AMMONIA	$46.62	$84.00	$42.66–$43.94	—	45%
Amylase blood test CPT 82150 AMYLASE	$21.09	$38.00	$21.66–$36.00	70% below	45%
Amylase blood test inpatient CPT 82150 AMYLASE	$21.09	$38.00	$21.66–$36.00	—	45%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$41.63	$75.00	$39.31–$68.03	57% below	44%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$41.63	$75.00	$39.31–$68.03	—	44%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$38.85	$70.00	$36.30–$63.49	60% below	45%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$38.85	$70.00	$36.30–$63.49	—	45%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP NATRIURETIC PEPTIDE	$124.88	$225.00	$123.75–$225.00	32% below	44%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP NATRIURETIC PEPTIDE	$124.88	$225.00	$123.75–$225.00	—	44%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE OTHR SOURCE	$27.75	$50.00	$27.50–$50.00	70% below	45%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE OTHR SOURCE	$27.75	$50.00	$27.50–$50.00	—	45%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$47.73	$86.00	$43.74–$73.10	29% below	45%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$47.73	$86.00	$43.74–$73.10	—	45%
Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN	$16.65	$30.00	$16.80	55% below	45%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN	$16.65	$30.00	$16.80	—	45%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATH	$261.96	$472.00	$36.53–$401.20	at median	45%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATH	$261.96	$472.00	$36.53–$401.20	—	45%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$83.25	$150.00	$76.14–$136.05	37% below	45%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$83.25	$150.00	$76.14–$136.05	—	45%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$14.43	$26.00	$14.17–$26.00	12% below	45%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$14.43	$26.00	$14.17–$26.00	—	45%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$12.77	$23.00	$13.11–$17.39	57% below	44%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$12.77	$23.00	$13.11–$17.39	—	44%
Blood lead test CPT 83655 LEAD	$38.85	$70.00	$53.14–$56.27	47% below	45%
Blood lead test inpatient CPT 83655 LEAD	$38.85	$70.00	$53.14–$56.27	—	45%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM	$24.42	$44.00	$33.01–$44.00	72% below	45%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE SERUM	$24.42	$44.00	$33.01–$44.00	—	45%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE AMERICAN RED CROSS	$9.99	$18.00	$10.26–$18.00	80% below	45%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE AMERICAN RED CROSS	$9.99	$18.00	$10.26–$18.00	—	45%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUAN	$27.75	$50.00	$17.71–$28.50	1% below	45%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUAN	$27.75	$50.00	$17.71–$28.50	—	45%
C-peptide blood test CPT 84681 C-PEPTIDE	$116.00	$209.00	$157.80	12% below	44%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$116.00	$209.00	$157.80	—	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$56.06	$101.00	$21.54–$91.61	14% below	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$56.06	$101.00	$21.54–$91.61	—	44%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$16.65	$30.00	$15.57	50% below	45%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$16.65	$30.00	$15.57	—	45%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA ZOSTER	$41.63	$75.00	$51.27–$63.75	59% below	44%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA ZOSTER	$41.63	$75.00	$51.27–$63.75	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMPLIF NA PROBE	$144.86	$261.00	$153.23–$221.85	16% below	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T AMPLIF NA PROBE	$144.86	$261.00	$153.23–$221.85	—	44%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$120.99	$218.00	$113.46–$197.73	at median	45%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$120.99	$218.00	$113.46–$197.73	—	45%
Complete blood count (CBC) with differential CPT 85025 CBC-DIFF-PLATELET CO	$38.85	$70.00	$38.50–$65.27	12% below	45%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-DIFF-PLATELET CO	$38.85	$70.00	$38.50–$65.27	—	45%
