SelfPayRates
Hospital Tulsa, OK

Wagoner Community Hospital

Listed in its price file as “Wagoner Hospital Authority”.

Wagoner Community Hospital in Wagoner, OK publishes cash prices for 239 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 Oklahoma median for 208 of 237 procedures and above it for 27. By typical cash price it ranks #8 of 60 Oklahoma hospitals and #2 of 18 hospitals in the Tulsa, OK area, cheapest first. Click a procedure to compare it with other hospitals nearby.

1200 W Cherokee St, Wagoner , OK 74467-4624 Collected Sep 27, 2026 Source price file (918) 485-5514

Acute care hospital Emergency department CMS star rating 2 of 5 CCN 370166 · CMS hospital register NPI 1386611580

Scans and imaging

ProcedureCash price List priceInsurers payvs OklahomaOff list
Abdominal CT scan without and with contrast CPT 74170 CT ABD W/WO CONTRAST $876.00 $1,752.00 $143.01–$169.34 33% below 50%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABD W/WO CONTRAST $876.00 $1,752.00 $143.01–$169.34 — 50%
Abdominal X-ray, 2 views CPT 74019 XR ABDOMEN 2 VIEWS $112.50 $225.00 $21.02–$212.68 46% below 50%
Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN 2 VIEWS $112.50 $225.00 $21.02–$212.68 — 50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3-4 VIEWS LT $142.50 $285.00 $22.64–$285.00 18% below 50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR ANKLE 3-4 VIEWS RT $142.50 $285.00 $22.64–$285.00 18% below 50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3-4 VIEWS RT $142.50 $285.00 $22.64–$285.00 — 50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3-4 VIEWS LT $142.50 $285.00 $22.64–$285.00 — 50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O CONTRAST RT $390.00 $780.00 $85.12–$200.63 57% below 50%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT UPPER EXTREMITY W/O CONTRAST LT $390.00 $780.00 $85.12–$200.63 57% below 50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREMITY W/O CONTRAST RT $390.00 $780.00 $85.12–$200.63 — 50%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT UPPER EXTREMITY W/O CONTRAST LT $390.00 $780.00 $85.12–$200.63 — 50%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED EXAM BILATERAL $160.50 $321.00 $41.04–$202.23 — 50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LT UNILAT LIMITED EXAM $160.50 $321.00 $41.04–$202.23 52% below 50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREASTS UNILATERAL LIMITED EXAM $160.50 $321.00 $41.04–$202.23 52% below 50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST RT UNILAT LIMITED EXAM $160.50 $321.00 $41.04–$202.23 52% below 50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST LIMITED EXAM UNILATERAL $160.50 $321.00 $41.04–$202.23 52% below 50%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST LIMITED EXAM BILATERAL $160.50 $321.00 $41.04–$202.23 — 50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREASTS UNILATERAL LIMITED EXAM $160.50 $321.00 $41.04–$202.23 — 50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LT UNILAT LIMITED EXAM $160.50 $321.00 $41.04–$202.23 — 50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST LIMITED EXAM UNILATERAL $160.50 $321.00 $41.04–$202.23 — 50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST RT UNILAT LIMITED EXAM $160.50 $321.00 $41.04–$202.23 — 50%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABDOMEN & PELVIS W/&W/O CONTRAST $876.00 $1,752.00 $334.27–$337.42 61% below 50%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CTA ABDOMEN & PELVIS W/&W/O CONTRAST $876.00 $1,752.00 $334.27–$337.42 — 50%
CT angiography (CTA) of the head CPT 70496 CTA HEAD W/C W/NC IMAGES $916.00 $1,832.00 $405.62–$412.11 31% below 50%
CT angiography (CTA) of the head inpatient CPT 70496 CTA HEAD W/C W/NC IMAGES $916.00 $1,832.00 $405.62–$412.11 — 50%
CT angiography (CTA) of the neck CPT 70498 CTA NECK W/C INC N/C IMAGE $916.00 $1,832.00 $143.26–$407.27 30% below 50%
CT angiography (CTA) of the neck inpatient CPT 70498 CTA NECK W/C INC N/C IMAGE $916.00 $1,832.00 $143.26–$407.27 — 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA, CHEST W/CONTRAST INCLUDING NON-CONTRAST IMAGES IF PERFORMED $916.00 $1,832.00 $143.26–$1,416.14 39% below 50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA THORACIC W/CONTRAST $916.00 $1,832.00 $143.26–$1,416.14 39% below 50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA THORACIC W/CONTRAST $916.00 $1,832.00 $143.26–$1,416.14 — 50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA, CHEST W/CONTRAST INCLUDING NON-CONTRAST IMAGES IF PERFORMED $916.00 $1,832.00 $143.26–$1,416.14 — 50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS W/O CONTRAST $770.00 $1,540.00 $84.69–$1,190.42 42% below 50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS W/O CONTRAST $770.00 $1,540.00 $84.69–$1,190.42 — 50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS W/CONTRAST $1,220.00 $2,440.00 $178.32–$1,145.03 26% below 50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS W/CONTRAST $1,220.00 $2,440.00 $178.32–$1,145.03 — 50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS W&W/O CONTRAST $1,220.00 $2,440.00 $201.24–$826.00 39% below 50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS W&W/O CONTRAST $1,220.00 $2,440.00 $201.24–$826.00 — 50%
CT scan of the abdomen with contrast CPT 74160 CT ABD W/CONTRAST $782.50 $1,565.00 $158.53–$169.34 26% below 50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABD W/CONTRAST $782.50 $1,565.00 $158.53–$169.34 — 50%
CT scan of the abdomen without contrast CPT 74150 CT ABD W/O CONTRAST $390.00 $780.00 $99.53–$101.15 60% below 50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABD W/O CONTRAST $390.00 $780.00 $99.53–$101.15 — 50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT FACIAL W/O CONTRAST $390.00 $780.00 $76.07–$780.00 59% below 50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT SINUS W/O CONTRAST $390.00 $780.00 $76.07–$780.00 59% below 50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT FACIAL W/O CONTRAST $390.00 $780.00 $76.07–$780.00 — 50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUS W/O CONTRAST $390.00 $780.00 $76.07–$780.00 — 50%
CT scan of the head or brain, no contrast dye CPT 70450 CT BRAIN W/O CONTRAST $390.00 $780.00 $55.30–$630.95 59% below 50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT BRAIN W/O CONTRAST $390.00 $780.00 $55.30–$630.95 — 50%
CT scan of the head without and with contrast CPT 70470 CT BRAIN W/WO CONTRAST $876.00 $1,752.00 $94.13–$381.77 32% below 50%
CT scan of the head without and with contrast inpatient CPT 70470 CT BRAIN W/WO CONTRAST $876.00 $1,752.00 $94.13–$381.77 — 50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L-SPINE W/O CONTRAST $390.00 $780.00 $92.98–$602.94 62% below 50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L-SPINE W/O CONTRAST $390.00 $780.00 $92.98–$602.94 — 50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C-SPINE W/O CONTRAST $390.00 $780.00 $72.18–$602.94 63% below 50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C-SPINE W/O CONTRAST $390.00 $780.00 $72.18–$602.94 — 50%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US CAROTID DOPPLER $331.50 $663.00 $212.09–$229.84 30% below 50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US CAROTID DOPPLER $331.50 $663.00 $212.09–$229.84 — 50%
Chest CT scan without and with contrast CPT 71270 CT CHEST W/WO CONTRAST $876.00 $1,752.00 $166.63 30% below 50%
Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST $876.00 $1,752.00 $166.63 — 50%
Chest X-ray, 2 views CPT 71046 XR CHEST 2 VIEWS $112.50 $225.00 $19.41–$225.00 37% below 50%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS $112.50 $225.00 $19.41–$225.00 — 50%
Chest X-ray, single view CPT 71045 XR CHEST SINGLE VIEW $112.50 $225.00 $14.01–$225.00 35% below 50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST SINGLE VIEW $112.50 $225.00 $14.01–$225.00 — 50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE 2V RT $112.50 $225.00 $19.95–$20.53 37% below 50%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XR CLAVICLE 2V LT $112.50 $225.00 $19.95–$20.53 37% below 50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE 2V LT $112.50 $225.00 $19.95–$20.53 — 50%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE 2V RT $112.50 $225.00 $19.95–$20.53 — 50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 XR DEXA BONE DENSITY $152.50 $305.00 $87.52–$235.77 25% below 50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 XR DEXA BONE DENSITY $152.50 $305.00 $87.52–$235.77 — 50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST W/O CONTRAST $390.00 $780.00 $68.25–$326.00 59% below 50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST $390.00 $780.00 $68.25–$326.00 — 50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST W/CONTRAST $782.50 $1,565.00 $146.26–$407.27 30% below 50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/CONTRAST $782.50 $1,565.00 $146.26–$407.27 — 50%
Diagnostic mammogram, both breasts both sides CPT 77066 MM MAMMO DIGITAL DIAGNOSTIC BILATERAL W/CAD $135.00 $270.00 $90.35–$260.32 — 50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MM MAMMO DIGITAL DIAGNOSTIC BILATERAL W/CAD $135.00 $270.00 $90.35–$260.32 — 50%
Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO DIGITAL RT DIAGNOSTIC W/CAD $122.50 $245.00 $70.92–$116.97 39% below 50%
Diagnostic mammogram, one breast one side CPT 77065 MM MAMMO DIGITAL LT DIAGNOSTIC W/CAD $122.50 $245.00 $70.92–$116.97 39% below 50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO DIGITAL LT DIAGNOSTIC W/CAD $122.50 $245.00 $70.92–$116.97 — 50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MM MAMMO DIGITAL RT DIAGNOSTIC W/CAD $122.50 $245.00 $70.92–$116.97 — 50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 US ART DOP BIL LOW EXTR $331.50 $663.00 $161.27–$410.92 29% below 50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 US ART DOP BIL LOW EXTR $331.50 $663.00 $161.27–$410.92 — 50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VENOUS DOPLER BILATERAL UP/LOW EXTREMITY $197.00 $394.00 $195.05–$394.00 — 50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX VENOUS EXTREMITY BILAT $331.50 $663.00 $195.05–$394.00 — 50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VENOUS DOPLER BILATERAL UP/LOW EXTREMITY $197.00 $394.00 $195.05–$394.00 — 50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX VENOUS EXTREMITY BILAT $331.50 $663.00 $195.05–$394.00 — 50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US ECHO W/DOPPLER/COLOR $739.50 $1,479.00 $102.20–$1,143.27 32% below 50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 GLOBAL US ECHO W/DOPPLER/COLOR $845.00 $1,690.00 $102.20–$1,143.27 22% below 50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US ECHO W/DOPPLER/COLOR $739.50 $1,479.00 $102.20–$1,143.27 — 50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 GLOBAL US ECHO W/DOPPLER/COLOR $845.00 $1,690.00 $102.20–$1,143.27 — 50%
Elbow X-ray, 2 views CPT 73070 LHI XR ELBOW 2 VIEWS $112.50 $225.00 $17.25–$173.93 35% below 50%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS LT $112.50 $225.00 $17.25–$173.93 35% below 50%
Elbow X-ray, 2 views one side CPT 73070 XR ELBOW 2 VIEWS RT $112.50 $225.00 $17.25–$173.93 35% below 50%
Elbow X-ray, 2 views inpatient CPT 73070 LHI XR ELBOW 2 VIEWS $112.50 $225.00 $17.25–$173.93 — 50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS RT $112.50 $225.00 $17.25–$173.93 — 50%
Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEWS LT $112.50 $225.00 $17.25–$173.93 — 50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS RT $112.50 $225.00 $20.53–$83.51 37% below 50%
Elbow X-ray, complete, 3 or more views one side CPT 73080 XR ELBOW 3 VIEWS LT $112.50 $225.00 $20.53–$83.51 37% below 50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS RT $112.50 $225.00 $20.53–$83.51 — 50%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 VIEWS LT $112.50 $225.00 $20.53–$83.51 — 50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT TEMPORAL/ORBIT BONE W/O CONTRAST $390.00 $780.00 $81.72 57% below 50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT IAC W/O CONTRAST $390.00 $780.00 $81.72 57% below 50%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT W/O CONTRAST $782.50 $1,565.00 $81.72 15% below 50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT TEMPORAL/ORBIT BONE W/O CONTRAST $390.00 $780.00 $81.72 — 50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT IAC W/O CONTRAST $390.00 $780.00 $81.72 — 50%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT W/O CONTRAST $782.50 $1,565.00 $81.72 — 50%
Forearm X-ray (radius and ulna), 2 views CPT 73090 XR FOREARM 1 VIEW L $112.50 $225.00 $17.52–$176.10 38% below 50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS RT $112.50 $225.00 $17.52–$176.10 38% below 50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 3 VIEWS LT $112.50 $225.00 $17.52–$176.10 38% below 50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 2 VIEWS LT $112.50 $225.00 $17.52–$176.10 38% below 50%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 XR FOREARM 3 VIEWS RT $112.50 $225.00 $17.52–$176.10 38% below 50%
Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 1 VIEW L $112.50 $225.00 $17.52–$176.10 — 50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 3 VIEWS RT $112.50 $225.00 $17.52–$176.10 — 50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS RT $112.50 $225.00 $17.52–$176.10 — 50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEWS LT $112.50 $225.00 $17.52–$176.10 — 50%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 3 VIEWS LT $112.50 $225.00 $17.52–$176.10 — 50%
Hand X-ray, 2 views one side CPT 73120 XR HAND 1 VIEW LT $85.00 $170.00 $18.87–$99.53 54% below 50%
Hand X-ray, 2 views one side CPT 73120 LHI XR HAND 2 VIEWS RT $152.50 $305.00 $18.87–$99.53 18% below 50%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS LT $152.50 $305.00 $18.87–$99.53 18% below 50%
Hand X-ray, 2 views one side CPT 73120 XR HAND 2 VIEWS RT $152.50 $305.00 $18.87–$99.53 18% below 50%
Hand X-ray, 2 views one side CPT 73120 LHI XR HAND 2 VIEWS LT $152.50 $305.00 $18.87–$99.53 18% below 50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 1 VIEW LT $85.00 $170.00 $18.87–$99.53 — 50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS LT $152.50 $305.00 $18.87–$99.53 — 50%
Hand X-ray, 2 views inpatient one side CPT 73120 LHI XR HAND 2 VIEWS LT $152.50 $305.00 $18.87–$99.53 — 50%
Hand X-ray, 2 views inpatient one side CPT 73120 LHI XR HAND 2 VIEWS RT $152.50 $305.00 $18.87–$99.53 — 50%
Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEWS RT $152.50 $305.00 $18.87–$99.53 — 50%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATTENDED (HOME KIT) $200.00 $400.00 $42.72–$400.00 47% below 50%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATTENDED (HOME KIT) $200.00 $400.00 $42.72–$400.00 — 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY PSG W/CPAP $1,250.00 $2,500.00 $433.54–$1,780.43 58% below 50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY PSG W/CPAP $1,250.00 $2,500.00 $433.54–$1,780.43 — 50%
Knee X-ray, 3 views CPT 73562 LHI XR KNEE 3 VIEWS $112.50 $225.00 $25.61–$285.00 42% below 50%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3V RT $142.50 $285.00 $25.61–$285.00 26% below 50%
Knee X-ray, 3 views one side CPT 73562 XR KNEE 3V LT $142.50 $285.00 $25.61–$285.00 26% below 50%
