Monrovia Memorial Hospital
Monrovia Memorial Hospital publishes cash prices for 207 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Click a procedure to compare it with other hospitals nearby.
Collected Sep 27, 2026 Source price file
The price file shows no self-pay discount
For 358 of the 358 prices listed here, the cash price in Monrovia Memorial Hospital's file equals its full list price (chargemaster), so the file publishes no self-pay discount. That is why it compares as expensive. Many hospitals still reduce bills for uninsured patients or offer financial assistance based on income: before a planned visit, ask the billing office for its self-pay rate and discount policy in writing. Other US hospitals whose cash price is their full list price.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 Ct Abdomen Wo And W | $2,460.00 | $2,460.00 | — | — |
| Ankle X-ray, complete, 3 or more views both sides CPT 73610 Xr Ankle Complete Bilat | $675.00 | $675.00 | — | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Left | $530.00 | $530.00 | — | — |
| Ankle X-ray, complete, 3 or more views one side CPT 73610 Xr Ankle Complete Right | $530.00 | $530.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upper Extremity Right | $1,110.00 | $1,110.00 | — | — |
| Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 Ct Upper Extremity Left | $1,110.00 | $1,110.00 | — | — |
| Barium swallow (esophagus X-ray with contrast) CPT 74220 Xr Esophagram | $475.00 | $475.00 | — | — |
| Bone scan, whole body (nuclear medicine) CPT 78306 Nm Bone Scan Whole Body | $1,860.00 | $1,860.00 | — | — |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 Ct Chest Ro Pe | $5,661.00 | $5,661.00 | — | — |
| CT scan of the abdomen with contrast CPT 74160 Ct Abdomen W | $5,620.00 | $5,620.00 | — | — |
| CT scan of the abdomen without contrast CPT 74150 Ct Abdomen Wo | $5,349.00 | $5,349.00 | — | — |
| CT scan of the face and sinuses, no contrast dye CPT 70486 Ct Sinus Wo Dye | $1,110.00 | $1,110.00 | — | — |
| CT scan of the head or brain, no contrast dye CPT 70450 CT scan | $4,614.00 | $4,614.00 | — | — |
| CT scan of the head without and with contrast CPT 70470 Ct Brain Wo And W | $2,460.00 | $2,460.00 | — | — |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 Ct L Spine | $1,110.00 | $1,110.00 | — | — |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 Ct C Spine | $5,245.00 | $5,245.00 | — | — |
| CT scan of the pelvis, with contrast dye CPT 72193 CT scan of pelvis with contrast | $5,459.00 | $5,459.00 | — | — |
| Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 Us Carotid | $1,412.00 | $1,412.00 | — | — |
| Chest CT scan without and with contrast CPT 71270 Ct Chest Wo And W | $2,460.00 | $2,460.00 | — | — |
| Chest X-ray, single view CPT 71045 Xr 1 View Cxr | $231.00 | $231.00 | — | — |
| Collarbone (clavicle) X-ray, complete both sides CPT 73000 Xr Clavical Bilat | $490.00 | $490.00 | — | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavical Left | $490.00 | $490.00 | — | — |
| Collarbone (clavicle) X-ray, complete one side CPT 73000 Xr Clavical Right | $490.00 | $490.00 | — | — |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 Us Renal Retroperitoneal | $1,265.00 | $1,265.00 | — | — |
| Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 Us Ob Complete | $745.00 | $745.00 | — | — |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 Ct Chest Wo | $5,500.00 | $5,500.00 | — | — |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 Ct Chest W | $5,807.00 | $5,807.00 | — | — |
| Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 Us Arterial Lower Ext Bilat | $1,375.00 | $1,375.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Upper Ext Bilat | $812.00 | $812.00 | — | — |
| Duplex ultrasound of the leg veins, both legs both sides CPT 93970 Us Venous Lower Ext Bilat | $1,375.00 | $1,375.00 | — | — |
| Elbow X-ray, 2 views both sides CPT 73070 Xr Elbow 2 View Bilat | $300.00 | $300.00 | — | — |
| Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 View Right | $300.00 | $300.00 | — | — |
| Elbow X-ray, 2 views one side CPT 73070 Xr Elbow 2 View Left | $300.00 | $300.00 | — | — |
| Elbow X-ray, complete, 3 or more views both sides CPT 73080 Xr Elbow Complete Bilat | $492.00 | $492.00 | — | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Right | $492.00 | $492.00 | — | — |