Complete blood count (CBC), no differential CPT 85027 CBC W PLT COMPL AUTOM	$40.52	$73.00	$40.15–$66.21	12% below	44%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W PLT COMPL AUTOM	$40.52	$73.00	$40.15–$66.21	—	44%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$84.92	$153.00	$71.92–$138.77	8% below	44%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$84.92	$153.00	$71.92–$138.77	—	44%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$90.47	$163.00	$82.62–$147.84	12% below	44%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$90.47	$163.00	$82.62–$147.84	—	44%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$36.63	$66.00	$33.48–$56.10	45% below	45%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$36.63	$66.00	$33.48–$56.10	—	45%
Creatinine blood test CPT 82565 CREATININE BLOOD	$16.65	$30.00	$17.10–$23.10	71% below	45%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$16.65	$30.00	$17.10–$23.10	—	45%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS	$79.92	$144.00	$74.25	30% below	45%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS	$79.92	$144.00	$74.25	—	45%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$33.30	$60.00	$33.00–$60.00	63% below	45%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$33.30	$60.00	$33.00–$60.00	—	45%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$71.60	$129.00	$88.18	50% below	44%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$71.60	$129.00	$88.18	—	44%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS/T PRESUMP INSTRM ANALYZ	$158.73	$286.00	$144.72–$195.51	13% below	45%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS/T PRESUMP INSTRM ANALYZ	$158.73	$286.00	$144.72–$195.51	—	45%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$46.62	$84.00	$42.66	11% below	45%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$46.62	$84.00	$42.66	—	45%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS	$58.28	$105.00	$53.90	43% below	44%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS	$58.28	$105.00	$53.90	—	44%
Estradiol blood test CPT 82670 ESTRADIOL	$88.80	$160.00	$93.94–$160.00	44% below	45%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$88.80	$160.00	$93.94–$160.00	—	45%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$104.34	$188.00	$159.80–$188.00	12% below	45%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$104.34	$188.00	$159.80–$188.00	—	45%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$62.72	$113.00	$57.24–$66.34	69% below	44%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$62.72	$113.00	$57.24–$66.34	—	44%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$100.46	$181.00	$91.80–$164.17	1% below	44%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$100.46	$181.00	$91.80–$164.17	—	44%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$31.64	$57.00	$36.28	45% below	44%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$31.64	$57.00	$36.28	—	44%
Folate (folic acid) blood test CPT 82746 FOLATE	$47.18	$85.00	$43.20–$68.85	44% below	44%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$47.18	$85.00	$43.20–$68.85	—	44%
Free T3 thyroid hormone test CPT 84481 FREE T3	$94.35	$170.00	$96.90–$136.66	37% below	45%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$94.35	$170.00	$96.90–$136.66	—	45%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE	$88.80	$160.00	$81.00–$145.12	7% below	45%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE THYROXINE	$88.80	$160.00	$81.00–$145.12	—	45%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$81.59	$147.00	$74.52–$118.17	42% below	44%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$81.59	$147.00	$74.52–$118.17	—	44%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 G G T	$41.63	$75.00	$42.00–$68.03	24% below	44%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 G G T	$41.63	$75.00	$42.00–$68.03	—	44%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST SERUM	$41.63	$75.00	$51.27–$60.29	61% below	44%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST SERUM	$41.63	$75.00	$51.27–$60.29	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA AMPLIF NA PROBE	$209.79	$378.00	$221.92–$321.30	at median	45%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA AMPLIF NA PROBE	$209.79	$378.00	$221.92–$321.30	—	45%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN - STOOL	$46.07	$83.00	$46.16–$47.31	53% below	44%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN - STOOL	$46.07	$83.00	$46.16–$47.31	—	44%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG WITH HIV1 & HIV2 AB	$126.54	$228.00	$129.96–$193.80	at median	45%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG WITH HIV1 & HIV2 AB	$126.54	$228.00	$129.96–$193.80	—	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C	$54.39	$98.00	$53.42–$88.89	12% below	45%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C	$54.39	$98.00	$53.42–$88.89	—	45%
