Hospital

Weeks Medical Center

Weeks Medical Center in Lancaster, NH publishes cash prices for 337 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the New Hampshire median for 263 of 332 procedures and above it for 36. By typical cash price it ranks #5 of 19 New Hampshire hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

173 Middle Street, Lancaster, NH 03584 Collected Sep 27, 2026 Source price file (603) 788-4911

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 301303 · CMS hospital register NPI 1265536718

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 1 action for a hospital named Weeks Medical Center in Lancaster, NH:

Jul 14, 2025 Met requirements

Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Abdominal CT scan without and with contrast CPT 74170 CT ABDOMEN W & WO CONTRAST	$1,698.48	$3,033.00	$1,046.18–$2,519.51	19% below	44%
Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W & WO CONTRAST	$1,698.48	$3,033.00	$1,046.18–$2,519.51	—	44%
Abdominal X-ray, 2 views CPT 74019 RADIOLOGIC EXAM ABD 2 VIEWS	$234.64	$419.00	$178.24–$347.35	10% below	44%
Abdominal X-ray, 2 views inpatient CPT 74019 RADIOLOGIC EXAM ABD 2 VIEWS	$234.64	$419.00	$178.24–$347.35	—	44%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY ANKLE 3 VIEWS	$213.36	$381.00	$67.54–$391.61	19% below	44%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY LEFT ANKLE MIN 3 VIEWS	$246.96	$441.00	$67.54–$391.61	6% below	44%
Ankle X-ray, complete, 3 or more views one side CPT 73610 X-RAY RIGHT ANKLE MIN 3 VIEWS	$246.96	$441.00	$67.54–$391.61	6% below	44%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY ANKLE 3 VIEWS	$213.36	$381.00	$67.54–$391.61	—	44%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY RIGHT ANKLE MIN 3 VIEWS	$246.96	$441.00	$67.54–$391.61	—	44%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 X-RAY LEFT ANKLE MIN 3 VIEWS	$246.96	$441.00	$67.54–$391.61	—	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 WC UPR/L XTR ART 2 LEVELS 3<	$215.04	$384.00	$304.59–$694.52	49% below	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 ANKLE BRACHIAL INDEX	$400.96	$716.00	$304.59–$694.52	5% below	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 WC UPR/L XTR ART 2 LEVELS 3<	$215.04	$384.00	$304.59–$694.52	—	44%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 ANKLE BRACHIAL INDEX	$400.96	$716.00	$304.59–$694.52	—	44%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT LT UPPER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,385.53	at median	44%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 CT RT UPPER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,385.53	at median	44%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT LT UPPER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,385.53	—	44%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200 CT RT UPPER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,385.53	—	44%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND,BREAST UNILAT RIGHT	$422.24	$754.00	$261.26–$734.55	24% below	44%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND BREAST UNILATERAL	$454.16	$811.00	$261.26–$734.55	18% below	44%
Breast ultrasound, complete, one breast one side CPT 76641 ULTRASOUND,BREAST UNILAT LEFT	$484.40	$865.00	$261.26–$734.55	13% below	44%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND,BREAST UNILAT RIGHT	$422.24	$754.00	$261.26–$734.55	—	44%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND BREAST UNILATERAL	$454.16	$811.00	$261.26–$734.55	—	44%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 ULTRASOUND,BREAST UNILAT LEFT	$484.40	$865.00	$261.26–$734.55	—	44%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST, UNILAT,LIMITED,LEFT	$323.68	$578.00	$187.80–$560.50	16% below	44%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST,UNILAT,LIMITED,RIGHT	$323.68	$578.00	$187.80–$560.50	16% below	44%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED	$345.52	$617.00	$187.80–$560.50	11% below	44%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST,UNILAT,LIMITED,RIGHT	$323.68	$578.00	$187.80–$560.50	—	44%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST, UNILAT,LIMITED,LEFT	$323.68	$578.00	$187.80–$560.50	—	44%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED	$345.52	$617.00	$187.80–$560.50	—	44%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 CT ANGIO ABD/PELVIS W WO CONT	$2,213.12	$3,952.00	$1,681.18–$3,276.21	13% below	44%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174 CT ANGIO ABD/PELVIS W WO CONT	$2,213.12	$3,952.00	$1,681.18–$3,276.21	—	44%
CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD W CONTRAST	$1,947.12	$3,477.00	$36.72–$3,407.46	1% below	44%
CT angiography (CTA) of the head inpatient CPT 70496 CT ANGIOGRAPHY HEAD W CONTRAST	$1,947.12	$3,477.00	$36.72–$3,407.46	—	44%
CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK W CONTRAST	$1,947.12	$3,477.00	$36.73–$2,882.43	1% below	44%
CT angiography (CTA) of the neck inpatient CPT 70498 CT ANGIOGRAPHY NECK W CONTRAST	$1,947.12	$3,477.00	$36.73–$2,882.43	—	44%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST WOC & WC	$2,110.64	$3,769.00	$1,060.90–$3,401.02	1% above	44%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST WOC & WC	$2,110.64	$3,769.00	$1,060.90–$3,401.02	—	44%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS WO CONTRAST	$2,484.72	$4,437.00	$1,139.29–$4,306.59	1% above	44%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS WO CONTRAST	$2,484.72	$4,437.00	$1,139.29–$4,306.59	—	44%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W CONTRST	$2,657.20	$4,745.00	$1,644.14–$4,213.56	at median	44%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W CONTRST	$2,657.20	$4,745.00	$1,644.14–$4,213.56	—	44%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD & PELVIS 1+ SECT/REGNS	$2,829.68	$5,053.00	$2,395.96–$3,450.69	6% below	44%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD & PELVIS 1+ SECT/REGNS	$2,829.68	$5,053.00	$2,395.96–$3,450.69	—	44%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W CONTRAST	$1,480.64	$2,644.00	$902.79–$1,816.10	11% below	44%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W CONTRAST	$1,480.64	$2,644.00	$902.79–$1,816.10	—	44%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO/C	$1,308.16	$2,336.00	$1,004.48–$1,635.20	3% below	44%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO/C	$1,308.16	$2,336.00	$1,004.48–$1,635.20	—	44%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$1,308.16	$2,336.00	$809.42–$2,309.59	11% below	44%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO CONTRAST	$1,308.16	$2,336.00	$809.42–$2,309.59	—	44%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO CONTRAST	$1,308.16	$2,336.00	$369.01–$2,336.00	at median	44%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO CONTRAST	$1,308.16	$2,336.00	$369.01–$2,336.00	—	44%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,480.64	$2,644.00	$2,091.68	at median	44%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W CONTRAST	$1,480.64	$2,644.00	$2,091.68	—	44%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W & WO CONTRAST	$1,653.12	$2,952.00	$1,281.22–$2,166.31	11% below	44%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W & WO CONTRAST	$1,653.12	$2,952.00	$1,281.22–$2,166.31	—	44%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE WO CONTRAST	$1,308.16	$2,336.00	$833.95–$1,936.54	3% below	44%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE WO CONTRAST	$1,308.16	$2,336.00	$833.95–$1,936.54	—	44%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT CERVICAL SPINE WO CONTR	$1,308.16	$2,336.00	$464.88–$1,936.54	8% below	44%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTR	$1,308.16	$2,336.00	$464.88–$1,936.54	—	44%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W CONTRAST	$1,480.64	$2,644.00	$1,805.59–$1,870.58	6% below	44%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W CONTRAST	$1,480.64	$2,644.00	$1,805.59–$1,870.58	—	44%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 UD CAROTID DUPLEX SCAN BILAT	$786.80	$1,405.00	$597.69–$1,164.75	—	44%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 UD CAROTID DUPLEX SCAN BILAT	$786.80	$1,405.00	$597.69–$1,164.75	—	44%
Chest X-ray, 2 views CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$211.68	$378.00	$130.98–$335.66	11% below	44%
Chest X-ray, 2 views inpatient CPT 71046 RADIOLOGIC EXAM CHEST 2 VIEWS	$211.68	$378.00	$130.98–$335.66	—	44%
Chest X-ray, single view CPT 71045 RADIOLOGIC EXAM CHEST ONE VIEW	$155.12	$277.00	$95.98–$277.00	24% below	44%
Chest X-ray, single view inpatient CPT 71045 RADIOLOGIC EXAM CHEST ONE VIEW	$155.12	$277.00	$95.98–$277.00	—	44%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XRAY LEFT CLAVICLE COMPLETE	$225.68	$403.00	$139.64–$334.29	9% below	44%
Collarbone (clavicle) X-ray, complete one side CPT 73000 XRAY RIGHT CLAVICLE COMPLETE	$225.68	$403.00	$139.64–$334.29	9% below	44%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XRAY RIGHT CLAVICLE COMPLETE	$225.68	$403.00	$139.64–$334.29	—	44%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XRAY LEFT CLAVICLE COMPLETE	$225.68	$403.00	$139.64–$334.29	—	44%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US RETROPERITONEAL COMPLETE	$458.64	$819.00	$292.38–$791.28	25% below	44%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RETROPERITONEAL COMPLETE	$458.64	$819.00	$292.38–$791.28	—	44%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BONE DENSITY AXIAL SKELETON	$418.88	$748.00	$259.18–$748.00	1% below	44%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BONE DENSITY AXIAL SKELETON	$418.88	$748.00	$259.18–$748.00	—	44%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,983.26	at median	44%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,983.26	—	44%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX W CONTRAST	$1,480.64	$2,644.00	$628.21–$2,244.76	11% below	44%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX W CONTRAST	$1,480.64	$2,644.00	$628.21–$2,244.76	—	44%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DX BILAT INC CAD	$694.96	$1,241.00	$430.01–$1,217.98	—	44%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DX BILAT INC CAD	$694.96	$1,241.00	$430.01–$1,217.98	—	44%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT RT INC CAD	$580.72	$1,037.00	$336.80–$1,026.06	at median	44%
Diagnostic mammogram, one breast one side CPT 77065 MAMMO DX UNILAT LT INC CAD	$580.72	$1,037.00	$336.80–$1,026.06	at median	44%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT RT INC CAD	$580.72	$1,037.00	$336.80–$1,026.06	—	44%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MAMMO DX UNILAT LT INC CAD	$580.72	$1,037.00	$336.80–$1,026.06	—	44%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL	$1,006.88	$1,798.00	$764.87–$1,474.36	—	44%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUPLEX EXT VEINS BILATERAL	$1,006.88	$1,798.00	$764.87–$1,474.36	—	44%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,537.20	$2,745.00	$951.14–$2,745.00	at median	44%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$1,537.20	$2,745.00	$951.14–$2,745.00	—	44%
Elbow X-ray, 2 views one side CPT 73070 X-RAY LEFT ELBOW (2 VIEWS)	$217.84	$389.00	$143.69–$226.32	15% below	44%
Elbow X-ray, 2 views one side CPT 73070 X-RAY RIGHT ELBOW (2 VIEWS)	$217.84	$389.00	$143.69–$226.32	15% below	44%
Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY RIGHT ELBOW (2 VIEWS)	$217.84	$389.00	$143.69–$226.32	—	44%
Elbow X-ray, 2 views inpatient one side CPT 73070 X-RAY LEFT ELBOW (2 VIEWS)	$217.84	$389.00	$143.69–$226.32	—	44%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY LT ELBOW (MIN 3 VIEWS)	$246.96	$441.00	$152.81–$398.83	11% below	44%
Elbow X-ray, complete, 3 or more views one side CPT 73080 X-RAY RT ELBOW (MIN 3 VIEWS)	$246.96	$441.00	$152.81–$398.83	11% below	44%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY LT ELBOW (MIN 3 VIEWS)	$246.96	$441.00	$152.81–$398.83	—	44%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 X-RAY RT ELBOW (MIN 3 VIEWS)	$246.96	$441.00	$152.81–$398.83	—	44%
Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT MID/INNER EAR WO CONT	$1,308.16	$2,336.00	$1,103.71–$1,878.61	6% below	44%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBIT MID/INNER EAR WO CONT	$1,308.16	$2,336.00	$1,103.71–$1,878.61	—	44%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY RIGHT FOREARM (2 VIEWS)	$217.84	$389.00	$134.79–$318.98	11% below	44%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 X-RAY LEFT FOREARM (2 VIEWS)	$217.84	$389.00	$134.79–$318.98	11% below	44%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY RIGHT FOREARM (2 VIEWS)	$217.84	$389.00	$134.79–$318.98	—	44%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 X-RAY LEFT FOREARM (2 VIEWS)	$217.84	$389.00	$134.79–$318.98	—	44%
Hand X-ray, 2 views one side CPT 73120 X-RAY RIGHT HAND (2 VIEWS)	$215.60	$385.00	$244.52–$262.92	18% below	44%
Hand X-ray, 2 views one side CPT 73120 X-RAY LEFT HAND (2 VIEWS)	$215.60	$385.00	$244.52–$262.92	18% below	44%
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY RIGHT HAND (2 VIEWS)	$215.60	$385.00	$244.52–$262.92	—	44%
Hand X-ray, 2 views inpatient one side CPT 73120 X-RAY LEFT HAND (2 VIEWS)	$215.60	$385.00	$244.52–$262.92	—	44%
Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY CALCANEUS 2 VIEWS	$168.56	$301.00	$125.36–$251.16	31% below	44%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY LEFT HEEL (2 VIEWS)	$217.84	$389.00	$125.36–$251.16	11% below	44%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 X-RAY RIGHT HEEL (2 VIEWS)	$217.84	$389.00	$125.36–$251.16	11% below	44%
Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 X-RAY CALCANEUS 2 VIEWS	$168.56	$301.00	$125.36–$251.16	—	44%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X-RAY RIGHT HEEL (2 VIEWS)	$217.84	$389.00	$125.36–$251.16	—	44%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 X-RAY LEFT HEEL (2 VIEWS)	$217.84	$389.00	$125.36–$251.16	—	44%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT RESP EFFT	$355.60	$635.00	$220.03–$563.88	40% below	44%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT RESP EFFT	$355.60	$635.00	$220.03–$563.88	—	44%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY CPAP / BIPAP	$2,446.64	$4,369.00	$1,513.86–$4,369.00	40% below	44%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY CPAP / BIPAP	$2,446.64	$4,369.00	$1,513.86–$4,369.00	—	44%
Knee X-ray, 3 views one side CPT 73562 X-RAY RIGHT KNEE (3 VIEWS)	$346.08	$618.00	$162.01–$548.78	1% above	44%
Knee X-ray, 3 views one side CPT 73562 X-RAY LEFT KNEE (3 VIEWS)	$346.08	$618.00	$162.01–$548.78	1% above	44%
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY RIGHT KNEE (3 VIEWS)	$346.08	$618.00	$162.01–$548.78	—	44%
Knee X-ray, 3 views inpatient one side CPT 73562 X-RAY LEFT KNEE (3 VIEWS)	$346.08	$618.00	$162.01–$548.78	—	44%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY LT KNEE (4 OR MORE VIEW)	$308.56	$551.00	$175.31–$467.80	4% below	44%
Knee X-ray, complete, 4 or more views one side CPT 73564 X-RAY RT KNEE (4 OR MORE VIEW)	$308.56	$551.00	$175.31–$467.80	4% below	44%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY LT KNEE (4 OR MORE VIEW)	$308.56	$551.00	$175.31–$467.80	—	44%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 X-RAY RT KNEE (4 OR MORE VIEW)	$308.56	$551.00	$175.31–$467.80	—	44%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT RT LOWER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,314.23	at median	44%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 CT LT LOWER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,314.23	at median	44%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT LT LOWER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,314.23	—	44%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700 CT RT LOWER EXTR WO CONTRAST	$1,308.16	$2,336.00	$809.42–$1,314.23	—	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US ABDOMEN LMTD SINGLE ORGAN	$424.48	$758.00	$262.65–$674.62	15% below	44%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMEN LMTD SINGLE ORGAN	$424.48	$758.00	$262.65–$674.62	—	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US XTR RT NON-VASCULAR LMTD	$266.00	$475.00	$222.50–$437.88	19% below	44%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 US XTR LT NON-VASCULAR LMTD	$266.00	$475.00	$222.50–$437.88	19% below	44%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US XTR RT NON-VASCULAR LMTD	$266.00	$475.00	$222.50–$437.88	—	44%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 US XTR LT NON-VASCULAR LMTD	$266.00	$475.00	$222.50–$437.88	—	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LDCT FOR LUNG CANCER SCREENING	$636.16	$1,136.00	$393.62–$1,136.00	18% below	44%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LDCT FOR LUNG CANCER SCREENING	$636.16	$1,136.00	$393.62–$1,136.00	—	44%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY RT LOWER LEG (2 VIEWS)	$220.08	$393.00	$89.37–$333.66	18% below	44%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 X-RAY LT LOWER LEG (2 VIEWS)	$220.08	$393.00	$89.37–$333.66	18% below	44%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY RT LOWER LEG (2 VIEWS)	$220.08	$393.00	$89.37–$333.66	—	44%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 X-RAY LT LOWER LEG (2 VIEWS)	$220.08	$393.00	$89.37–$333.66	—	44%
MR angiography (MRA) of the head without contrast CPT 70544 MRA HEAD WO CONTRAST	$1,961.68	$3,503.00	$1,213.79–$2,033.82	at median	44%
MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA HEAD WO CONTRAST	$1,961.68	$3,503.00	$1,213.79–$2,033.82	—	44%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI, BREAST,W/CONT & CAD,BILAT	$2,740.64	$4,894.00	$2,296.30–$4,057.13	—	44%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI, BREAST,W/CONT & CAD,BILAT	$2,740.64	$4,894.00	$2,296.30–$4,057.13	—	44%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI RT LOW EXTR JNT WO CONTR	$2,058.56	$3,676.00	$1,273.73–$3,264.29	at median	44%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI LT LOW EXT JNT WO CONTRAST	$2,058.56	$3,676.00	$1,273.73–$3,264.29	at median	44%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI RT LOW EXTR JNT WO CONTR	$2,058.56	$3,676.00	$1,273.73–$3,264.29	—	44%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI LT LOW EXT JNT WO CONTRAST	$2,058.56	$3,676.00	$1,273.73–$3,264.29	—	44%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI LT LOW EXT JNT W&WO CONTR	$3,478.16	$6,211.00	$3,104.26	6% below	44%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI RT LOW EXT JNT W&WO CONTR	$3,478.16	$6,211.00	$3,104.26	6% below	44%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI LT LOW EXT JNT W&WO CONTR	$3,478.16	$6,211.00	$3,104.26	—	44%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI RT LOW EXT JNT W&WO CONTR	$3,478.16	$6,211.00	$3,104.26	—	44%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$2,470.16	$4,411.00	$1,896.73–$3,664.22	1% above	44%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$2,470.16	$4,411.00	$1,896.73–$3,664.22	—	44%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN W & WO CONTRAST	$3,429.44	$6,124.00	$2,121.97–$5,630.22	4% below	44%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W & WO CONTRAST	$3,429.44	$6,124.00	$2,121.97–$5,630.22	—	44%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$2,280.88	$4,073.00	$1,017.85–$3,502.78	at median	44%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$2,280.88	$4,073.00	$1,017.85–$3,502.78	—	44%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN W & WO CONTRAST	$3,390.24	$6,054.00	$2,097.71–$6,054.00	3% below	44%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W & WO CONTRAST	$3,390.24	$6,054.00	$2,097.71–$6,054.00	—	44%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO CONTRAST	$2,447.76	$4,371.00	$1,383.81–$3,710.98	at median	44%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO CONTRAST	$2,447.76	$4,371.00	$1,383.81–$3,710.98	—	44%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W & WO CONTR	$3,292.24	$5,879.00	$2,721.94–$5,879.00	13% below	44%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W & WO CONTR	$3,292.24	$5,879.00	$2,721.94–$5,879.00	—	44%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,447.76	$4,371.00	$1,380.25–$4,287.18	at median	44%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,447.76	$4,371.00	$1,380.25–$4,287.18	—	44%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERV SPINE W & WO CONTRAST	$3,086.16	$5,511.00	$1,215.60–$4,678.84	11% below	44%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERV SPINE W & WO CONTRAST	$3,086.16	$5,511.00	$1,215.60–$4,678.84	—	44%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,447.76	$4,371.00	$939.77–$3,584.22	at median	44%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,447.76	$4,371.00	$939.77–$3,584.22	—	44%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WO/C&W/C	$3,081.68	$5,503.00	$473.26–$4,038.35	11% below	44%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WO/C&W/C	$3,081.68	$5,503.00	$473.26–$4,038.35	—	44%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$2,494.24	$4,454.00	$1,915.22–$3,041.64	at median	44%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$2,494.24	$4,454.00	$1,915.22–$3,041.64	—	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI U EXTR ANY JNT WO CONTRAST	$1,961.68	$3,503.00	$1,213.79–$3,085.89	at median	44%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI U EXTR ANY JNT WO CONTRAST	$1,961.68	$3,503.00	$1,213.79–$3,085.89	—	44%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$319.20	$570.00	$245.10–$467.40	21% below	44%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS	$319.20	$570.00	$245.10–$467.40	—	44%
Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W CONTRAST	$1,480.64	$2,644.00	$1,124.76–$2,244.76	1% below	44%
Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W CONTRAST	$1,480.64	$2,644.00	$1,124.76–$2,244.76	—	44%
Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK WO/C	$1,308.16	$2,336.00	$1,331.52	1% below	44%
Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK WO/C	$1,308.16	$2,336.00	$1,331.52	—	44%
Neck soft tissue X-ray CPT 70360 X-RAY NECK SOFT TISSUE	$215.60	$385.00	$117.01–$269.50	1% below	44%
Neck soft tissue X-ray inpatient CPT 70360 X-RAY NECK SOFT TISSUE	$215.60	$385.00	$117.01–$269.50	—	44%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERFUSION MLT STUDY	$2,868.32	$5,122.00	$1,774.77–$4,246.14	2% above	44%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERFUSION MLT STUDY	$2,868.32	$5,122.00	$1,774.77–$4,246.14	—	44%
Pelvic CT scan without contrast CPT 72192 CT PELVIS WO CONTRAST	$1,308.16	$2,336.00	$1,153.98–$1,940.52	6% below	44%
Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS WO CONTRAST	$1,308.16	$2,336.00	$1,153.98–$1,940.52	—	44%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED NON OB	$318.64	$569.00	$197.16–$286.78	11% below	44%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED NON OB	$318.64	$569.00	$197.16–$286.78	—	44%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIC (NON-OB) COMPLETE	$454.16	$811.00	$281.01–$665.02	14% below	44%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC (NON-OB) COMPLETE	$454.16	$811.00	$281.01–$665.02	—	44%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SINGLE FETUS	$551.04	$984.00	$572.50	10% below	44%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SINGLE FETUS	$551.04	$984.00	$572.50	—	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$441.84	$789.00	$198.83–$755.80	25% below	44%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$441.84	$789.00	$198.83–$755.80	—	44%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY LEFT RIBS (2 VIEWS)	$238.56	$426.00	$147.61–$393.52	at median	44%
Rib X-ray, one side, 2 views one side CPT 71100 X-RAY RIGHT RIBS (2 VIEWS)	$238.56	$426.00	$147.61–$393.52	at median	44%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY LEFT RIBS (2 VIEWS)	$238.56	$426.00	$147.61–$393.52	—	44%
Rib X-ray, one side, 2 views inpatient one side CPT 71100 X-RAY RIGHT RIBS (2 VIEWS)	$238.56	$426.00	$147.61–$393.52	—	44%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN BILAT INC CAD	$575.12	$1,027.00	$90.75–$1,027.00	—	44%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT RT INC CAD	$470.96	$841.00	$90.75–$1,027.00	1% below	44%
Screening mammogram, both breasts one side CPT 77067 MAMMO SCREEN UNILAT LT INC CAD	$470.96	$841.00	$90.75–$1,027.00	1% below	44%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN BILAT INC CAD	$575.12	$1,027.00	$90.75–$1,027.00	—	44%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT LT INC CAD	$470.96	$841.00	$90.75–$1,027.00	—	44%
Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO SCREEN UNILAT RT INC CAD	$470.96	$841.00	$90.75–$1,027.00	—	44%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XRAY RT SHOULDER (MIN 2 VIEWS)	$231.28	$413.00	$143.10–$387.00	11% below	44%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 X-RAY LT SHOULDER (MIN 2 VIEW)	$231.28	$413.00	$143.10–$387.00	11% below	44%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XRAY RT SHOULDER (MIN 2 VIEWS)	$231.28	$413.00	$143.10–$387.00	—	44%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 X-RAY LT SHOULDER (MIN 2 VIEW)	$231.28	$413.00	$143.10–$387.00	—	44%
Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY SINUSES (MIN 3 VIEWS)	$268.80	$480.00	$240.00	20% below	44%
Sinus X-ray, complete, 3 or more views inpatient CPT 70220 X-RAY SINUSES (MIN 3 VIEWS)	$268.80	$480.00	$240.00	—	44%
Skull X-ray, fewer than 4 views CPT 70250 X-RAY SKULL ( <4 VIEWS)	$258.16	$461.00	$264.36	at median	44%
Skull X-ray, fewer than 4 views inpatient CPT 70250 X-RAY SKULL ( <4 VIEWS)	$258.16	$461.00	$264.36	—	44%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 > W TECH	$1,882.16	$3,361.00	$1,955.45–$2,756.02	36% below	44%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 > W TECH	$1,882.16	$3,361.00	$1,955.45–$2,756.02	—	44%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY RIGHT FEMUR MIN 2 VIEWS	$253.68	$453.00	$192.71–$382.93	11% below	44%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 X-RAY LEFT FEMUR MIN 2 VIEWS	$253.68	$453.00	$192.71–$382.93	11% below	44%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY LEFT FEMUR MIN 2 VIEWS	$253.68	$453.00	$192.71–$382.93	—	44%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 X-RAY RIGHT FEMUR MIN 2 VIEWS	$253.68	$453.00	$192.71–$382.93	—	44%
Thoracic spine (mid back) CT scan without contrast CPT 72128 CT THORACIC SPINE WO CONTR	$1,116.64	$1,994.00	$711.86–$1,954.12	12% below	44%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE WO CONTR	$1,116.64	$1,994.00	$711.86–$1,954.12	—	44%
Toe X-ray, 2 or more views CPT 73660 X-RAY TOE 2 VIEWS	$190.40	$340.00	$36.03–$419.00	11% below	44%
Toe X-ray, 2 or more views one side CPT 73660 XRAY TOE(S) MIN 2 VIEW LT	$234.64	$419.00	$36.03–$419.00	9% above	44%
Toe X-ray, 2 or more views one side CPT 73660 XRAY TOE(S) MIN 2 VIEW RT	$234.64	$419.00	$36.03–$419.00	9% above	44%
Toe X-ray, 2 or more views inpatient CPT 73660 X-RAY TOE 2 VIEWS	$190.40	$340.00	$36.03–$419.00	—	44%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XRAY TOE(S) MIN 2 VIEW RT	$234.64	$419.00	$36.03–$419.00	—	44%
Toe X-ray, 2 or more views inpatient one side CPT 73660 XRAY TOE(S) MIN 2 VIEW LT	$234.64	$419.00	$36.03–$419.00	—	44%
Transvaginal pelvic ultrasound CPT 76830 NON-OB TRANSVAGINAL US	$524.16	$936.00	$324.32–$933.31	at median	44%
Transvaginal pelvic ultrasound inpatient CPT 76830 NON-OB TRANSVAGINAL US	$524.16	$936.00	$324.32–$933.31	—	44%
Transvaginal ultrasound during pregnancy CPT 76817 US OB TRANSVAGINAL	$404.32	$722.00	$250.17–$493.05	7% below	44%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB TRANSVAGINAL	$404.32	$722.00	$250.17–$493.05	—	44%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOMEN COMPLETE	$560.56	$1,001.00	$346.85–$888.89	15% below	44%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOMEN COMPLETE	$560.56	$1,001.00	$346.85–$888.89	—	44%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM AND CONTENTS	$411.60	$735.00	$316.05–$735.00	20% below	44%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM AND CONTENTS	$411.60	$735.00	$316.05–$735.00	—	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$479.92	$857.00	$296.95–$857.00	5% below	44%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$479.92	$857.00	$296.95–$857.00	—	44%
Upper arm X-ray (humerus), 2 views one side CPT 73060 LEFT HUMERUS MIN 2 VIEWS	$223.44	$399.00	$138.25–$330.77	16% below	44%
Upper arm X-ray (humerus), 2 views one side CPT 73060 RIGHT HUMERUS MIN 2 VIEWS	$223.44	$399.00	$138.25–$330.77	16% below	44%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 RIGHT HUMERUS MIN 2 VIEWS	$223.44	$399.00	$138.25–$330.77	—	44%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 LEFT HUMERUS MIN 2 VIEWS	$223.44	$399.00	$138.25–$330.77	—	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXT VEINS LT LMTD	$827.68	$1,478.00	$512.13–$1,310.54	1% above	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US DUPLEX EXT VEINS RT LMTD	$827.68	$1,478.00	$512.13–$1,310.54	1% above	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXT VEINS RT LMTD	$827.68	$1,478.00	$512.13–$1,310.54	—	44%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US DUPLEX EXT VEINS LT LMTD	$827.68	$1,478.00	$512.13–$1,310.54	—	44%
Wrist X-ray, 2 views one side CPT 73100 X-RAY LEFT WRIST (2 VIEWS)	$226.24	$404.00	$172.36–$328.49	11% below	44%
Wrist X-ray, 2 views one side CPT 73100 X-RAY RIGHT WRIST (2 VIEWS)	$226.24	$404.00	$172.36–$328.49	11% below	44%
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY RIGHT WRIST (2 VIEWS)	$226.24	$404.00	$172.36–$328.49	—	44%
Wrist X-ray, 2 views inpatient one side CPT 73100 X-RAY LEFT WRIST (2 VIEWS)	$226.24	$404.00	$172.36–$328.49	—	44%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XRAY LEFT WRIST (MIN 3 VIEWS)	$223.44	$399.00	$138.25–$391.02	16% below	44%
Wrist X-ray, complete, 3 or more views one side CPT 73110 X-RAY RIGHT WRIST (MIN 3 VIEW)	$223.44	$399.00	$138.25–$391.02	16% below	44%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 X-RAY RIGHT WRIST (MIN 3 VIEW)	$223.44	$399.00	$138.25–$391.02	—	44%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XRAY LEFT WRIST (MIN 3 VIEWS)	$223.44	$399.00	$138.25–$391.02	—	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY LEFT HIP (2-3 VIEWS)	$327.04	$584.00	$45.42–$484.14	1% above	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 X-RAY RIGHT HIP (2-3 VIEWS)	$327.04	$584.00	$45.42–$484.14	1% above	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY RIGHT HIP (2-3 VIEWS)	$327.04	$584.00	$45.42–$484.14	—	44%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 X-RAY LEFT HIP (2-3 VIEWS)	$327.04	$584.00	$45.42–$484.14	—	44%
X-ray of the abdomen, 1 view CPT 74018 RADIOLOGIC EXAM ABD ONE VIEW	$196.56	$351.00	$121.62–$301.86	12% below	44%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADIOLOGIC EXAM ABD ONE VIEW	$196.56	$351.00	$121.62–$301.86	—	44%
X-ray of the ankle, 2 views CPT 73600 X-RAY ANKLE 2 VIEWS	$199.36	$356.00	$135.72–$405.46	13% below	44%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY RIGHT ANKLE (2 VIEWS)	$230.72	$412.00	$135.72–$405.46	1% above	44%
X-ray of the ankle, 2 views one side CPT 73600 X-RAY LEFT ANKLE (2 VIEWS)	$230.72	$412.00	$135.72–$405.46	1% above	44%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY ANKLE 2 VIEWS	$199.36	$356.00	$135.72–$405.46	—	44%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY LEFT ANKLE (2 VIEWS)	$230.72	$412.00	$135.72–$405.46	—	44%
X-ray of the ankle, 2 views inpatient one side CPT 73600 X-RAY RIGHT ANKLE (2 VIEWS)	$230.72	$412.00	$135.72–$405.46	—	44%
X-ray of the finger(s), 2 or more views one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW RT	$207.20	$370.00	$117.01–$370.00	at median	44%
X-ray of the finger(s), 2 or more views one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW LT	$207.20	$370.00	$117.01–$370.00	at median	44%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW RT	$207.20	$370.00	$117.01–$370.00	—	44%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XRAY FINGER(S) MIN 2 VIEW LT	$207.20	$370.00	$117.01–$370.00	—	44%
X-ray of the foot, 2 views CPT 73620 X-RAY FOOT 2 VIEWS	$162.40	$290.00	$221.16–$230.51	29% below	44%
X-ray of the foot, 2 views one side CPT 73620 X-RAY LEFT FOOT (2 VIEWS)	$199.92	$357.00	$221.16–$230.51	12% below	44%
X-ray of the foot, 2 views one side CPT 73620 X-RAY RIGHT FOOT (2 VIEWS)	$199.92	$357.00	$221.16–$230.51	12% below	44%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY FOOT 2 VIEWS	$162.40	$290.00	$221.16–$230.51	—	44%
X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY LEFT FOOT (2 VIEWS)	$199.92	$357.00	$221.16–$230.51	—	44%
X-ray of the foot, 2 views inpatient one side CPT 73620 X-RAY RIGHT FOOT (2 VIEWS)	$199.92	$357.00	$221.16–$230.51	—	44%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY FOOT 3 VIEWS	$206.08	$368.00	$146.40–$444.00	30% below	44%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS	$280.00	$500.00	$146.40–$444.00	5% below	44%
X-ray of the foot, complete, 3 or more views one side CPT 73630 X-RAY LEFT FOOT MIN 3 VIEWS	$280.00	$500.00	$146.40–$444.00	5% below	44%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY FOOT 3 VIEWS	$206.08	$368.00	$146.40–$444.00	—	44%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY RIGHT FOOT MIN 3 VIEWS	$280.00	$500.00	$146.40–$444.00	—	44%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 X-RAY LEFT FOOT MIN 3 VIEWS	$280.00	$500.00	$146.40–$444.00	—	44%
X-ray of the hand, 3 or more views one side CPT 73130 XRAY LEFT HAND (MIN 3 VIEWS)	$250.32	$447.00	$140.77–$384.42	9% below	44%
X-ray of the hand, 3 or more views one side CPT 73130 X-RAY RIGHT HAND MIN 3 VIEWS	$250.32	$447.00	$140.77–$384.42	9% below	44%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 X-RAY RIGHT HAND MIN 3 VIEWS	$250.32	$447.00	$140.77–$384.42	—	44%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XRAY LEFT HAND (MIN 3 VIEWS)	$250.32	$447.00	$140.77–$384.42	—	44%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY LEFT KNEE 1 - 2 VIEWS	$246.96	$441.00	$152.81–$404.74	at median	44%
X-ray of the knee, 1 or 2 views one side CPT 73560 X-RAY RIGHT KNEE 1 - 2 VIEWS	$246.96	$441.00	$152.81–$404.74	at median	44%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY LEFT KNEE 1 - 2 VIEWS	$246.96	$441.00	$152.81–$404.74	—	44%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 X-RAY RIGHT KNEE 1 - 2 VIEWS	$246.96	$441.00	$152.81–$404.74	—	44%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY LOWER SPINE 2-3 VWS	$258.16	$461.00	$38.06–$461.00	11% below	44%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY LOWER SPINE 2-3 VWS	$258.16	$461.00	$38.06–$461.00	—	44%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY LOWER SPINE (MIN 4 VIEW)	$357.84	$639.00	$221.41–$513.88	7% below	44%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY LOWER SPINE (MIN 4 VIEW)	$357.84	$639.00	$221.41–$513.88	—	44%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY THORACIC SPINE (2 VIEWS)	$246.96	$441.00	$172.95–$374.41	13% below	44%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY THORACIC SPINE (2 VIEWS)	$246.96	$441.00	$172.95–$374.41	—	44%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONES COMPLETE MIN3 VWS	$261.52	$467.00	$379.72	7% below	44%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONES COMPLETE MIN3 VWS	$261.52	$467.00	$379.72	—	44%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM SPINE CERV 2-3 VWS	$238.56	$426.00	$147.61–$419.18	13% below	44%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM SPINE CERV 2-3 VWS	$238.56	$426.00	$147.61–$419.18	—	44%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY PELVIS (1 OR 2 VIEWS)	$250.32	$447.00	$143.69–$410.62	2% below	44%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY PELVIS (1 OR 2 VIEWS)	$250.32	$447.00	$143.69–$410.62	—	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY TAILBONE (MIN 2 VIEWS)	$211.68	$378.00	$17.23–$335.17	11% below	44%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY TAILBONE (MIN 2 VIEWS)	$211.68	$378.00	$17.23–$335.17	—	44%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
ACTH blood test CPT 82024 ADRENOCORTICOTROPIC HORMONE	$197.12	$352.00	$35.08–$177.65	20% below	44%
ACTH blood test inpatient CPT 82024 ADRENOCORTICOTROPIC HORMONE	$197.12	$352.00	$35.08–$177.65	—	44%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$17.36	$31.00	$5.24–$31.00	74% below	44%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$17.36	$31.00	$5.24–$31.00	—	44%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$16.80	$30.00	$5.11–$30.00	74% below	44%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$16.80	$30.00	$5.11–$30.00	—	44%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PROFILE	$315.28	$563.00	$43.26–$528.00	7% below	44%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PROFILE	$315.28	$563.00	$43.26–$528.00	—	44%
Albumin blood test CPT 82040 ALBUMIN SERUM	$39.20	$70.00	$30.10–$68.60	18% below	44%
Albumin blood test inpatient CPT 82040 ALBUMIN SERUM	$39.20	$70.00	$30.10–$68.60	—	44%
Aldosterone blood test CPT 82088 ALDOSTERONE	$228.48	$408.00	$37.01–$346.29	4% below	44%