Knee X-ray, 3 views inpatient CPT 73562 LHI XR KNEE 3 VIEWS $112.50 $225.00 $25.61–$285.00 — 50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3V LT $142.50 $285.00 $25.61–$285.00 — 50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3V RT $142.50 $285.00 $25.61–$285.00 — 50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4+V LT $142.50 $285.00 $29.39–$212.68 49% below 50%
Knee X-ray, complete, 4 or more views one side CPT 73564 XR KNEE 4+V RT $142.50 $285.00 $29.39–$212.68 49% below 50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4+V LT $142.50 $285.00 $29.39–$212.68 — 50%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4+V RT $142.50 $285.00 $29.39–$212.68 — 50%
Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O CONTRAST $390.00 $780.00 $68.79–$780.00 57% below 50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT CONFORMIS KNEE LT $390.00 $780.00 $68.79–$780.00 57% below 50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT RT W/O CONTRAST $390.00 $780.00 $68.79–$780.00 57% below 50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LOW EXT LT W/O CONTRAST $390.00 $780.00 $68.79–$780.00 57% below 50%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT CONFORMIS KNEE RT $390.00 $780.00 $68.79–$780.00 57% below 50%
Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O CONTRAST $390.00 $780.00 $68.79–$780.00 — 50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT CONFORMIS KNEE RT $390.00 $780.00 $68.79–$780.00 — 50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT RT W/O CONTRAST $390.00 $780.00 $68.79–$780.00 — 50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT CONFORMIS KNEE LT $390.00 $780.00 $68.79–$780.00 — 50%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LOW EXT LT W/O CONTRAST $390.00 $780.00 $68.79–$780.00 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LIMITED $236.00 $472.00 $47.74–$472.00 39% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER $236.00 $472.00 $47.74–$472.00 39% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER $236.00 $472.00 $47.74–$472.00 39% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US BILE DUCT $236.00 $472.00 $47.74–$472.00 39% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN $236.00 $472.00 $47.74–$472.00 39% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS $236.00 $472.00 $47.74–$472.00 39% below 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN $236.00 $472.00 $47.74–$472.00 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US BILE DUCT $236.00 $472.00 $47.74–$472.00 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LIMITED $236.00 $472.00 $47.74–$472.00 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER $236.00 $472.00 $47.74–$472.00 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER $236.00 $472.00 $47.74–$472.00 — 50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS $236.00 $472.00 $47.74–$472.00 — 50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US PORTABLE ULTRASOUND $160.50 $321.00 $25.61–$101.15 38% below 50%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US SOFT TISSUE EXTREMITIES $160.50 $321.00 $25.61–$101.15 38% below 50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US SOFT TISSUE EXTREMITIES $160.50 $321.00 $25.61–$101.15 — 50%
Limited ultrasound of an arm or leg (non-vascular) inpatient CPT 76882 US PORTABLE ULTRASOUND $160.50 $321.00 $25.61–$101.15 — 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT LOW DOSE CT SCAN (LDCT) FOR LUNG CANCER SCREENING $99.50 $199.00 $72.00–$199.00 72% below 50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LOW DOSE CT SCAN (LDCT) FOR LUNG CANCER SCREENING $99.50 $199.00 $72.00–$199.00 — 50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA RT 2V $112.50 $225.00 $19.97–$125.34 33% below 50%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 XR TIBIA/FIBULA LT 2V $112.50 $225.00 $19.97–$125.34 33% below 50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA RT 2V $112.50 $225.00 $19.97–$125.34 — 50%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR TIBIA/FIBULA LT 2V $112.50 $225.00 $19.97–$125.34 — 50%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR LOWER EXTREMITY JOINT W/O CONTRAST $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXTREMITY JOINT W/O CONTRAST LT (BA) $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST RT (BA) $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE W/O CONTRAST LT $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR ANKLE W/O CONTRAST RT $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE W/O CONTRAST LT (BA) $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOW EXT LT JOINT W/O CONTRAST $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MR LOW EXT RT JOINT W/O CONTRAST $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LOWER EXTREMITY JOINT W/O CONTRAST RT (BA) $930.50 $1,861.00 $115.42–$507.75 32% below 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR LOWER EXTREMITY JOINT W/O CONTRAST $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST RT (BA) $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ANKLE W/O CONTRAST LT $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXTREMITY JOINT W/O CONTRAST LT (BA) $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LOWER EXTREMITY JOINT W/O CONTRAST RT (BA) $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE W/O CONTRAST LT (BA) $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LOW EXT LT JOINT W/O CONTRAST $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR LOW EXT RT JOINT W/O CONTRAST $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MR ANKLE W/O CONTRAST RT $930.50 $1,861.00 $115.42–$507.75 — 50%
MRI of the abdomen without contrast CPT 74181 MR - MRCP $930.50 $1,861.00 $110.75–$229.93 19% below 50%
MRI of the abdomen without contrast CPT 74181 MR MRA ABD W/O CONTRAST $930.50 $1,861.00 $110.75–$229.93 19% below 50%
MRI of the abdomen without contrast CPT 74181 MRI-MRCP (BA) $930.50 $1,861.00 $110.75–$229.93 19% below 50%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST (BA) $930.50 $1,861.00 $110.75–$229.93 19% below 50%
MRI of the abdomen without contrast CPT 74181 MR ABD W/O CONTRAST $930.50 $1,861.00 $110.75–$229.93 19% below 50%
MRI of the abdomen without contrast inpatient CPT 74181 MR MRA ABD W/O CONTRAST $930.50 $1,861.00 $110.75–$229.93 — 50%
MRI of the abdomen without contrast inpatient CPT 74181 MR ABD W/O CONTRAST $930.50 $1,861.00 $110.75–$229.93 — 50%
MRI of the abdomen without contrast inpatient CPT 74181 MR - MRCP $930.50 $1,861.00 $110.75–$229.93 — 50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST (BA) $930.50 $1,861.00 $110.75–$229.93 — 50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI-MRCP (BA) $930.50 $1,861.00 $110.75–$229.93 — 50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABD W/WO CONTRAST $1,569.50 $3,139.00 $204.04–$337.42 16% below 50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR ABDOMEN W W/O CONTRAST (BA) $1,569.50 $3,139.00 $204.04–$337.42 16% below 50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABD W/WO CONTRAST $1,569.50 $3,139.00 $204.04–$337.42 — 50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR ABDOMEN W W/O CONTRAST (BA) $1,569.50 $3,139.00 $204.04–$337.42 — 50%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN W/O CONTRAST (BA) $930.50 $1,861.00 $105.19–$474.04 15% below 50%
MRI of the brain, no contrast dye CPT 70551 MR BRAIN W/O CONTRAST $930.50 $1,861.00 $105.19–$474.04 15% below 50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST (BA) $930.50 $1,861.00 $105.19–$474.04 — 50%
MRI of the brain, no contrast dye inpatient CPT 70551 MR BRAIN W/O CONTRAST $930.50 $1,861.00 $105.19–$474.04 — 50%
MRI of the brain, with and without contrast dye CPT 70553 MR BRAIN W/WO CONTRAST $1,569.50 $3,139.00 $174.52–$803.37 6% above 50%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W/WO CONTRAST (BA) $1,569.50 $3,139.00 $174.52–$803.37 6% above 50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST (BA) $1,569.50 $3,139.00 $174.52–$803.37 — 50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR BRAIN W/WO CONTRAST $1,569.50 $3,139.00 $174.52–$803.37 — 50%
MRI of the lower back, no contrast dye CPT 72148 MRI L-SPINE W/O CONTRAST (BA) $930.50 $1,861.00 $100.61–$1,193.00 22% below 50%
MRI of the lower back, no contrast dye CPT 72148 MR L-SPINE W/O CONTRAST $930.50 $1,861.00 $100.61–$1,193.00 22% below 50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI L-SPINE W/O CONTRAST (BA) $930.50 $1,861.00 $100.61–$1,193.00 — 50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR L-SPINE W/O CONTRAST $930.50 $1,861.00 $100.61–$1,193.00 — 50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI L-SPINE W/WO CONTRAST (BA) $1,569.50 $3,139.00 $174.52 1% above 50%
MRI of the lower back, without and then with contrast dye CPT 72158 MR L-SPINE W & W/O CONTRAST $1,569.50 $3,139.00 $174.52 1% above 50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI L-SPINE W/WO CONTRAST (BA) $1,569.50 $3,139.00 $174.52 — 50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR L-SPINE W & W/O CONTRAST $1,569.50 $3,139.00 $174.52 — 50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T-SPINE W/O CONTRAST $930.50 $1,861.00 $105.20–$507.75 15% below 50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR T-SPINE W/O CONTRAST (BA) $930.50 $1,861.00 $105.20–$507.75 15% below 50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T-SPINE W/O CONTRAST (BA) $930.50 $1,861.00 $105.20–$507.75 — 50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR T-SPINE W/O CONTRAST $930.50 $1,861.00 $105.20–$507.75 — 50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR C-SPINE W/O CONTRAST $930.50 $1,861.00 $100.07–$1,193.00 17% below 50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI C-SPINE W/O CONTRAST (BA) $930.50 $1,861.00 $100.07–$1,193.00 17% below 50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI C-SPINE W/O CONTRAST (BA) $930.50 $1,861.00 $100.07–$1,193.00 — 50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR C-SPINE W/O CONTRAST $930.50 $1,861.00 $100.07–$1,193.00 — 50%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS W/O CONTRAST $930.50 $1,861.00 $226.25–$495.00 10% below 50%
MRI of the pelvis, no contrast dye CPT 72195 MR PELVIS W/O CONTRAST (BA) $930.50 $1,861.00 $226.25–$495.00 10% below 50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS W/O CONTRAST (BA) $930.50 $1,861.00 $226.25–$495.00 — 50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR PELVIS W/O CONTRAST $930.50 $1,861.00 $226.25–$495.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT LT JOINT W/O CONTRAST $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST RT (BA) $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT RT JOINT W/O CONTRAST (BA) $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST LT $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST LT (BA) $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT LT JOINT W/O CONTRAST (BA) $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST RT $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MR UP EXT RT JOINT W/O CONTRAST $930.50 $1,861.00 $115.69–$345.00 35% below 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST RT (BA) $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UP EXT RT JOINT W/O CONTRAST (BA) $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST LT $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST LT (BA) $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UP EXT LT JOINT W/O CONTRAST (BA) $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UP EXT LT JOINT W/O CONTRAST $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UPPER EXTREMITY JOINT W/O CONTRAST RT $930.50 $1,861.00 $115.69–$345.00 — 50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MR UP EXT RT JOINT W/O CONTRAST $930.50 $1,861.00 $115.69–$345.00 — 50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 XR C-SPINE 4 OR 5 VIEWS $152.50 $305.00 $33.17 45% below 50%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 LHI XR C-SPINE 4 OR 5 VIEWS $152.50 $305.00 $33.17 45% below 50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 LHI XR C-SPINE 4 OR 5 VIEWS $152.50 $305.00 $33.17 — 50%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR C-SPINE 4 OR 5 VIEWS $152.50 $305.00 $33.17 — 50%
Neck soft tissue CT scan with contrast CPT 70491 CT ST NECK W/CONTRAST $782.50 $1,565.00 $103.53–$385.54 27% below 50%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT ST NECK W/CONTRAST $782.50 $1,565.00 $103.53–$385.54 — 50%
Neck soft tissue CT scan without contrast CPT 70490 CT ST NECK W/O CONTRAST $390.00 $780.00 $78.01–$212.68 54% below 50%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT ST NECK W/O CONTRAST $390.00 $780.00 $78.01–$212.68 — 50%
Neck soft tissue X-ray CPT 70360 XR NECK SOFT TISSUE $112.50 $225.00 $18.33–$18.86 30% below 50%
Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE $112.50 $225.00 $18.33–$18.86 — 50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MPI W/ EXERCISE $1,812.50 $3,625.00 $280.75–$2,802.13 32% below 50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MPI W/ CHEMICALS $1,812.50 $3,625.00 $280.75–$2,802.13 32% below 50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MPI W/ CHEMICALS $1,812.50 $3,625.00 $280.75–$2,802.13 — 50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MPI W/ EXERCISE $1,812.50 $3,625.00 $280.75–$2,802.13 — 50%
Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O CONTRAST $390.00 $780.00 $67.98–$210.18 60% below 50%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST $390.00 $780.00 $67.98–$210.18 — 50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US PELVIS LIMITED $160.50 $321.00 $21.91 47% below 50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER $160.50 $321.00 $21.91 47% below 50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIS LIMITED $160.50 $321.00 $21.91 — 50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER $160.50 $321.00 $21.91 — 50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS COMPLETE $236.00 $472.00 $58.51–$154.00 51% below 50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS COMPLETE $236.00 $472.00 $58.51–$154.00 — 50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US PREG LESS THAN 14WKS COMPLETE $236.00 $472.00 $59.13 38% below 50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US PREG LESS THAN 14WKS COMPLETE $236.00 $472.00 $59.13 — 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREG,LIMITED $236.00 $472.00 $93.30 30% below 50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREG,LIMITED $236.00 $472.00 $93.30 — 50%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILAT 2 VIEWS RT $112.50 $225.00 $21.02 41% below 50%
Rib X-ray, one side, 2 views one side CPT 71100 XR RIBS UNILAT 2 VIEWS LT $112.50 $225.00 $21.02 41% below 50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNILAT 2 VIEWS LT $112.50 $225.00 $21.02 — 50%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS UNILAT 2 VIEWS RT $112.50 $225.00 $21.02 — 50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT RT W/CXR 3+VIEWS $142.50 $285.00 $23.72–$93.36 42% below 50%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 XR RIBS UNILAT LT W/CXR 3+VIEWS $142.50 $285.00 $23.72–$93.36 42% below 50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT RT W/CXR 3+VIEWS $142.50 $285.00 $23.72–$93.36 — 50%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101 XR RIBS UNILAT LT W/CXR 3+VIEWS $142.50 $285.00 $23.72–$93.36 — 50%