| Elbow X-ray, complete, 3 or more views one side CPT 73080 Xr Elbow Complete Left | $492.00 | $492.00 | — | — |
| Eye socket (orbit) CT scan without contrast CPT 70480 Ct Orbits | $1,110.00 | $1,110.00 | — | — |
| Facial bones X-ray, complete, 3 or more views CPT 70150 Xr Facial Bones | $481.00 | $481.00 | — | — |
| Forearm X-ray (radius and ulna), 2 views both sides CPT 73090 Xr Forearm Bilat | $475.00 | $475.00 | — | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm Left | $400.00 | $400.00 | — | — |
| Forearm X-ray (radius and ulna), 2 views one side CPT 73090 Xr Forearm Right | $400.00 | $400.00 | — | — |
| Hand X-ray, 2 views both sides CPT 73120 Xr Hand 2 View Bilat | $261.00 | $261.00 | — | — |
| Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 View Right | $261.00 | $261.00 | — | — |
| Hand X-ray, 2 views one side CPT 73120 Xr Hand 2 View Left | $261.00 | $261.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views both sides CPT 73650 Xr Calcaneous Bilat | $530.00 | $530.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneous Left | $530.00 | $530.00 | — | — |
| Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 Xr Calcaneous Right | $530.00 | $530.00 | — | — |
| Knee X-ray, 3 views both sides CPT 73562 Xr Knee 3 View Bilat | $520.00 | $520.00 | — | — |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 View Right | $520.00 | $520.00 | — | — |
| Knee X-ray, 3 views one side CPT 73562 Xr Knee 3 View Left | $520.00 | $520.00 | — | — |
| Knee X-ray, complete, 4 or more views both sides CPT 73564 Xr Knee 4 View Bilat | $873.00 | $873.00 | — | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee 4 View Left | $437.00 | $437.00 | — | — |
| Knee X-ray, complete, 4 or more views one side CPT 73564 Xr Knee 4 View Right | $437.00 | $437.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Extremity Left | $5,103.00 | $5,103.00 | — | — |
| Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 Ct Lower Extremity Right | $5,103.00 | $5,103.00 | — | — |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 Us Abdomen Limited | $645.00 | $645.00 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views both sides CPT 73590 Xr Tibia Fibula Bilat | $490.00 | $490.00 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia Fibula Left | $490.00 | $490.00 | — | — |
| Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 Xr Tibia Fibula Right | $490.00 | $490.00 | — | — |
| MR angiography (MRA) of the head without contrast CPT 70544 Mra Head Wo Dye | $1,480.00 | $1,480.00 | — | — |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI scan of leg joint | $3,360.00 | $3,360.00 | — | — |
| MRI of the abdomen without contrast CPT 74181 Mri Abdomen Wo | $3,150.00 | $3,150.00 | — | — |
| MRI of the abdomen, without and then with contrast dye CPT 74183 Mri Abdomen Wo And W | $1,616.00 | $1,616.00 | — | — |
| MRI of the brain, no contrast dye CPT 70551 Mri Brain Wo | $1,830.00 | $1,830.00 | — | — |
| MRI of the brain, with and without contrast dye CPT 70553 MRI Scan | $4,733.00 | $4,733.00 | — | — |
| MRI of the lower back, no contrast dye CPT 72148 MRI scan of lower spinal canal | $3,588.00 | $3,588.00 | — | — |
| MRI of the lower back, without and then with contrast dye CPT 72158 Mri L Spine Wo And W | $4,733.00 | $4,733.00 | — | — |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 Mri T Spine Wo | $3,588.00 | $3,588.00 | — | — |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 Mri C Spine Wo W | $4,733.00 | $4,733.00 | — | — |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 Mri C Spine Wo | $3,588.00 | $3,588.00 | — | — |
| MRI of the pelvis, no contrast dye CPT 72195 Mri Pelvis Wo | $3,588.00 | $3,588.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Upper Extremity W Left | $3,898.00 | $3,898.00 | — | — |
| MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 Mri Upper Extremity Wo Right | $3,898.00 | $3,898.00 | — | — |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 Xr C Spine Complete | $516.00 | $516.00 | — | — |
| Neck soft tissue CT scan with contrast CPT 70491 Ct Soft Tissue Neck W | $5,673.00 | $5,673.00 | — | — |
| Neck soft tissue CT scan without contrast CPT 70490 Ct Soft Tissue Neck Wo | $5,377.00 | $5,377.00 | — | — |