Hemoglobin blood test CPT 85018 HGB ONLY	$8.33	$15.00	$8.25–$14.00	62% below	44%
Hemoglobin blood test inpatient CPT 85018 HGB ONLY	$8.33	$15.00	$8.25–$14.00	—	44%
Hepatitis B core antibody test (total) CPT 86704 ANTIBODY HEP B CORE TOTAL	$38.85	$70.00	$38.93–$70.00	45% below	45%
Hepatitis B core antibody test (total) inpatient CPT 86704 ANTIBODY HEP B CORE TOTAL	$38.85	$70.00	$38.93–$70.00	—	45%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$34.97	$63.00	$35.04–$43.07	44% below	44%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$34.97	$63.00	$35.04–$43.07	—	44%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA	$33.86	$61.00	$33.93–$34.77	54% below	44%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA	$33.86	$61.00	$33.93–$34.77	—	44%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$46.07	$83.00	$46.16–$70.55	69% below	44%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$46.07	$83.00	$46.16–$70.55	—	44%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$41.63	$75.00	$60.29	56% below	44%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$41.63	$75.00	$60.29	—	44%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE	$57.17	$103.00	$82.80	56% below	44%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE	$57.17	$103.00	$82.80	—	44%
Insulin blood test CPT 83525 INSULIN	$63.27	$114.00	$58.32–$91.64	24% below	45%
Insulin blood test inpatient CPT 83525 INSULIN	$63.27	$114.00	$58.32–$91.64	—	45%
Iron blood test (serum iron) CPT 83540 IRON	$36.63	$66.00	$33.48–$59.86	24% below	45%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$36.63	$66.00	$33.48–$59.86	—	45%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$48.29	$87.00	$44.28–$78.91	6% below	44%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$48.29	$87.00	$44.28–$78.91	—	44%
LH (luteinizing hormone) test CPT 83002 LH	$59.39	$107.00	$62.82–$107.00	53% below	44%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$59.39	$107.00	$62.82–$107.00	—	44%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$37.19	$67.00	$36.85–$67.00	52% below	44%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$37.19	$67.00	$36.85–$67.00	—	44%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$34.41	$62.00	$31.32–$50.74	32% below	45%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$34.41	$62.00	$31.32–$50.74	—	45%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$51.06	$92.00	$46.92–$83.44	31% below	45%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$51.06	$92.00	$46.92–$83.44	—	45%
Liver function blood test panel CPT 80076 HFP	$53.84	$97.00	$53.95–$75.35	13% below	44%
Liver function blood test panel inpatient CPT 80076 HFP	$53.84	$97.00	$53.95–$75.35	—	44%
Lyme disease antibody test CPT 86618 ANTIBODY LYME'S DISEASE	$54.39	$98.00	$49.68–$98.00	51% below	45%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY LYME'S DISEASE	$54.39	$98.00	$49.68–$98.00	—	45%
Magnesium blood test CPT 83735 MAGNESIUM	$47.18	$85.00	$44.50–$77.10	9% below	44%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$47.18	$85.00	$44.50–$77.10	—	44%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$41.63	$75.00	$75.00	55% below	44%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$41.63	$75.00	$75.00	—	44%
Mono test (heterophile antibody, Monospot) CPT 86308 AB QUAL HETEROPHILE	$16.65	$30.00	$19.17–$30.00	70% below	45%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 AB QUAL HETEROPHILE	$16.65	$30.00	$19.17–$30.00	—	45%