Aldosterone blood test inpatient CPT 82088 ALDOSTERONE	$228.48	$408.00	$37.01–$346.29	—	44%
Alkaline phosphatase (ALP) blood test CPT 84075 ALKALINE PHOSPHATASE	$29.12	$52.00	$42.64	58% below	44%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE	$29.12	$52.00	$42.64	—	44%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN SPEC IGE EA ALLERGEN	$30.24	$54.00	$4.75–$699.84	5% below	44%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN SPEC IGE EA ALLERGEN	$30.24	$54.00	$4.75–$699.84	—	44%
Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM	$53.76	$96.00	$15.24–$96.00	53% below	44%
Alpha-fetoprotein (AFP) blood test CPT 82105 PLACENTAL ALPHA MICROGLOB-1	$314.16	$561.00	$15.24–$96.00	175% above	44%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN SERUM	$53.76	$96.00	$15.24–$96.00	—	44%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 PLACENTAL ALPHA MICROGLOB-1	$314.16	$561.00	$15.24–$96.00	—	44%
Ammonia blood test CPT 82140 AMMONIA	$47.04	$84.00	$13.23–$84.00	46% below	44%
Ammonia blood test inpatient CPT 82140 AMMONIA	$47.04	$84.00	$13.23–$84.00	—	44%
Amylase blood test CPT 82150 AMYLASE	$21.28	$38.00	$5.89–$38.00	69% below	44%
Amylase blood test inpatient CPT 82150 AMYLASE	$21.28	$38.00	$5.89–$38.00	—	44%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$42.00	$75.00	$11.76–$75.00	56% below	44%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATED PEPTIDE	$42.00	$75.00	$11.76–$75.00	—	44%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$39.20	$70.00	$10.98–$70.00	59% below	44%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$39.20	$70.00	$10.98–$70.00	—	44%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP NATRIURETIC PEPTIDE	$126.00	$225.00	$35.66–$225.00	31% below	44%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP NATRIURETIC PEPTIDE	$126.00	$225.00	$35.66–$225.00	—	44%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 BACTERIAL CULTURE OTHR SOURCE	$28.00	$50.00	$7.83–$50.00	70% below	44%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 BACTERIAL CULTURE OTHR SOURCE	$28.00	$50.00	$7.83–$50.00	—	44%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL	$48.16	$86.00	$7.69–$84.76	29% below	44%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL	$48.16	$86.00	$7.69–$84.76	—	44%
Bilirubin blood test, total CPT 82247 TOTAL BILIRUBIN	$16.80	$30.00	$4.78–$30.00	55% below	44%
Bilirubin blood test, total inpatient CPT 82247 TOTAL BILIRUBIN	$16.80	$30.00	$4.78–$30.00	—	44%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL IV SURGICAL PATH	$264.32	$472.00	$18.28–$782.58	1% above	44%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL IV SURGICAL PATH	$264.32	$472.00	$18.28–$782.58	—	44%
Blood culture for bacteria CPT 87040 BLOOD CULTURE	$84.00	$150.00	$9.38–$147.00	36% below	44%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE	$84.00	$150.00	$9.38–$147.00	—	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$14.56	$26.00	$3.34–$26.00	11% below	44%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 DRAWING BLOOD	$14.56	$26.00	$3.34–$26.00	11% below	44%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$14.56	$26.00	$3.34–$26.00	—	44%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DRAWING BLOOD	$14.56	$26.00	$3.34–$26.00	—	44%
Blood glucose (sugar) test CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$12.88	$23.00	$3.57–$170.94	57% below	44%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE QUANTITATIVE BLOOD	$12.88	$23.00	$3.57–$170.94	—	44%
Blood lead test CPT 83655 LEAD	$39.20	$70.00	$11.00–$70.00	46% below	44%
Blood lead test inpatient CPT 83655 LEAD	$39.20	$70.00	$11.00–$70.00	—	44%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUALITATIVE SERUM	$24.64	$44.00	$6.83–$44.00	71% below	44%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUALITATIVE SERUM	$24.64	$44.00	$6.83–$44.00	—	44%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO TYPE AMERICAN RED CROSS	$10.08	$18.00	$2.72–$18.00	79% below	44%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO TYPE AMERICAN RED CROSS	$10.08	$18.00	$2.72–$18.00	—	44%
Blood urea nitrogen (BUN) test CPT 84520 UREA NITROGEN QUAN	$28.00	$50.00	$3.91–$50.00	at median	44%
Blood urea nitrogen (BUN) test inpatient CPT 84520 UREA NITROGEN QUAN	$28.00	$50.00	$3.91–$50.00	—	44%
C-peptide blood test CPT 84681 C-PEPTIDE	$117.04	$209.00	$20.55–$186.78	11% below	44%
C-peptide blood test inpatient CPT 84681 C-PEPTIDE	$117.04	$209.00	$20.55–$186.78	—	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$56.56	$101.00	$4.70–$98.98	14% below	44%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$56.56	$101.00	$4.70–$98.98	—	44%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$119.84	$214.00	$92.02–$100.50	38% below	44%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$119.84	$214.00	$92.02–$100.50	—	44%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY QUANT CA 19-9	$117.04	$209.00	$96.04–$209.00	15% below	44%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY QUANT CA 19-9	$117.04	$209.00	$96.04–$209.00	—	44%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY QUANT CA 125	$117.04	$209.00	$18.90–$209.00	20% below	44%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY QUANT CA 125	$117.04	$209.00	$18.90–$209.00	—	44%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS 19 TESTING- STATE	$64.96	$116.00	$46.60–$149.61	53% below	44%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 CORONAVIRUS 19 TESTING INHOUSE	$103.04	$184.00	$46.60–$149.61	25% below	44%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS CoV2 AMP PROBE, H THRUPUT	$144.48	$258.00	$46.60–$149.61	5% above	44%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS 19 TESTING- STATE	$64.96	$116.00	$46.60–$149.61	—	44%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 CORONAVIRUS 19 TESTING INHOUSE	$103.04	$184.00	$46.60–$149.61	—	44%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS CoV2 AMP PROBE, H THRUPUT	$144.48	$258.00	$46.60–$149.61	—	44%
Calcium blood test, total CPT 82310 CALCIUM TOTAL	$16.80	$30.00	$4.68–$30.00	49% below	44%
Calcium blood test, total inpatient CPT 82310 CALCIUM TOTAL	$16.80	$30.00	$4.68–$30.00	—	44%
Carcinoembryonic antigen (CEA) test CPT 82378 CEA	$107.52	$192.00	$17.22–$169.79	18% below	44%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CEA	$107.52	$192.00	$17.22–$169.79	—	44%
Chickenpox (varicella) immunity blood test CPT 86787 ANTIBODY VARICELLA ZOSTER	$42.00	$75.00	$12.73–$75.00	59% below	44%
Chickenpox (varicella) immunity blood test inpatient CPT 86787 ANTIBODY VARICELLA ZOSTER	$42.00	$75.00	$12.73–$75.00	—	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA T AMPLIF NA PROBE	$146.16	$261.00	$31.87–$261.00	15% below	44%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T AMPLIF NA PROBE	$146.16	$261.00	$31.87–$261.00	—	44%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$122.08	$218.00	$12.16–$213.64	1% above	44%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$122.08	$218.00	$12.16–$213.64	—	44%
Complete blood count (CBC) with differential CPT 85025 CBC-DIFF-PLATELET CO	$39.20	$70.00	$7.06–$70.00	11% below	44%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC-DIFF-PLATELET CO	$39.20	$70.00	$7.06–$70.00	—	44%
Complete blood count (CBC), no differential CPT 85027 CBC W PLT COMPL AUTOM	$40.88	$73.00	$5.88–$73.00	11% below	44%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W PLT COMPL AUTOM	$40.88	$73.00	$5.88–$73.00	—	44%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$85.68	$153.00	$9.59–$150.42	7% below	44%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$85.68	$153.00	$9.59–$150.42	—	44%
Cortisol blood test, total CPT 82533 CORTISOL TOTAL	$91.28	$163.00	$14.81–$145.52	11% below	44%
Cortisol blood test, total inpatient CPT 82533 CORTISOL TOTAL	$91.28	$163.00	$14.81–$145.52	—	44%
Creatine kinase (CK) blood test, total CPT 82550 CPK TOTAL	$36.96	$66.00	$5.91–$60.76	44% below	44%
Creatine kinase (CK) blood test, total inpatient CPT 82550 CPK TOTAL	$36.96	$66.00	$5.91–$60.76	—	44%
Creatinine blood test CPT 82565 CREATININE BLOOD	$16.80	$30.00	$5.06–$30.00	71% below	44%
Creatinine blood test inpatient CPT 82565 CREATININE BLOOD	$16.80	$30.00	$5.06–$30.00	—	44%
Cytomegalovirus (CMV) antibody test CPT 86644 ANTIBODY CYTOMEGALOVIRUS	$80.64	$144.00	$13.07–$118.72	29% below	44%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644 ANTIBODY CYTOMEGALOVIRUS	$80.64	$144.00	$13.07–$118.72	—	44%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER	$33.60	$60.00	$9.25–$60.00	63% below	44%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER	$33.60	$60.00	$9.25–$60.00	—	44%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$72.24	$129.00	$20.19–$129.00	49% below	44%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$72.24	$129.00	$20.19–$129.00	—	44%
Drug screen by lab instrument (any number of drug classes) CPT 80307 DS/T PRESUMP INSTRM ANALYZ	$160.16	$286.00	$56.44–$286.00	12% below	44%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS/T PRESUMP INSTRM ANALYZ	$160.16	$286.00	$56.44–$286.00	—	44%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL	$47.04	$84.00	$6.93–$69.64	10% below	44%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTE PANEL	$47.04	$84.00	$6.93–$69.64	—	44%
Epstein-Barr virus (EBV) antibody test CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS	$58.80	$105.00	$14.11–$105.00	42% below	44%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 ANTIBODY EPSTEIN-BARR VIRUS	$58.80	$105.00	$14.11–$105.00	—	44%
Estradiol blood test CPT 82670 ESTRADIOL	$89.60	$160.00	$27.60–$160.00	43% below	44%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$89.60	$160.00	$27.60–$160.00	—	44%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$105.28	$188.00	$16.87–$188.00	11% below	44%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$105.28	$188.00	$16.87–$188.00	—	44%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$63.28	$113.00	$17.83–$113.00	69% below	44%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$63.28	$113.00	$17.83–$113.00	—	44%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$101.36	$181.00	$12.38–$177.86	at median	44%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$101.36	$181.00	$12.38–$177.86	—	44%
Fibrinogen blood test CPT 85384 FIBRINOGEN	$31.92	$57.00	$8.83–$57.00	45% below	44%
Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN	$31.92	$57.00	$8.83–$57.00	—	44%
Folate (folic acid) blood test CPT 82746 FOLATE	$47.60	$85.00	$13.36–$85.00	44% below	44%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$47.60	$85.00	$13.36–$85.00	—	44%
Free T3 thyroid hormone test CPT 84481 FREE T3	$95.20	$170.00	$15.38–$150.37	36% below	44%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$95.20	$170.00	$15.38–$150.37	—	44%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE THYROXINE	$89.60	$160.00	$8.19–$156.80	6% below	44%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE THYROXINE	$89.60	$160.00	$8.19–$156.80	—	44%
Free testosterone test CPT 84402 TESTOSTERONE FREE	$82.32	$147.00	$23.13–$147.00	41% below	44%
Free testosterone test inpatient CPT 84402 TESTOSTERONE FREE	$82.32	$147.00	$23.13–$147.00	—	44%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 G G T	$42.00	$75.00	$6.54–$65.47	24% below	44%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 G G T	$42.00	$75.00	$6.54–$65.47	—	44%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TOLERANCE TEST	$15.68	$28.00	$4.32–$13.00	63% below	44%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TOLERANCE TEST	$15.68	$28.00	$4.32–$13.00	—	44%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOL TEST SERUM	$42.00	$75.00	$60.32	61% below	44%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOL TEST SERUM	$42.00	$75.00	$60.32	—	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA AMPLIF NA PROBE	$211.68	$378.00	$25.74–$378.00	1% above	44%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA AMPLIF NA PROBE	$211.68	$378.00	$25.74–$378.00	—	44%
H. pylori antibody blood test CPT 86677 ANTIBODY HELIOBACTER PYLORI	$54.32	$97.00	$71.34	70% below	44%
H. pylori antibody blood test inpatient CPT 86677 ANTIBODY HELIOBACTER PYLORI	$54.32	$97.00	$71.34	—	44%
H. pylori stool antigen test CPT 87338 H. PYLORI ANTIGEN - STOOL	$46.48	$83.00	$13.06–$83.00	53% below	44%
