Beaufort Memorial Hospital
Beaufort Memorial Hospital in Beaufort, SC publishes cash prices for 59 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
955 Ribaut Road, Beaufort, SC 29902 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABD PELVIS W CONT CMP | $3,635.40 | $6,059.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABD PELVIS W CONT CMP | $3,635.40 | $6,059.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 HEAD WO CONT | $1,534.20 | $2,557.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD WO CONT | $1,534.20 | $2,557.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 PELVIS W CONT | $1,731.60 | $2,886.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS W CONT | $1,731.60 | $2,886.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $143.40 | $239.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MMG DIR DIGITAL BI | $171.60 | $286.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MMMG DIGITAL BI | $257.40 | $429.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI | $143.40 | $239.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MMG DIR DIGITAL BI | $171.60 | $286.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MMMG DIGITAL BI | $257.40 | $429.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 DX MMG DIR DIGITAL UNI L | $137.40 | $229.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 DX MMG DIR DIGITAL UNI R | $137.40 | $229.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI LEFT | $110.40 | $184.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 DX MAMMO INCL CAD UNI RIGHT | $110.40 | $184.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DX MMG DIR DIGITAL UNI L | $137.40 | $229.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DX MMG DIR DIGITAL UNI R | $137.40 | $229.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI RIGHT | $110.40 | $184.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 DX MAMMO INCL CAD UNI LEFT | $110.40 | $184.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 LOWER EXT JOINT BI WO CONT | $2,658.60 | $4,431.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LOWER EXT JOINT L WO CONT | $2,148.60 | $3,581.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 LOWER EXT JOINT R WO CONT | $2,148.60 | $3,581.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 LOWER EXT JOINT BI WO CONT | $2,658.60 | $4,431.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 LOWER EXT JOINT R WO CONT | $2,148.60 | $3,581.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 LOWER EXT JOINT L WO CONT | $2,148.60 | $3,581.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 LOWER EXT JOINT BI WWO CONT | $3,370.80 | $5,618.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 LOWER EXT JOINT L WWO CONT | $2,722.80 | $4,538.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 LOWER EXT JOINT R WWO CONT | $2,722.80 | $4,538.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 LOWER EXT JOINT BI WWO CONT | $3,370.80 | $5,618.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 LOWER EXT JOINT R WWO CONT | $2,722.80 | $4,538.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 LOWER EXT JOINT L WWO CONT | $2,722.80 | $4,538.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 BRAIN WO CONT | $2,100.00 | $3,500.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN WO CONT | $2,100.00 | $3,500.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 BRAIN WWO CONT | $3,067.20 | $5,112.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN WWO CONT | $3,067.20 | $5,112.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE WO CONT | $2,193.60 | $3,656.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE WO CONT | $2,193.60 | $3,656.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB GREATER THAN 14WKS | $409.80 | $683.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB GREATER THAN 14WKS | $409.80 | $683.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $135.00 | $225.00 | 40% |
| Screening mammogram, both breasts both sides CPT 77067 SCREEN MMG DIR DIGITAL BI | $156.60 | $261.00 | 40% |
| Screening mammogram, both breasts one side CPT 77067 SCREENING MAMMOGRAM LT W CAD | $79.20 | $132.00 | 40% |
| Screening mammogram, both breasts one side CPT 77067 SCREENING MAMMOGRAM RT W CAD | $79.20 | $132.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD | $135.00 | $225.00 | 40% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREEN MMG DIR DIGITAL BI | $156.60 | $261.00 | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 SCREENING MAMMOGRAM RT W CAD | $79.20 | $132.00 | 40% |
| Screening mammogram, both breasts inpatient one side CPT 77067 SCREENING MAMMOGRAM LT W CAD | $79.20 | $132.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNOGRAPHY 4 CH | $1,858.80 | $3,098.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNOGRAPHY 4 CH | $1,858.80 | $3,098.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL (NONOBSTETRIC) | $651.00 | $1,085.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL (NONOBSTETRIC) | $651.00 | $1,085.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 ABDOMEN UPPER | $987.00 | $1,645.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN UPPER | $987.00 | $1,645.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE W OBLIQUES | $534.00 | $890.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE W OBLIQUES | $534.00 | $890.00 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 CHEMISTRY PANEL 7 | $123.00 | $205.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 CHEMISTRY PANEL 7 | $123.00 | $205.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $138.60 | $231.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE,HDL | $138.60 | $231.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $138.60 | $231.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE,HDL | $138.60 | $231.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT,CBC AND DIFF | $86.40 | $144.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE BLOOD COUNT W/DIFF | $91.80 | $153.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HEMAGRAM | $91.80 | $153.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 BLOOD COUNT,CBC AND DIFF | $86.40 | $144.