SelfPayRates
Hospital Houston-Pasadena-The Woodlands, TX

Liberty Dayton Regional Medical Center

Liberty Dayton Regional Medical Center in Liberty, TX publishes cash prices for 351 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 Texas median for 272 of 348 procedures and above it for 76. By typical cash price it ranks #59 of 305 Texas hospitals and #4 of 62 hospitals in the Houston, TX area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1353 N Travis St, Liberty, TX 77575 Collected Sep 27, 2026 Source price file (936) 336-7316

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 451375 · CMS hospital register

Scans and imaging

ProcedureCash price List priceInsurers payvs TexasOff list
Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen W/ + W/o Contrast $1,033.00 $1,476.00 $886.00–$1,402.00 64% below 30%
Abdominal X-ray, 2 views CPT 74019 Xr Abdomen 2 View $239.00 $341.00 $205.00–$324.00 40% below 30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Left $195.00 $279.00 $167.00–$265.00 48% below 30%
Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Right $195.00 $279.00 $167.00–$265.00 48% below 30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Us Abi's $307.00 $439.00 $263.00–$417.00 50% below 30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 Us Abi Eo $307.00 $439.00 $263.00–$417.00 50% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow W/o Contrast Left $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus W/o Contrast Right $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Humerus W/o Contrast Left $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand W/o Contrast Right $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Hand W/o Contrast Left $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm W/o Contrast Right $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Forearm W/o Contrast Left $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist W/o Contrast Right $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Wrist W/o Contrast Left $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder W/o Contrast Right $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Shoulder W/o Contrast Left $664.00 $948.00 $569.00–$901.00 64% below 30%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Elbow W/o Contrast Right $664.00 $948.00 $569.00–$901.00 64% below 30%
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Right $620.00 $886.00 $532.00–$842.00 40% above 30%
Breast ultrasound, complete, one breast one side CPT 76641 Us Breast Left $620.00 $886.00 $532.00–$842.00 40% above 30%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 Ct Angiography Abdomen/pelvis W/ + W/o C $1,217.00 $1,739.00 $1,043.00–$1,652.00 72% below 30%
CT angiography (CTA) of the head CPT 70496 Ct Angiography Head $1,217.00 $1,739.00 $1,043.00–$1,652.00 57% below 30%
CT angiography (CTA) of the neck CPT 70498 Ct Angio Neck W/ Contrast $1,217.00 $1,739.00 $1,043.00–$1,652.00 55% below 30%
CT angiography (CTA) of the neck CPT 70498 Ldh Ct Angio Neck W/ Contrast $1,217.00 $1,739.00 $1,043.00–$1,652.00 55% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ldh Ct Angiography Chest $1,217.00 $1,739.00 $1,043.00–$1,652.00 57% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angio Chest $1,217.00 $1,739.00 $1,043.00–$1,652.00 57% below 30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Angiography Chest Pe $1,217.00 $1,739.00 $1,043.00–$1,652.00 57% below 30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 Ct Heart W/ Cont Structure/morphology $1,652.00 $2,360.00 $1,416.00–$2,242.00 1% below 30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 Ct Cardiac Calcium Score $216.00 $308.00 $185.00–$293.00 14% above 30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ldh Ct Abd/pel W/o Contrast $904.00 $1,292.00 $775.00–$1,227.00 73% below 30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 Ct Abdomen/pelvis W/o Contrast $904.00 $1,292.00 $775.00–$1,227.00 73% below 30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT scan of abdomen and pelvis with contrast $1,236.00 $1,766.00 $1,060.00–$1,678.00 68% below 30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ldh Ct Abd/pel W + W/o Contrast $1,336.00 $1,908.00 $1,145.00–$1,813.00 68% below 30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 Ct Abdomen/pelvis W + W/o Contrast $1,336.00 $1,908.00 $1,145.00–$1,813.00 68% below 30%
CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W/ Contrast $904.00 $1,292.00 $775.00–$1,227.00 65% below 30%
CT scan of the abdomen without contrast CPT 74150 Ct Abdomen W/o Contrast $664.00 $948.00 $569.00–$901.00 68% below 30%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Maxillofacial W/o Contrast $664.00 $948.00 $569.00–$901.00 60% below 30%
CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinus W/o Contrast $664.00 $948.00 $569.00–$901.00 60% below 30%
CT scan of the head or brain, no contrast dye CPT 70450 CT scan $664.00 $948.00 $569.00–$901.00 65% below 30%
CT scan of the head with contrast CPT 70460 Ct Head Or Brain W/ Contrast $904.00 $1,292.00 $775.00–$1,227.00 49% below 30%
CT scan of the head without and with contrast CPT 70470 Ct Head Or Brain W/ + W/o Contrast $1,033.00 $1,476.00 $886.00–$1,402.00 55% below 30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct Spine Lumbar W/o Contrast $664.00 $948.00 $569.00–$901.00 68% below 30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct Spine Cervical W/o Contrast $664.00 $948.00 $569.00–$901.00 68% below 30%
CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast $904.00 $1,292.00 $775.00–$1,227.00 59% below 30%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 Us Carotid Doppler Bilateral $511.00 $730.00 $438.00–$694.00 — 30%
Chest CT scan without and with contrast CPT 71270 Ct Chest W/wo Contrast $1,033.00 $1,476.00 $886.00–$1,402.00 62% below 30%
Chest CT scan without and with contrast CPT 71270 Ct Chest /Abdomen/pelvis W + W/o Contras $1,033.00 $1,476.00 $886.00–$1,402.00 62% below 30%
Chest CT scan without and with contrast CPT 71270 Ldh Ct Chest W/wo Contrast $1,033.00 $1,476.00 $886.00–$1,402.00 62% below 30%
Chest X-ray, 2 views CPT 71046 Xr Chest 2 Views $195.00 $279.00 $167.00–$265.00 50% below 30%
Chest X-ray, single view CPT 71045 Xr Chest 1 View $195.00 $279.00 $167.00–$265.00 40% below 30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Right $195.00 $279.00 $167.00–$265.00 44% below 30%
Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavicle Left $195.00 $279.00 $167.00–$265.00 44% below 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest/abd/pel W/o Contrast $657.00 $938.00 $563.00–$891.00 61% below 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ldh Ct Chest W/o Contrast $657.00 $938.00 $563.00–$891.00 61% below 30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest W/o Contrast $659.00 $941.00 $565.00–$894.00 61% below 30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W/ Contrast $904.00 $1,292.00 $775.00–$1,227.00 58% below 30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest/abd/pel W/ Contrast $904.00 $1,292.00 $775.00–$1,227.00 58% below 30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W/contrast $904.00 $1,292.00 $775.00–$1,227.00 58% below 30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ldh Ct Chest W/ Contrast $906.00 $1,295.00 $777.00–$1,230.00 58% below 30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Le Arterial Duplex Bilateral $624.00 $891.00 $535.00–$846.00 — 30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Le Venous Duplex Bilateral $566.00 $808.00 $485.00–$768.00 — 30%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Ue Venous Duplex Bilateral $566.00 $808.00 $485.00–$768.00 — 30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 Us Echo Complete $1,155.00 $1,650.00 $990.00–$1,568.00 51% below 30%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Right $186.00 $266.00 $160.00–$253.00 43% below 30%
Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 Views Left $186.00 $266.00 $160.00–$253.00 43% below 30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Left $195.00 $279.00 $167.00–$265.00 49% below 30%
Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Right $195.00 $279.00 $167.00–$265.00 49% below 30%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Iac W/o Contrast $664.00 $948.00 $569.00–$901.00 60% below 30%
Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbit Sella Etc. W/o Contrast $664.00 $948.00 $569.00–$901.00 60% below 30%
Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones Minimum 3 Views $239.00 $341.00 $205.00–$324.00 44% below 30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Left $195.00 $279.00 $167.00–$265.00 48% below 30%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm 2 Views Right $195.00 $279.00 $167.00–$265.00 48% below 30%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Right $186.00 $266.00 $160.00–$253.00 43% below 30%
Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 Views Left $186.00 $266.00 $160.00–$253.00 43% below 30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Left $195.00 $279.00 $167.00–$265.00 33% below 30%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneus Right $195.00 $279.00 $167.00–$265.00 33% below 30%
Knee X-ray, 3 views one side CPT 73562 Xr Knee Complete Right $195.00 $279.00 $167.00–$265.00 52% below 30%
Knee X-ray, 3 views one side CPT 73562 Xr Knee Complete Left $195.00 $279.00 $167.00–$265.00 52% below 30%
Knee X-ray, complete, 4 or more views CPT 73564 Radiology Charge $237.00 $338.00 $203.00–$321.00 44% below 30%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete Right 73564 $239.00 $341.00 $205.00–$324.00 44% below 30%
Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee Complete Left 73564 $239.00 $341.00 $205.00–$324.00 44% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip W/o Contrast Left $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Tibia/fibula W/o Contrast Left $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Tibia/fibula W/o Contrast Right $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur W/o Contrast Right $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Femur W/o Contrast Left $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle W/o Contrast Left $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee W/o Contrast Right $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Ankle W/o Contrast Right $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot W/o Contrast Left $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Foot W/o Contrast Right $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Knee W/o Contrast Left $664.00 $948.00 $569.00–$901.00 62% below 30%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Hip W/o Contrast Right $664.00 $948.00 $569.00–$901.00 62% below 30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited $359.00 $513.00 $308.00–$487.00 43% below 30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Limited Anatomic Specific $359.00 $513.00 $308.00–$487.00 24% below 30%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 Us Superficial Mass $359.00 $513.00 $308.00–$487.00 24% below 30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 Ct Low Dose Lung Screening $228.00 $326.00 $196.00–$310.00 5% below 30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia/fibula 2 Views Right $195.00 $279.00 $167.00–$265.00 44% below 30%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia/fibula 2 Views Left $195.00 $279.00 $167.00–$265.00 44% below 30%
MR angiography (MRA) of the head without contrast CPT 70544 Mra Head W/o Contrast $1,341.00 $1,916.00 $1,150.00–$1,820.00 37% below 30%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle W/ + W/o Contrast Left $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee W/ + W/o Contrast Right $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Knee W/ + W/o Contrast Left $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip W/ + W/o Contrast Right $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Hip W/ + W/o Contrast Left $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Ankle W/ + W/o Contrast Right $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Foot W/ + W/o Contrast Left $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 Mri Foot W/ + W/o Contrast Right $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of the abdomen without contrast CPT 74181 Mri Abdomen Mrcp W/o Cont $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen W/ + W/o Contrast $1,775.00 $2,535.00 $1,521.00–$2,408.00 45% below 30%
MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen Mrcp W/ + W/o Cont $1,775.00 $2,535.00 $1,521.00–$2,408.00 45% below 30%
MRI of the brain, no contrast dye CPT 70551 Mri Brain W/o Contrast $1,269.00 $1,813.00 $1,088.00–$1,722.00 42% below 30%
MRI of the brain, with and without contrast dye CPT 70553 MRI Scan $1,775.00 $2,535.00 $1,521.00–$2,408.00 41% below 30%
MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal $1,269.00 $1,813.00 $1,088.00–$1,722.00 45% below 30%
MRI of the lower back, without and then with contrast dye CPT 72158 Mri Spine Lumbar W/ + W/o Contrast $1,775.00 $2,535.00 $1,521.00–$2,408.00 44% below 30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri Spine Thoracic W/o Contrast $1,248.00 $1,783.00 $1,070.00–$1,694.00 42% below 30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri Spine Cervical W/ + W/o Contrast $1,775.00 $2,535.00 $1,521.00–$2,408.00 46% below 30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri Spine Cervical W/o Contrast $1,248.00 $1,783.00 $1,070.00–$1,694.00 46% below 30%
MRI of the pelvis without and with contrast CPT 72197 Mri Pelvis W/ + W/o Contrast $1,775.00 $2,535.00 $1,521.00–$2,408.00 48% below 30%
MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis W/o Contrast $1,269.00 $1,813.00 $1,088.00–$1,722.00 48% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist W/o Contrast Right $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow W/o Contrast Right $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder W/o Contrast Left $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Shoulder W/o Contrast Right $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Elbow W/o Contrast Left $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Wrist W/o Contrast Left $1,269.00 $1,813.00 $1,088.00–$1,722.00 43% below 30%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck/chest W/contrast $904.00 $1,292.00 $775.00–$1,227.00 56% below 30%
Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck W/ Contrast $904.00 $1,292.00 $775.00–$1,227.00 56% below 30%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck/chest W/o Contrast $664.00 $948.00 $569.00–$901.00 62% below 30%
Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck W/o Contrast $664.00 $948.00 $569.00–$901.00 62% below 30%
Neck soft tissue X-ray CPT 70360 Xr Neck Soft Tissue $195.00 $279.00 $167.00–$265.00 19% below 30%
Pelvic CT scan without contrast CPT 72192 Ct Pelvis W/o Contrast $664.00 $948.00 $569.00–$901.00 60% below 30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvis Non-ob Limited $359.00 $513.00 $308.00–$487.00 26% below 30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvis Non-ob Complete $466.00 $666.00 $400.00–$633.00 46% below 30%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Abdomial ultrasound of pregnant uterus $466.00 $666.00 $400.00–$633.00 29% below 30%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Us Ob < 14 Weeks Single $466.00 $666.00 $400.00–$633.00 24% below 30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Ob Limited (Afi) $358.00 $512.00 $307.00–$486.00 22% below 30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Us Pregnancy Limited $359.00 $513.00 $308.00–$487.00 22% below 30%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Right $195.00 $279.00 $167.00–$265.00 45% below 30%
Rib X-ray, one side, 2 views one side CPT 71100 Xr Ribs 2 Views Left $195.00 $279.00 $167.00–$265.00 45% below 30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Right $195.00 $279.00 $167.00–$265.00 43% below 30%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Left $195.00 $279.00 $167.00–$265.00 43% below 30%
Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinuses Paranasal Complete $239.00 $341.00 $205.00–$324.00 43% below 30%
Skull X-ray, fewer than 4 views CPT 70250 Xr Skull < 4 Views $239.00 $341.00 $205.00–$324.00 32% below 30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur Left $195.00 $279.00 $167.00–$265.00 44% below 30%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 Xr Femur Right $195.00 $279.00 $167.00–$265.00 44% below 30%
Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct Spine Thoracic W/o Contrast $664.00 $948.00 $569.00–$901.00 66% below 30%
Toe X-ray, 2 or more views one side CPT 73660 Xr Toes Right $195.00 $279.00 $167.00–$265.00 34% below 30%
Toe X-ray, 2 or more views one side CPT 73660 Xr Toes Left $195.00 $279.00 $167.00–$265.00 34% below 30%
Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina $383.00 $547.00 $328.00–$520.00 40% below 30%
Transvaginal ultrasound during pregnancy CPT 76817 Us Pregnancy Transvaginal $466.00 $666.00 $400.00–$633.00 9% below 30%
Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen $466.00 $666.00 $400.00–$633.00 46% below 30%
Ultrasound of the scrotum and testicles CPT 76870 Us Scrotum (Contents) $466.00 $666.00 $400.00–$633.00 24% below 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Thyroid $359.00 $513.00 $308.00–$487.00 43% below 30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Head/neck Soft Tissue $359.00 $513.00 $308.00–$487.00 43% below 30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Right $195.00 $279.00 $167.00–$265.00 44% below 30%
Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Left $195.00 $279.00 $167.00–$265.00 44% below 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Ue Venous Duplex Left $412.00 $589.00 $353.00–$560.00 49% below 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Le Venous Duplex Left $412.00 $589.00 $353.00–$560.00 49% below 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Le Venous Duplex Right $412.00 $589.00 $353.00–$560.00 49% below 30%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Ue Venous Duplex Right $412.00 $589.00 $353.00–$560.00 49% below 30%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Right $186.00 $266.00 $160.00–$253.00 42% below 30%
Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 Views Left $186.00 $266.00 $160.00–$253.00 42% below 30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Left $195.00 $279.00 $167.00–$265.00 49% below 30%
Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Right $195.00 $279.00 $167.00–$265.00 49% below 30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip Complete Right $195.00 $279.00 $167.00–$265.00 52% below 30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 Xr Hip Complete Left $195.00 $279.00 $167.00–$265.00 52% below 30%
X-ray of the abdomen, 1 view CPT 74018 Xr Abdomen 1 View $186.00 $266.00 $160.00–$253.00 45% below 30%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Right $186.00 $266.00 $160.00–$253.00 38% below 30%
X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 Views Left $186.00 $266.00 $160.00–$253.00 38% below 30%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger Left $195.00 $279.00 $167.00–$265.00 26% below 30%
X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger Right $195.00 $279.00 $167.00–$265.00 26% below 30%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Right $186.00 $266.00 $160.00–$253.00 44% below 30%
X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 Views Left $186.00 $266.00 $160.00–$253.00 44% below 30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Min 3v Right 73630 $195.00 $279.00 $167.00–$265.00 48% below 30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Min 3v Left 73630 $195.00 $279.00 $167.00–$265.00 48% below 30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Left $195.00 $279.00 $167.00–$265.00 48% below 30%
X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Right $195.00 $279.00 $167.00–$265.00 48% below 30%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Left $195.00 $279.00 $167.00–$265.00 50% below 30%
X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Right $195.00 $279.00 $167.00–$265.00 50% below 30%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee One Or Two Views Right $186.00 $266.00 $160.00–$253.00 37% below 30%
X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee One Or Two Views Left $186.00 $266.00 $160.00–$253.00 37% below 30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr Spine Lumbosacral 2 Or 3 Views $239.00 $341.00 $205.00–$324.00 49% below 30%
X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back $239.00 $341.00 $205.00–$324.00 62% below 30%
X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones Minimum 3 Views $195.00 $279.00 $167.00–$265.00 33% below 30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr Spine Cervical 2 Or 3 Views $186.00 $266.00 $160.00–$253.00 50% below 30%
X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis 1 View $239.00 $341.00 $205.00–$324.00 36% below 30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum $186.00 $266.00 $160.00–$253.00 43% below 30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Coccyx $186.00 $266.00 $160.00–$253.00 43% below 30%

Lab tests

ProcedureCash price List priceInsurers payvs TexasOff list
ACTH blood test CPT 82024 Adrenocorticotropic Hormone (Acth) Qst $354.00 $505.00 $303.00–$480.00 49% above 30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alanine Aminotransferase $21.00 $30.00 $18.00–$29.00 64% below 30%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 Alt Qst $37.00 $53.00 $32.00–$50.00 37% below 30%
AST (aspartate aminotransferase) enzyme test CPT 84450 Aspartate Aminotransferase $20.00 $28.00 $17.00–$27.00 65% below 29%
AST (aspartate aminotransferase) enzyme test CPT 84450 Ast Qst $37.00 $53.00 $32.00–$50.00 36% below 30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel (Refl) Qst $227.00 $325.00 $195.00–$309.00 41% below 30%
Albumin blood test CPT 82040 Albumin Level $14.00 $20.00 $12.00–$19.00 62% below 30%
Albumin blood test CPT 82040 Albumin Qst $39.00 $55.00 $33.00–$52.00 5% above 29%
Aldosterone blood test CPT 82088 Aldosterone Qst $132.00 $189.00 $113.00–$180.00 8% below 30%
Aldosterone blood test CPT 82088 Aldost Qst $132.00 $189.00 $113.00–$180.00 8% below 30%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase $15.00 $22.00 $13.00–$21.00 74% below 32%
Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phos Qst $43.00 $61.00 $37.00–$58.00 26% below 30%
Alkaline phosphatase (ALP) blood test CPT 84075 84075 Qst $92.00 $131.00 $79.00–$124.00 57% above 30%
Alkaline phosphatase (ALP) blood test CPT 84075 Alkaline Phosphatase, Bone Specific Qst $176.00 $251.00 $151.00–$238.00 201% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 Latex Ige Qst $24.00 $34.00 $20.00–$32.00 13% below 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Common Ragweed (Short) (W1) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Elm (T8) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander (E5) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White (F1) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass (G6) Ige, Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Stemphylium Botryosum (M10) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Mucor Race (M4) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Birch (T3) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander (E1) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach (I6) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Mountain Cedar (T6) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Asperg Fum (M3) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Urine Proteins (E72) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Nettle (W20) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan/hickory (T22) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Marsh Elder (W16) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Urine Proteins $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 White Mulberry (T70) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 White Ash (T15) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Mouse Urine Proteins (E72) Ige Class Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Bahia Grass (G17) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium Notatum (M1) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Gluten (F79), Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Crab (F23) Ige, Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Crayfish (Rf320) Ige, Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Yeast (F45), Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Dermato Far (D2) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Altern Alt (M6) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat Dander (E1) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Pteronyssinus (D1) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cottonwood (T14) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog Dander (E5) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach (I6) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Dermato Pter (D1) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladospor Herb (M2) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Pecan Nut (F201) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium Herbarum (M2) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria Alternata (A Mold) (M6) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda Grass (G2) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus Fumigatus (M3) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Sheep Sorrel (W18) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Rough Pigweed (W14) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Maple (Box Elder) (T1) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy Grass (G6) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium Notatum (M1) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Oak (T7) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Rye (F5) Ige, Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Oat (F7) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach Ige $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Lobster (F80) Ige $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Cow's Milk (F2) Ige Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut, Total With Reflex To Peanut Component Panel Qst $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Dermatophagoides Farinae (D2) $31.00 $45.00 $27.00–$43.00 12% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Tea (F222) Ige Qst $33.00 $47.00 $28.00–$45.00 19% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 Beef (Bos Spp) Ige Qst $43.00 $62.00 $37.00–$59.00 55% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Lamb/mutton (Ovis Spp) Ige Qst $43.00 $62.00 $37.00–$59.00 55% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Pork (Sus Spp) Ige Qst $43.00 $62.00 $37.00–$59.00 55% above 31%
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Hornet (I5) Ige Qst $53.00 $75.00 $45.00–$71.00 91% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Yellow Jacket (I3) Ige Qst $53.00 $75.00 $45.00–$71.00 91% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Paper Wasp (I4) Ige Qst $53.00 $75.00 $45.00–$71.00 91% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Honey Bee (I1) Ige Qst $53.00 $75.00 $45.00–$71.00 91% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 White-faced Hornet (I2) Ige Qst $53.00 $75.00 $45.00–$71.00 91% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Hazelnut (F17) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Almond (F20) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Cashew Nut (F202) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Codfish (F3) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut (F13) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Salmon (F41) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Scallop (F338) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed (F10) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp (F24) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Soybean (F14) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Tuna (F40) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Walnut (F256) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Wheat (F4) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Egg White (F1) Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Milk (F2) Ige Qst $55.00 $78.00 $47.00–$74.00 98% above 29%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige Mulberry Red Tree Qst $68.00 $97.00 $58.00–$92.00 145% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 86003 Qst $68.00 $97.00 $58.00–$92.00 145% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige Curvularia Spicifera Qst $83.00 $119.00 $71.00–$113.00 199% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific Ige Arizona Ash Qst $139.00 $198.00 $119.00–$188.00 401% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill Food Allergy Profile Qst $669.00 $955.00 $573.00–$907.00 2313% above 30%
Allergy blood test, specific IgE, per allergen CPT 86003 Bill Respiratory Allergy Profile Region X : Ok, Tx Qst $1,159.00 $1,655.00 $993.00–$1,572.00 4081% above 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 Alpha Fetoprotein Tumor Marker Qst $35.00 $50.00 $30.00–$48.00 71% below 30%
Alpha-fetoprotein (AFP) blood test CPT 82105 Maternal Serum Afp Qst $58.00 $83.00 $50.00–$79.00 53% below 30%
Ammonia blood test CPT 82140 Ammonia Level $115.00 $164.00 $98.00–$156.00 21% below 30%
Ammonia blood test CPT 82140 Ammonia Level Qst $115.00 $164.00 $98.00–$156.00 21% below 30%
Amylase blood test CPT 82150 Amylase, Random Urine W/creatinine Qst $34.00 $48.00 $29.00–$46.00 65% below 29%
Amylase blood test CPT 82150 Amylase Level $34.00 $48.00 $29.00–$46.00 65% below 29%
Amylase blood test CPT 82150 Amylase Qst $53.00 $75.00 $45.00–$71.00 46% below 29%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Qst $169.00 $241.00 $145.00–$229.00 175% above 30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab, Igg, Qst $200.00 $286.00 $172.00–$272.00 225% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Bill Antinuclear Antibodies (Ana) $25.00 $36.00 $22.00–$34.00 72% below 31%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen Qst $106.00 $151.00 $91.00–$143.00 20% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Titer Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 .Ana Titer And Pattern Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Anachoice(r) Screen Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen, Ifa With Reflex To Titer/pattern/cascade Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen,ifa, With Rflx To Titer And Pattern Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 .Antinuclear Antibodies Titer And Pattern Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen, Ifa W/reflex To Titer And Pattern/lupus Panel Qst $122.00 $175.00 $105.00–$166.00 38% above 30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana Screen, Ifa, With Reflex To Titer And Pattern/systemic Sclerosis, Qst $195.00 $278.00 $167.00–$264.00 120% above 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp $98.00 $140.00 $84.00–$133.00 47% below 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B Type Natriuretic Peptide (Bnp) $98.00 $140.00 $84.00–$133.00 47% below 30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Probnp, N Terminal Qst $271.00 $387.00 $232.00–$368.00 46% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Csf Mb Qst $11.00 $15.00 $9.00–$14.00 84% below 27%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Csf Culture Send Out Qst $12.00 $17.00 $10.00–$16.00 83% below 29%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Ear, External Mb Qst $22.00 $31.00 $19.00–$29.00 68% below 29%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Aerobic Bacteria With Gram Stain Mb Qst $84.00 $120.00 $72.00–$114.00 21% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Genital Mb Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Sputum/lower Respiratory Mb Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Aerobic Bacteria Mb Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Throat Culture Send Out Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Nose/throat Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Genital Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Aerobic Culture Send Out Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Throat Mb Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 87070 Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture, Aerobic Bacteria Qst $141.00 $201.00 $121.00–$191.00 103% above 30%
Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel $50.00 $72.00 $43.00–$68.00 79% below 31%
Bilirubin blood test, total CPT 82247 82247 Qst $13.00 $19.00 $11.00–$18.00 81% below 32%
Bilirubin blood test, total CPT 82247 Bilirubin, Total Qst $13.00 $19.00 $11.00–$18.00 81% below 32%
Bilirubin blood test, total CPT 82247 Bilirubin Total $37.00 $53.00 $32.00–$50.00 45% below 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 88305 Surgical Path Microscopic Examination Qst $172.00 $246.00 $148.00–$234.00 42% below 30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tissue, Pathology Report Qst $344.00 $491.00 $295.00–$466.00 16% above 30%
Blood culture for bacteria CPT 87040 Culture, Blood Mb Qst $172.00 $246.00 $148.00–$234.00 28% below 30%
Blood culture for bacteria CPT 87040 Culture, Blood Qst $172.00 $246.00 $148.00–$234.00 28% below 30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Collection: Venous Draw $18.00 $26.00 $16.00–$25.00 9% below 31%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Bill Venipuncture $19.00 $27.00 $16.00–$26.00 4% below 30%
Blood glucose (sugar) test CPT 82947 2 Hour Specimen Qst $27.00 $38.00 $23.00–$36.00 39% below 29%
Blood glucose (sugar) test CPT 82947 Glucose Fasting $37.00 $53.00 $32.00–$50.00 17% below 30%
Blood glucose (sugar) test CPT 82947 Glucose, Postprandial/ 2 Hour Qst $37.00 $53.00 $32.00–$50.00 17% below 30%
Blood glucose (sugar) test CPT 82947 Glucose Level $37.00 $53.00 $32.00–$50.00 17% below 30%
Blood glucose (sugar) test CPT 82947 .Gtt Glucose Fasting $37.00 $53.00 $32.00–$50.00 17% below 30%
Blood glucose (sugar) test CPT 82947 Glucose, Plasma Qst $37.00 $53.00 $32.00–$50.00 17% below 30%
Blood glucose (sugar) test CPT 82947 Glucose Qst $37.00 $53.00 $32.00–$50.00 17% below 30%
Blood lead test CPT 83655 Lead, Random Urine Qst $30.00 $43.00 $26.00–$41.00 43% below 30%
Blood lead test CPT 83655 Lead Level Qst $120.00 $171.00 $103.00–$162.00 126% above 30%
Blood lead test CPT 83655 Lead, 24 Hour Urine Qst $141.00 $201.00 $121.00–$191.00 166% above 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Hcg Quantitative $91.00 $130.00 $78.00–$124.00 34% below 30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Serum Pregnancy Test Qualitative $91.00 $130.00 $78.00–$124.00 34% below 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Reference Abo/rh $271.00 $387.00 $232.00–$368.00 207% above 30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Aborh $271.00 $387.00 $232.00–$368.00 207% above 30%
Blood urea nitrogen (BUN) test CPT 84520 Blood Urea Nitrogen $15.00 $22.00 $13.00–$21.00 74% below 32%
C-peptide blood test CPT 84681 C-peptide, Lc/ms/ms Qst $139.00 $199.00 $119.00–$189.00 71% above 30%
C-peptide blood test CPT 84681 C-peptide. $141.00 $201.00 $121.00–$191.00 73% above 30%
C-peptide blood test CPT 84681 C-peptide Qst $141.00 $201.00 $121.00–$191.00 73% above 30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-reactive Protein Qst $121.00 $173.00 $104.00–$164.00 108% above 30%
CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9 Qst $218.00 $312.00 $187.00–$296.00 61% above 30%
CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125 Qst $285.00 $407.00 $244.00–$387.00 78% above 30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2, Covid-19 Amp Prb Sendout $245.00 $350.00 $210.00–$333.00 175% above 30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 (Covid-19) Pcr (Genexpert) $245.00 $350.00 $210.00–$333.00 175% above 30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Sars-cov-2 Rna (Covid-19), Qualitative Naat Qst $245.00 $350.00 $210.00–$333.00 175% above 30%
Calcium blood test, total CPT 82310 82310 Qst $34.00 $48.00 $29.00–$46.00 46% below 29%
Calcium blood test, total CPT 82310 Calcium Level Total $39.00 $56.00 $34.00–$53.00 38% below 30%
Calcium blood test, total CPT 82310 Calcium, Random Urine (W/o Creatinine) Qst $43.00 $62.00 $37.00–$59.00 32% below 31%
Calcium blood test, total CPT 82310 Calcium Lvl Qst $86.00 $123.00 $74.00–$117.00 37% above 30%
Carcinoembryonic antigen (CEA) test CPT 82378 Carcinoembryonic Antigen Qst $187.00 $267.00 $160.00–$254.00 17% above 30%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igg Ab Qst $53.00 $76.00 $46.00–$72.00 16% below 30%