H. pylori stool antigen test inpatient CPT 87338 H. PYLORI ANTIGEN - STOOL	$46.48	$83.00	$13.06–$83.00	—	44%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 INFECTIOUS AGENT DET NA PROBE	$273.28	$488.00	$55.51	35% below	44%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 INFECTIOUS AGENT DET NA PROBE	$273.28	$488.00	$55.51	—	44%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV1 AG WITH HIV1 & HIV2 AB	$127.68	$228.00	$21.87–$204.63	1% above	44%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV1 AG WITH HIV1 & HIV2 AB	$127.68	$228.00	$21.87–$204.63	—	44%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HGB A1C	$54.88	$98.00	$8.82–$96.04	11% below	44%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HGB A1C	$54.88	$98.00	$8.82–$96.04	—	44%
Hemoglobin blood test CPT 85018 HGB ONLY	$8.40	$15.00	$2.15–$15.00	62% below	44%
Hemoglobin blood test inpatient CPT 85018 HGB ONLY	$8.40	$15.00	$2.15–$15.00	—	44%
Hepatitis B core antibody test (total) CPT 86704 ANTIBODY HEP B CORE TOTAL	$39.20	$70.00	$10.94–$70.00	45% below	44%
Hepatitis B core antibody test (total) inpatient CPT 86704 ANTIBODY HEP B CORE TOTAL	$39.20	$70.00	$10.94–$70.00	—	44%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B SURFACE ANTIBODY	$35.28	$63.00	$9.75–$63.00	44% below	44%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B SURFACE ANTIBODY	$35.28	$63.00	$9.75–$63.00	—	44%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG EIA	$34.16	$61.00	$9.39–$61.00	54% below	44%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG EIA	$34.16	$61.00	$9.39–$61.00	—	44%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C ANTIBODY	$46.48	$83.00	$12.96–$83.00	69% below	44%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C ANTIBODY	$46.48	$83.00	$12.96–$83.00	—	44%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C NUCLEIC ACID QUANT	$137.76	$246.00	$38.91–$231.00	69% below	44%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$218.40	$390.00	$38.91–$231.00	51% below	44%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C NUCLEIC ACID QUANT	$137.76	$246.00	$38.91–$231.00	—	44%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$218.40	$390.00	$38.91–$231.00	—	44%
Herpes blood test, HSV-1 antibody CPT 86695 ANTIBODY HERPES SIMPLEX TYPE 1	$75.04	$134.00	$11.98–$119.26	21% below	44%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 ANTIBODY HERPES SIMPLEX TYPE 1	$75.04	$134.00	$11.98–$119.26	—	44%
Herpes blood test, HSV-2 antibody CPT 86696 ANTIBODY HERPES SIMPLEX TYPE 2	$108.64	$194.00	$17.58–$172.66	11% below	44%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 ANTIBODY HERPES SIMPLEX TYPE 2	$108.64	$194.00	$17.58–$172.66	—	44%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP HIGH SENSITIVITY	$42.00	$75.00	$32.25–$75.00	56% below	44%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP HIGH SENSITIVITY	$42.00	$75.00	$32.25–$75.00	—	44%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTINE	$57.68	$103.00	$44.29–$103.00	56% below	44%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTINE	$57.68	$103.00	$44.29–$103.00	—	44%
Insulin blood test CPT 83525 INSULIN	$63.84	$114.00	$10.38–$101.88	24% below	44%
Insulin blood test inpatient CPT 83525 INSULIN	$63.84	$114.00	$10.38–$101.88	—	44%
Iron blood test (serum iron) CPT 83540 IRON	$36.96	$66.00	$5.88–$64.68	24% below	44%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$36.96	$66.00	$5.88–$64.68	—	44%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$48.72	$87.00	$7.94–$85.26	5% below	44%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$48.72	$87.00	$7.94–$85.26	—	44%
Kidney function blood test panel CPT 80069 RENAL FUNCTION	$57.68	$103.00	$7.89–$83.75	15% below	44%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION	$57.68	$103.00	$7.89–$83.75	—	44%
LH (luteinizing hormone) test CPT 83002 LH	$59.92	$107.00	$16.82–$107.00	53% below	44%
LH (luteinizing hormone) test inpatient CPT 83002 LH	$59.92	$107.00	$16.82–$107.00	—	44%
Lactate (lactic acid) blood test CPT 83605 LACTIC ACID	$37.52	$67.00	$10.51–$88.65	52% below	44%
Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID	$37.52	$67.00	$10.51–$88.65	—	44%
Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE DEHYDROGENASE	$34.72	$62.00	$5.48–$53.35	31% below	44%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LACTATE DEHYDROGENASE	$34.72	$62.00	$5.48–$53.35	—	44%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$51.52	$92.00	$6.26–$90.16	31% below	44%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$51.52	$92.00	$6.26–$90.16	—	44%
Liver function blood test panel CPT 80076 HFP	$54.32	$97.00	$7.42–$95.54	12% below	44%
Liver function blood test panel inpatient CPT 80076 HFP	$54.32	$97.00	$7.42–$95.54	—	44%
Lyme disease antibody test CPT 86618 ANTIBODY LYME'S DISEASE	$54.88	$98.00	$15.47–$98.00	50% below	44%
Lyme disease antibody test inpatient CPT 86618 ANTIBODY LYME'S DISEASE	$54.88	$98.00	$15.47–$98.00	—	44%
Magnesium blood test CPT 83735 MAGNESIUM	$47.60	$85.00	$6.09–$85.00	8% below	44%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$47.60	$85.00	$6.09–$85.00	—	44%
Measles (rubeola) antibody test CPT 86765 ANTIBODY RUBEOLA	$42.00	$75.00	$12.73–$75.00	54% below	44%
Measles (rubeola) antibody test inpatient CPT 86765 ANTIBODY RUBEOLA	$42.00	$75.00	$12.73–$75.00	—	44%
Mono test (heterophile antibody, Monospot) CPT 86308 AB QUAL HETEROPHILE	$16.80	$30.00	$4.70–$30.00	70% below	44%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 AB QUAL HETEROPHILE	$16.80	$30.00	$4.70–$30.00	—	44%
Mumps immunity blood test CPT 86735 ANTIBODY MUMPS	$42.56	$76.00	$12.89–$76.00	50% below	44%
Mumps immunity blood test inpatient CPT 86735 ANTIBODY MUMPS	$42.56	$76.00	$12.89–$76.00	—	44%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PROSTATIC SPECIFIC ANTIGE	$59.36	$106.00	$45.58–$106.00	34% below	44%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PROSTATIC SPECIFIC ANTIGE	$59.36	$106.00	$45.58–$106.00	—	44%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPEC ANTIGEN TOTAL	$59.36	$106.00	$14.34–$106.00	42% below	44%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPEC ANTIGEN TOTAL	$59.36	$106.00	$14.34–$106.00	—	44%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP THIN	$141.12	$252.00	$24.17–$252.00	18% above	44%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP THIN	$141.12	$252.00	$24.17–$252.00	—	44%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE	$231.28	$413.00	$37.50–$404.74	at median	44%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE	$231.28	$413.00	$37.50–$404.74	—	44%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PLASMA OR WHOLE BLOOD	$20.16	$36.00	$5.46–$36.00	62% below	44%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PLASMA OR WHOLE BLOOD	$20.16	$36.00	$5.46–$36.00	—	44%
Phosphorus (phosphate) blood test CPT 84100 PHOSPHATE	$15.68	$28.00	$4.31–$23.77	75% below	44%
Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHATE	$15.68	$28.00	$4.31–$23.77	—	44%
Potassium blood test CPT 84132 POTASSIUM SERUM	$15.68	$28.00	$4.33–$28.00	67% below	44%
Potassium blood test inpatient CPT 84132 POTASSIUM SERUM	$15.68	$28.00	$4.33–$28.00	—	44%
Progesterone blood test CPT 84144 PROGESTERONE ASSAY	$106.96	$191.00	$92.19–$177.27	22% below	44%
Progesterone blood test inpatient CPT 84144 PROGESTERONE ASSAY	$106.96	$191.00	$92.19–$177.27	—	44%
Prolactin blood test CPT 84146 PROLACTIN	$62.16	$111.00	$17.60–$111.00	56% below	44%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$62.16	$111.00	$17.60–$111.00	—	44%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$35.84	$64.00	$3.90–$58.05	11% below	44%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$35.84	$64.00	$3.90–$58.05	—	44%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST, PRESUMP, DIRECT OBV	$39.20	$70.00	$11.45–$65.80	40% above	44%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST, PRESUMP, DIRECT OBV	$39.20	$70.00	$11.45–$65.80	—	44%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA IA W DO	$71.68	$128.00	$15.04–$102.94	35% below	44%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA IA W DO	$71.68	$128.00	$15.04–$102.94	—	44%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 RAPID STREP A SCREEN	$70.00	$125.00	$11.32–$123.38	10% below	44%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 RAPID STREP A SCREEN	$70.00	$125.00	$11.32–$123.38	—	44%
Renin blood test CPT 84244 RENIN	$123.76	$221.00	$19.97–$186.87	17% below	44%
Renin blood test inpatient CPT 84244 RENIN	$123.76	$221.00	$19.97–$186.87	—	44%
Rh blood typing CPT 86901 RH TYPE AMERICAN RED CROSS	$10.08	$18.00	$2.72–$18.00	80% below	44%
Rh blood typing inpatient CPT 86901 RH TYPE AMERICAN RED CROSS	$10.08	$18.00	$2.72–$18.00	—	44%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$19.04	$34.00	$5.15–$34.00	62% below	44%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$19.04	$34.00	$5.15–$34.00	—	44%
Rubella antibody test (immunity check) CPT 86762 ANTIBODY RUBELLA	$46.48	$83.00	$14.22–$83.00	39% below	44%
Rubella antibody test (immunity check) inpatient CPT 86762 ANTIBODY RUBELLA	$46.48	$83.00	$14.22–$83.00	—	44%
Sodium blood test CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE	$16.24	$29.00	$4.37–$14.64	51% below	44%
Sodium blood test inpatient CPT 84295 SODIUM; SERUM, PLASMA OR WHOLE	$16.24	$29.00	$4.37–$14.64	—	44%
Stool ova and parasites exam CPT 87177 OVA & PARASITES DIR SMR W ID	$28.56	$51.00	$8.09–$51.00	73% below	44%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITES DIR SMR W ID	$28.56	$51.00	$8.09–$51.00	—	44%
Stool test for hidden blood (guaiac FOBT) CPT 82270 STOOL OCCULT BLOOD SCREENING	$14.56	$26.00	$13.39	41% below	44%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 STOOL OCCULT BLOOD SCREENING	$14.56	$26.00	$13.39	—	44%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLD SCREEN FHG QUAL 1-3	$51.52	$92.00	$68.80–$143.12	59% below	44%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD FHG QUAL 1-3	$89.60	$160.00	$68.80–$143.12	29% below	44%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLD SCREEN FHG QUAL 1-3	$51.52	$92.00	$68.80–$143.12	—	44%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD FHG QUAL 1-3	$89.60	$160.00	$68.80–$143.12	—	44%
Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM	$68.32	$122.00	$12.02	39% below	44%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 TREPONEMA PALLIDUM	$68.32	$122.00	$12.02	—	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$14.56	$26.00	$3.87–$26.00	58% below	44%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$14.56	$26.00	$3.87–$26.00	—	44%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$198.80	$355.00	$56.29–$355.00	8% below	44%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$198.80	$355.00	$56.29–$355.00	—	44%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$83.44	$149.00	$2.23–$149.00	42% below	44%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$83.44	$149.00	$2.23–$149.00	—	44%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODIES EACH	$47.04	$84.00	$13.22–$84.00	61% below	44%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODIES EACH	$47.04	$84.00	$13.22–$84.00	—	44%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$110.32	$197.00	$15.26–$197.00	3% below	44%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$110.32	$197.00	$15.26–$197.00	—	44%
Total IgE blood test CPT 82785 IGE	$53.20	$95.00	$14.95–$95.00	45% below	44%
Total IgE blood test inpatient CPT 82785 IGE	$53.20	$95.00	$14.95–$95.00	—	44%
Total cholesterol blood test CPT 82465 CHOLESTEROL SERUM OR WB	$14.56	$26.00	$3.95–$26.00	62% below	44%
Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL SERUM OR WB	$14.56	$26.00	$3.95–$26.00	—	44%
Total thyroxine (T4) blood test CPT 84436 THYROXINE TOTAL	$35.84	$64.00	$6.24–$60.00	44% below	44%
Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE TOTAL	$35.84	$64.00	$6.24–$60.00	—	44%
Total triiodothyronine (T3) blood test CPT 84480 T3 TOTAL	$45.92	$82.00	$12.88–$82.00	57% below	44%
Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 TOTAL	$45.92	$82.00	$12.88–$82.00	—	44%
Transferrin blood test CPT 84466 TRANSFERRIN	$67.76	$121.00	$11.59–$108.43	45% below	44%
Transferrin blood test inpatient CPT 84466 TRANSFERRIN	$67.76	$121.00	$11.59–$108.43	—	44%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$113.12	$202.00	$31.87–$202.00	33% below	44%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$113.12	$202.00	$31.87–$202.00	—	44%
Triglycerides blood test CPT 84478 TRIGLYCERIDES	$19.04	$34.00	$5.22–$34.00	71% below	44%
Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES	$19.04	$34.00	$5.22–$34.00	—	44%
Troponin test, quantitative CPT 84484 TROPONIN QUAN	$107.52	$192.00	$9.72–$192.00	14% below	44%
Troponin test, quantitative inpatient CPT 84484 TROPONIN QUAN	$107.52	$192.00	$9.72–$192.00	—	44%
Uric acid blood test CPT 84550 URIC ACID BLOOD	$15.12	$27.00	$4.11–$27.00	74% below	44%
Uric acid blood test inpatient CPT 84550 URIC ACID BLOOD	$15.12	$27.00	$4.11–$27.00	—	44%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/ SCOPE	$38.64	$69.00	$2.88–$69.00	17% below	44%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/ SCOPE	$38.64	$69.00	$2.88–$69.00	—	44%
Urinalysis without microscope exam, automated CPT 81003 AUTOMATED URINALYSIS WO MICRO	$8.40	$15.00	$2.05–$15.00	67% below	44%
Urinalysis without microscope exam, automated inpatient CPT 81003 AUTOMATED URINALYSIS WO MICRO	$8.40	$15.00	$2.05–$15.00	—	44%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS WO MICRO	$17.92	$32.00	$3.16–$32.00	4% below	44%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS WO MICRO	$17.92	$32.00	$3.16–$32.00	—	44%
Urine culture for bacteria, with colony count CPT 87086 CULTURE URINE	$26.32	$47.00	$7.33–$47.00	68% below	44%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE URINE	$26.32	$47.00	$7.33–$47.00	—	44%
Urine microalbumin (albumin) test CPT 82043 MICROALBUMIN URINE 24	$73.92	$132.00	$5.25–$129.36	11% below	44%
Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN URINE 24	$73.92	$132.00	$5.25–$129.36	—	44%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY VISUAL COLOR	$28.00	$50.00	$7.82–$50.00	21% below	44%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$28.00	$50.00	$6.25–$49.35	21% below	44%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY VISUAL COLOR	$28.00	$50.00	$7.82–$50.00	—	44%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$28.00	$50.00	$6.25–$49.35	—	44%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 LEVEL	$80.08	$143.00	$13.69–$143.00	18% below	44%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 LEVEL	$80.08	$143.00	$13.69–$143.00	—	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$186.48	$333.00	$26.88–$326.34	at median	44%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$186.48	$333.00	$26.88–$326.34	—	44%
Zinc blood test CPT 84630 ZINC	$36.96	$66.00	$10.34–$66.00	58% below	44%
Zinc blood test inpatient CPT 84630 ZINC	$36.96	$66.00	$10.34–$66.00	—	44%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 GONADOTROPIN CHORIONIC QUANT	$48.72	$87.00	$13.67–$87.00	50% below	44%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 GONADOTROPIN CHORIONIC QUANT	$48.72	$87.00	$13.67–$87.00	—	44%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION	$390.32	$697.00	$296.50–$419.59	61% below	44%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION	$390.32	$697.00	$296.50–$419.59	—	44%
Colonoscopy with polyp removal CPT 45385 Colon W/Polyp Snare Technique	$3,978.24	$7,104.00	$1,468.75–$7,104.00	100% above	44%
Colonoscopy with polyp removal inpatient CPT 45385 Colon W/Polyp Snare Technique	$3,978.24	$7,104.00	$1,468.75–$7,104.00	—	44%
Colonoscopy with tissue sample CPT 45380 Colo w/biopsy	$1,852.48	$3,308.00	$1,146.22–$4,418.85	5% above	44%
Colonoscopy with tissue sample inpatient CPT 45380 Colo w/biopsy	$1,852.48	$3,308.00	$1,146.22–$4,418.85	—	44%
Colonoscopy, diagnostic CPT 45378 Colo brushing/washing	$1,385.44	$2,474.00	$123.70–$2,028.68	8% above	44%
Colonoscopy, diagnostic inpatient CPT 45378 Colo brushing/washing	$1,385.44	$2,474.00	$123.70–$2,028.68	—	44%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCP W/INSRT INDWLG	$2,122.96	$3,791.00	$2,521.74–$13,835.19	14% above	44%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCP W/INSRT INDWLG	$2,122.96	$3,791.00	$2,521.74–$13,835.19	—	44%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSOPY	$622.16	$1,111.00	$395.00–$6,026.18	23% below	44%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSOPY	$622.16	$1,111.00	$395.00–$6,026.18	—	44%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED CERUMEN UNILAT	$63.84	$114.00	$48.50–$70.62	11% below	44%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACTED CERUMEN UNILAT	$63.84	$114.00	$48.50–$70.62	—	44%
Earwax removal with instruments, one ear CPT 69210 RMV IMPACTED EAR WAX 1-2 EARS	$63.84	$114.00	$39.50	3% below	44%
Earwax removal with instruments, one ear inpatient CPT 69210 RMV IMPACTED EAR WAX 1-2 EARS	$63.84	$114.00	$39.50	—	44%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,081.92	$1,932.00	$212.70–$1,624.39	20% below	44%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 CT GUIDED FACET INJECTION	$1,191.12	$2,127.00	$212.70–$1,624.39	12% below	44%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 INJ PARAVERT F JNT L/S 1 LEV	$1,081.92	$1,932.00	$212.70–$1,624.39	—	44%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 CT GUIDED FACET INJECTION	$1,191.12	$2,127.00	$212.70–$1,624.39	—	44%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMMORRHOIDAL BANDING	$432.32	$772.00	$821.23	22% below	44%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMMORRHOIDAL BANDING	$432.32	$772.00	$821.23	—	44%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D OF ABSCESS	$157.92	$282.00	$97.71–$239.42	19% below	44%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D OF ABSCESS	$157.92	$282.00	$97.71–$239.42	—	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ MAJOR JNT/BURSA	$186.48	$333.00	$66.34–$141.66	42% below	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 CT/FL Guided JT Injection	$345.52	$617.00	$262.47–$505.94	7% above	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ MAJOR JNT/BURSA	$186.48	$333.00	$66.34–$141.66	—	44%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 CT/FL Guided JT Injection	$345.52	$617.00	$262.47–$505.94	—	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ INTERM JNT/BURSA	$70.56	$126.00	$92.14–$96.23	74% below	44%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJ INTERM JNT/BURSA	$70.56	$126.00	$92.14–$96.23	—	44%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJECT SM JNT/BURSA	$59.92	$107.00	$53.50	76% below	44%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 DRAIN/INJECT SM JNT/BURSA	$59.92	$107.00	$53.50	—	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 WC INT WND RPR S/TR/EXT=<2.5CM	$547.68	$978.00	$416.04	69% above	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INT WND RPR S/TR/EXT =<2.5 CM	$547.68	$978.00	$605.87	69% above	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INT WND RPR S/TR/EXT =<2.5 CM	$547.68	$978.00	$605.87	—	44%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 WC INT WND RPR S/TR/EXT=<2.5CM	$547.68	$978.00	$416.04	—	44%
Lower-back epidural injection, with imaging guidance CPT 62323 INJECT EPID/SUBARA LUMB W/IMAG	$878.08	$1,568.00	$903.06	13% below	44%
Lower-back epidural injection, with imaging guidance CPT 62323 CT ESI INTERLAMINAR	$905.52	$1,617.00	$922.38–$1,340.49	10% below	44%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJECT EPID/SUBARA LUMB W/IMAG	$878.08	$1,568.00	$903.06	—	44%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT ESI INTERLAMINAR	$905.52	$1,617.00	$922.38–$1,340.49	—	44%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PT SMPL SINGLE	$104.16	$186.00	$66.40	21% below	44%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PT SMPL SINGLE	$104.16	$186.00	$66.40	—	44%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$733.60	$1,310.00	$647.14–$1,000.45	27% below	44%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$733.60	$1,310.00	$647.14–$1,000.45	—	44%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED	$314.72	$562.00	$429.20	12% below	44%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED	$314.72	$562.00	$429.20	—	44%
Prostate biopsy CPT 55700 PROSTATE NEEDLE PUNCH BX	$1,330.56	$2,376.00	$1,010.75–$1,931.93	7% above	44%
Prostate biopsy inpatient CPT 55700 PROSTATE NEEDLE PUNCH BX	$1,330.56	$2,376.00	$1,010.75–$1,931.93	—	44%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT	$2,142.56	$3,826.00	$490.00	11% below	44%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 DESTROY LUMB/SAC FACET JNT	$2,142.56	$3,826.00	$490.00	—	44%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FOREIGN BODY SIMPLE	$272.72	$487.00	$283.34–$413.46	5% below	44%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FOREIGN BODY SIMPLE	$272.72	$487.00	$283.34–$413.46	—	44%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 Colo Screening	$2,086.00	$3,725.00	$931.25–$3,725.00	19% above	44%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 Colo Screening	$2,086.00	$3,725.00	$931.25–$3,725.00	—	44%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 Colo Screening high risk	$2,812.32	$5,022.00	$928.57–$4,962.67	63% above	44%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 Colo Screening high risk	$2,812.32	$5,022.00	$928.57–$4,962.67	—	44%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT	$97.44	$174.00	$60.29–$172.92	11% below	44%
Short arm splint (forearm and hand) CPT 29125 APPLY SHORT ARM SPLINT STATIC	$157.92	$282.00	$235.00	44% above	44%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT	$97.44	$174.00	$60.29–$172.92	—	44%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLY SHORT ARM SPLINT STATIC	$157.92	$282.00	$235.00	—	44%
Short leg splint (calf to foot) CPT 29515 APPLY SHORT LEG SPLINT	$108.08	$193.00	$112.29–$171.38	at median	44%
Short leg splint (calf to foot) inpatient CPT 29515 APPLY SHORT LEG SPLINT	$108.08	$193.00	$112.29–$171.38	—	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SMPL REP S/N/A/G/TR/E 2.5 CM/<	$484.96	$866.00	$125.00–$866.00	127% above	44%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SMPL REP S/N/A/G/TR/E 2.5 CM/<	$484.96	$866.00	$125.00–$866.00	—	44%
Skin biopsy, punch, one lesion CPT 11104 WC PUNCH BX SKIN SINGLE LESION	$119.84	$214.00	$146.14	23% below	44%
Skin biopsy, punch, one lesion inpatient CPT 11104 WC PUNCH BX SKIN SINGLE LESION	$119.84	$214.00	$146.14	—	44%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT LUMBAR DIAGNOSTIC	$291.76	$521.00	$241.07	47% below	44%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCT LUMBAR DIAGNOSTIC	$291.76	$521.00	$241.07	—	44%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR SUPERFICIAL WND 2.6-7.5 CM	$318.64	$569.00	$110.00–$558.61	50% above	44%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 RPR SUPERFICIAL WND 2.6-7.5 CM	$318.64	$569.00	$110.00–$558.61	—	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5CM OR <	$314.72	$562.00	$120.00–$518.86	48% above	44%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR F/E/E/N/L/M 2.5CM OR <	$314.72	$562.00	$120.00–$518.86	—	44%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATE LT PLEURA W/ IMAGING	$761.60	$1,360.00	$671.84	28% below	44%
Thoracentesis with imaging guidance one side CPT 32555 ASPIRATE RT PLEURA W/ IMAGING	$761.60	$1,360.00	$671.84	28% below	44%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASPIRATE LT PLEURA W/ IMAGING	$761.60	$1,360.00	$671.84	—	44%
Thoracentesis with imaging guidance inpatient one side CPT 32555 ASPIRATE RT PLEURA W/ IMAGING	$761.60	$1,360.00	$671.84	—	44%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES	$73.36	$131.00	$56.33–$107.42	72% below	44%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 1-2 MUSCLES	$73.36	$131.00	$56.33–$107.42	—	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX,RT,W/LCL DEV,1ST LES	$1,291.92	$2,307.00	$1,283.15–$1,913.66	18% below	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX,LT,W/LCL DEV,1ST LES	$1,291.92	$2,307.00	$1,283.15–$1,913.66	18% below	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX,RT,W/LCL DEV,1ST LES	$1,291.92	$2,307.00	$1,283.15–$1,913.66	—	44%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX,LT,W/LCL DEV,1ST LES	$1,291.92	$2,307.00	$1,283.15–$1,913.66	—	44%
Upper endoscopy (EGD) with biopsy CPT 43239 EGD w Colonoscopy	$1,368.64	$2,444.00	$395.00–$3,542.92	at median	44%
Upper endoscopy (EGD) with biopsy CPT 43239 GASTROSCOPY WITH BIOPSY	$1,436.96	$2,566.00	$395.00–$3,542.92	5% above	44%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD w Colonoscopy	$1,368.64	$2,444.00	$395.00–$3,542.92	—	44%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 GASTROSCOPY WITH BIOPSY	$1,436.96	$2,566.00	$395.00–$3,542.92	—	44%