| Neck soft tissue X-ray CPT 70360 Xr Neck Soft Tissue | $305.00 | $305.00 | — | — |
| Pelvic CT scan without contrast CPT 72192 Ct Pelvis/abdomen Wo Contrast | $389.00 | $389.00 | — | — |
| Pelvic CT scan without contrast CPT 72192 Ct Pelvis Wo Contrast | $389.00 | $389.00 | — | — |
| Pelvic CT scan without contrast CPT 72192 Ct Pelvis Wo Dye | $5,360.00 | $5,360.00 | — | — |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 Us Pelvic Limited | $845.00 | $845.00 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Pelvic Complete | $597.00 | $597.00 | — | — |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 Us Prostate | $731.00 | $731.00 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs Unilateral Left | $195.00 | $195.00 | — | — |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 Xr Ribs Unilateral Right | $385.00 | $385.00 | — | — |
| Shoulder X-ray, complete, 2 or more views both sides CPT 73030 Xr Shoulder Complete Bilat | $557.00 | $557.00 | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Left | $557.00 | $557.00 | — | — |
| Shoulder X-ray, complete, 2 or more views one side CPT 73030 Xr Shoulder Complete Right | $557.00 | $557.00 | — | — |
| Sinus X-ray, complete, 3 or more views CPT 70220 Xr Sinus Series | $461.00 | $461.00 | — | — |
| Skull X-ray, fewer than 4 views CPT 70250 Xr Skull Limited | $326.00 | $326.00 | — | — |
| Swallow study (modified barium swallow, video X-ray) CPT 74230 Xr Cine Esophagram | $526.00 | $526.00 | — | — |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 Ct T Spine | $1,110.00 | $1,110.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe Great Toe Left | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 2nd Right | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 3rd Right | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 4th Right | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 5th Right | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 2nd Left | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 5th Left | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 4th Left | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe 3rd Left | $94.00 | $94.00 | — | — |
| Toe X-ray, 2 or more views one side CPT 73660 Xr Toe Great Toe Right | $94.00 | $94.00 | — | — |
| Transvaginal pelvic ultrasound CPT 76830 Ultrasound pelvis through vagina | $945.00 | $945.00 | — | — |
| Transvaginal ultrasound during pregnancy CPT 76817 Us Ob Transvaginal | $428.00 | $428.00 | — | — |
| Ultrasound of the abdomen, complete CPT 76700 Ultrasound of abdomen | $1,325.00 | $1,325.00 | — | — |
| Ultrasound of the scrotum and testicles CPT 76870 Us Scrotal | $1,185.00 | $1,185.00 | — | — |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 Us Soft Tissue Thyroid | $985.00 | $985.00 | — | — |
| Upper arm X-ray (humerus), 2 views both sides CPT 73060 Xr Humerus Bilat | $432.00 | $432.00 | — | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Right | $432.00 | $432.00 | — | — |
| Upper arm X-ray (humerus), 2 views one side CPT 73060 Xr Humerus Left | $432.00 | $432.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Venous Lower Ext Right | $726.00 | $726.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Venous Upper Ext Right | $726.00 | $726.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Venous Lower Ext Left | $726.00 | $726.00 | — | — |
| Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 Us Venous Upper Ext Left | $726.00 | $726.00 | — | — |
| Wrist X-ray, 2 views both sides CPT 73100 Xr Wrist 2 View Bilat | $261.00 | $261.00 | — | — |
| Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 View Left | $261.00 | $261.00 | — | — |
| Wrist X-ray, 2 views one side CPT 73100 Xr Wrist 2 View Right | $261.00 | $261.00 | — | — |
| Wrist X-ray, complete, 3 or more views both sides CPT 73110 Xr Wrist Complete Bilat | $675.00 | $675.00 | — | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Left | $539.00 | $539.00 | — | — |
| Wrist X-ray, complete, 3 or more views one side CPT 73110 Xr Wrist Complete Right | $539.00 | $539.00 | — | — |
| X-ray of the abdomen, 1 view CPT 74018 Xr Kub | $275.00 | $275.00 | — | — |