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS	$42.18	$76.00	$76.00	51% below	45%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS	$42.18	$76.00	$76.00	—	45%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PROSTATIC SPECIFIC ANTIGE	$58.83	$106.00	$60.42–$85.21	35% below	45%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PROSTATIC SPECIFIC ANTIGE	$58.83	$106.00	$60.42–$85.21	—	45%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPEC ANTIGEN TOTAL	$58.83	$106.00	$55.06–$77.42	43% below	45%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPEC ANTIGEN TOTAL	$58.83	$106.00	$55.06–$77.42	—	45%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP THIN	$139.86	$252.00	$140.16–$214.20	17% above	45%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP THIN	$139.86	$252.00	$140.16–$214.20	—	45%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$229.22	$413.00	$208.98–$292.57	1% below	44%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$229.22	$413.00	$208.98–$292.57	—	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PLASMA OR WHOLE BLOOD	$19.98	$36.00	$18.91–$36.00	63% below	45%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PLASMA OR WHOLE BLOOD	$19.98	$36.00	$18.91–$36.00	—	45%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE	$15.54	$28.00	$14.04–$23.80	75% below	45%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHATE	$15.54	$28.00	$14.04–$23.80	—	45%
Potassium blood test CPT 84132 POTASSIUM SERUM	$15.54	$28.00	$15.96–$22.51	67% below	45%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$15.54	$28.00	$15.96–$22.51	—	45%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$35.52	$64.00	$30.09–$58.05	12% below	45%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$35.52	$64.00	$30.09–$58.05	—	45%
Renin blood test CPT 84244 RENIN	$122.66	$221.00	$123.76–$141.71	18% below	44%
Renin blood test inpatient CPT 84244 RENIN	$122.66	$221.00	$123.76–$141.71	—	44%
Rh blood typing CPT 86901 RH TYPE AMERICAN RED CROSS	$9.99	$18.00	$10.26–$18.00	80% below	45%
Rh blood typing inpatient CPT 86901 RH TYPE AMERICAN RED CROSS	$9.99	$18.00	$10.26–$18.00	—	45%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$18.87	$34.00	$17.80–$23.24	62% below	45%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$18.87	$34.00	$17.80–$23.24	—	45%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$46.07	$83.00	$83.00	40% below	44%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$46.07	$83.00	$83.00	—	44%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE	$16.10	$29.00	$21.92	51% below	44%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE	$16.10	$29.00	$21.92	—	44%
Stool ova and parasites exam CPT 87177 OVA & PARASITES DIR SMR W ID	$28.31	$51.00	$27.54–$43.35	73% below	44%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES DIR SMR W ID	$28.31	$51.00	$27.54–$43.35	—	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$14.43	$26.00	$16.43–$22.10	59% below	45%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$14.43	$26.00	$16.43–$22.10	—	45%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$197.03	$355.00	$197.45–$268.10	9% below	44%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$197.03	$355.00	$197.45–$268.10	—	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$82.70	$149.00	$75.60–$119.78	43% below	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$82.70	$149.00	$75.60–$119.78	—	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$46.62	$84.00	$59.72–$68.54	61% below	45%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH	$46.62	$84.00	$59.72–$68.54	—	45%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$109.34	$197.00	$100.84–$167.45	4% below	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$109.34	$197.00	$100.84–$167.45	—	44%
Total IgE blood test CPT 82785 IGE	$52.73	$95.00	$72.09	45% below	44%
Total IgE blood test inpatient CPT 82785 IGE	$52.73	$95.00	$72.09	—	44%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM OR WB	$14.43	$26.00	$14.56	62% below	45%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM OR WB	$14.43	$26.00	$14.56	—	45%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$35.52	$64.00	$32.40–$35.60	45% below	45%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$35.52	$64.00	$32.40–$35.60	—	45%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$45.51	$82.00	$63.14–$66.91	57% below	45%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$45.51	$82.00	$63.14–$66.91	—	45%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$112.11	$202.00	$118.59–$138.09	34% below	45%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$112.11	$202.00	$118.59–$138.09	—	45%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$18.87	$34.00	$19.04	71% below	45%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$18.87	$34.00	$19.04	—	45%