Chickenpox (varicella) immunity blood test CPT 86787 Varicella Zoster Igm Ab Qst $90.00 $128.00 $77.00–$122.00 43% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Ct/ng Pcr $53.00 $75.00 $45.00–$71.00 58% below 29%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis By Pcr $53.00 $75.00 $45.00–$71.00 58% below 29%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Rna, Tma, Urogenit $132.00 $189.00 $113.00–$180.00 5% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia/n. Gonorrhoeae Rna, Tma Qst $132.00 $189.00 $113.00–$180.00 5% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Qst $132.00 $189.00 $113.00–$180.00 5% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomitis Rna, Tma, Throat $132.00 $189.00 $113.00–$180.00 5% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Rna Qst $291.00 $415.00 $249.00–$394.00 131% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 87491 Chlamydia Trachomatis $326.00 $466.00 $280.00–$443.00 159% above 30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trachomatis Rna, Tma Qst $326.00 $466.00 $280.00–$443.00 159% above 30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids $173.00 $247.00 $148.00–$235.00 11% below 30%
Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated $38.00 $54.00 $32.00–$51.00 58% below 30%
Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals $63.00 $90.00 $54.00–$86.00 79% below 30%
Cortisol blood test, total CPT 82533 Cortisol Am Qst $95.00 $135.00 $81.00–$128.00 3% above 30%
Cortisol blood test, total CPT 82533 Cortisol Level Pm $95.00 $135.00 $81.00–$128.00 3% above 30%
Cortisol blood test, total CPT 82533 Cortisol Level Am $95.00 $135.00 $81.00–$128.00 3% above 30%
Cortisol blood test, total CPT 82533 Cortisol, Total Qst $95.00 $135.00 $81.00–$128.00 3% above 30%
Cortisol blood test, total CPT 82533 Cortisol Level $95.00 $135.00 $81.00–$128.00 3% above 30%
Cortisol blood test, total CPT 82533 Cortisol, Total, Lc/ms/ms Qst $223.00 $319.00 $191.00–$303.00 143% above 30%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase $30.00 $43.00 $26.00–$41.00 58% below 30%
Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase (Ck), (Cpk); Total $30.00 $43.00 $26.00–$41.00 58% below 30%
Creatine kinase (CK) blood test, total CPT 82550 Creatinine Kinase, Total Qst $40.00 $57.00 $34.00–$54.00 44% below 30%
Creatinine blood test CPT 82565 Creatinine. Qst $37.00 $53.00 $32.00–$50.00 39% below 30%
Creatinine blood test CPT 82565 Creatinine $37.00 $53.00 $32.00–$50.00 39% below 30%
Creatinine blood test CPT 82565 Creatinine Qst $37.00 $53.00 $32.00–$50.00 39% below 30%
Cytomegalovirus (CMV) antibody test CPT 86644 Cmv Igg Qst $79.00 $113.00 $68.00–$107.00 3% above 30%
D-dimer blood test (blood clot marker) CPT 85379 D-dimer $56.00 $80.00 $48.00–$76.00 68% below 30%
D-dimer blood test (blood clot marker) CPT 85379 D-dimer Qst $127.00 $182.00 $109.00–$173.00 27% below 30%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s. $56.00 $80.00 $48.00–$76.00 64% below 30%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea-s $56.00 $80.00 $48.00–$76.00 64% below 30%
DHEA sulfate (DHEA-S) blood test CPT 82627 Dhea Sulfate Qst $56.00 $80.00 $48.00–$76.00 64% below 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxycodone, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Opiates, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Methadone Metabolite, Urine Qst. $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Cocaine Metabolite, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Marijuana Metabolite, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Creatinine,urine Qst. $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Benzodiazepines, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Barbiturates, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Amphetamines, Urine Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Ph Dm Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Oxidant Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Specific Gravity Dm Qst $87.00 $124.00 $74.00–$118.00 21% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Nicotine Metabolite Screen Qst $130.00 $186.00 $112.00–$177.00 81% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen Standard $136.00 $194.00 $116.00–$184.00 89% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Urine Drug Screen (56) $136.00 $194.00 $116.00–$184.00 89% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitor, Synthetic Cannabinoids, W/conf, Urine Qst $168.00 $240.00 $144.00–$228.00 133% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Lsd Screen, Blood, Qst $233.00 $333.00 $200.00–$316.00 224% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 8, With Confirmation, Serum Or Plasma Qst $267.00 $381.00 $229.00–$362.00 271% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Monitoring, Panel 7 With Confirmation, Urine, Qst $298.00 $426.00 $256.00–$405.00 314% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Bill Uds (Chain Of Custody) $447.00 $638.00 $383.00–$606.00 521% above 30%
Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Abuse Panel 9, Serum Qst $447.00 $638.00 $383.00–$606.00 521% above 30%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel Standard $36.00 $51.00 $31.00–$48.00 81% below 29%
Epstein-Barr virus (EBV) antibody test CPT 86665 86665 Qst $202.00 $288.00 $173.00–$274.00 110% above 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 Ebv Vca Igg Antibodies Qst $202.00 $288.00 $173.00–$274.00 110% above 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Igm Qst $202.00 $288.00 $173.00–$274.00 110% above 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus Vca Ab (Igg) Qst $202.00 $289.00 $173.00–$275.00 110% above 30%
Epstein-Barr virus (EBV) antibody test CPT 86665 Epstein Barr Virus Vca Ab (Igm) Qst $202.00 $289.00 $173.00–$275.00 110% above 30%
Estradiol blood test CPT 82670 Estradiol Qst $146.00 $208.00 $125.00–$198.00 1% above 30%
Estradiol blood test CPT 82670 Estradiol (E2) Qst $146.00 $208.00 $125.00–$198.00 1% above 30%
Estradiol blood test CPT 82670 Estradiol, Ultrasensitive Qst $146.00 $208.00 $125.00–$198.00 1% above 30%
FSH (follicle-stimulating hormone) test CPT 83001 Fsh $46.00 $65.00 $39.00–$62.00 71% below 29%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle-stimulating Hormone Qst $53.00 $76.00 $46.00–$72.00 67% below 30%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Qst $90.00 $129.00 $77.00–$123.00 44% below 30%
FSH (follicle-stimulating hormone) test CPT 83001 Fsh, Pediatrics Qst $197.00 $281.00 $169.00–$267.00 23% above 30%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Qst $410.00 $585.00 $351.00–$556.00 92% above 30%
Ferritin blood test (iron stores) CPT 82728 82728 Qst $182.00 $260.00 $156.00–$247.00 76% above 30%
Ferritin blood test (iron stores) CPT 82728 Ferritin $182.00 $260.00 $156.00–$247.00 76% above 30%
Ferritin blood test (iron stores) CPT 82728 Ferritin Qst $182.00 $260.00 $156.00–$247.00 76% above 30%
Fibrinogen blood test CPT 85384 Fibrinogen Activity, Clauss Qst $79.00 $113.00 $68.00–$107.00 14% below 30%
Folate (folic acid) blood test CPT 82746 Folate Lvl $160.00 $229.00 $137.00–$218.00 69% above 30%
Folate (folic acid) blood test CPT 82746 Folate Qst $160.00 $229.00 $137.00–$218.00 69% above 30%
Free T3 thyroid hormone test CPT 84481 Free T3 Qst $131.00 $187.00 $112.00–$178.00 7% below 30%
Free T3 thyroid hormone test CPT 84481 Triiodothyronine Free $131.00 $187.00 $112.00–$178.00 7% below 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Index Qst $40.00 $57.00 $34.00–$54.00 55% below 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 $57.00 $81.00 $49.00–$77.00 35% below 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4, Free, Direct Dialysis Qst $57.00 $81.00 $49.00–$77.00 35% below 30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Thyroxine Free Qst $96.00 $137.00 $82.00–$130.00 9% above 30%
Free testosterone test CPT 84402 Testosterone, Free (Dialysis) And Total,ms Qst $36.00 $51.00 $31.00–$48.00 67% below 29%
Free testosterone test CPT 84402 Testoster Free Qst $201.00 $287.00 $172.00–$273.00 82% above 30%
Free testosterone test CPT 84402 84402 Testosterone, Free, Qst $201.00 $287.00 $172.00–$273.00 82% above 30%
Free testosterone test CPT 84402 Testosterone Free, Lc/ms/ms Qst $201.00 $287.00 $172.00–$273.00 82% above 30%
Free testosterone test CPT 84402 Testosterone, Free Qst $201.00 $287.00 $172.00–$273.00 82% above 30%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 Gamma Glutamyl Transferase $23.00 $33.00 $20.00–$31.00 64% below 30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 80050 General Health Panel $165.00 $236.00 $142.00–$224.00 63% below 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Fasting Specimen Qst $27.00 $38.00 $23.00–$36.00 71% below 29%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose, Gestational Screen (50g), 135 Cutoff Qst $37.00 $53.00 $32.00–$50.00 60% below 30%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose, Gestational Screen (50g), 140 Cutoff. Qst $37.00 $53.00 $32.00–$50.00 60% below 30%
Glucose tolerance test, 3 samples CPT 82951 Specimen 2 Qst $37.00 $53.00 $32.00–$50.00 76% below 30%
Glucose tolerance test, 3 samples CPT 82951 Specimen 1 Qst $37.00 $53.00 $32.00–$50.00 76% below 30%
Glucose tolerance test, 3 samples CPT 82951 Specimen 3 Qst $37.00 $53.00 $32.00–$50.00 76% below 30%
Glucose tolerance test, 3 samples CPT 82951 .Gtt-1 Hr $50.00 $72.00 $43.00–$68.00 67% below 31%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Neisseria Gonorrhoeae Pcr $53.00 $75.00 $45.00–$71.00 63% below 29%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae By Pcr $53.00 $75.00 $45.00–$71.00 63% below 29%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Rna, Tma Qst $132.00 $189.00 $113.00–$180.00 7% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Qst $132.00 $189.00 $113.00–$180.00 7% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Rna, Tma, Urogenit $132.00 $189.00 $113.00–$180.00 7% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhea Rna, Tma, Throa $132.00 $189.00 $113.00–$180.00 7% below 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Neisseria Gonorrhoeae Rna Qst $291.00 $415.00 $249.00–$394.00 106% above 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 87591 Neisseria Gonorrhea $326.00 $466.00 $280.00–$443.00 131% above 30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. Gonnorrhoeae Rna, Tma Qst $326.00 $466.00 $280.00–$443.00 131% above 30%
H. pylori antibody blood test CPT 86677 H Pylori $245.00 $350.00 $210.00–$333.00 87% above 30%
H. pylori stool antigen test CPT 87338 H. Pylori Ag, Stool Qst $206.00 $294.00 $176.00–$279.00 107% above 30%
H. pylori stool antigen test CPT 87338 Bill Helicobacter Pylori Anitgen, Eia, Stool Qst $323.00 $461.00 $277.00–$438.00 225% above 30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 Hiv 1 Rna Quantitation $438.00 $626.00 $376.00–$595.00 36% above 30%
HIV-1 and HIV-2 antibody test CPT 86703 Bill Only Hiv 1 And Hiv 2 Single Result $173.00 $247.00 $148.00–$235.00 66% above 30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv Qst $50.00 $72.00 $43.00–$68.00 64% below 31%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Human Papilloma Virus Qst $126.00 $180.00 $108.00–$171.00 78% above 30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv Mrna E6/e7 Qst $126.00 $180.00 $108.00–$171.00 78% above 30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 Hpv Mrna E6/e7, Surepath Vial Qst $158.00 $225.00 $135.00–$214.00 123% above 30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c With Eag, Qst $20.00 $29.00 $17.00–$28.00 78% below 31%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Cardio Iq Hemoglobin A1c Qst $53.00 $75.00 $45.00–$71.00 42% below 29%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c $53.00 $75.00 $45.00–$71.00 42% below 29%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c W/calculated Mean Plasma Glucose (Mpg) Qst $53.00 $75.00 $45.00–$71.00 42% below 29%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c Qst $92.00 $132.00 $79.00–$125.00 at median 30%
Hemoglobin blood test CPT 85018 Hgb E Qst $11.00 $16.00 $10.00–$15.00 77% below 31%
Hemoglobin blood test CPT 85018 85018hemoglobin Qst $11.00 $16.00 $10.00–$15.00 77% below 31%
Hemoglobin blood test CPT 85018 85018 Qst $12.00 $17.00 $10.00–$16.00 74% below 29%
Hemoglobin blood test CPT 85018 Hemoglobin And Hematocrit $12.00 $17.00 $10.00–$16.00 74% below 29%
Hemoglobin blood test CPT 85018 Hemoglobin Poc $12.00 $17.00 $10.00–$16.00 74% below 29%
Hemoglobin blood test CPT 85018 Hemoglobin $12.00 $17.00 $10.00–$16.00 74% below 29%
Hepatitis B core antibody test (total) CPT 86704 86704hepatitis B Core Antibody, Total Qst $19.00 $27.00 $16.00–$26.00 79% below 30%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Antibody Total With Reflex To Igm Qst $25.00 $36.00 $22.00–$34.00 72% below 31%
Hepatitis B core antibody test (total) CPT 86704 Bill Hep B Core Antibody (Hbsab) $45.00 $64.00 $38.00–$61.00 50% below 30%
Hepatitis B core antibody test (total) CPT 86704 Hepatitis B Core Ab Total Qst $59.00 $85.00 $51.00–$81.00 34% below 31%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody Qst $59.00 $85.00 $51.00–$81.00 10% below 31%