| X-ray of the ankle, 2 views both sides CPT 73600 Xr Ankle 2 View Bilat | $530.00 | $530.00 | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 View Left | $530.00 | $530.00 | — | — |
| X-ray of the ankle, 2 views one side CPT 73600 Xr Ankle 2 View Right | $530.00 | $530.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 4th Left | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 2nd Right | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger Thumb Left | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 3rd Right | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 4th Right | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 3rd Left | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 5th Right | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 5th Left | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger 2nd Left | $194.00 | $194.00 | — | — |
| X-ray of the finger(s), 2 or more views one side CPT 73140 Xr Finger Thumb Right | $230.00 | $230.00 | — | — |
| X-ray of the foot, 2 views both sides CPT 73620 Xr Foot 2 View Bilat | $503.00 | $503.00 | — | — |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 View Right | $503.00 | $503.00 | — | — |
| X-ray of the foot, 2 views one side CPT 73620 Xr Foot 2 View Left | $503.00 | $503.00 | — | — |
| X-ray of the foot, complete, 3 or more views both sides CPT 73630 Xr Foot Complete Bilat | $675.00 | $675.00 | — | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Left | $503.00 | $503.00 | — | — |
| X-ray of the foot, complete, 3 or more views one side CPT 73630 Xr Foot Complete Right | $503.00 | $503.00 | — | — |
| X-ray of the hand, 3 or more views both sides CPT 73130 Xr Hand Complete Bilat | $464.00 | $464.00 | — | — |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Left | $464.00 | $464.00 | — | — |
| X-ray of the hand, 3 or more views one side CPT 73130 Xr Hand Complete Right | $675.00 | $675.00 | — | — |
| X-ray of the knee, 1 or 2 views both sides CPT 73560 Xr Knee 2 View Bilat | $520.00 | $520.00 | — | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 2 View Right | $520.00 | $520.00 | — | — |
| X-ray of the knee, 1 or 2 views one side CPT 73560 Xr Knee 2 View Left | $520.00 | $520.00 | — | — |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 Xr L Spine Limited | $316.00 | $316.00 | — | — |
| X-ray of the lower back, 4 or more views CPT 72110 X-Ray of lower back | $590.00 | $590.00 | — | — |
| X-ray of the nasal bones, 3 or more views CPT 70160 Xr Nasal Bones | $331.00 | $331.00 | — | — |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 Xr C Spine Limited | $351.00 | $351.00 | — | — |
| X-ray of the pelvis, 1 or 2 views CPT 72170 Xr Pelvis | $300.00 | $300.00 | — | — |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 Xr Sacrum Coccyx | $275.00 | $275.00 | — | — |
Lab tests
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| ACTH blood test CPT 82024 Acth Plasma | $24.00 | $24.00 | — | — |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 Sgpt (Alt) | $110.00 | $110.00 | — | — |
| AST (aspartate aminotransferase) enzyme test CPT 84450 Sgot (Ast) | $110.00 | $110.00 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Hepatitis Panel | $19.00 | $19.00 | — | — |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Profile | $19.00 | $19.00 | — | — |
| Albumin blood test CPT 82040 Albumin | $90.00 | $90.00 | — | — |
| Aldosterone blood test CPT 82088 Aldosterone Serum | $19.00 | $19.00 | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phosphatase Ref | $4.00 | $4.00 | — | — |
| Alkaline phosphatase (ALP) blood test CPT 84075 Alk Phosphatase | $90.00 | $90.00 | — | — |
| Alpha-fetoprotein (AFP) blood test CPT 82105 Afp Serum | $7.00 | $7.00 | — | — |
| Ammonia blood test CPT 82140 Ammonia (Nh3) | $10.00 | $10.00 | — | — |
| Amylase blood test CPT 82150 Amylase Urine | $4.00 | $4.00 | — | — |