Troponin test, quantitative CPT 84484 TROPONIN QUAN	$106.56	$192.00	$87.48–$192.00	14% below	45%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUAN	$106.56	$192.00	$87.48–$192.00	—	45%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$14.99	$27.00	$13.50–$25.00	74% below	44%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$14.99	$27.00	$13.50–$25.00	—	44%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/ SCOPE	$38.30	$69.00	$21.59–$62.58	18% below	44%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/ SCOPE	$38.30	$69.00	$21.59–$62.58	—	44%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS WO MICRO	$8.33	$15.00	$7.56–$15.00	67% below	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 AUTOMATED URINALYSIS WO MICRO	$8.33	$15.00	$7.56–$15.00	—	44%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$26.09	$47.00	$25.85–$47.00	68% below	44%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$26.09	$47.00	$25.85–$47.00	—	44%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE 24	$73.26	$132.00	$72.60–$99.79	12% below	45%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE 24	$73.26	$132.00	$72.60–$99.79	—	45%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY VISUAL COLOR	$27.75	$50.00	$34.18–$47.00	21% below	45%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY VISUAL COLOR	$27.75	$50.00	$34.18–$47.00	—	45%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 LEVEL	$79.37	$143.00	$72.36–$115.83	19% below	44%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 LEVEL	$79.37	$143.00	$72.36–$115.83	—	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$184.82	$333.00	$168.48–$283.05	1% below	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$184.82	$333.00	$168.48–$283.05	—	44%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25 DIHYDROXY	$236.99	$427.00	$302.40	20% below	44%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 25 DIHYDROXY	$236.99	$427.00	$302.40	—	44%
Zinc blood test CPT 84630 ZINC	$36.63	$66.00	$35.98–$53.06	58% below	45%
Zinc blood test inpatient CPT 84630 ZINC	$36.63	$66.00	$35.98–$53.06	—	45%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC QUANT	$48.29	$87.00	$51.08–$87.00	51% below	44%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC QUANT	$48.29	$87.00	$51.08–$87.00	—	44%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Colonoscopy with polyp removal CPT 45385 Colon W/Polyp Snare Technique	$3,942.72	$7,104.00	$1,797.66–$5,360.36	98% above	45%
Colonoscopy with polyp removal inpatient CPT 45385 Colon W/Polyp Snare Technique	$3,942.72	$7,104.00	$1,797.66–$5,360.36	—	45%
Colonoscopy with tissue sample CPT 45380 Colo w/biopsy	$1,835.94	$3,308.00	$1,797.66–$3,812.67	4% above	45%
Colonoscopy with tissue sample inpatient CPT 45380 Colo w/biopsy	$1,835.94	$3,308.00	$1,797.66–$3,812.67	—	45%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSOPY	$2,000.22	$3,604.00	$1,155.00–$1,197.00	148% above	45%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSOPY	$2,000.22	$3,604.00	$1,155.00–$1,197.00	—	45%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED CERUMEN UNILAT	$63.27	$114.00	$90.17	12% below	45%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACTED CERUMEN UNILAT	$63.27	$114.00	$90.17	—	45%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,072.26	$1,932.00	$977.94–$1,239.81	21% below	45%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,072.26	$1,932.00	$977.94–$1,239.81	—	45%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS	$156.51	$282.00	$237.86	20% below	45%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS	$156.51	$282.00	$237.86	—	45%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECT EPID/SUBARA LUMB W/IMAG	$870.24	$1,568.00	$1,332.80–$1,422.18	14% below	45%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT EPID/SUBARA LUMB W/IMAG	$870.24	$1,568.00	$1,332.80–$1,422.18	—	45%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$727.05	$1,310.00	$769.10–$895.52	28% below	45%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$727.05	$1,310.00	$769.10–$895.52	—	45%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colo Screening	$2,067.38	$3,725.00	$2,048.75–$3,166.25	18% above	44%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colo Screening	$2,067.38	$3,725.00	$2,048.75–$3,166.25	—	44%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colo Screening high risk	$2,787.21	$5,022.00	$2,762.10–$3,796.63	61% above	