Hepatitis B surface antigen (HBsAg) test CPT 87340 87340hepatitis B Surface Antigen Qst $22.00 $31.00 $19.00–$29.00 72% below 29%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hep B Surf Ag Confirm Qst $59.00 $85.00 $51.00–$81.00 24% below 31%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Ag Qst $122.00 $175.00 $105.00–$166.00 57% above 30%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab Qst $59.00 $85.00 $51.00–$81.00 32% below 31%
Hepatitis C antibody blood test (screening) CPT 86803 Donor, Hepatitis C Antibody (Anti-hcv) Qst $179.00 $256.00 $154.00–$243.00 106% above 30%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Ab W/rfl Rna, Pcr W/rfl Genotype,lipa Qst $227.00 $325.00 $195.00–$309.00 161% above 30%
Hepatitis C antibody blood test (screening) one side CPT 86803 Hepatitis C Ab W/reflex To Hcv, Rna Qnt, Rt-pcr Qst $223.00 $318.00 $191.00–$302.00 156% above 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Viral Rna, Quantitative, Real Time Pcr Qst $253.00 $362.00 $217.00–$344.00 14% below 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Rna Pcr Qst $253.00 $362.00 $217.00–$344.00 14% below 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 .Hcv Rna, Quantitative Real Time Pcr Qst $253.00 $362.00 $217.00–$344.00 14% below 30%
Hepatitis C viral load (HCV RNA) test CPT 87522 Hcv Rna, Qn Pcr W/refl To Genotype, Lipa(r) $253.00 $362.00 $217.00–$344.00 14% below 30%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1 Igg Qst $101.00 $144.00 $86.00–$137.00 28% above 30%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1 Igg Index: Qst $136.00 $194.00 $116.00–$184.00 73% above 30%
Herpes blood test, HSV-1 antibody CPT 86695 Herpes Simplex Type I/ii Qst $154.00 $220.00 $132.00–$209.00 95% above 30%
Herpes blood test, HSV-1 antibody CPT 86695 86695 Qst $154.00 $220.00 $132.00–$209.00 95% above 30%
Herpes blood test, HSV-1 antibody CPT 86695 Hsv 1/2 Igm Ab Qst $154.00 $220.00 $132.00–$209.00 95% above 30%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igg Qst $101.00 $144.00 $86.00–$137.00 12% above 30%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igm Screen Qst $136.00 $194.00 $116.00–$184.00 51% above 30%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igg Index: Qst $136.00 $194.00 $116.00–$184.00 51% above 30%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 (Igg), With Refl To Hsv-2 Inhibition, Qst $154.00 $220.00 $132.00–$209.00 71% above 30%
Herpes blood test, HSV-2 antibody CPT 86696 Hsv 2 Igg Ab Qst $154.00 $220.00 $132.00–$209.00 71% above 30%
Herpes blood test, HSV-2 antibody CPT 86696 86696 Qst $154.00 $220.00 $132.00–$209.00 71% above 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 Cardio Crp Qst $69.00 $98.00 $59.00–$93.00 13% below 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 Cardio C-reactive Protein Qst $105.00 $150.00 $90.00–$143.00 32% above 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 Cardio Iq Hs-crp Qst $105.00 $150.00 $90.00–$143.00 32% above 30%
High-sensitivity CRP (hs-CRP) test CPT 86141 Bill C-tenative Protein Hgh Sensitivity Hscrp $280.00 $400.00 $240.00–$380.00 251% above 30%
Homocysteine blood test CPT 83090 Homocystiene $71.00 $101.00 $61.00–$96.00 53% below 30%
Homocysteine blood test CPT 83090 Homocysteine Qst $71.00 $101.00 $61.00–$96.00 53% below 30%
Insulin blood test CPT 83525 Insulin Qst $60.00 $86.00 $52.00–$82.00 29% below 30%
Insulin blood test CPT 83525 Insulin; Total $60.00 $86.00 $52.00–$82.00 29% below 30%
Insulin blood test CPT 83525 Insulin, Intact, Lc/ms/ms Qst $139.00 $199.00 $119.00–$189.00 65% above 30%
Iron blood test (serum iron) CPT 83540 Iron, Total Qst $106.00 $151.00 $91.00–$143.00 22% above 30%
Iron blood test (serum iron) CPT 83540 Iron Qst $106.00 $151.00 $91.00–$143.00 22% above 30%
Iron blood test (serum iron) CPT 83540 83540 Qst $106.00 $151.00 $91.00–$143.00 22% above 30%
Iron blood test (serum iron) CPT 83540 Iron Level Qst $106.00 $151.00 $91.00–$143.00 22% above 30%
Iron blood test (serum iron) CPT 83540 Iron Lvl $106.00 $151.00 $91.00–$143.00 22% above 30%
Iron-binding capacity (TIBC) test CPT 83550 83550 Qst $50.00 $72.00 $43.00–$68.00 49% below 31%
Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity Qst $106.00 $151.00 $91.00–$143.00 8% above 30%
Iron-binding capacity (TIBC) test CPT 83550 Iron Total, Tibc And % Saturation Panel $106.00 $151.00 $91.00–$143.00 8% above 30%
Kidney function blood test panel CPT 80069 Kidney function panel test $55.00 $78.00 $47.00–$74.00 69% below 29%
LH (luteinizing hormone) test CPT 83002 Lh, Pediatrics Qst $197.00 $281.00 $169.00–$267.00 30% above 30%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone Qst $211.00 $302.00 $181.00–$287.00 40% above 30%
Lactate (lactic acid) blood test CPT 83605 I-stat Cg4+ Lactate $25.00 $35.00 $21.00–$33.00 74% below 29%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid Qst $31.00 $44.00 $26.00–$42.00 68% below 30%
Lactate (lactic acid) blood test CPT 83605 Lactic Acid $31.00 $44.00 $26.00–$42.00 68% below 30%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ld, Pleural Fluid Qst $22.00 $32.00 $19.00–$30.00 53% below 31%
Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase $22.00 $32.00 $19.00–$30.00 53% below 31%
Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Total Qst $50.00 $71.00 $43.00–$67.00 6% above 30%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level $43.00 $62.00 $37.00–$59.00 55% below 31%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Qst $47.00 $67.00 $40.00–$64.00 50% below 30%
Liver function blood test panel CPT 80076 Liver function blood test $48.00 $69.00 $41.00–$66.00 78% below 30%
Lyme disease antibody test CPT 86618 Lyme Ab Screen Qst $284.00 $405.00 $243.00–$385.00 243% above 30%
Lyme disease antibody test CPT 86618 Lyme Disease Ab, Total W/refl Wb (Igg, Igm) Qst $284.00 $405.00 $243.00–$385.00 243% above 30%
Magnesium blood test CPT 83735 Magnesium Level $35.00 $50.00 $30.00–$48.00 29% below 30%
Magnesium blood test CPT 83735 Magnesium, 24hr Urine Qst $48.00 $69.00 $41.00–$66.00 3% below 30%
Magnesium blood test CPT 83735 Magnesium $59.00 $85.00 $51.00–$81.00 19% above 31%
Magnesium blood test CPT 83735 Magnesium, Rbc Qst $78.00 $111.00 $67.00–$105.00 57% above 30%
Measles (rubeola) antibody test CPT 86765 Measles Ab (Igg) Qst $70.00 $100.00 $60.00–$95.00 90% above 30%
Measles (rubeola) antibody test CPT 86765 Measles Antibody (Igm) Qst $70.00 $100.00 $60.00–$95.00 90% above 30%
Measles (rubeola) antibody test CPT 86765 86765 Qst $424.00 $605.00 $363.00–$575.00 1053% above 30%
Mono test (heterophile antibody, Monospot) CPT 86308 Mono Screen 5 $27.00 $38.00 $23.00–$36.00 68% below 29%
Mono test (heterophile antibody, Monospot) CPT 86308 Poc Infectious Mononucleosis Qst $27.00 $38.00 $23.00–$36.00 68% below 29%
Mumps immunity blood test CPT 86735 Mumps Igg Antibodies Qst $57.00 $81.00 $49.00–$77.00 7% below 30%
Mumps immunity blood test CPT 86735 Mumps Ab Igm, Ifa (Csf) Qst $136.00 $194.00 $116.00–$184.00 121% above 30%
Mumps immunity blood test CPT 86735 86735 Qst $211.00 $301.00 $181.00–$286.00 243% above 30%
PSA (prostate-specific antigen) blood test, free CPT 84154 Total prostate-specific antigen (PSA) test $39.00 $55.00 $33.00–$52.00 65% below 29%
PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test $77.00 $110.00 $66.00–$105.00 14% below 30%
Pap test (liquid-based, automated screening with review) CPT 88175 Surepath Imaging Pap And Hpv Dna, C. Trachomatis, N. Gonorrhoeae Qst $76.00 $109.00 $65.00–$104.00 3% above 30%
Pap test (liquid-based, automated screening with review) CPT 88175 Surepath (Tm) Imaging Pap Qst $126.00 $180.00 $108.00–$171.00 71% above 30%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytotechnologist Qst: $158.00 $225.00 $135.00–$214.00 115% above 30%
Pap test (liquid-based, automated screening with review) CPT 88175 Surepath Imaging Pap And Hpv Dna Reflex Hpv 16,18 Qst $284.00 $405.00 $243.00–$385.00 286% above 30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytotechnologist Qst: $126.00 $180.00 $108.00–$171.00 39% above 30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Surepath Pap Qst $126.00 $180.00 $108.00–$171.00 39% above 30%
Parathyroid hormone (PTH) blood test CPT 83970 83970 Qst $97.00 $138.00 $83.00–$131.00 55% below 30%
Parathyroid hormone (PTH) blood test CPT 83970 Pth Qst $97.00 $138.00 $83.00–$131.00 55% below 30%
Parathyroid hormone (PTH) blood test CPT 83970 Pth, Intact W/o Calcium Qst $97.00 $138.00 $83.00–$131.00 55% below 30%
Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test $34.00 $48.00 $29.00–$46.00 37% below 29%
Phosphorus (phosphate) blood test CPT 84100 Phosphorus Level $23.00 $33.00 $20.00–$31.00 63% below 30%
Phosphorus (phosphate) blood test CPT 84100 Phosphate (As Phosphorus) Qst $37.00 $53.00 $32.00–$50.00 41% below 30%
Potassium blood test CPT 84132 Potassium Level $22.00 $31.00 $19.00–$29.00 66% below 29%
Potassium blood test CPT 84132 Potassium, Serum, Qst $37.00 $53.00 $32.00–$50.00 43% below 30%
Progesterone blood test CPT 84144 Progesterone $149.00 $213.00 $128.00–$202.00 30% above 30%
Progesterone blood test CPT 84144 Progesterone. $149.00 $213.00 $128.00–$202.00 30% above 30%
Progesterone blood test CPT 84144 Bill Progesterone, Lc/ms/ms Qst $200.00 $286.00 $172.00–$272.00 74% above 30%
Progesterone blood test CPT 84144 Progesterone Level Qst $200.00 $286.00 $172.00–$272.00 74% above 30%
Prolactin blood test CPT 84146 Prolactin Lvl $41.00 $58.00 $35.00–$55.00 65% below 29%
Prolactin blood test CPT 84146 Prolactin, Undiluted Qst $63.00 $90.00 $54.00–$86.00 46% below 30%
Prolactin blood test CPT 84146 Prolactin, Diluted Qst $63.00 $90.00 $54.00–$86.00 46% below 30%
Prolactin blood test CPT 84146 Prolactin, Total And Monomeric Qst $279.00 $398.00 $239.00–$378.00 141% above 30%
Prolactin blood test CPT 84146 Prolactin Level Qst $279.00 $398.00 $239.00–$378.00 141% above 30%
Prolactin blood test CPT 84146 84146 Qst $279.00 $398.00 $239.00–$378.00 141% above 30%
Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time $22.00 $31.00 $19.00–$29.00 53% below 29%
Rapid flu test (influenza antigen) CPT 87804 Influenza A&b 1 $46.00 $65.00 $39.00–$62.00 52% below 29%
Rapid flu test (influenza antigen) CPT 87804 Influenza A&b Poc $46.00 $65.00 $39.00–$62.00 52% below 29%
Rapid flu test (influenza antigen) CPT 87804 Influenza Virus B Ag Qst $155.00 $222.00 $133.00–$211.00 63% above 30%
Rapid flu test (influenza antigen) CPT 87804 Influenza Virus A Ag Qst $155.00 $222.00 $133.00–$211.00 63% above 30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Test Standard $41.00 $58.00 $35.00–$55.00 59% below 29%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Strep Poc $41.00 $58.00 $35.00–$55.00 59% below 29%
Renin blood test CPT 84244 Plasma Renin Activity (Pra) Qst $90.00 $128.00 $77.00–$122.00 12% below 30%
Renin blood test CPT 84244 Aldosterone/renin Activity Ratio Qst $221.00 $315.00 $189.00–$299.00 115% above 30%
Rh blood typing CPT 86901 Rh Typing $83.00 $118.00 $71.00–$112.00 29% above 30%
Rheumatoid factor (RF) test CPT 86431 Rheum Fact Qst $106.00 $151.00 $91.00–$143.00 92% above 30%
Rheumatoid factor (RF) test CPT 86431 86431 Rheumatoid Factor Charge $139.00 $199.00 $119.00–$189.00 152% above 30%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Qst $139.00 $199.00 $119.00–$189.00 152% above 30%
Rubella antibody test (immunity check) CPT 86762 Rubella Igg Ab Qst $57.00 $81.00 $49.00–$77.00 17% above 30%
Rubella antibody test (immunity check) CPT 86762 86762 Qst $193.00 $275.00 $165.00–$261.00 297% above 30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sed Rate, Automated $21.00 $30.00 $18.00–$29.00 63% below 30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 Sed Rate By Modified Westergren Qst $25.00 $35.00 $21.00–$33.00 55% below 29%
Sodium blood test CPT 84295 Sodium $15.00 $22.00 $13.00–$21.00 76% below 32%
Sodium blood test CPT 84295 Sodium Level $15.00 $22.00 $13.00–$21.00 76% below 32%
Stool ova and parasites exam CPT 87177 Ova And Parasites, Conc And Perm Smear Mb Qst $39.00 $55.00 $33.00–$52.00 56% below 29%
Stool ova and parasites exam CPT 87177 O&p Conc/id Qst $279.00 $398.00 $239.00–$378.00 213% above 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood X3 $14.00 $20.00 $12.00–$19.00 64% below 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood X2 $14.00 $20.00 $12.00–$19.00 64% below 30%
Stool test for hidden blood (guaiac FOBT) CPT 82270 .Occult Blood 1st $14.00 $20.00 $12.00–$19.00 64% below 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 Fta-abs Qst $34.00 $49.00 $29.00–$47.00 27% below 31%