| Amylase blood test CPT 82150 Amylase Serum | $110.00 | $110.00 | — | — |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Ccp Antibody | $12.00 | $12.00 | — | — |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 Ana-antinuclear Antibodies | $4.00 | $4.00 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Ref Bnp | $49.00 | $49.00 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 N T Probnp | $78.00 | $78.00 | — | — |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 Bnp | $350.00 | $350.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Aerobic | $6.00 | $6.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Sputum | $9.00 | $9.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Lower Respiratory | $9.00 | $9.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Body Fluid | $14.00 | $14.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Wound Source | $16.00 | $16.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Throat | $37.00 | $37.00 | — | — |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 Culture Tissue | $63.00 | $63.00 | — | — |
| Basic metabolic panel (blood test) CPT 80048 Basic metabolic panel | $500.00 | $500.00 | — | — |
| Bilirubin blood test, total CPT 82247 Bilirubim Total | $90.00 | $90.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path1st Site | $55.00 | $55.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path4th Site 83805 | $81.00 | $81.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path3rd Site | $81.00 | $81.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path4th Site | $81.00 | $81.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path7th Site | $111.00 | $111.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path6th Site | $111.00 | $111.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path5th Site | $111.00 | $111.00 | — | — |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 Surgical Path8th Site | $148.00 | $148.00 | — | — |
| Blood culture for bacteria CPT 87040 Culture Blood | $11.00 | $11.00 | — | — |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting Ref | $3.00 | $3.00 | — | — |
| Blood glucose (sugar) test CPT 82947 Glucose Fasting | $90.00 | $90.00 | — | — |
| Blood glucose (sugar) test CPT 82947 Glucose | $90.00 | $90.00 | — | — |
| Blood glucose (sugar) test CPT 82947 Istat Glucose | $100.00 | $100.00 | — | — |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 Pregnancy Testing Serum | $32.00 | $32.00 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Abo Typing / Rh Ref | $24.00 | $24.00 | — | — |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Blood Type | $73.00 | $73.00 | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 Bun | $90.00 | $90.00 | — | — |
| Blood urea nitrogen (BUN) test CPT 84520 Istat Bun/creatinine | $100.00 | $100.00 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Crp | $5.00 | $5.00 | — | — |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C Reactive Proteine | $5.00 | $5.00 | — | — |
| C. difficile toxin gene test (stool PCR) CPT 87493 Clostridium Dificil Dna Probe | $125.00 | $125.00 | — | — |
| CA 19-9 blood test (tumor marker) CPT 86301 Ca 19-9 (Cancer Antigen 19-9) | $11.00 | $11.00 | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125 | $8.00 | $8.00 | — | — |
| CA-125 blood test (ovarian cancer marker) CPT 86304 Ca 125 | $48.00 | $48.00 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid Pcr | $50.00 | $50.00 | — | — |
| COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 Covid Ag Diagnostic Test | $100.00 | $100.00 | — | — |
| Calcium blood test, total CPT 82310 Calcium | $90.00 | $90.00 | — | — |
| Carcinoembryonic antigen (CEA) test CPT 82378 Cea | $8.00 | $8.00 | — | — |
| Chickenpox (varicella) immunity blood test CPT 86787 Varicella-zoster Ab | $16.00 | $16.00 | — | — |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia | $18.00 | $18.00 | — | — |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Blood test, lipids | $400.00 | $400.00 | — | — |
| Complete blood count (CBC) with differential CPT 85025 Complete blood cell count (CBC), with differential white blood cells, automated | $3.00 | $3.00 | — | — |
| Complete blood count (CBC), no differential CPT 85027 Complete blood cell count (CBC), automated | $250.00 | $250.00 | — | — |
| Comprehensive metabolic panel (blood test) CPT 80053 Blood test, comprehensive group of blood chemicals | $750.00 | $750.00 | — | — |
| Cortisol blood test, total CPT 82533 Cortisol Level | $6.00 | $6.00 | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 Ck-creatine Kinase Ref | $3.00 | $3.00 | — | — |
| Creatine kinase (CK) blood test, total CPT 82550 Creatine Kinase Ck Total | $90.00 | $90.00 | — | — |