Screening mammogram, both breasts both sides CPT 77067 MM MAMMO DIGITAL SCREENING BILATERAL W/CAD $292.00 $584.00 $74.72–$451.43 — 50%
Screening mammogram, both breasts one side CPT 77067 MM MAMMO DIGITAL SCREENING RT W/CAD $146.00 $292.00 $74.72–$451.43 19% below 50%
Screening mammogram, both breasts one side CPT 77067 MM MAMMO DIGITAL SCREENING LT W/CAD $146.00 $292.00 $74.72–$451.43 19% below 50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MM MAMMO DIGITAL SCREENING BILATERAL W/CAD $292.00 $584.00 $74.72–$451.43 — 50%
Screening mammogram, both breasts inpatient one side CPT 77067 MM MAMMO DIGITAL SCREENING LT W/CAD $146.00 $292.00 $74.72–$451.43 — 50%
Screening mammogram, both breasts inpatient one side CPT 77067 MM MAMMO DIGITAL SCREENING RT W/CAD $146.00 $292.00 $74.72–$451.43 — 50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP RT 2V $142.50 $285.00 $21.64–$285.00 32% below 50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 LHI XR SHOULDER COMP RT 2V $142.50 $285.00 $21.64–$285.00 32% below 50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP LT 3V $142.50 $285.00 $21.64–$285.00 32% below 50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 LHI XR SHOULDER COMP LT 2V $142.50 $285.00 $21.64–$285.00 32% below 50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP LT 2V $142.50 $285.00 $21.64–$285.00 32% below 50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR SHOULDER COMP RT 3V $142.50 $285.00 $21.64–$285.00 32% below 50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 LHI XR SHOULDER COMP LT 2V $142.50 $285.00 $21.64–$285.00 — 50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COMP LT 3V $142.50 $285.00 $21.64–$285.00 — 50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COMP RT 2V $142.50 $285.00 $21.64–$285.00 — 50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COMP LT 2V $142.50 $285.00 $21.64–$285.00 — 50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 LHI XR SHOULDER COMP RT 2V $142.50 $285.00 $21.64–$285.00 — 50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER COMP RT 3V $142.50 $285.00 $21.64–$285.00 — 50%
Sinus X-ray, complete, 3 or more views CPT 70220 LHI XR SINUSES COMP 3VIEWS $112.50 $225.00 $22.10 45% below 50%
Sinus X-ray, complete, 3 or more views CPT 70220 XR SINUSES COMP 3VIEWS $112.50 $225.00 $22.10 45% below 50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 LHI XR SINUSES COMP 3VIEWS $112.50 $225.00 $22.10 — 50%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUSES COMP 3VIEWS $112.50 $225.00 $22.10 — 50%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY PSG DIAGNOSTIC ONLY $1,250.00 $2,500.00 $413.57–$1,932.50 55% below 50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY PSG DIAGNOSTIC ONLY $1,250.00 $2,500.00 $413.57–$1,932.50 — 50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2V LT $112.50 $225.00 $21.83–$110.70 42% below 50%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 XR FEMUR 2V RT $112.50 $225.00 $21.83–$110.70 42% below 50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2V LT $112.50 $225.00 $21.83–$110.70 — 50%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR 2V RT $112.50 $225.00 $21.83–$110.70 — 50%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT T-SPINE W/O CONTRAST $390.00 $780.00 $71.90–$213.60 62% below 50%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT T-SPINE W/O CONTRAST $390.00 $780.00 $71.90–$213.60 — 50%
Toe X-ray, 2 or more views one side CPT 73660 XR FOOT GREAT TOE 2+ VIEWS LT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE RIGHT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR FOOT 5TH TOE 2+ VIEWS LT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR FOOT 4TH TOE 2+ VIEWS LT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR FOOT 4TH TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR FOOT GREAT TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR FOOT 5TH TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views one side CPT 73660 XR TOE LEFT $112.50 $225.00 $18.33–$19.14 32% below 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT GREAT TOE 2+ VIEWS LT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT GREAT TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT 5TH TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT 4TH TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT 4TH TOE 2+ VIEWS LT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE 2+ VIEWS RT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR FOOT 5TH TOE 2+ VIEWS LT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE RIGHT $112.50 $225.00 $18.33–$19.14 — 50%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE LEFT $112.50 $225.00 $18.33–$19.14 — 50%
Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL PELVIS $236.00 $472.00 $68.76–$101.15 41% below 50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL PELVIS $236.00 $472.00 $68.76–$101.15 — 50%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN COMPLETE $236.00 $472.00 $62.56–$171.00 55% below 50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN COMPLETE $236.00 $472.00 $62.56–$171.00 — 50%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM/TESTICLE $236.00 $472.00 $56.35–$166.00 34% below 50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM/TESTICLE $236.00 $472.00 $56.35–$166.00 — 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US THYROID $236.00 $472.00 $66.88–$364.86 42% below 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US SOFT TISSUE NECK $236.00 $472.00 $66.88–$364.86 42% below 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID $236.00 $472.00 $66.88–$364.86 — 50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK $236.00 $472.00 $66.88–$364.86 — 50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS MIN 2 VIEWS RT $112.50 $225.00 $20.25–$82.57 36% below 50%
Upper arm X-ray (humerus), 2 views one side CPT 73060 XR HUMERUS MIN 2 VIEWS LT $112.50 $225.00 $20.25–$82.57 36% below 50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS MIN 2 VIEWS RT $112.50 $225.00 $20.25–$82.57 — 50%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS MIN 2 VIEWS LT $112.50 $225.00 $20.25–$82.57 — 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOP LT UP/LOW EXT $236.00 $472.00 $93.30–$249.00 50% below 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VEN DOP RT UP/LOW EXT $236.00 $472.00 $93.30–$249.00 50% below 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOP LT UP/LOW EXT $236.00 $472.00 $93.30–$249.00 — 50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VEN DOP RT UP/LOW EXT $236.00 $472.00 $93.30–$249.00 — 50%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS LT $112.50 $225.00 $20.75–$225.00 31% below 50%
Wrist X-ray, 2 views one side CPT 73100 XR WRIST 2 VIEWS RT $112.50 $225.00 $20.75–$225.00 31% below 50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS LT $112.50 $225.00 $20.75–$225.00 — 50%
Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RT $112.50 $225.00 $20.75–$225.00 — 50%
Wrist X-ray, complete, 3 or more views CPT 73110 LHI XR WRIST COMP MIN 3 VIEWS $112.50 $225.00 $27.47–$110.70 38% below 50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR NAVICULAR MIN 3 VIEWS RT $112.50 $225.00 $27.47–$110.70 38% below 50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP MIN 3 VIEWS RT $112.50 $225.00 $27.47–$110.70 38% below 50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR NAVICULAR MIN 3 VIEWS LT $112.50 $225.00 $27.47–$110.70 38% below 50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR WRIST COMP MIN 3 VIEWS LT $112.50 $225.00 $27.47–$110.70 38% below 50%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 LHI XR WRIST COMP MIN 3 VIEWS $112.50 $225.00 $27.47–$110.70 — 50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP MIN 3 VIEWS LT $112.50 $225.00 $27.47–$110.70 — 50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR NAVICULAR MIN 3 VIEWS RT $112.50 $225.00 $27.47–$110.70 — 50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR NAVICULAR MIN 3 VIEWS LT $112.50 $225.00 $27.47–$110.70 — 50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST COMP MIN 3 VIEWS RT $112.50 $225.00 $27.47–$110.70 — 50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2 VIEWS RT $112.50 $225.00 $29.93–$176.10 41% below 50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP 2 VIEWS LT $112.50 $225.00 $29.93–$176.10 41% below 50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2 VIEWS RT $112.50 $225.00 $29.93–$176.10 — 50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2 VIEWS LT $112.50 $225.00 $29.93–$176.10 — 50%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW $112.50 $225.00 $17.25–$82.58 34% below 50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW $112.50 $225.00 $17.25–$82.58 — 50%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1-2 VIEWS LT $142.50 $285.00 $20.53–$83.75 19% below 50%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1-2 VIEWS RT $142.50 $285.00 $20.53–$83.75 19% below 50%
X-ray of the ankle, 2 views one side CPT 73600 LHI XR ANKLE 1-2 VIEWS RT $142.50 $285.00 $20.53–$83.75 19% below 50%
X-ray of the ankle, 2 views one side CPT 73600 LHI XR ANKLE 1-2 VIEWS LT $142.50 $285.00 $20.53–$83.75 19% below 50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1-2 VIEWS LT $142.50 $285.00 $20.53–$83.75 — 50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 LHI XR ANKLE 1-2 VIEWS RT $142.50 $285.00 $20.53–$83.75 — 50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 LHI XR ANKLE 1-2 VIEWS LT $142.50 $285.00 $20.53–$83.75 — 50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1-2 VIEWS RT $142.50 $285.00 $20.53–$83.75 — 50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2 VIEWS LT $112.50 $225.00 $25.61–$110.70 31% below 50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER 2V RIGHT $112.50 $225.00 $25.61–$110.70 31% below 50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2 VIEWS LT $112.50 $225.00 $25.61–$110.70 — 50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER 2V RIGHT $112.50 $225.00 $25.61–$110.70 — 50%
X-ray of the foot, 2 views one side CPT 73620 LHI XR FOOT 1-2V LT $112.50 $225.00 $16.98–$147.00 34% below 50%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1-2V RT $112.50 $225.00 $16.98–$147.00 34% below 50%
X-ray of the foot, 2 views one side CPT 73620 LHI XR FOOT 1-2V RT $112.50 $225.00 $16.98–$147.00 34% below 50%
X-ray of the foot, 2 views one side CPT 73620 XR FOOT 1-2V LT $112.50 $225.00 $16.98–$147.00 34% below 50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1-2V RT $112.50 $225.00 $16.98–$147.00 — 50%
X-ray of the foot, 2 views inpatient one side CPT 73620 LHI XR FOOT 1-2V LT $112.50 $225.00 $16.98–$147.00 — 50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 1-2V LT $112.50 $225.00 $16.98–$147.00 — 50%
X-ray of the foot, 2 views inpatient one side CPT 73620 LHI XR FOOT 1-2V RT $112.50 $225.00 $16.98–$147.00 — 50%
X-ray of the foot, complete, 3 or more views CPT 73630 LHI XR FOOT MIN 3 VIEWS $112.50 $225.00 $21.02–$225.00 46% below 50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP RT 3-4V $112.50 $225.00 $21.02–$225.00 46% below 50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR FOOT COMP LT 3-4V $112.50 $225.00 $21.02–$225.00 46% below 50%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 LHI XR FOOT MIN 3 VIEWS $112.50 $225.00 $21.02–$225.00 — 50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP RT 3-4V $112.50 $225.00 $21.02–$225.00 — 50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT COMP LT 3-4V $112.50 $225.00 $21.02–$225.00 — 50%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND 3-4V RT $112.50 $225.00 $23.45–$225.00 47% below 50%
X-ray of the hand, 3 or more views one side CPT 73130 XR HAND MIN 3 VIEWS LT $112.50 $225.00 $23.45–$225.00 47% below 50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3-4V RT $112.50 $225.00 $23.45–$225.00 — 50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND MIN 3 VIEWS LT $112.50 $225.00 $23.45–$225.00 — 50%
X-ray of the knee, 1 or 2 views one side CPT 73560 LHI XR KNEE 1-2V LT $112.50 $225.00 $21.91–$176.10 36% below 50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2V LT $112.50 $225.00 $21.91–$176.10 36% below 50%
X-ray of the knee, 1 or 2 views one side CPT 73560 LHI XR KNEE 1-2V RT $112.50 $225.00 $21.91–$176.10 36% below 50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR KNEE 1-2V RT $112.50 $225.00 $21.91–$176.10 36% below 50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2V RT $112.50 $225.00 $21.91–$176.10 — 50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 LHI XR KNEE 1-2V LT $112.50 $225.00 $21.91–$176.10 — 50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 LHI XR KNEE 1-2V RT $112.50 $225.00 $21.91–$176.10 — 50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2V LT $112.50 $225.00 $21.91–$176.10 — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SP BENDING VWS FLEX/EXT $142.50 $285.00 $23.45–$235.77 33% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LHI XR L-SPINE 2 OR 3 VIEWS $151.00 $302.00 $23.45–$235.77 29% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR L-SPINE 2 OR 3 VIEWS $152.50 $305.00 $23.45–$235.77 28% below 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SP BENDING VWS FLEX/EXT $142.50 $285.00 $23.45–$235.77 — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LHI XR L-SPINE 2 OR 3 VIEWS $151.00 $302.00 $23.45–$235.77 — 50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR L-SPINE 2 OR 3 VIEWS $152.50 $305.00 $23.45–$235.77 — 50%
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE MIN 4 VIEWS $152.50 $305.00 $33.02 50% below 50%
X-ray of the lower back, 4 or more views CPT 72110 LHI XR L-SPINE 4+V $152.50 $305.00 $33.02 50% below 50%
X-ray of the lower back, 4 or more views CPT 72110 XR L-SPINE 4+V $152.50 $305.00 $33.02 50% below 50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE MIN 4 VIEWS $152.50 $305.00 $33.02 — 50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LHI XR L-SPINE 4+V $152.50 $305.00 $33.02 — 50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR L-SPINE 4+V $152.50 $305.00 $33.02 — 50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR T-SPINE 2 VIEWS $152.50 $305.00 $18.87–$212.68 28% below 50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR T-SPINE 2 VIEWS $152.50 $305.00 $18.87–$212.68 — 50%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES 3+VIEWS $112.50 $225.00 $24.69 31% below 50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES 3+VIEWS $112.50 $225.00 $24.69 — 50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C-SPINE 2 OR 3 VIEWS $142.50 $285.00 $23.45–$220.31 30% below 50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 LHI XR C-SPINE 2 OR 3 VIEWS $142.50 $285.00 $23.45–$220.31 30% below 50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C-SPINE 2 OR 3 VIEWS $142.50 $285.00 $23.45–$220.31 — 50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 LHI XR C-SPINE 2 OR 3 VIEWS $142.50 $285.00 $23.45–$220.31 — 50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1 VIEW $152.50 $305.00 $15.90–$305.00 21% below 50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 VIEW $152.50 $305.00 $15.90–$305.00 — 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR SACRUM/COCCYX 2+ VIEWS $112.50 $225.00 $19.68–$20.25 37% below 50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM/COCCYX 2+ VIEWS $112.50 $225.00 $19.68–$20.25 — 50%