Syphilis antibody test (Treponema pallidum) CPT 86780 .Treponema Pallidum Ab Rflx Qst $122.00 $174.00 $104.00–$165.00 163% above 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Antibody, Immunoassay, Qst $122.00 $174.00 $104.00–$165.00 163% above 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 Syphilis Antibody Cascading Reflex Qst $122.00 $174.00 $104.00–$165.00 163% above 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Ab, Particle Agglutination $202.00 $288.00 $173.00–$274.00 336% above 30%
Syphilis antibody test (Treponema pallidum) CPT 86780 Treponema Pallidum Ab Qst $202.00 $288.00 $173.00–$274.00 336% above 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr (Dx) W/refl Titer And Confirm Testing Qst $19.00 $27.00 $16.00–$26.00 64% below 30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr W/reflex Titer Qst $25.00 $35.00 $21.00–$33.00 52% below 29%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon-tb Gold Plus Qst $535.00 $764.00 $458.00–$726.00 161% above 30%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total, Ms, Qst $36.00 $52.00 $31.00–$49.00 64% below 31%
Testosterone blood test, total (not free testosterone) CPT 84403 Testost Tot Qst $54.00 $77.00 $46.00–$73.00 47% below 30%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level Total, M Qst $63.00 $90.00 $54.00–$86.00 38% below 30%
Testosterone blood test, total (not free testosterone) CPT 84403 84403 Testosterone, Total, Qst $63.00 $90.00 $54.00–$86.00 38% below 30%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total Qst $63.00 $90.00 $54.00–$86.00 38% below 30%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Level $75.00 $107.00 $64.00–$102.00 26% below 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 86376 Qst $183.00 $262.00 $157.00–$249.00 105% above 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase Ab Qst $183.00 $262.00 $157.00–$249.00 105% above 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver Kidney Microsomal Antibody (Igg) Qst $183.00 $262.00 $157.00–$249.00 105% above 30%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Perox Ab Qst $183.00 $262.00 $157.00–$249.00 105% above 30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) $92.00 $132.00 $79.00–$125.00 25% below 30%
Total IgE blood test CPT 82785 Ige Qst $34.00 $49.00 $29.00–$47.00 62% below 31%
Total IgE blood test CPT 82785 Immunoglobulin E $34.00 $49.00 $29.00–$47.00 62% below 31%
Total IgE blood test CPT 82785 Immunoglobulin E Qst $37.00 $53.00 $32.00–$50.00 58% below 30%
Total IgE blood test CPT 82785 82785 Qst $37.00 $53.00 $32.00–$50.00 58% below 30%
Total IgE blood test CPT 82785 Bill Respiratory Allergy Profile Region X : Ok, Tx Qst $134.00 $191.00 $115.00–$181.00 51% above 30%
Total cholesterol blood test CPT 82465 Cardio Iq® Cholesterol, Total, Qst $9.00 $13.00 $8.00–$12.00 87% below 31%
Total cholesterol blood test CPT 82465 Cholesterol Total $15.00 $22.00 $13.00–$21.00 78% below 32%
Total cholesterol blood test CPT 82465 Cholesterol Qst $69.00 $98.00 $59.00–$93.00 2% above 30%
Total thyroxine (T4) blood test CPT 84436 T4, Total $30.00 $43.00 $26.00–$41.00 63% below 30%
Total thyroxine (T4) blood test CPT 84436 T4 Thyroxine $30.00 $43.00 $26.00–$41.00 63% below 30%
Total thyroxine (T4) blood test CPT 84436 T4 Total Qst $40.00 $57.00 $34.00–$54.00 50% below 30%
Total triiodothyronine (T3) blood test CPT 84480 T3, Total $50.00 $72.00 $43.00–$68.00 60% below 31%
Total triiodothyronine (T3) blood test CPT 84480 T3 Total $80.00 $114.00 $68.00–$108.00 36% below 30%
Total triiodothyronine (T3) blood test CPT 84480 Bill T-3 Total $80.00 $114.00 $68.00–$108.00 36% below 30%
Transferrin blood test CPT 84466 Transferrin Qst $84.00 $120.00 $72.00–$114.00 29% below 30%
Trichomonas test (NAAT) CPT 87661 Sureswab(r) Trichomonas Vaginalis Rna, Ql, Tma Qst $235.00 $336.00 $202.00–$319.00 169% above 30%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Rna, Female, Qst $235.00 $336.00 $202.00–$319.00 169% above 30%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Rna, Ql Tma Qst $235.00 $336.00 $202.00–$319.00 169% above 30%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Rna, Male, Qst $291.00 $415.00 $249.00–$394.00 233% above 30%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis Rna Qst $291.00 $415.00 $249.00–$394.00 233% above 30%
Trichomonas test (NAAT) CPT 87661 Trichomonas Vaginalis (Tv), Tma Qst $326.00 $466.00 $280.00–$443.00 273% above 30%
Trichomonas test (NAAT) CPT 87661 87661 Trichomonas Vaginalis (Tv), Tma $326.00 $466.00 $280.00–$443.00 273% above 30%
Triglycerides blood test CPT 84478 Cardio Iq® Triglycerides Qst $12.00 $17.00 $10.00–$16.00 86% below 29%
Triglycerides blood test CPT 84478 Triglycerides $22.00 $32.00 $19.00–$30.00 75% below 31%
Triglycerides blood test CPT 84478 Triglycerides Qst $69.00 $98.00 $59.00–$93.00 21% below 30%
Troponin test, quantitative CPT 84484 Troponin I $62.00 $89.00 $53.00–$85.00 54% below 30%
Troponin test, quantitative CPT 84484 Troponin T $62.00 $89.00 $53.00–$85.00 54% below 30%
Troponin test, quantitative CPT 84484 Troponin T, Qst $113.00 $162.00 $97.00–$154.00 17% below 30%
Troponin test, quantitative CPT 84484 Troponin I Qst $223.00 $318.00 $191.00–$302.00 65% above 30%
Uric acid blood test CPT 84550 Uric Acid $22.00 $32.00 $19.00–$30.00 76% below 31%
Uric acid blood test CPT 84550 Uric Acid Qst $27.00 $39.00 $23.00–$37.00 70% below 31%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis test using microscope $22.00 $32.00 $19.00–$30.00 80% below 31%
Urinalysis with microscope exam, manual CPT 81000 Urinalysis test using microscope $10.00 $14.00 $8.00–$13.00 75% below 29%
Urinalysis without microscope exam, automated CPT 81003 Urinalysis test $12.00 $17.00 $10.00–$16.00 76% below 29%
Urine culture for bacteria, with colony count CPT 87086 Urine Cult Qst $89.00 $127.00 $76.00–$121.00 36% below 30%
Urine culture for bacteria, with colony count CPT 87086 Culture, Urine, Routine Mb Qst $89.00 $127.00 $76.00–$121.00 36% below 30%
Urine culture for bacteria, with colony count CPT 87086 87086 Qst $89.00 $127.00 $76.00–$121.00 36% below 30%
Urine culture for bacteria, with colony count CPT 87086 Urine Sp. Cult Qst $89.00 $127.00 $76.00–$121.00 36% below 30%
Urine microalbumin (albumin) test CPT 82043 Microalbumin, 24 Hr Urine Qst $25.00 $36.00 $22.00–$34.00 51% below 31%
Urine microalbumin (albumin) test CPT 82043 Microalbumin Level 24 Hour Urine $104.00 $148.00 $89.00–$141.00 104% above 30%
Urine microalbumin (albumin) test CPT 82043 U Micro Albumin 1 $104.00 $148.00 $89.00–$141.00 104% above 30%
Urine microalbumin (albumin) test CPT 82043 82043 Qst $104.00 $148.00 $89.00–$141.00 104% above 30%
Urine microalbumin (albumin) test CPT 82043 Microalb/creat Ratio $104.00 $148.00 $89.00–$141.00 104% above 30%
Urine microalbumin (albumin) test CPT 82043 U Microalbumin Qst $104.00 $148.00 $89.00–$141.00 104% above 30%
Urine microalbumin (albumin) test CPT 82043 Microalbumin, Urine W/o Creat Qst $104.00 $148.00 $89.00–$141.00 104% above 30%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Poc $22.00 $31.00 $19.00–$29.00 74% below 29%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy Test Qualitative $22.00 $31.00 $19.00–$29.00 74% below 29%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Qst $21.00 $30.00 $18.00–$29.00 77% below 30%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level Qst $35.00 $50.00 $30.00–$48.00 61% below 30%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level $35.00 $50.00 $30.00–$48.00 61% below 30%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B2 Level Qst $35.00 $50.00 $30.00–$48.00 61% below 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level $69.00 $99.00 $59.00–$94.00 44% below 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25-hydroxy Total Ia Qst $149.00 $213.00 $128.00–$202.00 21% above 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Cardio Iq Vitamin D, 25-hydroxy Qst $149.00 $213.00 $128.00–$202.00 21% above 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D, 25-hydroxy, Tot, D2 , D3 Qst $149.00 $213.00 $128.00–$202.00 21% above 30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 82306 Qst $149.00 $213.00 $128.00–$202.00 21% above 30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 82652 Qst $149.00 $213.00 $128.00–$202.00 10% below 30%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vitamin D, 1,25 Dihydroxy Qst $149.00 $213.00 $128.00–$202.00 10% below 30%
Zinc blood test CPT 84630 Zinc Level Qst $64.00 $92.00 $55.00–$87.00 7% below 30%
Zinc blood test CPT 84630 Zinc Level $64.00 $92.00 $55.00–$87.00 7% below 30%
Zinc blood test CPT 84630 Zinc, Rbc Qst $95.00 $136.00 $82.00–$129.00 38% above 30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Human Chorionic Gonadotropin (Hcg) Serum Qst $36.00 $51.00 $31.00–$48.00 68% below 29%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Hcg; Total Qn. $125.00 $179.00 $107.00–$170.00 11% above 30%

Surgery and procedures

ProcedureCash price List priceInsurers payvs TexasOff list
Cardioversion, elective (restoring heart rhythm) CPT 92960 92960  Cardioversion Elective Arrhythmia External Ed Techfee $1,374.00 $1,963.00 $1,178.00–$1,865.00 4% below 30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Closed Treatment Of Distal Radial Fracture W/o Manipulation $683.00 $975.00 $585.00–$926.00 33% above 30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 Profee25600 Closed Treatment Of Distal Radial Fracture W/o Manipulation $721.00 $1,030.00 $618.00–$979.00 41% above 30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 17000 Destruction Benign/premalig Lesion Charge $117.00 $167.00 $100.00–$159.00 42% below 30%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/lavage,unilateral $34.00 $48.00 $29.00–$46.00 72% below 29%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Impacted Cerumen Using Irrigation/lavage, Unilateral. $34.00 $48.00 $29.00–$46.00 72% below 29%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 69209 Removal Of Impacted Cerumen By Irrigation/lavage, Unilateral $125.00 $178.00 $107.00–$169.00 2% above 30%
Earwax removal with instruments, one ear CPT 69210 69210 Removal Of Cerumen Instrumentation $115.00 $165.00 $99.00–$157.00 28% below 30%
Earwax removal with instruments, one ear CPT 69210 Removal Impacted Cerumen-instrumentation $115.00 $165.00 $99.00–$157.00 28% below 30%
Earwax removal with instruments, one ear CPT 69210 69210 Ear Lavage Tech Chg $115.00 $165.00 $99.00–$157.00 28% below 30%
Earwax removal with instruments, one ear one side CPT 69210 69210 Removal Impacted Cerumen Instrumentation Unilat Techfee $125.00 $178.00 $107.00–$169.00 22% below 30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 58100-biopsy Of Uterus Lining $211.00 $302.00 $181.00–$287.00 43% below 30%
Incision and drainage of a simple or single skin abscess CPT 10060 49905 Intra-abd Omental Flap. $226.00 $323.00 $194.00–$307.00 52% below 30%
Incision and drainage of a simple or single skin abscess CPT 10060 10060 Drain Skin Abscess, Simple/single Charge $226.00 $323.00 $194.00–$307.00 52% below 30%
Incision and drainage of a simple or single skin abscess CPT 10060 Incision And Drainage Of Abscess (Eg, Carbuncle, Suppurative $417.00 $596.00 $358.00–$566.00 11% below 30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Profeeinjection; Tendon, Sheath, Ligament $83.00 $119.00 $71.00–$113.00 81% below 30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Inj(s); Single Tendon Sheath, Or Ligament, Aponeurosis (Eg, Planterar ""Fascia"") Charge $122.00 $175.00 $105.00–$166.00 72% below 30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 Injection; Tendon, Sheath, Ligament $620.00 $886.00 $532.00–$842.00 40% above 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Profeearthrocentesis Lrg Joint $98.00 $140.00 $84.00–$133.00 85% below 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocentesis Major Joint, Shoulder, Hip, Knee Charge $138.00 $197.00 $118.00–$187.00 79% below 30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 20610 Arthrocentesis Aspir&/inj Major Jt/bursa W/o Us Techfee $620.00 $886.00 $532.00–$842.00 6% below 30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 11981 Insertion, Non Bio Drug Delivery Implant $309.00 $442.00 $265.00–$420.00 29% above 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Profeearthrocentesis Med Joint $79.00 $113.00 $68.00–$107.00 87% below 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis, Aspiration And Or Injection; Intermediate Joint Or Bursa Technical Charge $117.00 $167.00 $100.00–$159.00 80% below 30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 20605 Arthrocentesis Aspir&/inj Interm Jt/burs W/o Us Techfee $620.00 $886.00 $532.00–$842.00 5% above 30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Profeearthrocentesis Sm Joint $77.00 $110.00 $66.00–$105.00 82% below 30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis, Aspirtn And/or Inj; Small Joint Or Bursa (Eg, Fingers, Toes) Charge $113.00 $162.00 $97.00–$154.00 74% below 30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 20600 Arthrocentesis Aspir&/inj Small Jt/bursa W/o Us Techfee $620.00 $886.00 $532.00–$842.00 42% above 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 Profeeinterm Lac 0-2.5 Cm $321.00 $459.00 $275.00–$436.00 40% below 30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 12031 Repair Intermediate S/a/t/e 2.5 Cm/< Techfee $839.00 $1,199.00 $719.00–$1,139.00 58% above 30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Excision, Benign Lesion Including Margins, Except Skin Tag, Trunk, Arms Or Legs; 0.5cm Or Less $188.00 $268.00 $161.00–$255.00 77% below 30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 11440 Excision, Other Benign Lesion, Except Skin Tag, Face, Ears, Eyelids, Nose, Lips, Mucus Membran $319.00 $456.00 $274.00–$433.00 64% below 30%