45%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colo Screening high risk	$2,787.21	$5,022.00	$2,762.10–$3,796.63	—	45%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT	$96.57	$174.00	$99.18–$163.00	12% below	45%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT	$96.57	$174.00	$99.18–$163.00	—	45%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$107.12	$193.00	$97.74–$156.33	at median	44%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT	$107.12	$193.00	$97.74–$156.33	—	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL REP S/N/A/G/TR/E 2.5 CM/<	$480.63	$866.00	$381.11–$767.88	125% above	45%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL REP S/N/A/G/TR/E 2.5 CM/<	$480.63	$866.00	$381.11–$767.88	—	45%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR SUPERFICIAL WND 2.6-7.5 CM	$315.80	$569.00	$471.88–$504.53	48% above	44%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR SUPERFICIAL WND 2.6-7.5 CM	$315.80	$569.00	$471.88–$504.53	—	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5CM OR <	$311.91	$562.00	$110.00–$562.00	47% above	45%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5CM OR <	$311.91	$562.00	$110.00–$562.00	—	45%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX,RT,W/LCL DEV,1ST LES	$1,280.39	$2,307.00	$1,189.10–$2,202.48	18% below	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX,LT,W/LCL DEV,1ST LES	$1,280.39	$2,307.00	$1,189.10–$2,202.48	18% below	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX,RT,W/LCL DEV,1ST LES	$1,280.39	$2,307.00	$1,189.10–$2,202.48	—	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX,LT,W/LCL DEV,1ST LES	$1,280.39	$2,307.00	$1,189.10–$2,202.48	—	44%
Upper endoscopy (EGD) with biopsy CPT 43239 GASTROSCOPY WITH BIOPSY	$1,424.13	$2,566.00	$450.00–$4,107.60	4% above	45%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD w Colonoscopy	$3,108.00	$5,600.00	$450.00–$4,107.60	127% above	45%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 GASTROSCOPY WITH BIOPSY	$1,424.13	$2,566.00	$450.00–$4,107.60	—	45%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w Colonoscopy	$3,108.00	$5,600.00	$450.00–$4,107.60	—	45%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR COMPONENT	$764.79	$1,378.00	$496.26–$1,221.87	at median	45%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$764.79	$1,378.00	$496.26–$1,221.87	at median	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$764.79	$1,378.00	$496.26–$1,221.87	—	45%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR COMPONENT	$764.79	$1,378.00	$496.26–$1,221.87	—	45%
Chemotherapy IV infusion, first hour CPT 96413 IV CHEMO INFUSION INITIAL HOUR	$634.37	$1,143.00	$578.34–$640.88	13% above	44%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV CHEMO INFUSION INITIAL HOUR	$634.37	$1,143.00	$578.34–$640.88	—	44%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE, FIRST 30-74MIN	$2,076.81	$3,742.00	$100.00–$3,159.81	1% below	45%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE, FIRST 30-74MIN	$2,076.81	$3,742.00	$100.00–$3,159.81	—	45%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/RHYTHM STRIP	$182.60	$329.00	$180.95–$329.00	4% above	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/RHYTHM STRIP	$182.60	$329.00	$180.95–$329.00	—	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT NOT REQUIRING PHYS	$138.20	$249.00	$136.95–$225.84	28% below	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT NOT REQUIRING PHYS	$138.20	$249.00	$136.95–$225.84	—	44%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT W/STRAIGHTFWD MDM	$249.75	$450.00	$100.00–$408.15	12% below	45%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT W/STRAIGHTFWD MDM	$249.75	$450.00	$100.00–$408.15	—	45%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT W/LOW MDM	$440.67	$794.00	$100.00–$720.16	17% below	45%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT W/LOW MDM	$440.67	$794.00	$100.00–$720.16	—	45%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT W/MODERATE MDM	$693.20	$1,249.00	$100.00–$1,107.49	24% below	44%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT W/MODERATE MDM	$693.20	$1,249.00	$100.00–$1,107.49	—	44%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT W/HIGH MDM	$995.12	$1,793.00	$100.00	23% below	44%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT W/HIGH MDM	$995.12	$1,793.00	$100.00	—	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INFUSION INITIAL	$259.19	$467.00	$256.85–$396.95	13% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INFUSION INITIAL	$259.19	$467.00	$256.85–$396.95	—	44%