Lab tests

ProcedureCash price List priceInsurers payvs OklahomaOff list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE $131.53 $263.05 $38.62–$48.28 1% below 50%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE $131.53 $263.05 $38.62–$48.28 — 50%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT/SGPT $18.03 $36.05 $4.71–$6.63 46% below 50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT $18.03 $36.05 $4.71–$6.63 — 50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL $182.50 $365.00 $42.37–$59.54 at median 50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL $182.50 $365.00 $42.37–$59.54 — 50%
Albumin blood test CPT 82040 ALBUMIN $16.83 $33.65 $4.40–$6.19 45% below 50%
Albumin blood test inpatient CPT 82040 ALBUMIN $16.83 $33.65 $4.40–$6.19 — 50%
Aldosterone blood test CPT 82088 ALDOSTERONE;URINE $148.50 $297.00 $40.75 7% above 50%
Aldosterone blood test CPT 82088 ALDOSTERONE;SERUM $164.00 $328.00 $40.75 18% above 50%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE;URINE $148.50 $297.00 $40.75 — 50%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE;SERUM $164.00 $328.00 $40.75 — 50%
Allergy blood test, specific IgE, per allergen CPT 86003 COCKROACH IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 PENICILLIUM IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ELM IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CURVULARIA IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 HELMINTHROSPORIUM SATIVUM IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 TURKEY IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 PECAN IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ASPERGILLUS FUMIGATUS IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 WALNUT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 SHRIMP IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CLAM IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CODFISH IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE OAK IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 DERMATOPHAGOIDES IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ORANGE IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CASHEW IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 BRAZIL NUT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 HAZELNUT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALMOND IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 PISTACHIO IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CHICKEN IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CASEIN IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 OAT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 TOMATO IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 TUNA IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG YOLK IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 PORK IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 RICE IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 STRAWBERRY IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 POTATO IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 BEEF IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CHOCOLATE IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 GREEN PEA IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 BANANA IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 BARLEY IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 PEACH IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 MILK IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CORN IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 SETOMELANOMA ROSTRATA (M8) IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGEN SINGLE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 SOYBEAN IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 APPLE FRUIT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 GLUTEN ALLERGEN IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 LATEX ALLERGY TEST $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 WHEAT IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 WHITE ASH IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 BERMUDA GRASS IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 KENTUCKY BLUE GRASS IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 JOHNSON GRASS IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAGWEED COMMON IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 MARSHELDER ROUGH IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALTERNARIA TENUIS IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CLADOSPORIUM IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 DUST MITE IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 HOUSE DUST IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 CAT DANDER IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 DOG DANDER IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 EGG WHITE IGE $17.75 $35.50 $4.64 18% below 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALPHA GAL IGE $22.44 $44.88 $4.64–$34.69 4% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN ANTIBODY TEST QUAN $23.00 $46.00 $4.64 6% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST ALLERGEN 1ST QN $207.90 $415.80 $4.64 862% above 50%
Allergy blood test, specific IgE, per allergen CPT 86003 GENERAL OK/KS ALLERGEN PANEL $232.70 $465.40 $4.64 977% above 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAGWEED COMMON IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SETOMELANOMA ROSTRATA (M8) IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGEN SINGLE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 APPLE FRUIT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GLUTEN ALLERGEN IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 LATEX ALLERGY TEST $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHEAT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG WHITE IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SOYBEAN IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CORN IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MILK IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEACH IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BARLEY IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BANANA IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GREEN PEA IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHOCOLATE IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BEEF IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 POTATO IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 STRAWBERRY IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RICE IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PORK IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 EGG YOLK IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TUNA IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TOMATO IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 OAT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASEIN IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHICKEN IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PISTACHIO IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALMOND IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HAZELNUT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BRAZIL NUT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CASHEW IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ORANGE IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DERMATOPHAGOIDES IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE OAK IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CODFISH IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLAM IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 SHRIMP IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WALNUT IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ASPERGILLUS FUMIGATUS IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PECAN IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 TURKEY IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HELMINTHROSPORIUM SATIVUM IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CURVULARIA IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ELM IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PENICILLIUM IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 COCKROACH IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DOG DANDER IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CAT DANDER IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 HOUSE DUST IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 DUST MITE IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CLADOSPORIUM IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALTERNARIA TENUIS IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 MARSHELDER ROUGH IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 JOHNSON GRASS IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 KENTUCKY BLUE GRASS IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BERMUDA GRASS IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 WHITE ASH IGE $17.75 $35.50 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALPHA GAL IGE $22.44 $44.88 $4.64–$34.69 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN ANTIBODY TEST QUAN $23.00 $46.00 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST ALLERGEN 1ST QN $207.90 $415.80 $4.64 — 50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GENERAL OK/KS ALLERGEN PANEL $232.70 $465.40 $4.64 — 50%
Alpha-fetoprotein (AFP) blood test CPT 82105 HCG-AFP $26.50 $53.00 $14.92–$16.50 50% below 50%
Alpha-fetoprotein (AFP) blood test CPT 82105 AFP-ALPHA FETOPROTEIN;SERUM $29.50 $59.00 $14.92–$16.50 45% below 50%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER $80.50 $161.00 $14.92–$16.50 51% above 50%
Alpha-fetoprotein (AFP) blood test CPT 82105 MATERNAL SCREEN 4 (QUAD SCREEN) $158.21 $316.42 $14.92–$16.50 197% above 50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 HCG-AFP $26.50 $53.00 $14.92–$16.50 — 50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 AFP-ALPHA FETOPROTEIN;SERUM $29.50 $59.00 $14.92–$16.50 — 50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA FETOPROTEIN TUMOR MARKER $80.50 $161.00 $14.92–$16.50 — 50%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 MATERNAL SCREEN 4 (QUAD SCREEN) $158.21 $316.42 $14.92–$16.50 — 50%
Ammonia blood test CPT 82140 AMMONIA $46.00 $92.00 $12.96–$14.57 23% below 50%
Ammonia blood test inpatient CPT 82140 AMMONIA $46.00 $92.00 $12.96–$14.57 — 50%
Amylase blood test CPT 82150 AMYLASE;SERUM $22.05 $44.10 $5.76–$20.20 52% below 50%
Amylase blood test CPT 82150 AMYLASE;URINE $22.05 $44.10 $5.76–$20.20 52% below 50%
Amylase blood test CPT 82150 AMYLASE;FLUID $22.50 $45.00 $5.76–$20.20 51% below 50%
Amylase blood test CPT 82150 AMYLASE ISOENZYMES $43.84 $87.68 $5.76–$20.20 5% below 50%
Amylase blood test inpatient CPT 82150 AMYLASE;SERUM $22.05 $44.10 $5.76–$20.20 — 50%
Amylase blood test inpatient CPT 82150 AMYLASE;URINE $22.05 $44.10 $5.76–$20.20 — 50%
Amylase blood test inpatient CPT 82150 AMYLASE;FLUID $22.50 $45.00 $5.76–$20.20 — 50%
Amylase blood test inpatient CPT 82150 AMYLASE ISOENZYMES $43.84 $87.68 $5.76–$20.20 — 50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB $44.50 $89.00 $11.66–$12.70 32% below 50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE AB $44.50 $89.00 $11.66–$12.70 — 50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR AB SCREEN (ANA) $94.50 $189.00 $9.07–$146.10 55% above 50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR AB SCREEN (ANA) $94.50 $189.00 $9.07–$146.10 — 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP RAMP $98.15 $196.30 $29.45–$196.30 13% below 50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP PRO $98.15 $196.30 $29.45–$196.30 13% below 50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP RAMP $98.15 $196.30 $29.45–$196.30 — 50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP PRO $98.15 $196.30 $29.45–$196.30 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CATH TIP $15.71 $31.42 $7.67–$10.78 64% below 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ENVIRONMENTAL $29.50 $59.00 $7.67–$10.78 33% below 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE THROAT $29.50 $59.00 $7.67–$10.78 33% below 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE LOWER RESPIRATORY $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE CSF $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EAR $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE EYE $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE WOUND $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE GENITAL $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC BACTERIAL - NON-HOSPICE $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE BODY FLUID $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE ROUTINE $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE AEROBIC BACTERIAL $64.50 $129.00 $7.67–$10.78 46% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE NOSE $72.50 $145.00 $7.67–$10.78 64% above 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CATH TIP $15.71 $31.42 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ENVIRONMENTAL $29.50 $59.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE THROAT $29.50 $59.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE LOWER RESPIRATORY $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE ROUTINE $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE GENITAL $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC BACTERIAL $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EAR $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE AEROBIC BACTERIAL - NON-HOSPICE $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE CSF $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE EYE $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE WOUND $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE BODY FLUID $64.50 $129.00 $7.67–$10.78 — 50%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE NOSE $72.50 $145.00 $7.67–$10.78 — 50%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL $28.80 $57.60 $7.53–$10.58 37% below 50%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL $28.80 $57.60 $7.53–$10.58 — 50%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL $17.08 $34.15 $4.47–$6.28 55% below 50%
Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL;BODY FLUID $17.20 $34.40 $4.47–$6.28 55% below 50%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL $17.08 $34.15 $4.47–$6.28 — 50%
Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL;BODY FLUID $17.20 $34.40 $4.47–$6.28 — 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURG PATH GROSS AND MICROSCOPIC $117.50 $235.00 $28.85–$238.45 15% below 50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPY $125.00 $250.00 $28.85–$238.45 9% below 50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURG PATH GROSS AND MICROSCOPIC $117.50 $235.00 $28.85–$238.45 — 50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV - SURGICAL PATHOLOGY, GROSS AND MICROSCOPY $125.00 $250.00 $28.85–$238.45 — 50%
Blood culture for bacteria CPT 87040 CULTURE BLD $59.50 $119.00 $9.18–$47.44 18% below 50%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLD $59.50 $119.00 $9.18–$47.44 — 50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE $7.00 $14.00 $7.71–$14.00 33% below 50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE $7.00 $14.00 $7.71–$14.00 — 50%
Blood lead test CPT 83655 LEAD;BLOOD $41.50 $83.00 $10.77–$11.87 10% below 50%
Blood lead test CPT 83655 LEAD;URINE $53.36 $106.72 $10.77–$11.87 15% above 50%
Blood lead test CPT 83655 LEAD QUANTITATIVE;URINE $109.15 $218.30 $10.77–$11.87 136% above 50%
Blood lead test inpatient CPT 83655 LEAD;BLOOD $41.50 $83.00 $10.77–$11.87 — 50%
Blood lead test inpatient CPT 83655 LEAD;URINE $53.36 $106.72 $10.77–$11.87 — 50%
Blood lead test inpatient CPT 83655 LEAD QUANTITATIVE;URINE $109.15 $218.30 $10.77–$11.87 — 50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE $25.60 $51.20 $6.69–$152.26 44% below 50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE;URINE $80.00 $160.00 $6.69–$152.26 76% above 50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE $25.60 $51.20 $6.69–$152.26 — 50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE;URINE $80.00 $160.00 $6.69–$152.26 — 50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BB BLD TYPING ABO $32.00 $64.00 $2.66–$49.47 46% below 50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BB BLD TYPING ABO $32.00 $64.00 $2.66–$49.47 — 50%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN $13.43 $26.85 $3.51 45% below 50%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN $13.43 $26.85 $3.51 — 50%