Nail removal (partial or complete), one nail CPT 11730 11730 Avulsion Of Nail Plate, Partial Or Complete, Simple; Single Charge $236.00 $337.00 $202.00–$320.00 23% below 30%
Nail removal (partial or complete), one nail CPT 11730 Avulsion Nail Plate Partial/complete Simple 1 Techfee $417.00 $596.00 $358.00–$566.00 36% above 30%
Occipital nerve block (injection for headaches) CPT 64405 Inj Greater Occipital Nerve Techfee $858.00 $1,225.00 $735.00–$1,164.00 101% above 30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Of Nail And Matrix, Partial Or Complete $332.00 $474.00 $284.00–$450.00 37% below 30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Excision Of Nail And Nail Matric, Partial Or Complete Tech Fee $798.00 $1,140.00 $684.00–$1,083.00 52% above 30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 Injection(s), Anesthetic Agent(s) And/or Steroid; Femoral Ne $839.00 $1,199.00 $719.00–$1,139.00 59% above 30%
Removal of a foreign object under the skin, simple CPT 10120 10120 Incision And Removal Of Foreign Body, Simple $326.00 $466.00 $280.00–$443.00 39% below 30%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal Of Foreign Body, Subcutaneous Tissues; Simple Charge $326.00 $466.00 $280.00–$443.00 39% below 30%
Removal of a foreign object under the skin, simple CPT 10120 Incision & Removal Foreign Body Subq Tiss Simple Techfee $839.00 $1,199.00 $719.00–$1,139.00 58% above 30%
Short arm cast (elbow to hand) CPT 29075 Profeeforearm Cast Application $190.00 $272.00 $163.00–$258.00 31% below 30%
Short arm cast (elbow to hand) CPT 29075 29075 Application Of Cast, Short Arm $193.00 $275.00 $165.00–$261.00 30% below 30%
Short arm cast (elbow to hand) CPT 29075 Application Cast Elbow Finger Short Arm $558.00 $797.00 $478.00–$757.00 102% above 30%
Short arm splint (forearm and hand) CPT 29125 Profeeshort Arm Splintapplication $87.00 $124.00 $74.00–$118.00 63% below 30%
Short arm splint (forearm and hand) CPT 29125 Profeethumb Splintapplication $87.00 $124.00 $74.00–$118.00 63% below 30%
Short arm splint (forearm and hand) CPT 29125 29125 Short Arm Splint Application $144.00 $206.00 $124.00–$196.00 39% below 30%
Short arm splint (forearm and hand) CPT 29125 29125 Application Short Arm Splint Forearm-hand Static Techfee $271.00 $387.00 $232.00–$368.00 15% above 30%
Short arm splint (forearm and hand) CPT 29125 29125 App Short Arm Splint Ed Charge $271.00 $387.00 $232.00–$368.00 15% above 30%
Short arm splint (forearm and hand) CPT 29125 29125 Apl Splint Short Arm $2,714.00 $3,877.00 $2,326.00–$3,683.00 1048% above 30%
Short leg cast (below the knee) CPT 29405 29405 Application Of Case, Short Leg $174.00 $249.00 $149.00–$237.00 48% below 30%
Short leg splint (calf to foot) CPT 29515 Profeeshort Leg Splintapplication $107.00 $153.00 $92.00–$145.00 59% below 30%
Short leg splint (calf to foot) CPT 29515 29515 Application Of Short Leg Splint $158.00 $225.00 $135.00–$214.00 39% below 30%
Short leg splint (calf to foot) CPT 29515 29515 Application Short Leg Splint Calf Foot Techfee $331.00 $473.00 $284.00–$449.00 27% above 30%
Short leg splint (calf to foot) CPT 29515 29515 Splint App Short Leg Ed Charge $331.00 $473.00 $284.00–$449.00 27% above 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Repair Simple Scalp, Neck, Axillae, Ext Genital $201.00 $287.00 $172.00–$273.00 45% below 30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 Simple Repair Scalp/neck/ax/genit/trunk 2.5cm/< Techfee $417.00 $596.00 $358.00–$566.00 15% above 30%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Of Skin, Single Lesion $115.00 $165.00 $99.00–$157.00 75% below 30%
Skin tag removal, up to 15 tags CPT 11200 11200 Removal Of Skin Tags, Mult Fibrocutaneous Tags, Any Area; Up To & W/15 Lesions Charge $160.00 $228.00 $137.00–$217.00 50% below 30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 62270 Spinal Puncture, Lumbar, Diagnostic. $1,455.00 $2,078.00 $1,247.00–$1,974.00 39% above 30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia, Trunk And/or $244.00 $349.00 $209.00–$332.00 47% below 30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 Smpl Repair Scalp/neck/ax/genit/trunk 2.6-7.5cm Techfee $417.00 $596.00 $358.00–$566.00 9% below 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 Profeesimple Lac 0-2.5 Cm $121.00 $173.00 $104.00–$164.00 69% below 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Repair Simple Face, Ears, Eyelids, Nose, Lips And/or Mucous Membranes; 2.5 Cm > Charge $248.00 $354.00 $212.00–$336.00 37% below 30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 12011 Simple Repair F/e/e/n/l/m 2.5cm/< Techfee $417.00 $596.00 $358.00–$566.00 7% above 30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 Shave Biopsy Of Skin, Single Lesion $90.00 $129.00 $77.00–$123.00 75% below 30%
Trigger point injections, 1 or 2 muscles CPT 20552 Profeetrigger Point Injection $78.00 $112.00 $67.00–$106.00 86% below 30%
Trigger point injections, 1 or 2 muscles CPT 20552 Injection(s); Single Or Multiple Trigger Point(s), 1 Or 2 Muscle(s) $119.00 $170.00 $102.00–$162.00 79% below 30%
Trigger point injections, 1 or 2 muscles CPT 20552 20522 Trigger Point Injection $620.00 $886.00 $532.00–$842.00 7% above 30%
Wart removal, up to 14 warts CPT 17110 Destruction (Eg, Laser/electro/cryo/chemosurgery/curettement), Of Warts; Up To 14 Lesions Charge $145.00 $207.00 $124.00–$197.00 28% below 30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debride Skin/soft Tissue Charge $264.00 $377.00 $226.00–$358.00 74% below 30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debridement, Subcutaneous Tissue (Includes Epidermis And Dermis) 20 Sq Cm Or Less Techfee $839.00 $1,199.00 $719.00–$1,139.00 17% below 30%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs TexasOff list
Blood transfusion (giving blood or blood components) CPT 36430 Blood Administration $918.00 $1,312.00 $787.00–$1,246.00 4% above 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 94640 Airway Inhalation Treatment $42.00 $60.00 $36.00–$57.00 79% below 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Meter Dose Inhaler (Mdi) Subsequent $217.00 $310.00 $186.00–$295.00 7% above 30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 Mini-neb Subsequent $372.00 $532.00 $319.00–$505.00 83% above 30%
Critical care, first 30 to 74 minutes CPT 99291 99291- Ed Critical Care-1st Hour $1,775.00 $2,536.00 $1,522.00–$2,409.00 32% below 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Weight Loss Ekg $74.00 $105.00 $63.00–$100.00 74% below 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Ekg 12 Lead, Tracing Only Charge ( Poc Ekg) $105.00 $150.00 $90.00–$143.00 63% below 30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 Electrocardiogram Opd $125.00 $179.00 $107.00–$170.00 56% below 30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 99281- Ed Visit Level 1 Ed Facility Charge Ticket $185.00 $264.00 $158.00–$251.00 29% below 30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 99282- Ed Visit Level 2 $333.00 $475.00 $285.00–$451.00 29% below 30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 99283- Ed Visit Level 3 Intermediate $582.00 $831.00 $499.00–$789.00 29% below 30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 99284- Ed Visit Level 4 Moderate $894.00 $1,277.00 $766.00–$1,213.00 32% below 30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 99285- Ed Visit Level 5 High Decision Making $1,287.00 $1,839.00 $1,103.00–$1,747.00 36% below 30%
Family therapy with the patient, 50 minutes CPT 90847 Family psychotherapy, including patient, 50 min $220.00 $314.00 $188.00–$298.00 22% below 30%
Family therapy without the patient, 50 minutes CPT 90846 Family psychotherapy, not including patient, 50 min $212.00 $303.00 $182.00–$288.00 18% below 30%
Group psychotherapy session CPT 90853 Group psychotherapy $59.00 $84.00 $50.00–$80.00 69% below 30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360 Iv Infusion Hydration Initial 31 Min-1 Hour $442.00 $632.00 $379.00–$600.00 2% below 30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 96360hydration, First Hour- Hosp $442.00 $632.00 $379.00–$600.00 2% below 30%
IV infusion of a medicine, first hour CPT 96365 Iv Infusion Therapy, Prophylaxis /Dx 1st To 1 Hred Facility Charge Ticket $442.00 $632.00 $379.00–$600.00 6% below 30%
IV infusion of a medicine, first hour CPT 96365 96365 Covid Infusion Administration Fee $442.00 $632.00 $379.00–$600.00 6% below 30%
IV push of a medicine, first drug CPT 96374 96374 Iv Push, Single Or Initial $442.00 $632.00 $379.00–$600.00 91% above 30%
IV push of a medicine, first drug CPT 96374 96374iv Push, Single Or Initial- Hosp $442.00 $632.00 $379.00–$600.00 91% above 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Therapeutic; Prophylactic, Or Diagnostic Injection, Subcutaneous Or Intramuscular $30.00 $43.00 $26.00–$41.00 80% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Injection Admin, Sq Or Im- Hosp $150.00 $214.00 $128.00–$203.00 1% below 30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 96372 Injection Sub Q Or Im $150.00 $214.00 $128.00–$203.00 1% below 30%
Mental health diagnostic evaluation (intake), without medical services CPT 90791 Psychiatric Diagnostic Evaluation Ldh_tx $386.00 $552.00 $331.00–$524.00 at median 30%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Of Movement, Balance, Coordination, Kinesthetic $78.00 $111.00 $67.00–$105.00 31% below 30%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuromuscular Reeducation Assistant Units $78.00 $111.00 $67.00–$105.00 31% below 30%
Neuromuscular re-education, 15 minutes CPT 97112 Pt Neuromuscular Reeducation Units $78.00 $111.00 $67.00–$105.00 31% below 30%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Reeducation Units $78.00 $111.00 $67.00–$105.00 31% below 30%
Neuromuscular re-education, 15 minutes CPT 97112 Neuromuscular Reeducation Charges $78.00 $111.00 $67.00–$105.00 31% below 30%
Neuromuscular re-education, 15 minutes CPT 97112 Ot Neuromuscular Reeducation Assistant Units $78.00 $111.00 $67.00–$105.00 31% below 30%
New patient office visit, about 30 minutes CPT 99203 New patient office or other outpatient visit, 30 min $242.00 $346.00 $208.00–$329.00 14% above 30%
New patient office visit, about 45 minutes CPT 99204 New patient office or other outpatient visit, 45 min $466.00 $666.00 $400.00–$633.00 45% above 30%
New patient office visit, about 60 minutes CPT 99205 New patient office or other outpatient visit, 60 min $452.00 $646.00 $388.00–$614.00 35% above 30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Obs Consultation New Patient Level 2 $110.00 $157.00 $94.00–$149.00 35% below 30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Ed Consultation New Patient Level 2 $110.00 $157.00 $94.00–$149.00 35% below 30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 Office/op New Visit Level 2 99202 $150.00 $214.00 $128.00–$203.00 12% below 30%
Occupational therapy evaluation, low complexity CPT 97165 Ot Low Complex Units $234.00 $334.00 $200.00–$317.00 4% below 30%
Occupational therapy evaluation, low complexity CPT 97165 Occupational Therapy Evaluation, Low Complexity $234.00 $334.00 $200.00–$317.00 4% below 30%