| Creatinine blood test CPT 82565 Creatinine Serum | $90.00 | $90.00 | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 Dic Dissemeniated Intravascular Coag 3 | $15.00 | $15.00 | — | — |
| D-dimer blood test (blood clot marker) CPT 85379 D-dimer | $20.00 | $20.00 | — | — |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 Drug Sceen With Confirmation | $52.00 | $52.00 | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Istat Electrolyte Panel | $200.00 | $200.00 | — | — |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 Electrolyte Panel Serum | $200.00 | $200.00 | — | — |
| FSH (follicle-stimulating hormone) test CPT 83001 Fsh | $7.00 | $7.00 | — | — |
| Ferritin blood test (iron stores) CPT 82728 Ferritin | $5.00 | $5.00 | — | — |
| Fibrinogen blood test CPT 85384 Fibrinogen | $5.00 | $5.00 | — | — |
| Fibrinogen blood test CPT 85384 Dic Dissemeniated Intravascular Coag 4 | $12.00 | $12.00 | — | — |
| Folate (folic acid) blood test CPT 82746 Folate | $5.00 | $5.00 | — | — |
| Free T3 thyroid hormone test CPT 84481 T3 Free Serum | $5.00 | $5.00 | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 Free | $5.00 | $5.00 | — | — |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 T4-free | $5.00 | $5.00 | — | — |
| Free testosterone test CPT 84402 Free Testosterone | $14.00 | $14.00 | — | — |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 Ggt | $3.00 | $3.00 | — | — |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 Gonococcus | $27.00 | $27.00 | — | — |
| H. pylori stool antigen test CPT 87338 H Pylori Igg | $33.00 | $33.00 | — | — |
| H. pylori stool antigen test CPT 87338 Helico Pylo Stool | $33.00 | $33.00 | — | — |
| HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 Hiv-1 Ab (Elisa) | $9.00 | $9.00 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c | $4.00 | $4.00 | — | — |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hgba1c | $5.00 | $5.00 | — | — |
| Hemoglobin blood test CPT 85018 Hemoglobin | $100.00 | $100.00 | — | — |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody | $3.00 | $3.00 | — | — |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen | $3.00 | $3.00 | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Hcv Hepatitis C Virus Antibody | $6.00 | $6.00 | — | — |
| Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Antibody | $6.00 | $6.00 | — | — |
| Hepatitis C viral load (HCV RNA) test CPT 87522 Hepatitis C Virus (Hcv) Rna Pcr Qual | $122.00 | $122.00 | — | — |
| Hepatitis C viral load (HCV RNA) test one side CPT 87522 Hcv Rt-pcr Quantitative | $122.00 | $122.00 | — | — |
| Iron blood test (serum iron) CPT 83540 Iron | $3.00 | $3.00 | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 Total Iron Binding Capacity | $7.00 | $7.00 | — | — |
| Iron-binding capacity (TIBC) test CPT 83550 Tibc | $8.00 | $8.00 | — | — |
| Kidney function blood test panel CPT 80069 Kidney function panel test | $400.00 | $400.00 | — | — |
| LH (luteinizing hormone) test CPT 83002 Testosterone Lev | $20.00 | $20.00 | — | — |
| Lactate (lactic acid) blood test CPT 83605 Lactic Acid Plasma | $9.00 | $9.00 | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh Fluid | $3.00 | $3.00 | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate (Ld) (Ldh) Enzyme | $12.00 | $12.00 | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Lactate Dehydrogenase (Ldh) Isoenzyme | $12.00 | $12.00 | — | — |
| Lactate dehydrogenase (LDH) blood test CPT 83615 Ldh | $110.00 | $110.00 | — | — |
| Lipase blood test (pancreas enzyme) CPT 83690 Lipase | $4.00 | $4.00 | — | — |
| Liver function blood test panel CPT 80076 Liver function blood test | $500.00 | $500.00 | — | — |
| Magnesium blood test CPT 83735 Magnesium Ref | $9.00 | $9.00 | — | — |
| Magnesium blood test CPT 83735 Magnesium | $110.00 | $110.00 | — | — |
| Mumps immunity blood test CPT 86735 Mumps Ab Ig | $10.00 | $10.00 | — | — |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Total prostate-specific antigen (PSA) test | $5.00 | $5.00 | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Pth Intact | $6.00 | $6.00 | — | — |
| Parathyroid hormone (PTH) blood test CPT 83970 Pth-intact | $6.00 | $6.00 | — | — |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Coagulation assessment blood test | $250.00 | $250.00 | — | — |