C-peptide blood test CPT 84681 C-PEPTIDE $71.00 $142.00 $18.51–$20.40 16% below 50%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE $71.00 $142.00 $18.51–$20.40 — 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN $19.00 $38.00 $3.89–$29.37 50% below 50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN $19.00 $38.00 $3.89–$29.37 — 50%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125 IMMUNO TUMOR AG $112.50 $225.00 $18.51 38% above 50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125 IMMUNO TUMOR AG $112.50 $225.00 $18.51 — 50%
Calcium blood test, total CPT 82310 CALCIUM $17.55 $35.10 $5.06–$27.13 52% below 50%
Calcium blood test, total inpatient CPT 82310 CALCIUM $17.55 $35.10 $5.06–$27.13 — 50%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA $66.50 $133.00 $18.58 35% below 50%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA $66.50 $133.00 $18.58 — 50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB $44.00 $88.00 $11.46 24% below 50%
Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA ZOSTER AB IGG $44.00 $88.00 $11.46 24% below 50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB IGG $44.00 $88.00 $11.46 — 50%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA ZOSTER AB $44.00 $88.00 $11.46 — 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS $87.50 $175.00 $31.21–$148.74 9% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA PROBE $119.50 $239.00 $31.21–$148.74 49% above 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS $87.50 $175.00 $31.21–$148.74 — 50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA PROBE $119.50 $239.00 $31.21–$148.74 — 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL $45.60 $91.20 $10.04–$70.50 31% below 50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPOFIT PROFILE $128.00 $256.00 $10.04–$70.50 94% above 50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL $45.60 $91.20 $10.04–$70.50 — 50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPOFIT PROFILE $128.00 $256.00 $10.04–$70.50 — 50%
Complete blood count (CBC) with differential CPT 85025 CBC COMPLETE;AUTOMATED W/DIFFERENTIAL $26.65 $53.30 $5.83–$41.20 41% below 50%
Complete blood count (CBC) with differential CPT 85025 CBC COMPLETE; AUTOMATED W/DIFFERENTIAL $26.65 $53.30 $5.83–$41.20 41% below 50%
Complete blood count (CBC) with differential CPT 85025 CBC COMPLETE W/MANUAL DIFF $26.65 $53.30 $5.83–$41.20 41% below 50%
Complete blood count (CBC) with differential CPT 85025 CBC COMPLETE; AUTOMATED W/DIFFERENTIAL - NON-HOSPICE $27.00 $54.00 $5.83–$41.20 40% below 50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC COMPLETE;AUTOMATED W/DIFFERENTIAL $26.65 $53.30 $5.83–$41.20 — 50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC COMPLETE W/MANUAL DIFF $26.65 $53.30 $5.83–$41.20 — 50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC COMPLETE; AUTOMATED W/DIFFERENTIAL $26.65 $53.30 $5.83–$41.20 — 50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC COMPLETE; AUTOMATED W/DIFFERENTIAL - NON-HOSPICE $27.00 $54.00 $5.83–$41.20 — 50%
Complete blood count (CBC), no differential CPT 85027 CBC COMPLETE; AUTOMATED W/O DIFF $22.18 $44.35 $5.75–$6.47 48% below 50%
Complete blood count (CBC), no differential CPT 85027 CBC COMPLETE; AUTOMATED HGB, HCT, RBC, WBC AND PLATELET COUNT $48.00 $96.00 $5.75–$6.47 13% above 50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC COMPLETE; AUTOMATED W/O DIFF $22.18 $44.35 $5.75–$6.47 — 50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC COMPLETE; AUTOMATED HGB, HCT, RBC, WBC AND PLATELET COUNT $48.00 $96.00 $5.75–$6.47 — 50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL $35.98 $71.95 $7.92–$55.62 48% below 50%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL - NON-HOSPICE $36.00 $72.00 $7.92–$55.62 48% below 50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL $35.98 $71.95 $7.92–$55.62 — 50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL - NON-HOSPICE $36.00 $72.00 $7.92–$55.62 — 50%
Cortisol blood test, total CPT 82533 CORTISOL;SALIVA $55.53 $111.05 $14.50–$20.38 17% below 50%
Cortisol blood test, total CPT 82533 CORTISOL AM $56.00 $112.00 $14.50–$20.38 16% below 50%
Cortisol blood test, total CPT 82533 CORTISOL PM $56.00 $112.00 $14.50–$20.38 16% below 50%
Cortisol blood test, total inpatient CPT 82533 CORTISOL;SALIVA $55.53 $111.05 $14.50–$20.38 — 50%
Cortisol blood test, total inpatient CPT 82533 CORTISOL AM $56.00 $112.00 $14.50–$20.38 — 50%
Cortisol blood test, total inpatient CPT 82533 CORTISOL PM $56.00 $112.00 $14.50–$20.38 — 50%
Creatine kinase (CK) blood test, total CPT 82550 CREATINE KINASE $29.50 $59.00 $4.88–$59.00 21% below 50%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CREATINE KINASE $29.50 $59.00 $4.88–$59.00 — 50%
Creatinine blood test CPT 82565 CREATININE $17.43 $34.85 $4.55 41% below 50%
Creatinine blood test inpatient CPT 82565 CREATININE $17.43 $34.85 $4.55 — 50%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER $59.00 $118.00 $9.05–$101.65 39% below 50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER $59.00 $118.00 $9.05–$101.65 — 50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S $75.50 $151.00 $22.23–$27.79 at median 50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S $75.50 $151.00 $22.23–$27.79 — 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRICYCLICS SCREEN QL $33.67 $67.34 $55.27–$77.68 64% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-ETHANOL METABOLITE (1) SCREEN $36.75 $73.50 $55.27–$77.68 61% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 URINE DRUG SCREEN COC ONLY EMERGENCY FEE $37.50 $75.00 $55.27–$77.68 60% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-BARBITURATES (2/2) SCREEN $38.95 $77.90 $55.27–$77.68 59% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-NORTRIPTYLINE SCREEN $46.10 $92.20 $55.27–$77.68 51% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-COCAINE (1/2) SCREEN $51.55 $103.10 $55.27–$77.68 46% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-DOXEPIN SCREEN $52.73 $105.45 $55.27–$77.68 44% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-AMPHETAMINES (2/2) SCREEN $52.88 $105.75 $55.27–$77.68 44% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-METHADONE (2/2) SCREEN $55.55 $111.10 $55.27–$77.68 41% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-DESIPRAMINE SCREEN $58.55 $117.10 $55.27–$77.68 38% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-IMIPRAMINE SCREEN $58.55 $117.10 $55.27–$77.68 38% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-MEPROBAMATE (2/2) SCREEN $59.95 $119.90 $55.27–$77.68 37% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-AMITRIPTYLINE SCREEN $60.90 $121.80 $55.27–$77.68 36% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-BENZODIAZEPINES (2/2) SCREEN $62.93 $125.85 $55.27–$77.68 34% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ACETAMINOPHEN $65.50 $131.00 $55.27–$77.68 31% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-OPIATES, DRUG & METABOLITE EACH (4/4) SCREEN $66.20 $132.40 $55.27–$77.68 30% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 BLOOD - DRUG SCREEN - INDUSTRIAL $69.90 $139.80 $55.27–$77.68 26% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-HYDROCODONE (1/1) SCREEN $70.25 $140.50 $55.27–$77.68 26% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-COTININE SCREEN $80.58 $161.15 $55.27–$77.68 15% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-HYDROMORPHONE (1/1) SCREEN $87.45 $174.90 $55.27–$77.68 8% below 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-ALKALOIDS SCREEN $102.13 $204.25 $55.27–$77.68 8% above 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ROHYPNOL;URINE $155.35 $310.70 $55.27–$77.68 64% above 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TRAMADOL, QL, SCREEN, URINE $155.35 $310.70 $55.27–$77.68 64% above 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 FENTANYL, QL, SCREEN, URINE $155.35 $310.70 $55.27–$77.68 64% above 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 ROHYPNOL;SERUM $155.35 $310.70 $55.27–$77.68 64% above 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG SCREEN 10 PANEL-COC $198.00 $396.00 $55.27–$77.68 109% above 50%
Drug screen by lab instrument (any number of drug classes) CPT 80307 TL-SCREEN (1/1) $247.40 $494.80 $55.27–$77.68 161% above 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRICYCLICS SCREEN QL $33.67 $67.34 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-ETHANOL METABOLITE (1) SCREEN $36.75 $73.50 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 URINE DRUG SCREEN COC ONLY EMERGENCY FEE $37.50 $75.00 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-BARBITURATES (2/2) SCREEN $38.95 $77.90 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-NORTRIPTYLINE SCREEN $46.10 $92.20 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-COCAINE (1/2) SCREEN $51.55 $103.10 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-DOXEPIN SCREEN $52.73 $105.45 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-AMPHETAMINES (2/2) SCREEN $52.88 $105.75 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-METHADONE (2/2) SCREEN $55.55 $111.10 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-IMIPRAMINE SCREEN $58.55 $117.10 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-DESIPRAMINE SCREEN $58.55 $117.10 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-MEPROBAMATE (2/2) SCREEN $59.95 $119.90 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-AMITRIPTYLINE SCREEN $60.90 $121.80 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-BENZODIAZEPINES (2/2) SCREEN $62.93 $125.85 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ACETAMINOPHEN $65.50 $131.00 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-OPIATES, DRUG & METABOLITE EACH (4/4) SCREEN $66.20 $132.40 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 BLOOD - DRUG SCREEN - INDUSTRIAL $69.90 $139.80 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-HYDROCODONE (1/1) SCREEN $70.25 $140.50 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-COTININE SCREEN $80.58 $161.15 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-HYDROMORPHONE (1/1) SCREEN $87.45 $174.90 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-ALKALOIDS SCREEN $102.13 $204.25 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ROHYPNOL;SERUM $155.35 $310.70 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 FENTANYL, QL, SCREEN, URINE $155.35 $310.70 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TRAMADOL, QL, SCREEN, URINE $155.35 $310.70 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ROHYPNOL;URINE $155.35 $310.70 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN 10 PANEL-COC $198.00 $396.00 $55.27–$77.68 — 50%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 TL-SCREEN (1/1) $247.40 $494.80 $55.27–$77.68 — 50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VCA IGM $106.00 $212.00 $16.14–$18.14 53% above 50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VCA IGG $106.00 $212.00 $16.14–$18.14 53% above 50%
Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR VCA G/M PANEL $106.00 $212.00 $16.14–$18.14 53% above 50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VCA IGG $106.00 $212.00 $16.14–$18.14 — 50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VCA IGM $106.00 $212.00 $16.14–$18.14 — 50%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EPSTEIN-BARR VCA G/M PANEL $106.00 $212.00 $16.14–$18.14 — 50%
Estradiol blood test CPT 82670 ESTRADIOL;FREE $61.38 $122.75 $20.96–$34.93 31% below 50%
Estradiol blood test CPT 82670 ESTRADIOL;SERUM $95.50 $191.00 $20.96–$34.93 7% above 50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL;FREE $61.38 $122.75 $20.96–$34.93 — 50%
Estradiol blood test inpatient CPT 82670 ESTRADIOL;SERUM $95.50 $191.00 $20.96–$34.93 — 50%
FSH (follicle-stimulating hormone) test CPT 83001 FSH $63.50 $127.00 $13.94–$23.23 8% below 50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH $63.50 $127.00 $13.94–$23.23 — 50%
Ferritin blood test (iron stores) CPT 82728 FERRITIN $46.35 $92.70 $10.22–$71.66 28% below 50%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN $46.35 $92.70 $10.22–$71.66 — 50%
Folate (folic acid) blood test CPT 82746 FOLATE $50.08 $100.15 $11.03–$77.42 19% below 50%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE $50.08 $100.15 $11.03–$77.42 — 50%
Free T3 thyroid hormone test CPT 84481 T3 FREE $58.00 $116.00 $12.71–$89.67 35% below 50%
Free T3 thyroid hormone test inpatient CPT 84481 T3 FREE $58.00 $116.00 $12.71–$89.67 — 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE $30.68 $61.35 $6.77–$47.42 50% below 50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 $30.68 $61.35 $6.77–$47.42 50% below 50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE $30.68 $61.35 $6.77–$47.42 — 50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 $30.68 $61.35 $6.77–$47.42 — 50%
Free testosterone test CPT 84402 TESTOSTERONE; FREE $86.63 $173.25 $19.10–$133.92 at median 50%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE $86.63 $173.25 $19.10–$133.92 — 50%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 GGT/GGTP $24.53 $49.05 $6.40–$9.00 50% below 50%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GGT/GGTP $24.53 $49.05 $6.40–$9.00 — 50%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL $203.50 $407.00 $31.24 4% above 50%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL $203.50 $407.00 $31.24 — 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 VIKOR;NEISSERIA GONORRHOEA DETECTION BY DNA OR RNA $97.48 $194.95 $31.21–$148.74 17% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC PROBE $119.50 $239.00 $31.21–$148.74 44% above 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 VIKOR;NEISSERIA GONORRHOEA DETECTION BY DNA OR RNA $97.48 $194.95 $31.21–$148.74 — 50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC PROBE $119.50 $239.00 $31.21–$148.74 — 50%
H. pylori stool antigen test CPT 87338 H PYLORI AG STOOL $13.75 $27.50 $12.79–$14.38 88% below 50%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG STOOL $13.75 $27.50 $12.79–$14.38 — 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1 ANTIGEN W/HIV-1 & 2 AB;SINGLE RESULT $60.00 $120.00 $21.42–$92.76 25% above 50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1 ANTIGEN W/HIV-1 & 2 AB;SINGLE RESULT $60.00 $120.00 $21.42–$92.76 — 50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV;HIGH RISK BY DNA OR RNA $87.50 $175.00 $31.21 at median 50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV;HIGH RISK BY DNA OR RNA $87.50 $175.00 $31.21 — 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C) $33.03 $66.05 $7.28–$51.06 23% below 50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED (A1C) $33.03 $66.05 $7.28–$51.06 — 50%
Hemoglobin blood test CPT 85018 HEMOGLOBIN $20.50 $41.00 $2.11–$41.00 2% above 50%
Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN $20.50 $41.00 $2.11–$41.00 — 50%
Hepatitis B core antibody test (total) CPT 86704 HEP B CORE AB TOTAL $46.00 $92.00 $10.72 6% below 50%
Hepatitis B core antibody test (total) inpatient CPT 86704 HEP B CORE AB TOTAL $46.00 $92.00 $10.72 — 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB $41.50 $83.00 $9.55–$10.74 6% below 50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB $41.50 $83.00 $9.55–$10.74 — 50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SURFACE AG $35.50 $71.00 $9.19–$10.33 15% below 50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE AG $35.50 $71.00 $9.19–$10.33 — 50%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB $49.00 $98.00 $12.69–$98.00 4% below 50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB $49.00 $98.00 $12.69–$98.00 — 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA QUANT W/REFLEX TO GENOTYPING $145.88 $291.75 $38.11–$42.84 34% below 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEP C VIRAL LOAD QUANT $202.50 $405.00 $38.11–$42.84 9% below 50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C PCR $202.50 $405.00 $38.11–$42.84 9% below 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA QUANT W/REFLEX TO GENOTYPING $145.88 $291.75 $38.11–$42.84 — 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C PCR $202.50 $405.00 $38.11–$42.84 — 50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEP C VIRAL LOAD QUANT $202.50 $405.00 $38.11–$42.84 — 50%