IV infusion of a medicine, first hour CPT 96365 IV INF THER/PROPH/DIAG INITIAL	$341.88	$616.00	$338.80–$558.71	3% above	45%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THER/PROPH/DIAG INITIAL	$341.88	$616.00	$338.80–$558.71	—	45%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL THER/PROPH/DIA	$189.26	$341.00	$187.55–$314.40	1% below	44%
IV push of a medicine, first drug CPT 96374 IV INJ INITIAL THER/PROPH/DIAG	$189.26	$341.00	$187.55–$314.40	1% below	44%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL THER/PROPH/DIA	$189.26	$341.00	$187.55–$314.40	—	44%
IV push of a medicine, first drug inpatient CPT 96374 IV INJ INITIAL THER/PROPH/DIAG	$189.26	$341.00	$187.55–$314.40	—	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THER/PROPH/DIAG SC IM	$82.70	$149.00	$77.00–$149.00	15% above	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THER/PROPH/DIAG SC IM	$82.70	$149.00	$77.00–$149.00	—	44%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION 15M	$98.24	$177.00	$95.58–$156.95	1% below	44%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCLE RE-EDUC EA 15 MI	$98.24	$177.00	$147.50	1% below	44%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCLE RE-EDUC EA 15 MI	$98.24	$177.00	$147.50	—	44%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION 15M	$98.24	$177.00	$95.58–$156.95	—	44%
New patient office visit, about 30 minutes CPT 99203 OV,NEW,LOW MDM,30-44MIN	$70.49	$127.00	$52.84	50% below	44%
New patient office visit, about 30 minutes inpatient CPT 99203 OV,NEW,LOW MDM,30-44MIN	$70.49	$127.00	$52.84	—	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT MED NUTRITION THER EA 15M	$37.74	$68.00	$30.74	40% below	45%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INIT MED NUTRITION THER EA 15M	$37.74	$68.00	$30.74	—	45%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$213.68	$385.00	$219.45–$325.26	10% below	44%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$213.68	$385.00	$219.45–$325.26	—	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$272.51	$491.00	$248.40–$270.05	at median	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$272.51	$491.00	$248.40–$270.05	—	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$213.68	$385.00	$211.75–$385.00	6% below	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$213.68	$385.00	$211.75–$385.00	—	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$240.87	$434.00	$219.78–$393.64	at median	45%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$240.87	$434.00	$219.78–$393.64	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15MIN OTA	$86.58	$156.00	$80.97–$145.64	1% below	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN PTA	$92.13	$166.00	$92.88–$166.89	5% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN	$102.12	$184.00	$92.88–$166.89	17% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15M	$102.12	$184.00	$80.97–$145.64	17% above	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15MIN OTA	$86.58	$156.00	$80.97–$145.64	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN PTA	$92.13	$166.00	$92.88–$166.89	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15M	$102.12	$184.00	$80.97–$145.64	—	45%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN	$102.12	$184.00	$92.88–$166.89	—	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUT EXCERCISE 15MIN PTA	$98.79	$178.00	$103.95–$171.42	at median	45%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES 15 MIN	$104.90	$189.00	$103.95–$171.42	6% above	44%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUT EXCERCISE 15MIN PTA	$98.79	$178.00	$103.95–$171.42	—	45%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES 15 MIN	$104.90	$189.00	$103.95–$171.42	—	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 MAC/ANES OP VST ESTAB 20 MIN	$59.94	$108.00	$61.56	19% below	45%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 MAC/ANES OP VST ESTAB 20 MIN	$59.94	$108.00	$61.56	—	45%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 MAC/ANES EST,STR FWD, 10 MIN	$56.06	$101.00	$51.30	35% below	44%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 MAC/ANES EST,STR FWD, 10 MIN	$56.06	$101.00	$51.30	—	44%