Occupational therapy evaluation, low complexity CPT 97165 Ot Evaluation Low Complexity Units $234.00 $334.00 $200.00–$317.00 4% below 30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt High Complex Units $209.00 $298.00 $179.00–$283.00 32% below 30%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 Pt Evaluation High Complexity Units $209.00 $298.00 $179.00–$283.00 32% below 30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Low Complex Units $209.00 $298.00 $179.00–$283.00 4% above 30%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 Pt Evaluation Low Complexity Units $209.00 $298.00 $179.00–$283.00 4% above 30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Evaluation Moderate Complexity Units $209.00 $298.00 $179.00–$283.00 17% below 30%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 Pt Moderate Complex Units $209.00 $298.00 $179.00–$283.00 17% below 30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Assistant Units $71.00 $102.00 $61.00–$97.00 37% below 30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Manual Therapy Charge Units $71.00 $102.00 $61.00–$97.00 37% below 30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Pt Manual Therapy Units $71.00 $102.00 $61.00–$97.00 37% below 30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 Ot Manual Therapy Units $71.00 $102.00 $61.00–$97.00 37% below 30%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Physical therapy, therapeutic exercise $76.00 $108.00 $65.00–$103.00 32% below 30%
Preventive checkup, new patient aged 18–39 CPT 99385 Initial new patient preventative medicine evaluation (18-39 years) $271.00 $387.00 $232.00–$368.00 96% above 30%
Preventive checkup, new patient aged 40–64 CPT 99386 Initial new patient preventative medicine evaluation (40-64 years) $328.00 $469.00 $281.00–$446.00 133% above 30%
Preventive checkup, new patient aged 65 or older CPT 99387 99387 Preventive Care New Pt 65 And Over $354.00 $506.00 $304.00–$481.00 116% above 30%
Preventive checkup, returning patient aged 18–39 CPT 99395 99395 Seq Preventive Medicine 18-39 Years Established $245.00 $350.00 $210.00–$333.00 114% above 30%
Preventive checkup, returning patient aged 40–64 CPT 99396 99396 Preventive Care Est Pt 40-64 $267.00 $382.00 $229.00–$363.00 61% above 30%
Preventive checkup, returning patient aged 65 or older CPT 99397 99397 Preventive Care Est Pt 65 And Over $284.00 $405.00 $243.00–$385.00 65% above 30%
Psychiatric evaluation with medical services CPT 90792 Psychiatric Diagnostic Evaluation, W/medical Services Ldh_tx $433.00 $618.00 $371.00–$587.00 32% above 30%
Psychotherapy for crisis, first 60 minutes CPT 90839 Psychotherapy For Crisis; First 60 Minutes Ldh_tx $312.00 $445.00 $267.00–$423.00 4% below 30%
Psychotherapy session, 30 minutes CPT 90832 Psychotherapy, 30 min $168.00 $240.00 $144.00–$228.00 11% below 30%
Psychotherapy session, 45 minutes CPT 90834 Psychotherapy, 45 min $222.00 $317.00 $190.00–$301.00 19% below 30%
Psychotherapy session, 60 minutes CPT 90837 Psychotherapy, 60 min $326.00 $465.00 $279.00–$442.00 19% above 30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 Tobacco Counseling Charge $62.00 $89.00 $53.00–$85.00 40% above 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Behavorial Healthov Est. Patient; Level 5 $243.00 $347.00 $208.00–$330.00 21% below 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Ed Consultation Established Patient Level 5 $300.00 $429.00 $257.00–$408.00 3% below 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Obs Consultation Established Patient Level 5 $300.00 $429.00 $257.00–$408.00 3% below 30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Office/op Established Visit Level 5 99215 $378.00 $540.00 $324.00–$513.00 22% above 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Restart Patient Weight Loss $95.00 $135.00 $81.00–$128.00 54% below 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Behavorial Healthov Est. Patient; Level 3 $112.00 $160.00 $96.00–$152.00 45% below 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Obs Consultation Established Patient Level 3 $138.00 $197.00 $118.00–$187.00 33% below 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Ed Consultation Established Patient Level 3 $138.00 $197.00 $118.00–$187.00 33% below 30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 99213 Office/op Established Visit Level 3 99213 $191.00 $273.00 $164.00–$259.00 7% below 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Behavorial Healthov Est. Patient; Level 4 $172.00 $246.00 $148.00–$234.00 20% below 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Obs Consultation Established Patient Level 4 $203.00 $290.00 $174.00–$276.00 5% below 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Ed Consultation Established Patient Level 4 $203.00 $290.00 $174.00–$276.00 5% below 30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 99214 Office/op Established Visit Level 4 $270.00 $385.00 $231.00–$366.00 26% above 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Op Tx Room Level 2 $60.00 $86.00 $52.00–$82.00 63% below 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Monthly Weight Loss $70.00 $100.00 $60.00–$95.00 57% below 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Obs Consultation Established Patient Level 2 $74.00 $105.00 $63.00–$100.00 55% below 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Ed Consultation Established Patient Level 2 $74.00 $105.00 $63.00–$100.00 55% below 30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 99212 Office/op Established Visit Level 2 $118.00 $168.00 $101.00–$160.00 28% below 30%
Specialist consultation, low complexity or 30+ minutes CPT 99243 Patient office consultation, 40 min $165.00 $235.00 $141.00–$223.00 85% above 30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 Patient office consultation, 60 min $279.00 $399.00 $239.00–$379.00 72% above 30%
Speech and language evaluation CPT 92523 Slp Sound Prod W/ Lang Comp Eval Units $500.00 $714.00 $428.00–$678.00 18% above 30%
Speech and language evaluation CPT 92523 Evaluation Of Speech Sound Production $500.00 $714.00 $428.00–$678.00 18% above 30%
Speech and language evaluation CPT 92523 Speech Sound Prod W/ Languarge Charge $500.00 $714.00 $428.00–$678.00 18% above 30%
Speech therapy session, individual CPT 92507 Treatment Of Speech,language,voice,communication $169.00 $241.00 $145.00–$229.00 22% below 30%
Speech therapy session, individual CPT 92507 Tx Of Speech/lang/voice/comm/auditory $169.00 $241.00 $145.00–$229.00 22% below 30%
Speech therapy session, individual CPT 92507 Slp Auditory Processing Tx Units $169.00 $241.00 $145.00–$229.00 22% below 30%
Speech therapy session, individual CPT 92507 Treatment Of Speech, Language, Voice, Communication, And/ Or Auditory Processing Disorder $169.00 $241.00 $145.00–$229.00 22% below 30%
Spirometry (breathing test) CPT 94010 Spirometry-ldh $328.00 $469.00 $281.00–$446.00 8% below 30%
Spirometry before and after a bronchodilator CPT 94060 Spirometry Pre & Post $654.00 $934.00 $560.00–$887.00 10% above 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activities Assistant Units $81.00 $115.00 $69.00–$109.00 28% below 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 Ot Therapeutic Activities Units $81.00 $115.00 $69.00–$109.00 28% below 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charges $81.00 $115.00 $69.00–$109.00 28% below 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 Therapeutic Activities Charge $83.00 $118.00 $71.00–$112.00 26% below 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activity Units $83.00 $118.00 $71.00–$112.00 26% below 30%
Therapeutic activities (functional training), 15 minutes CPT 97530 Pt Therapeutic Activity Assistant Units $83.00 $118.00 $71.00–$112.00 26% below 30%

Vaccines

ProcedureCash price List priceInsurers payvs TexasOff list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 Moderna (Sarcov2 Vac 50 Mcg/0.5ml Im $307.00 $438.00 $263.00–$416.00 150% above 30%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 Pfizer (Sarscv2 Vac 30 Mcg Trs-suc Im $276.00 $394.00 $236.00–$374.00 145% above 30%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 90696 Kinrix Vaccine $190.00 $271.00 $163.00–$257.00 173% above 30%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 90700 Dtap Vaccine $130.00 $186.00 $112.00–$177.00 44% above 30%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 Pediarix Vaccine (Dtap-hep B-ipv) $201.00 $287.00 $172.00–$273.00 18% below 30%
DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 90698 Pentacel Dtap-hib-ipv $288.00 $411.00 $247.00–$390.00 3% above 30%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 90651 Hpv (Human Papillomavirus Vaccine) $523.00 $747.00 $448.00–$710.00 25% below 30%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651 Hpv (Human Papillomavirus Vaccine) $677.00 $967.00 $580.00–$919.00 3% below 30%
Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 90633 Hep A Pediatric Vaccine $182.00 $260.00 $156.00–$247.00 94% above 30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 90746 Hepatitis B Vaccine, Adult Dosage, 3 Dose Schedule, Im $148.00 $211.00 $127.00–$200.00 18% below 30%
Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 90744  Hepb Vaccine Ped/adolesc 3 Dose Schedule Im $158.00 $225.00 $135.00–$214.00 66% above 30%
Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 90647 Prp-omp Conj. 3-dose Im Use In Poc $150.00 $214.00 $128.00–$203.00 106% above 30%
Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 Hib Vaccine (Hemophilus Influenza B) $150.00 $214.00 $128.00–$203.00 219% above 30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 90707 Measles, Mumps, And Rubella Vaccine (Mmr), Live, For Subcutaneous Use $239.00 $341.00 $205.00–$324.00 3% below 30%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 90710 Mmrv $440.00 $628.00 $377.00–$597.00 29% above 30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 Meningococcal Vaccine Ldh_tx $264.00 $377.00 $226.00–$358.00 26% below 30%
Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 Menquadfi(meningococcal Conjugate Vaccine) $524.00 $749.00 $449.00–$712.00 27% below 30%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 90670 Pneumococcal Conjugate Vaccine, 13 Valent; Im $248.00 $355.00 $213.00–$337.00 49% below 30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 Prevnar 20 Ldh $328.00 $469.00 $281.00–$446.00 42% below 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 Pneumococcal Polysaccharide Vaccine, 23-valent, Adult Dosage, For Subcutaneous Or Im $132.00 $188.00 $113.00–$179.00 48% below 30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 90732 Pneumococcal 23 Vaccine $187.00 $267.00 $160.00–$254.00 26% below 30%
Polio vaccine, inactivated (IPV) CPT 90713 90713 Poliovirus Vaccine, Inactivated (Ipv) $150.00 $214.00 $128.00–$203.00 55% below 30%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 Abrysvo (Rsv Vaccine, Pref, Subunit, Bivalen, For Im Use) $773.00 $1,104.00 $662.00–$1,049.00 21% above 30%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 Rotavirus Commercial $214.00 $306.00 $184.00–$291.00 77% above 30%
Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 90681 Rotavirus Vaccine2 Doses $248.00 $355.00 $213.00–$337.00 105% above 30%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 90680 Rotavirus Vaccine, Pentavalent, Live, For Oral $248.00 $355.00 $213.00–$337.00 141% above 30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 90750 Shingrix (Shingles) Vaccination $326.00 $465.00 $279.00–$442.00 4% below 30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 Tetanus, Diphtheria Toxoids & Acellular Pertussis Vaccine (Tdap), 7 Years Or Older, Im Use Poc $126.00 $180.00 $108.00–$171.00 17% below 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 Vfc Immunization Administration $10.00 $14.00 $8.00–$13.00 87% below 29%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization Administration; 1 Vaccine $43.00 $61.00 $37.00–$58.00 42% below 30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Immunization Adm, Im Inj $150.00 $214.00 $128.00–$203.00 101% above 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 Vfc Immunization Administration, Ea. Additional $10.00 $14.00 $8.00–$13.00 81% below 29%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization Administration; Each Additional $30.00 $43.00 $26.00–$41.00 44% below 30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Inj Admin Vaccine, Each Add $70.00 $100.00 $60.00–$95.00 31% above 30%

Source file: https://secure.claraprice.net/price-transparency/RQQA-1685471383027/machine-readable/202797853_liberty-dayton-regional-medical-center_standardcharges.json