Herpes blood test, HSV-1 antibody CPT 86695 T.HERPES SIMPLEX VIRUS IGG TYPE 1 EIA (FOR TORCH) $25.49 $50.98 $11.73 56% below 50%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 $44.88 $89.75 $11.73 23% below 50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 T.HERPES SIMPLEX VIRUS IGG TYPE 1 EIA (FOR TORCH) $25.49 $50.98 $11.73 — 50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 $44.88 $89.75 $11.73 — 50%
Herpes blood test, HSV-2 antibody CPT 86696 T.HERPES SIMPLEX VIRUS IGG TYPE 2 EIA (FOR TORCH) $23.35 $46.70 $17.21 58% below 50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 $65.85 $131.70 $17.21 19% above 50%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 1 & 2 IGG $66.00 $132.00 $17.21 19% above 50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 T.HERPES SIMPLEX VIRUS IGG TYPE 2 EIA (FOR TORCH) $23.35 $46.70 $17.21 — 50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 $65.85 $131.70 $17.21 — 50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 1 & 2 IGG $66.00 $132.00 $17.21 — 50%
Insulin blood test CPT 83525 INSULIN $39.00 $78.00 $8.57–$14.29 17% below 50%
Insulin blood test inpatient CPT 83525 INSULIN $39.00 $78.00 $8.57–$14.29 — 50%
Iron blood test (serum iron) CPT 83540 IRON SERUM $22.03 $44.05 $4.85–$34.05 39% below 50%
Iron blood test (serum iron) inpatient CPT 83540 IRON SERUM $22.03 $44.05 $4.85–$34.05 — 50%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY $29.75 $59.50 $6.56–$45.99 36% below 50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY $29.75 $59.50 $6.56–$45.99 — 50%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL $59.50 $119.00 $7.72–$8.68 15% below 50%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL $59.50 $119.00 $7.72–$8.68 — 50%
LH (luteinizing hormone) test CPT 83002 LH $63.50 $127.00 $13.89–$23.15 13% below 50%
LH (luteinizing hormone) test inpatient CPT 83002 LH $63.50 $127.00 $13.89–$23.15 — 50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID $36.63 $73.25 $10.29–$136.00 24% below 50%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID $68.00 $136.00 $10.29–$136.00 41% above 50%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID $36.63 $73.25 $10.29–$136.00 — 50%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID $68.00 $136.00 $10.29–$136.00 — 50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE $16.00 $32.00 $5.37–$6.04 54% below 50%
Lactate dehydrogenase (LDH) blood test CPT 83615 LDH;BODY FLUID $45.50 $91.00 $5.37–$6.04 30% above 50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE $16.00 $32.00 $5.37–$6.04 — 50%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH;BODY FLUID $45.50 $91.00 $5.37–$6.04 — 50%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE $23.45 $46.90 $6.13–$36.25 56% below 50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE $23.45 $46.90 $6.13–$36.25 — 50%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL $50.00 $100.00 $7.27–$100.00 8% below 50%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL $50.00 $100.00 $7.27–$100.00 — 50%
Magnesium blood test CPT 83735 MAGNESIUM $22.78 $45.55 $5.03–$45.55 33% below 50%
Magnesium blood test CPT 83735 MAGNESIUM URINE $22.78 $45.55 $5.03–$45.55 33% below 50%
Magnesium blood test CPT 83735 RBC MAGNESIUM LEVEL $47.00 $94.00 $5.03–$45.55 37% above 50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM $22.78 $45.55 $5.03–$45.55 — 50%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE $22.78 $45.55 $5.03–$45.55 — 50%
Magnesium blood test inpatient CPT 83735 RBC MAGNESIUM LEVEL $47.00 $94.00 $5.03–$45.55 — 50%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB $50.00 $100.00 $11.46 21% above 50%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB $50.00 $100.00 $11.46 — 50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONONUCLEOSIS (EBV) ANALYZER $17.63 $35.25 $4.61–$5.18 51% below 50%
Mono test (heterophile antibody, Monospot) CPT 86308 MONOTEST SCREEN $51.00 $102.00 $4.61–$5.18 42% above 50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONONUCLEOSIS (EBV) ANALYZER $17.63 $35.25 $4.61–$5.18 — 50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOTEST SCREEN $51.00 $102.00 $4.61–$5.18 — 50%
Mumps immunity blood test CPT 86735 MUMPS IGG (IMMUNITY ) $44.50 $89.00 $11.61 21% below 50%
Mumps immunity blood test CPT 86735 MUMPS IGG/IGM $46.00 $92.00 $11.61 18% below 50%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG (IMMUNITY ) $44.50 $89.00 $11.61 — 50%
Mumps immunity blood test inpatient CPT 86735 MUMPS IGG/IGM $46.00 $92.00 $11.61 — 50%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP SMEAR;CERVICAL OR VAGINAL $66.50 $133.00 $23.67 4% below 50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP SMEAR;CERVICAL OR VAGINAL $66.50 $133.00 $23.67 — 50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT $32.50 $65.00 $5.35–$52.58 at median 50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT $32.50 $65.00 $5.35–$52.58 — 50%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHORUS $16.13 $32.25 $4.22–$5.93 51% below 50%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHORUS $16.13 $32.25 $4.22–$5.93 — 50%
Potassium blood test CPT 84132 POTASSIUM $15.65 $31.30 $4.23–$4.76 52% below 50%
Potassium blood test inpatient CPT 84132 POTASSIUM $15.65 $31.30 $4.23–$4.76 — 50%
Progesterone blood test CPT 84144 PROGESTERONE $71.50 $143.00 $15.65–$26.08 2% below 50%
Progesterone blood test inpatient CPT 84144 PROGESTERONE $71.50 $143.00 $15.65–$26.08 — 50%
Prolactin blood test CPT 84146 PROLACTIN ULTRASENSITIVE 12 YRS OR < $32.97 $65.93 $17.24–$24.23 65% below 50%
Prolactin blood test CPT 84146 PROLACTIN $66.00 $132.00 $17.24–$24.23 30% below 50%
Prolactin blood test inpatient CPT 84146 PROLACTIN ULTRASENSITIVE 12 YRS OR < $32.97 $65.93 $17.24–$24.23 — 50%
Prolactin blood test inpatient CPT 84146 PROLACTIN $66.00 $132.00 $17.24–$24.23 — 50%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME $35.50 $71.00 $3.82–$57.43 9% above 50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME $35.50 $71.00 $3.82–$57.43 — 50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP GRP A AG QL EIA $56.00 $112.00 $14.70–$112.00 15% above 50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP GRP A AG QL EIA $56.00 $112.00 $14.70–$112.00 — 50%
Renin blood test CPT 84244 RENIN ACTIVITY;PLASMA $75.00 $150.00 $21.99 29% below 50%
Renin blood test CPT 84244 RENIN $104.65 $209.29 $21.99 1% below 50%
Renin blood test inpatient CPT 84244 RENIN ACTIVITY;PLASMA $75.00 $150.00 $21.99 — 50%
Renin blood test inpatient CPT 84244 RENIN $104.65 $209.29 $21.99 — 50%
Rh blood typing CPT 86901 BB BLD TYPING RH (D) $16.00 $32.00 $2.66–$24.74 63% below 50%
Rh blood typing inpatient CPT 86901 BB BLD TYPING RH (D) $16.00 $32.00 $2.66–$24.74 — 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGM REPEAT $13.13 $26.25 $12.80 75% below 50%
Rubella antibody test (immunity check) CPT 86762 T.RUBELLA IGM EIA (FOR TORCH) $25.49 $50.98 $12.80 52% below 50%
Rubella antibody test (immunity check) CPT 86762 T.RUBELLA IGG EIA (FOR TORCH) $25.49 $50.98 $12.80 52% below 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGM $29.80 $59.60 $12.80 43% below 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB SCREEN $30.00 $60.00 $12.80 43% below 50%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB IGG $49.50 $99.00 $12.80 6% below 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGM REPEAT $13.13 $26.25 $12.80 — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 T.RUBELLA IGG EIA (FOR TORCH) $25.49 $50.98 $12.80 — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 T.RUBELLA IGM EIA (FOR TORCH) $25.49 $50.98 $12.80 — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGM $29.80 $59.60 $12.80 — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB SCREEN $30.00 $60.00 $12.80 — 50%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB IGG $49.50 $99.00 $12.80 — 50%
Stool ova and parasites exam CPT 87177 PARASITOLOGY-BODY FLUID $45.50 $91.00 $7.92–$91.00 26% below 50%
Stool ova and parasites exam CPT 87177 SMEAR OVA & PARASITES (DRY) $45.50 $91.00 $7.92–$91.00 26% below 50%
Stool ova and parasites exam CPT 87177 OVA & PARASITE $45.50 $91.00 $7.92–$91.00 26% below 50%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE $45.50 $91.00 $7.92–$91.00 — 50%
Stool ova and parasites exam inpatient CPT 87177 SMEAR OVA & PARASITES (DRY) $45.50 $91.00 $7.92–$91.00 — 50%
Stool ova and parasites exam inpatient CPT 87177 PARASITOLOGY-BODY FLUID $45.50 $91.00 $7.92–$91.00 — 50%
Syphilis antibody test (Treponema pallidum) CPT 86780 RPR SYPHILIS SCREEN $45.50 $91.00 $11.78–$70.34 15% above 50%
Syphilis antibody test (Treponema pallidum) CPT 86780 FTA-FLORESENT TREPONELMAL AB ABSORPTION $45.50 $91.00 $11.78–$70.34 15% above 50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-FLORESENT TREPONELMAL AB ABSORPTION $45.50 $91.00 $11.78–$70.34 — 50%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 RPR SYPHILIS SCREEN $45.50 $91.00 $11.78–$70.34 — 50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB GOLD $105.70 $211.40 $55.13–$77.48 38% below 50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD $105.70 $211.40 $55.13–$77.48 — 50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL FEMALE & CHILD <13 YRS $87.93 $175.85 $19.36–$136.05 2% below 50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL $88.00 $176.00 $19.36–$136.05 2% below 50%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL;MALE $88.00 $176.00 $19.36–$136.05 2% below 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL FEMALE & CHILD <13 YRS $87.93 $175.85 $19.36–$136.05 — 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL;MALE $88.00 $176.00 $19.36–$136.05 — 50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL $88.00 $176.00 $19.36–$136.05 — 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB $18.55 $37.09 $10.91–$76.60 69% below 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE (TPO) $49.55 $99.10 $10.91–$76.60 17% below 50%
Thyroid peroxidase (TPO) antibody test CPT 86376 ANTI LKM $110.94 $221.88 $10.91–$76.60 85% above 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB $18.55 $37.09 $10.91–$76.60 — 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE (TPO) $49.55 $99.10 $10.91–$76.60 — 50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 ANTI LKM $110.94 $221.88 $10.91–$76.60 — 50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH $57.23 $114.45 $12.60–$88.47 7% above 50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH $57.23 $114.45 $12.60–$88.47 — 50%
Total IgE blood test CPT 82785 TOTAL IGE $56.08 $112.15 $14.64 8% above 50%
Total IgE blood test CPT 82785 IGE TOTAL $56.50 $113.00 $14.64 9% above 50%
Total IgE blood test inpatient CPT 82785 TOTAL IGE $56.08 $112.15 $14.64 — 50%
Total IgE blood test inpatient CPT 82785 IGE TOTAL $56.50 $113.00 $14.64 — 50%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL (T4 TOTAL) $23.38 $46.75 $6.11–$8.59 46% below 50%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL (T4 TOTAL) $23.38 $46.75 $6.11–$8.59 — 50%
Total triiodothyronine (T3) blood test CPT 84480 TOTAL T3 $48.63 $97.25 $12.61–$17.73 18% below 50%
Total triiodothyronine (T3) blood test inpatient CPT 84480 TOTAL T3 $48.63 $97.25 $12.61–$17.73 — 50%
Transferrin blood test CPT 84466 TRANSFERRIN $44.50 $89.00 $11.48–$12.51 22% below 50%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN $44.50 $89.00 $11.48–$12.51 — 50%
Triglycerides blood test CPT 84478 TRIGLYCERIDES $19.55 $39.10 $5.11–$7.18 43% below 50%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES $19.55 $39.10 $5.11–$7.18 — 50%
Troponin test, quantitative CPT 84484 TROP RAMP $52.50 $105.00 $9.35–$105.00 26% below 50%
Troponin test, quantitative CPT 84484 TROPONIN I QUANTITATIVE $52.50 $105.00 $9.35–$105.00 26% below 50%
Troponin test, quantitative CPT 84484 TROPONIN Q8HR $52.50 $105.00 $9.35–$105.00 26% below 50%
Troponin test, quantitative inpatient CPT 84484 TROPONIN I QUANTITATIVE $52.50 $105.00 $9.35–$105.00 — 50%
Troponin test, quantitative inpatient CPT 84484 TROP RAMP $52.50 $105.00 $9.35–$105.00 — 50%
Troponin test, quantitative inpatient CPT 84484 TROPONIN Q8HR $52.50 $105.00 $9.35–$105.00 — 50%
Uric acid blood test CPT 84550 URIC ACID $15.38 $30.75 $3.39–$23.77 42% below 50%
Uric acid blood test inpatient CPT 84550 URIC ACID $15.38 $30.75 $3.39–$23.77 — 50%
Urinalysis with microscope exam, automated CPT 81001 UA AUTO W/MICRO $7.65 $15.30 $2.38–$12.25 73% below 50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY $7.93 $15.85 $2.38–$12.25 72% below 50%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY - NON-HOSPICE $8.00 $16.00 $2.38–$12.25 72% below 50%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA AUTO W/MICRO $7.65 $15.30 $2.38–$12.25 — 50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY $7.93 $15.85 $2.38–$12.25 — 50%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS; AUTOMATED W/MICROSCOPY - NON-HOSPICE $8.00 $16.00 $2.38–$12.25 — 50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED SPECIFIC GRAVITY W/O MICROSCOPY $5.63 $11.25 $1.69–$11.25 61% below 50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS;AUTOMATED W/O MICROSCOPY $5.63 $11.25 $1.69–$11.25 61% below 50%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS; AUTOMATED W/O MICROSCOPY $7.70 $15.40 $1.69–$11.25 46% below 50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS;AUTOMATED W/O MICROSCOPY $5.63 $11.25 $1.69–$11.25 — 50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED SPECIFIC GRAVITY W/O MICROSCOPY $5.63 $11.25 $1.69–$11.25 — 50%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS; AUTOMATED W/O MICROSCOPY $7.70 $15.40 $1.69–$11.25 — 50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE W/COLONY COUNT $27.50 $55.00 $7.18–$42.52 43% below 50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE W/COLONY COUNT - NON-HOSPICE $27.50 $55.00 $7.18–$42.52 43% below 50%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE W/COLONY COUNT FLEXED $39.00 $78.00 $7.18–$42.52 19% below 50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE W/COLONY COUNT $27.50 $55.00 $7.18–$42.52 — 50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE W/COLONY COUNT - NON-HOSPICE $27.50 $55.00 $7.18–$42.52 — 50%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE W/COLONY COUNT FLEXED $39.00 $78.00 $7.18–$42.52 — 50%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN $18.98 $37.95 $4.34–$7.23 50% below 50%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN $18.98 $37.95 $4.34–$7.23 — 50%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST;VISUAL $21.50 $43.00 $7.66–$43.00 20% below 50%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST;VISUAL $21.50 $43.00 $7.66–$43.00 — 50%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 $51.28 $102.55 $11.31–$79.27 17% below 50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 $51.28 $102.55 $11.31–$79.27 — 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 FRACTIONATED VITAMIN D $54.50 $109.00 $22.20–$156.15 58% below 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D TOTAL $101.00 $202.00 $22.20–$156.15 23% below 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 FRACTIONATED VITAMIN D $54.50 $109.00 $22.20–$156.15 — 50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D TOTAL $101.00 $202.00 $22.20–$156.15 — 50%
Zinc blood test CPT 84630 ZINC $49.00 $98.00 $11.17 15% below 50%
Zinc blood test inpatient CPT 84630 ZINC $49.00 $98.00 $11.17 — 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG-TUMOR MARKER QUANTITATIVE $25.68 $51.35 $13.39–$102.55 58% below 50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANTITATIVE $51.28 $102.55 $13.39–$102.55 16% below 50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG-TUMOR MARKER QUANTITATIVE $25.68 $51.35 $13.39–$102.55 — 50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANTITATIVE $51.28 $102.55 $13.39–$102.55 — 50%