Speech therapy session, individual CPT 92507 SPEECH, LANGUAGE, VOICE TX	$198.14	$357.00	$196.35–$286.99	16% below	44%
Speech therapy session, individual inpatient CPT 92507 SPEECH, LANGUAGE, VOICE TX	$198.14	$357.00	$196.35–$286.99	—	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15MIN PTA	$92.69	$167.00	$90.18–$150.47	at median	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACT 15MIN OTA	$92.69	$167.00	$150.47–$151.30	at median	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TRANSFER TRAIN 15MIN PTA	$92.69	$167.00	$90.18–$150.47	at median	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$98.79	$178.00	$150.47–$151.30	7% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TRANSFER TRAIN 15M	$98.79	$178.00	$90.18–$150.47	7% above	45%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15 MIN	$98.79	$178.00	$90.18–$150.47	7% above	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACT 15MIN OTA	$92.69	$167.00	$150.47–$151.30	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15MIN PTA	$92.69	$167.00	$90.18–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TRANSFER TRAIN 15MIN PTA	$92.69	$167.00	$90.18–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$98.79	$178.00	$150.47–$151.30	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TRANSFER TRAIN 15M	$98.79	$178.00	$90.18–$150.47	—	45%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15 MIN	$98.79	$178.00	$90.18–$150.47	—	45%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$181.49	$327.00	$260.95	12% below	44%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$181.49	$327.00	$260.95	—	44%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE PF 2024-25	$19.43	$35.00	$35.00	13% below	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRIVALENT 2025-26	$61.61	$111.00	$35.00	177% above	44%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE PF 2024-25	$19.43	$35.00	$35.00	—	44%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE TRIVALENT 2025-26	$61.61	$111.00	$35.00	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC H-DOSE >65YRS 2022-23	$47.18	$85.00	$64.94–$104.50	57% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC H-DOSE >65YR; 2021-22	$47.18	$85.00	$64.94–$104.50	57% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC H-DOSE >65YRS 2023-24	$47.18	$85.00	$64.94–$104.50	57% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC QV2020-21(65YR UP)/PF	$48.84	$88.00	$64.94–$104.50	56% below	45%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF 2024-25	$52.73	$95.00	$64.94–$104.50	52% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HDOSE TRIVALNT 2025-26	$239.21	$431.00	$64.94–$104.50	116% above	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC H-DOSE >65YRS 2022-23	$47.18	$85.00	$64.94–$104.50	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC H-DOSE >65YRS 2023-24	$47.18	$85.00	$64.94–$104.50	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC H-DOSE >65YR; 2021-22	$47.18	$85.00	$64.94–$104.50	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC QV2020-21(65YR UP)/PF	$48.84	$88.00	$64.94–$104.50	—	45%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HD PF 2024-25	$52.73	$95.00	$64.94–$104.50	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HDOSE TRIVALNT 2025-26	$239.21	$431.00	$64.94–$104.50	—	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >= 7 YEARS IM	$71.60	$129.00	$79.70–$144.90	36% above	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >= 7 YEARS IM	$71.60	$129.00	$79.70–$144.90	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE	$29.42	$53.00	$29.15–$49.88	3% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE M/S	$29.42	$53.00	$29.15–$49.88	3% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$30.53	$55.00	$29.15–$49.88	at median	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SINGLE	$30.53	$55.00	$29.15–$49.88	at median	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE	$29.42	$53.00	$29.15–$49.88	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE M/S	$29.42	$53.00	$29.15–$49.88	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$30.53	$55.00	$29.15–$49.88	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SINGLE	$30.53	$55.00	$29.15–$49.88	—	44%

Source file: https://hospitalpricetransparencyfiles.com/upper-connecticut-valley-hospital/020276210_Upper-Connecticut-Valley-Hospital_standardcharges.csv