| Phosphorus (phosphate) blood test CPT 84100 Phosphorus | $110.00 | $110.00 | — | — |
| Potassium blood test CPT 84132 Potassium Serum | $90.00 | $90.00 | — | — |
| Potassium blood test CPT 84132 Istat Potassium | $100.00 | $100.00 | — | — |
| Prolactin blood test CPT 84146 Prolactin | $8.00 | $8.00 | — | — |
| Prolactin blood test CPT 84146 Assay Of Prolactin | $8.00 | $8.00 | — | — |
| Prothrombin time (PT/INR) clotting test CPT 85610 Blood test, clotting time | $250.00 | $250.00 | — | — |
| Rh blood typing CPT 86901 Rh Typing Ref | $13.00 | $13.00 | — | — |
| Rh blood typing CPT 86901 Rh-typing | $22.00 | $22.00 | — | — |
| Rh blood typing CPT 86901 Rh Typing | $73.00 | $73.00 | — | — |
| Rheumatoid factor (RF) test CPT 86431 Ra Rheumatoid Arthritis | $4.00 | $4.00 | — | — |
| Rheumatoid factor (RF) test CPT 86431 Rheumatoid Arthritis (Ra) Factor | $24.00 | $24.00 | — | — |
| Sodium blood test CPT 84295 Sodium Serum | $90.00 | $90.00 | — | — |
| Stool ova and parasites exam CPT 87177 Ova + Parasite Exam | $4.00 | $4.00 | — | — |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 Occult Blood Source Fecal | $120.00 | $120.00 | — | — |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rpr | $3.00 | $3.00 | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Quantiferon Tb Gold | $55.00 | $55.00 | — | — |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 Tb Gold Test | $60.00 | $60.00 | — | — |
| Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone | $7.00 | $7.00 | — | — |
| Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroidperoxidase Antibodies | $6.00 | $6.00 | — | — |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Blood test, thyroid stimulating hormone (TSH) | $6.00 | $6.00 | — | — |
| Total IgE blood test CPT 82785 Immunoglob E | $7.00 | $7.00 | — | — |
| Total IgE blood test CPT 82785 Immunoglob-e | $7.00 | $7.00 | — | — |
| Total cholesterol blood test CPT 82465 Cholesterol | $110.00 | $110.00 | — | — |
| Total thyroxine (T4) blood test CPT 84436 T4-total | $4.00 | $4.00 | — | — |
| Total thyroxine (T4) blood test CPT 84436 T4 Total | $4.00 | $4.00 | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 Triiodothyronine T3 | $7.00 | $7.00 | — | — |
| Total triiodothyronine (T3) blood test CPT 84480 Triodothyronine | $7.00 | $7.00 | — | — |
| Transferrin blood test CPT 84466 Transferrin | $6.00 | $6.00 | — | — |
| Triglycerides blood test CPT 84478 Triglycerides Fluid | $3.00 | $3.00 | — | — |
| Triglycerides blood test CPT 84478 Triglyceride | $110.00 | $110.00 | — | — |
| Troponin test, quantitative CPT 84484 Ref Troponin | $79.00 | $79.00 | — | — |
| Troponin test, quantitative CPT 84484 Troponin I | $300.00 | $300.00 | — | — |
| Uric acid blood test CPT 84550 Uric Acid | $3.00 | $3.00 | — | — |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis test | $120.00 | $120.00 | — | — |
| Urine culture for bacteria, with colony count CPT 87086 Culture Urine | $12.00 | $12.00 | — | — |
| Urine culture for bacteria, with colony count CPT 87086 Culture Aerobic Urine | $12.00 | $12.00 | — | — |
| Urine microalbumin (albumin) test CPT 82043 Microalb/creat Ratio Randm Ur | $8.00 | $8.00 | — | — |
| Urine pregnancy test, read by color change CPT 81025 Pregnancy Testing Urine | $75.00 | $75.00 | — | — |
| Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 | $5.00 | $5.00 | — | — |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy | $11.00 | $11.00 | — | — |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 Vit D 1,25 Dihydroxy | $19.00 | $19.00 | — | — |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 Beta Hcg | $8.00 | $8.00 | — | — |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 Prevnar 20 Syringe | $3,271.00 | $3,271.00 | — | — |
| Lower-back epidural injection, with imaging guidance CPT 62323 Injection(s) of therapeutic substance | $5,000.00 | $5,000.00 | — | — |
| Lower-back epidural injection, without imaging guidance CPT 62322 Injection(s) of therapeutic substance | $5,000.00 | $5,000.00 | — | — |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Injection(s) of anesthetic into lower spine using imaging guidance | $5,000.00 | $5,000.00 | — | — |
| Spinal tap (lumbar puncture), diagnostic CPT 62270 Xr Lumbar Puncture | $1,876.00 | $1,876.00 | — | — |