Surgery and procedures

ProcedureCash price List priceInsurers payvs OklahomaOff list
Incision and drainage of a simple or single skin abscess CPT 10060 ER I&D ABSCESS;SIMPLE OR SINGLE $190.00 $380.00 $88.48–$185.99 16% below 50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 ER I&D ABSCESS;SIMPLE OR SINGLE $190.00 $380.00 $88.48–$185.99 — 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ER DRAIN/INJ MAJOR JOINT/BURSA W/O US $275.00 $550.00 $275.17 10% above 50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ER DRAIN/INJ MAJOR JOINT/BURSA W/O US $275.00 $550.00 $275.17 — 50%
Paracentesis with imaging guidance CPT 49083 CT GUIDED ABDOMINAL PARACENTESIS $550.50 $1,101.00 $877.56–$885.49 36% below 50%
Paracentesis with imaging guidance CPT 49083 US GUIDED ABDOMINAL PARACENTESIS $550.50 $1,101.00 $877.56–$885.49 36% below 50%
Paracentesis with imaging guidance inpatient CPT 49083 CT GUIDED ABDOMINAL PARACENTESIS $550.50 $1,101.00 $877.56–$885.49 — 50%
Paracentesis with imaging guidance inpatient CPT 49083 US GUIDED ABDOMINAL PARACENTESIS $550.50 $1,101.00 $877.56–$885.49 — 50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 ER PERMANENT REMOVAL OF NAIL ALL OR PART $425.50 $851.00 $355.79 9% above 50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 ER PERMANENT REMOVAL OF NAIL ALL OR PART $425.50 $851.00 $355.79 — 50%
Short leg splint (calf to foot) CPT 29515 ER APLLICATION SHORT LEG SPLINT $152.50 $305.00 $125.43–$147.09 3% above 50%
Short leg splint (calf to foot) inpatient CPT 29515 ER APLLICATION SHORT LEG SPLINT $152.50 $305.00 $125.43–$147.09 — 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 ER REPAIR SUPERFICIAL WOUND 2.5 CM OR < $190.00 $380.00 $176.95–$337.79 4% below 50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 ER REPAIR SUPERFICIAL WOUND 2.5 CM OR < $190.00 $380.00 $176.95–$337.79 — 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 ER REPAIR SUPERFICIAL WOUND 2.6-7.5 CM $190.00 $380.00 $88.48–$380.00 10% below 50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 ER REPAIR SUPERFICIAL WOUND 2.6-7.5 CM $190.00 $380.00 $88.48–$380.00 — 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER REPAIR SUPERFICIAL WOUND UP 2.5 CM $124.00 $248.00 $176.95–$380.00 46% below 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 ER REPAIR SUPERFICIAL WOUND 2.5 CM OR < $190.00 $380.00 $176.95–$380.00 17% below 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ER REPAIR SUPERFICIAL WOUND UP 2.5 CM $124.00 $248.00 $176.95–$380.00 — 50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 ER REPAIR SUPERFICIAL WOUND 2.5 CM OR < $190.00 $380.00 $176.95–$380.00 — 50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US GUIDED BREAST BIOPSY W/CLIP PLACEMENT $1,052.50 $2,105.00 $1,515.88–$1,516.48 42% below 50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US GUIDED BREAST BIOPSY W/CLIP PLACEMENT $1,052.50 $2,105.00 $1,515.88–$1,516.48 — 50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 ER DEBRIDEMENT OF SUBQ 1ST 20 SQ CM OR < $350.00 $700.00 $350.55 14% below 50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 ER DEBRIDEMENT OF SUBQ 1ST 20 SQ CM OR < $350.00 $700.00 $350.55 — 50%