Upper endoscopy (EGD), diagnostic CPT 43235 GASTROSCOPY	$2,195.76	$3,921.00	$90.05–$3,862.18	52% above	44%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 GASTROSCOPY	$2,195.76	$3,921.00	$90.05–$3,862.18	—	44%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 HOLMIUM LASER	$2,233.28	$3,988.00	$2,521.74	—	44%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 HOLMIUM LASER	$2,233.28	$3,988.00	$2,521.74	—	44%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 WC DEB SUBQ TISS 20 SQ CM/<	$800.80	$1,430.00	$495.50–$1,387.10	144% above	44%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 WC DEB SUBQ TISS 20 SQ CM/<	$800.80	$1,430.00	$495.50–$1,387.10	—	44%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
Blood transfusion (giving blood or blood components) CPT 36430 ONCOLOGY BLD TRANSFUSION DAILY	$549.36	$981.00	$421.83–$1,142.36	28% below	44%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$771.68	$1,378.00	$421.83–$1,142.36	1% above	44%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD OR COMPONENT	$771.68	$1,378.00	$421.83–$1,142.36	1% above	44%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 ONCOLOGY BLD TRANSFUSION DAILY	$549.36	$981.00	$421.83–$1,142.36	—	44%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$771.68	$1,378.00	$421.83–$1,142.36	—	44%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD OR COMPONENT	$771.68	$1,378.00	$421.83–$1,142.36	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT INITIAL	$128.80	$230.00	$79.70–$204.24	at median	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TX INITIAL	$128.80	$230.00	$79.70–$184.97	at median	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TREATMENT SUBSQ	$128.80	$230.00	$79.70–$204.24	at median	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$128.80	$230.00	$79.70–$184.97	at median	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TX INITIAL	$128.80	$230.00	$79.70–$184.97	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT SUBSQ	$128.80	$230.00	$79.70–$204.24	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT INITIAL	$128.80	$230.00	$79.70–$204.24	—	44%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$128.80	$230.00	$79.70–$184.97	—	44%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$561.68	$1,003.00	$435.35–$851.55	at median	44%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV, 16-60 MIN-INITIAL	$603.68	$1,078.00	$373.53–$1,056.44	7% above	44%
Chemotherapy IV infusion, first hour CPT 96413 IV CHEMO INFUSION INITIAL HOUR	$640.08	$1,143.00	$408.05–$651.51	14% above	44%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$561.68	$1,003.00	$435.35–$851.55	—	44%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV, 16-60 MIN-INITIAL	$603.68	$1,078.00	$373.53–$1,056.44	—	44%
Chemotherapy IV infusion, first hour inpatient CPT 96413 IV CHEMO INFUSION INITIAL HOUR	$640.08	$1,143.00	$408.05–$651.51	—	44%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE, FIRST 30-74MIN	$2,095.52	$3,742.00	$125.00–$3,667.16	at median	44%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE, FIRST 30-74MIN	$2,095.52	$3,742.00	$125.00–$3,667.16	—	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/RHYTHM STRIP W/O INTERP	$121.52	$217.00	$114.00–$329.00	31% below	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG W/RHYTHM STRIP	$184.24	$329.00	$114.00–$329.00	5% above	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/RHYTHM STRIP W/O INTERP	$121.52	$217.00	$114.00–$329.00	—	44%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG W/RHYTHM STRIP	$184.24	$329.00	$114.00–$329.00	—	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ED VISIT NOT REQUIRING PHYS	$139.44	$249.00	$86.28–$246.52	27% below	44%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ED VISIT NOT REQUIRING PHYS	$139.44	$249.00	$86.28–$246.52	—	44%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ED VISIT W/STRAIGHTFWD MDM	$252.00	$450.00	$100.00–$443.50	11% below	44%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ED VISIT W/STRAIGHTFWD MDM	$252.00	$450.00	$100.00–$443.50	—	44%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ED VISIT W/LOW MDM	$444.64	$794.00	$100.00–$794.00	16% below	44%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ED VISIT W/LOW MDM	$444.64	$794.00	$100.00–$794.00	—	44%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ED VISIT W/MODERATE MDM	$699.44	$1,249.00	$110.00–$1,230.52	23% below	44%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ED VISIT W/MODERATE MDM	$699.44	$1,249.00	$110.00–$1,230.52	—	44%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ED VISIT W/HIGH MDM	$1,004.08	$1,793.00	$125.00–$1,763.64	23% below	44%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ED VISIT W/HIGH MDM	$1,004.08	$1,793.00	$125.00–$1,763.64	—	44%
Exercise stress test, tracing only, the hospital charge CPT 93017 CVSCLR STRESS TEST W/TRACING	$743.12	$1,327.00	$459.81–$1,126.62	12% below	44%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CVSCLR STRESS TEST W/TRACING	$743.12	$1,327.00	$459.81–$1,126.62	—	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION INFUSION INITIAL	$261.52	$467.00	$161.82–$467.00	12% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDR, INIT 31 MIN TO 1 HR	$261.52	$467.00	$161.82–$467.00	12% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRAT INITIAL 31 MN TO 1 HR	$261.52	$467.00	$161.82–$467.00	12% below	44%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INFUSION INITIAL	$261.52	$467.00	$161.82–$467.00	—	44%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDR, INIT 31 MIN TO 1 HR	$261.52	$467.00	$161.82–$467.00	—	44%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRAT INITIAL 31 MN TO 1 HR	$261.52	$467.00	$161.82–$467.00	—	44%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY, INITIAL UP TO 1 HR	$309.68	$553.00	$213.44–$603.68	7% below	44%
IV infusion of a medicine, first hour CPT 96365 IV INF THER/PROPH/DIAG INITIAL	$344.96	$616.00	$213.44–$603.68	4% above	44%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY, INITIAL UP TO 1 HR	$309.68	$553.00	$213.44–$603.68	—	44%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF THER/PROPH/DIAG INITIAL	$344.96	$616.00	$213.44–$603.68	—	44%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL	$190.96	$341.00	$118.16–$334.18	at median	44%
IV push of a medicine, first drug CPT 96374 IV PUSH INITIAL THER/PROPH/DIA	$190.96	$341.00	$118.16–$334.18	at median	44%
IV push of a medicine, first drug CPT 96374 IV PUSH, SING OR INIT SBSTNC	$190.96	$341.00	$118.16–$334.18	at median	44%
IV push of a medicine, first drug CPT 96374 IV INJ INITIAL THER/PROPH/DIAG	$190.96	$341.00	$118.16–$334.18	at median	44%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL THER/PROPH/DIA	$190.96	$341.00	$118.16–$334.18	—	44%
IV push of a medicine, first drug inpatient CPT 96374 IV INJ INITIAL THER/PROPH/DIAG	$190.96	$341.00	$118.16–$334.18	—	44%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH, SING OR INIT SBSTNC	$190.96	$341.00	$118.16–$334.18	—	44%
IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL	$190.96	$341.00	$118.16–$334.18	—	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THERA/PROPH/DIAG SC IM	$35.84	$64.00	$13.72–$149.00	50% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SUBCU OR IM	$64.96	$116.00	$49.35–$114.14	10% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$64.96	$116.00	$49.35–$114.14	10% below	44%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ THER/PROPH/DIAG SC IM	$78.40	$140.00	$49.35–$114.14	9% above	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THERA/PROPH/DIAG SC IM	$35.84	$64.00	$13.72–$149.00	—	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SUBCU OR IM	$64.96	$116.00	$49.35–$114.14	—	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$64.96	$116.00	$49.35–$114.14	—	44%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ THER/PROPH/DIAG SC IM	$78.40	$140.00	$49.35–$114.14	—	44%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCLE RE-EDUC EA 15 MI	$99.12	$177.00	$147.50	at median	44%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION 15M	$99.12	$177.00	$99.58–$156.95	at median	44%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCLE RE-EDUC EA 15 MI	$99.12	$177.00	$147.50	—	44%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION 15M	$99.12	$177.00	$99.58–$156.95	—	44%
New patient office visit, about 30 minutes CPT 99203 WC OV,NEW,LOW MDM,30-44MIN	$141.12	$252.00	$25.20–$127.18	at median	44%
New patient office visit, about 30 minutes inpatient CPT 99203 WC OV,NEW,LOW MDM,30-44MIN	$141.12	$252.00	$25.20–$127.18	—	44%
New patient office visit, about 45 minutes CPT 99204 WC OV, NEW, MOD MDM,45-59MIN	$172.48	$308.00	$142.77–$235.22	3% below	44%
New patient office visit, about 45 minutes inpatient CPT 99204 WC OV, NEW, MOD MDM,45-59MIN	$172.48	$308.00	$142.77–$235.22	—	44%
New patient office visit, about 60 minutes CPT 99205 WC OV, NEW, HIGH MDM,60 MIN	$203.84	$364.00	$179.82	11% below	44%
New patient office visit, about 60 minutes inpatient CPT 99205 WC OV, NEW, HIGH MDM,60 MIN	$203.84	$364.00	$179.82	—	44%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 WC,NEW,STR FWD MDM,10-29MIN	$109.76	$196.00	$16.86–$159.37	at median	44%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 WC,NEW,STR FWD MDM,10-29MIN	$109.76	$196.00	$16.86–$159.37	—	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 INIT MED NUTRITION THER EA 15M	$38.08	$68.00	$22.18–$227.84	39% below	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT-INTIAL PER 15MIN	$38.08	$68.00	$22.18–$227.84	39% below	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 INIT MED NUTRITION THER EA 15M	$38.08	$68.00	$22.18–$227.84	—	44%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT-INTIAL PER 15MIN	$38.08	$68.00	$22.18–$227.84	—	44%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$215.60	$385.00	$218.43–$349.20	10% below	44%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$215.60	$385.00	$218.43–$349.20	—	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PRH EVAL HIGH COMPLEX 45 MIN	$257.60	$460.00	$360.32–$409.15	5% below	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$274.96	$491.00	$360.32–$409.15	1% above	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PRH EVAL HIGH COMPLEX 45 MIN	$257.60	$460.00	$360.32–$409.15	—	44%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$274.96	$491.00	$360.32–$409.15	—	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PRH EVAL LOW COMPLEX 20 MIN	$202.16	$361.00	$137.45–$349.20	11% below	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$215.60	$385.00	$137.45–$349.20	5% below	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PRH EVAL LOW COMPLEX 20 MIN	$202.16	$361.00	$137.45–$349.20	—	44%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$215.60	$385.00	$137.45–$349.20	—	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PRH EVAL MOD COMPLEX 30 MIN	$227.92	$407.00	$150.38–$368.47	6% below	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$243.04	$434.00	$150.38–$368.47	1% above	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PRH EVAL MOD COMPLEX 30 MIN	$227.92	$407.00	$150.38–$368.47	—	44%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$243.04	$434.00	$150.38–$368.47	—	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15MIN OTA	$87.36	$156.00	$63.76–$163.15	at median	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15MIN PTA	$92.96	$166.00	$63.76–$166.89	6% above	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PRH MANUAL THERAPY (15 MIN)	$96.32	$172.00	$63.76–$166.89	10% above	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 15 MIN	$103.04	$184.00	$63.76–$166.89	18% above	44%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT MANUAL THERAPY 15M	$103.04	$184.00	$63.76–$163.15	18% above	44%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15MIN OTA	$87.36	$156.00	$63.76–$163.15	—	44%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15MIN PTA	$92.96	$166.00	$63.76–$166.89	—	44%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PRH MANUAL THERAPY (15 MIN)	$96.32	$172.00	$63.76–$166.89	—	44%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 15 MIN	$103.04	$184.00	$63.76–$166.89	—	44%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT MANUAL THERAPY 15M	$103.04	$184.00	$63.76–$163.15	—	44%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PRH EXERCISE (15 MIN UNIT)	$99.12	$177.00	$65.49–$320.92	at median	44%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUT EXCERCISE 15MIN PTA	$99.68	$178.00	$65.49–$320.92	1% above	44%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES 15 MIN	$105.84	$189.00	$3.44–$455.98	7% above	44%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PRH EXERCISE (15 MIN UNIT)	$99.12	$177.00	$65.49–$320.92	—	44%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUT EXCERCISE 15MIN PTA	$99.68	$178.00	$65.49–$320.92	—	44%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES 15 MIN	$105.84	$189.00	$3.44–$455.98	—	44%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 WC OV,EST,HIGH MDM, 40 MIN	$188.16	$336.00	$116.42–$273.20	8% below	44%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 WC OV,EST,HIGH MDM, 40 MIN	$188.16	$336.00	$116.42–$273.20	—	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OV,EST,LOW MDM,20 MIN	$58.24	$104.00	$58.51	21% below	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ONC RM,EST,LOW MDM,20 MIN	$117.60	$210.00	$90.30–$106.12	59% above	44%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 WC OV, EST, LOW MDM,20 MIN	$125.44	$224.00	$77.62–$198.91	69% above	44%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OV,EST,LOW MDM,20 MIN	$58.24	$104.00	$58.51	—	44%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ONC RM,EST,LOW MDM,20 MIN	$117.60	$210.00	$90.30–$106.12	—	44%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 WC OV, EST, LOW MDM,20 MIN	$125.44	$224.00	$77.62–$198.91	—	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OV,EST,MOD MDM, 30 MIN	$81.76	$146.00	$80.71	32% below	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 ONC RM,EST,MOD MDM, 30-39MIN	$147.28	$263.00	$111.88–$215.66	23% above	44%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 WC OV,EST,MOD MDM, 30-39MIN	$157.36	$281.00	$97.37–$249.53	32% above	44%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OV,EST,MOD MDM, 30 MIN	$81.76	$146.00	$80.71	—	44%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 ONC RM,EST,MOD MDM, 30-39MIN	$147.28	$263.00	$111.88–$215.66	—	44%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 WC OV,EST,MOD MDM, 30-39MIN	$157.36	$281.00	$97.37–$249.53	—	44%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 WC,EST,STRGHT FWD MDM,10 MIN	$94.64	$169.00	$57.57–$150.07	10% above	44%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 WC,EST,STRGHT FWD MDM,10 MIN	$94.64	$169.00	$57.57–$150.07	—	44%
Speech and language evaluation CPT 92523 EVAL SPEECH PROD W LANG COMPRE	$266.56	$476.00	$164.93–$476.00	24% below	44%
Speech and language evaluation inpatient CPT 92523 EVAL SPEECH PROD W LANG COMPRE	$266.56	$476.00	$164.93–$476.00	—	44%
Speech therapy session, individual CPT 92507 SPEECH, LANGUAGE, VOICE TX	$199.92	$357.00	$123.70–$307.02	16% below	44%
Speech therapy session, individual inpatient CPT 92507 SPEECH, LANGUAGE, VOICE TX	$199.92	$357.00	$123.70–$307.02	—	44%
Spirometry (breathing test) CPT 94010 SPIROMETRY W GRAPHIC RECORD	$50.40	$90.00	$1.94–$83.32	74% below	44%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY W GRAPHIC RECORD	$50.40	$90.00	$1.94–$83.32	—	44%
Spirometry before and after a bronchodilator CPT 94060 PFT W/BRONCHO DILAT	$153.44	$274.00	$106.38–$300.86	54% below	44%
Spirometry before and after a bronchodilator CPT 94060 BRONCHOSPASM PRE & POST BD	$171.92	$307.00	$106.38–$300.86	49% below	44%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT W/BRONCHO DILAT	$153.44	$274.00	$106.38–$300.86	—	44%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHOSPASM PRE & POST BD	$171.92	$307.00	$106.38–$300.86	—	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 PRH THERAPY ACTIVITY (15 MIN)	$93.52	$167.00	$57.87–$150.47	1% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15MIN PTA	$93.52	$167.00	$57.87–$150.47	1% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACT 15MIN OTA	$93.52	$167.00	$83.50–$148.33	1% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TRANSFER TRAIN 15MIN PTA	$93.52	$167.00	$57.87–$150.47	1% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT TRANSFER TRAIN 15M	$99.68	$178.00	$57.87–$150.47	8% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$99.68	$178.00	$83.50–$148.33	8% above	44%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITY 15 MIN	$99.68	$178.00	$57.87–$150.47	8% above	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PRH THERAPY ACTIVITY (15 MIN)	$93.52	$167.00	$57.87–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15MIN PTA	$93.52	$167.00	$57.87–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACT 15MIN OTA	$93.52	$167.00	$83.50–$148.33	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TRANSFER TRAIN 15MIN PTA	$93.52	$167.00	$57.87–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITY 15 MIN	$99.68	$178.00	$57.87–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT TRANSFER TRAIN 15M	$99.68	$178.00	$57.87–$150.47	—	44%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT THERAPEUTIC ACTIVITY 15 MIN	$99.68	$178.00	$83.50–$148.33	—	44%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY(THERAPEUTIC)	$171.36	$306.00	$131.58–$259.79	17% below	44%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPEUTIC PHLEBOTOMY	$183.12	$327.00	$249.73–$260.95	11% below	44%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY(THERAPEUTIC)	$171.36	$306.00	$131.58–$259.79	—	44%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPEUTIC PHLEBOTOMY	$183.12	$327.00	$249.73–$260.95	—	44%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs New Hampshire	Off list
COVID-19 vaccine (Moderna), age 12 and older CPT 91322 COVID VAC 12Y+ 23/24 50MCG	$71.68	$128.00	$143.01	53% below	44%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322 COVID VAC 12Y+ 23/24 50MCG	$71.68	$128.00	$143.01	—	44%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 COVID VAC 2024-25 (12YR+)	$86.80	$155.00	$142.80–$155.00	21% below	44%
COVID-19 vaccine (Pfizer-BioNTech), age 12 and older inpatient CPT 91320 COVID VAC 2024-25 (12YR+)	$86.80	$155.00	$142.80–$155.00	—	44%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK PF (EGG-FREE) 2024-25	$53.20	$95.00	$46.55–$93.77	36% below	44%
Flu shot, recombinant, egg-free (Flublok) CPT 90673 FLUBLOK TRIVAL RCM/PF 2025-26	$241.36	$431.00	$46.55–$93.77	191% above	44%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK PF (EGG-FREE) 2024-25	$53.20	$95.00	$46.55–$93.77	—	44%
Flu shot, recombinant, egg-free (Flublok) inpatient CPT 90673 FLUBLOK TRIVAL RCM/PF 2025-26	$241.36	$431.00	$46.55–$93.77	—	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE PF 2024-25	$19.60	$35.00	$21.90–$35.00	12% below	44%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUZONE TRIVALENT 2025-26	$62.16	$111.00	$21.90–$35.00	180% above	44%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE PF 2024-25	$19.60	$35.00	$21.90–$35.00	—	44%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE TRIVALENT 2025-26	$62.16	$111.00	$21.90–$35.00	—	44%
Hepatitis A vaccine, adult dose CPT 90632 HEP A VIRUS INAC 1440U INJ	$263.03	$469.70	$463.60	257% above	44%
Hepatitis A vaccine, adult dose inpatient CPT 90632 HEP A VIRUS INAC 1440U INJ	$263.03	$469.70	$463.60	—	44%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 ENGERIX-B (20 MCG/ML) SYRINGE	$220.19	$393.20	$107.46–$238.00	63% above	44%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 ENGERIX-B (20 MCG/ML) SYRINGE	$220.19	$393.20	$107.46–$238.00	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC H-DOSE >65YRS 2023-24	$47.60	$85.00	$71.94	57% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VACC H-DOSE >65YRS 2022-23	$47.60	$85.00	$71.94	57% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLU VAC H-DOSE >65YR; 2021-22	$47.60	$85.00	$71.94	57% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HD PF 2024-25	$53.20	$95.00	$71.94	52% below	44%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HDOSE TRIVALNT 2025-26	$241.36	$431.00	$71.94	117% above	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC H-DOSE >65YRS 2022-23	$47.60	$85.00	$71.94	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VAC H-DOSE >65YR; 2021-22	$47.60	$85.00	$71.94	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLU VACC H-DOSE >65YRS 2023-24	$47.60	$85.00	$71.94	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HD PF 2024-25	$53.20	$95.00	$71.94	—	44%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HDOSE TRIVALNT 2025-26	$241.36	$431.00	$71.94	—	44%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) CPT 90670 PNEUMO-13 (PREVNAR-13) 0.5 SYR	$362.32	$647.00	$252.84	37% below	44%
Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMO-13 (PREVNAR-13) 0.5 SYR	$362.32	$647.00	$252.84	—	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VC VACCINE IM	$154.00	$275.00	$199.24–$306.65	69% below	44%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOCOCCAL 20-VC VACCINE IM	$154.00	$275.00	$199.24–$306.65	—	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOCOCCAL VACCINE INJ >2YRS	$189.28	$338.00	$130.81–$333.61	8% below	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 VIAL VACCINE	$252.56	$451.00	$130.81	23% above	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOCOCCAL VACCINE INJ >2YRS	$189.28	$338.00	$130.81–$333.61	—	44%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 VIAL VACCINE	$252.56	$451.00	$130.81	—	44%
RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 NIRSEVIMAB-ALIP 50MG/.5ML	$1,557.16	$2,780.65	$1,315.83	48% above	44%
RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 NIRSEVIMAB-ALIP 50MG/.5ML	$1,557.16	$2,780.65	$1,315.83	—	44%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE (PCEC)/PF	$625.52	$1,117.00	$569.19–$2,319.30	2% above	44%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$674.24	$1,204.00	$569.19–$2,319.30	10% above	44%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE (PCEC)/PF	$625.52	$1,117.00	$569.19–$2,319.30	—	44%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$674.24	$1,204.00	$569.19–$2,319.30	—	44%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 ZOSTER IM VACCINE (RCMB)	$327.60	$585.00	$585.00	72% above	44%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 ZOSTER IM VACCINE (RCMB)	$327.60	$585.00	$585.00	—	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACCINE NO PRSRV IM, >=7YRS	$74.48	$133.00	$91.77–$133.00	4% above	44%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV IM, >=7YRS	$74.48	$133.00	$91.77–$133.00	—	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE >= 7 YEARS IM	$100.24	$179.00	$53.29–$217.13	90% above	44%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >= 7 YEARS IM	$100.24	$179.00	$53.29–$217.13	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SINGLE SS	$12.32	$22.00	$19.64–$432.99	60% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$29.12	$52.00	$19.64–$432.99	4% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN FLU VIRUS VACCINE M/S	$29.68	$53.00	$19.64–$432.99	3% below	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN SINGLE	$30.80	$55.00	$19.64–$432.99	1% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADM FLU VIRUS VACCINE	$30.80	$55.00	$19.64–$432.99	1% above	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SINGLE SS	$12.32	$22.00	$19.64–$432.99	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN ONE VACCINE	$29.12	$52.00	$19.64–$432.99	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN FLU VIRUS VACCINE M/S	$29.68	$53.00	$19.64–$432.99	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADM FLU VIRUS VACCINE	$30.80	$55.00	$19.64–$432.99	—	44%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN SINGLE	$30.80	$55.00	$19.64–$432.99	—	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDTL VACC SS	$12.32	$22.00	$10.00–$20.91	36% below	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADDL	$14.56	$26.00	$10.00–$20.91	24% below	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADM EA ADDTL VAC	$15.68	$28.00	$10.00–$20.91	19% below	44%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUN ADMIN EA ADDTL VACCINE	$15.68	$28.00	$10.00–$20.91	19% below	44%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADDTL VACC SS	$12.32	$22.00	$10.00–$20.91	—	44%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADDL	$14.56	$26.00	$10.00–$20.91	—	44%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUN ADMIN EA ADDTL VACCINE	$15.68	$28.00	$10.00–$20.91	—	44%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADM EA ADDTL VAC	$15.68	$28.00	$10.00–$20.91	—	44%

Source file: https://hospitalpricetransparencyfiles.com/weeks-medical-center/020222242_Weeks-Medical-Center_standardcharges.csv