Doctor visits and therapy

ProcedureCash price List priceInsurers payvs OklahomaOff list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPONENT 1 UNIT $115.00 $230.00 $345.57–$409.20 84% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD -2 UNITS $229.50 $459.00 $345.57–$409.20 68% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 ER TRANSFUSION BLOOD OR BLOOD COMPONENT $334.00 $668.00 $345.57–$409.20 54% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD-3 UNITS $344.00 $688.00 $345.57–$409.20 53% below 50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION SERVICE ONE PER DAY $382.00 $764.00 $345.57–$409.20 47% below 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPONENT 1 UNIT $115.00 $230.00 $345.57–$409.20 — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD -2 UNITS $229.50 $459.00 $345.57–$409.20 — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ER TRANSFUSION BLOOD OR BLOOD COMPONENT $334.00 $668.00 $345.57–$409.20 — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD-3 UNITS $344.00 $688.00 $345.57–$409.20 — 50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SERVICE ONE PER DAY $382.00 $764.00 $345.57–$409.20 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT $210.00 $420.00 $6.64–$355.64 59% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INCENTIVE SPIROMETRY INITIAL $210.00 $420.00 $6.64–$355.64 59% above 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INCENTIVE SPIROMETRY INITIAL $210.00 $420.00 $6.64–$355.64 — 50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT $210.00 $420.00 $6.64–$355.64 — 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 12 LEAD EKG $98.50 $197.00 $5.10–$197.00 23% below 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NM 12 LEAD EKG $98.50 $197.00 $5.10–$197.00 23% below 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 12 LEAD EKG $98.50 $197.00 $5.10–$197.00 — 50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NM 12 LEAD EKG $98.50 $197.00 $5.10–$197.00 — 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER LEVEL 1 $86.00 $172.00 $70.67–$172.00 39% below 50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER LEVEL 1 $86.00 $172.00 $70.67–$172.00 — 50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER LEVEL 2 $140.00 $280.00 $78.41–$280.00 54% below 50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER LEVEL 2 $140.00 $280.00 $78.41–$280.00 — 50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER LEVEL 3 $246.50 $493.00 $242.94–$493.00 51% below 50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER LEVEL 3 $246.50 $493.00 $242.94–$493.00 — 50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER LEVEL 4 $400.00 $800.00 $373.62–$800.00 46% below 50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER LEVEL 4 $400.00 $800.00 $373.62–$800.00 — 50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER LEVEL 5 $586.00 $1,172.00 $511.29–$905.96 49% below 50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER LEVEL 5 $586.00 $1,172.00 $511.29–$905.96 — 50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ER INITIAL HYDRATION IV INFUSION 31 MIN TO 1 HOUR $215.00 $430.00 $170.62–$430.00 25% above 50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 OP INITIAL HYDRATION IV INFUSION >30 MIN TO 1 HOUR $215.00 $430.00 $170.62–$430.00 25% above 50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ER INITIAL HYDRATION IV INFUSION 31 MIN TO 1 HOUR $215.00 $430.00 $170.62–$430.00 — 50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 OP INITIAL HYDRATION IV INFUSION >30 MIN TO 1 HOUR $215.00 $430.00 $170.62–$430.00 — 50%
IV infusion of a medicine, first hour CPT 96365 OP INITIAL TX/DX IV INFUSION UP TO 1 HR $103.50 $207.00 $184.86–$368.71 56% below 50%
IV infusion of a medicine, first hour CPT 96365 ER THERAPEUTIC, PROPHYLACTIC OR DIAGNOSTIC IV INFUSION 1ST HOUR $195.50 $391.00 $184.86–$368.71 16% below 50%
IV infusion of a medicine, first hour CPT 96365 ER INITIAL TX/DX IV INFUSION 1ST HOUR $215.00 $430.00 $184.86–$368.71 8% below 50%
IV infusion of a medicine, first hour CPT 96365 OP INITIAL TX/DX IV INFUSION 1ST HOUR $215.00 $430.00 $184.86–$368.71 8% below 50%
IV infusion of a medicine, first hour inpatient CPT 96365 OP INITIAL TX/DX IV INFUSION UP TO 1 HR $103.50 $207.00 $184.86–$368.71 — 50%
IV infusion of a medicine, first hour inpatient CPT 96365 ER THERAPEUTIC, PROPHYLACTIC OR DIAGNOSTIC IV INFUSION 1ST HOUR $195.50 $391.00 $184.86–$368.71 — 50%
IV infusion of a medicine, first hour inpatient CPT 96365 ER INITIAL TX/DX IV INFUSION 1ST HOUR $215.00 $430.00 $184.86–$368.71 — 50%
IV infusion of a medicine, first hour inpatient CPT 96365 OP INITIAL TX/DX IV INFUSION 1ST HOUR $215.00 $430.00 $184.86–$368.71 — 50%
IV push of a medicine, first drug CPT 96374 ER IVP SINGLE OR INITIAL DRUG 1 PER DAY $122.00 $244.00 $170.62–$430.00 17% below 50%
IV push of a medicine, first drug CPT 96374 OP IVP SINGLE OR INITIAL DRUG 1 PER DAY $122.00 $244.00 $170.62–$430.00 17% below 50%
IV push of a medicine, first drug CPT 96374 OP IVP INITIAL PUSH $215.00 $430.00 $170.62–$430.00 46% above 50%
IV push of a medicine, first drug CPT 96374 ER IVP INITIAL PUSH $215.00 $430.00 $170.62–$430.00 46% above 50%
IV push of a medicine, first drug inpatient CPT 96374 OP IVP SINGLE OR INITIAL DRUG 1 PER DAY $122.00 $244.00 $170.62–$430.00 — 50%
IV push of a medicine, first drug inpatient CPT 96374 ER IVP SINGLE OR INITIAL DRUG 1 PER DAY $122.00 $244.00 $170.62–$430.00 — 50%
IV push of a medicine, first drug inpatient CPT 96374 ER IVP INITIAL PUSH $215.00 $430.00 $170.62–$430.00 — 50%
IV push of a medicine, first drug inpatient CPT 96374 OP IVP INITIAL PUSH $215.00 $430.00 $170.62–$430.00 — 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP THERAPEUTIC, PROPHYLACTIC, DIAGNOSTIC IM/SUBQ INJECTION $55.00 $110.00 $58.46–$156.63 12% below 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER THERAPEUTIC, PROPHYLACTIC OR DIAGNOSTIC IM/SUBQ INJECTION $67.00 $134.00 $58.46–$156.63 7% above 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 OP IM/SUBQ INJECTION $72.50 $145.00 $58.46–$156.63 16% above 50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ER IM/SUBQ INJECTION $72.50 $145.00 $58.46–$156.63 16% above 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP THERAPEUTIC, PROPHYLACTIC, DIAGNOSTIC IM/SUBQ INJECTION $55.00 $110.00 $58.46–$156.63 — 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER THERAPEUTIC, PROPHYLACTIC OR DIAGNOSTIC IM/SUBQ INJECTION $67.00 $134.00 $58.46–$156.63 — 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 OP IM/SUBQ INJECTION $72.50 $145.00 $58.46–$156.63 — 50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ER IM/SUBQ INJECTION $72.50 $145.00 $58.46–$156.63 — 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 SWING BED PT EVALUATION LOW COMPLEXITY 20 MIN $137.00 $274.00 $61.16–$110.25 22% above 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVALUATION INPATIENT LOW COMPLEXITY 20 MIN $137.00 $274.00 $61.16–$110.25 22% above 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 OP PT EVAL LOW COMPLEXITY 20 MIN $137.00 $274.00 $61.16–$110.25 22% above 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVALUATION INPATIENT LOW COMPLEXITY 20 MIN $137.00 $274.00 $61.16–$110.25 — 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 SWING BED PT EVALUATION LOW COMPLEXITY 20 MIN $137.00 $274.00 $61.16–$110.25 — 50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 OP PT EVAL LOW COMPLEXITY 20 MIN $137.00 $274.00 $61.16–$110.25 — 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 SWING BED PT EVALUATION MOD COMPLEXITY 30 MIN $137.00 $274.00 $92.87 4% above 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVALUATION INPATIENT MOD COMPLEXITY 30 MIN $137.00 $274.00 $92.87 4% above 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVALUATION INPATIENT MOD COMPLEXITY 30 MIN $137.00 $274.00 $92.87 — 50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 SWING BED PT EVALUATION MOD COMPLEXITY 30 MIN $137.00 $274.00 $92.87 — 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRC 1 EA 15 MIN $15.00 $30.00 $23.09–$136.00 78% below 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT EXERCISE THERAPEUTIC 15 MIN INPATIENT $67.00 $134.00 $23.09–$136.00 at median 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT CPM CHECK/REAPPLY $67.00 $134.00 $23.09–$136.00 at median 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OP PT THERAPEUTIC EXERCISE 15 MIN $67.00 $134.00 $23.09–$136.00 at median 50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 SWING BED PT THERAPEUTIC EXERCISE 15 MIN $67.00 $134.00 $23.09–$136.00 at median 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRC 1 EA 15 MIN $15.00 $30.00 $23.09–$136.00 — 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT EXERCISE THERAPEUTIC 15 MIN INPATIENT $67.00 $134.00 $23.09–$136.00 — 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 SWING BED PT THERAPEUTIC EXERCISE 15 MIN $67.00 $134.00 $23.09–$136.00 — 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OP PT THERAPEUTIC EXERCISE 15 MIN $67.00 $134.00 $23.09–$136.00 — 50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT CPM CHECK/REAPPLY $67.00 $134.00 $23.09–$136.00 — 50%
Spirometry (breathing test) CPT 94010 SPIROMETRY $30.50 $61.00 $132.64 83% below 50%
Spirometry (breathing test) CPT 94010 SIMPLE SPIROMETRY $78.50 $157.00 $132.64 56% below 50%
Spirometry (breathing test) CPT 94010 SPIROMETRY/PFT SIMPLE $181.50 $363.00 $132.64 1% above 50%
Spirometry (breathing test) CPT 94010 EVALUATION OF WHEEZING PRE/POST ADM $280.00 $560.00 $23.45–$560.00 56% above 50%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY $30.50 $61.00 $132.64 — 50%
Spirometry (breathing test) inpatient CPT 94010 SIMPLE SPIROMETRY $78.50 $157.00 $132.64 — 50%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY/PFT SIMPLE $181.50 $363.00 $132.64 — 50%
Spirometry (breathing test) inpatient CPT 94010 EVALUATION OF WHEEZING PRE/POST ADM $280.00 $560.00 $23.45–$560.00 — 50%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING PRE/POST ADM $266.50 $533.00 $23.45–$560.00 30% below 50%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY/PFT PRE & POST BRONCH $266.50 $533.00 $23.45–$560.00 30% below 50%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY/PFT PRE & POST BRONCH $266.50 $533.00 $23.45–$560.00 — 50%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING PRE/POST ADM $266.50 $533.00 $23.45–$560.00 — 50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 BB THERAPUTIC PHLEBOTOMY $75.00 $150.00 $150.00 38% below 50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 BB THERAPUTIC PHLEBOTOMY $75.00 $150.00 $150.00 — 50%

Vaccines

ProcedureCash price List priceInsurers payvs OklahomaOff list
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone HIGH-DOSE 2025-26 SYR 1 ea, 0.5 mL $56.20 $112.40 $54.46–$96.20 64% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluZONE HIGH-DOSE QUAD 2020-21 1 ea, 0.7 mL $61.64 $123.27 $54.46–$96.20 60% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluZONE HIGH-DOSE QUAD 2021-22 1 ea, 0.7 mL $64.95 $129.90 $54.46–$96.20 58% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluZONE HIGH-DOSE 2018-19 SYR 1 ea, 0.5 mL $69.07 $138.13 $54.46–$96.20 55% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluZONE HIGH-DOSE 2019-20 SYR 0.5 mL, 0.5 mL $69.07 $138.13 $54.46–$96.20 55% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FluZONE HIGH-DOSE QUAD 2022-23 1 ea, 0.7 mL $70.15 $140.30 $54.46–$96.20 55% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone HIGH-DOSE TRIV 2024-25 1 ea, 0.5 mL $70.34 $140.68 $54.46–$96.20 54% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 Fluzone High-Dose Quad 2023-24 1 ea, 0.7 mL $72.40 $144.79 $54.46–$96.20 53% below 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone HIGH-DOSE 2025-26 SYR 1 ea, 0.5 mL $56.20 $112.40 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZONE HIGH-DOSE QUAD 2020-21 1 ea, 0.7 mL $61.64 $123.27 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZONE HIGH-DOSE QUAD 2021-22 1 ea, 0.7 mL $64.95 $129.90 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZONE HIGH-DOSE 2019-20 SYR 0.5 mL, 0.5 mL $69.07 $138.13 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZONE HIGH-DOSE 2018-19 SYR 1 ea, 0.5 mL $69.07 $138.13 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FluZONE HIGH-DOSE QUAD 2022-23 1 ea, 0.7 mL $70.15 $140.30 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone HIGH-DOSE TRIV 2024-25 1 ea, 0.5 mL $70.34 $140.68 $54.46–$96.20 — 50%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 Fluzone High-Dose Quad 2023-24 1 ea, 0.7 mL $72.40 $144.79 $54.46–$96.20 — 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 DIPHTHERIA & TETANUS TOXOIDS INJ SYRINGE $28.43 $56.85 $53.68–$69.44 61% below 50%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 DIPHTHERIA & TETANUS TOXOIDS INJ SYRINGE $28.43 $56.85 $53.68–$69.44 — 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP $79.70 $159.39 $44.04 1% above 50%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP $79.70 $159.39 $44.04 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OP INFLUENZA VACCINE IMMUNIZATION INJ $41.00 $82.00 $63.38–$145.00 31% below 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER INFLUENZA VACCINE IMMUNIZATION INJ $72.50 $145.00 $63.38–$145.00 22% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER PNEUMONIA VACCINE IMMUNIZATION INJ $72.50 $145.00 $63.38–$145.00 22% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OP PNEUMOCOCCAL VACCINE IMMUNIZATION INJ $72.50 $145.00 $63.38–$145.00 22% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER IMMUNIZATION ADMIN ONE $72.50 $145.00 $63.38–$145.00 22% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ER IMMUNIZATION ACTIVE TETANUS $72.50 $145.00 $63.38–$145.00 22% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 OP VACCINE ADMINISTRATION $72.50 $145.00 $63.38–$145.00 22% above 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 OP INFLUENZA VACCINE IMMUNIZATION INJ $41.00 $82.00 $63.38–$145.00 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER IMMUNIZATION ACTIVE TETANUS $72.50 $145.00 $63.38–$145.00 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER IMMUNIZATION ADMIN ONE $72.50 $145.00 $63.38–$145.00 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 OP PNEUMOCOCCAL VACCINE IMMUNIZATION INJ $72.50 $145.00 $63.38–$145.00 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER PNEUMONIA VACCINE IMMUNIZATION INJ $72.50 $145.00 $63.38–$145.00 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ER INFLUENZA VACCINE IMMUNIZATION INJ $72.50 $145.00 $63.38–$145.00 — 50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 OP VACCINE ADMINISTRATION $72.50 $145.00 $63.38–$145.00 — 50%

Source file: https://hospitalpricetransparencyfiles.com/wagoner-hospital-authority/322276246_Wagoner-Hospital-Authority_standardcharges.csv