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HEMAGRAM | $91.80 | $153.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE BLOOD COUNT W/DIFF | $91.80 | $153.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 HEMAGRAM (MANUAL CBC) | $13.80 | $23.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 HEMAGRAM | $48.00 | $80.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC HANDWRITTEN ORDER | $48.00 | $80.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMAGRAM (MANUAL CBC) | $13.80 | $23.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC HANDWRITTEN ORDER | $48.00 | $80.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HEMAGRAM | $48.00 | $80.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 CMP PICCOLO | $134.40 | $224.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 METABOLIC PROFILE | $134.40 | $224.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 METABOLIC PROFILE | $134.40 | $224.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP PICCOLO | $134.40 | $224.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $64.80 | $108.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $64.80 | $108.00 | 40% |
| Liver function blood test panel CPT 80076 LIVER PROFILE | $58.80 | $98.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 LIVER PROFILE | $58.80 | $98.00 | 40% |
| Obstetric blood test panel CPT 80055 RPR/OB PROFILE | $156.00 | $260.00 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PROFILE OUTPATIENT | $156.00 | $260.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 RPR/OB PROFILE | $156.00 | $260.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PROFILE OUTPATIENT | $156.00 | $260.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 FREE PSA | $42.60 | $71.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE PSA | $42.60 | $71.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 TOTAL PSA | $42.60 | $71.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPECIFIC AG | $129.60 | $216.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING TEST | $132.60 | $221.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 TOTAL PSA | $42.60 | $71.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPECIFIC AG | $129.60 | $216.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING TEST | $132.60 | $221.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-MIXING STUDY | $15.00 | $25.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PARTIAL THROMBOPLASTIN TIME | $51.60 | $86.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 PTT (LAC) SCREEN | $106.20 | $177.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 FACTOR 8 SCREEN (PTT) | $106.20 | $177.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-MIXING STUDY | $15.00 | $25.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $51.60 | $86.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 FACTOR 8 SCREEN (PTT) | $106.20 | $177.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT (LAC) SCREEN | $106.20 | $177.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME PT | $30.60 | $51.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME PT | $30.60 | $51.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (NEONATE) | $36.00 | $60.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE | $117.00 | $195.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (PKU) 50177 | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 20 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE-HS | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 40 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 30 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH 60 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (NEONATE) | $36.00 | $60.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE | $117.00 | $195.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 60 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (PKU) 50177 | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE-HS | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 40 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 30 MINUTE POST | $148.20 | $247.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH 20 MINUTE POST | $148.20 | $247.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS | $57.00 | $95.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/O CULTURE | $73.20 | $122.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS | $57.00 | $95.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/O CULTURE | $73.20 | $122.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 SPECIFIC GRAVITY | $27.00 | $45.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 OB-UA | $27.00 | $45.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK W/O MICRO | $27.00 | $45.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 SPECIFIC GRAVITY | $27.00 | $45.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 OB-UA | $27.00 | $45.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK W/O MICRO | $27.00 | $45.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 REMOVE CATARACT, INSERT LENS | $6,457.80 | $10,763.00 | 40% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY, LESION REMOVAL | $1,455.60 | $2,426.00 | 40% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $1,455.60 | $2,426.00 | 40% |
| Colonoscopy, diagnostic CPT 45378 DIAGNOSTIC COLONOSCOPY | $1,455.60 | $2,426.00 | 40% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY; CHOLECYSTECOMY | $8,391.00 | $13,985.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older both sides CPT 49505 INGUIN HERNIA RPR >5YO BILAT | $5,239.80 | $8,733.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA | $3,079.20 | $5,132.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 INGUIN HERNIA REPAIR > 5 YO | $4,030.80 | $6,718.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient both sides CPT 49505 INGUIN HERNIA RPR >5YO BILAT | $5,239.80 | $8,733.00 | 40% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 REPAIR INGUINAL HERNIA | $3,079.20 | $5,132.00 | 40% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTH SUR KNEE MENISCEC MED/LAT | $4,545.00 | $7,575.00 | 40% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTH SUR KNEE MENISCEC MED/LAT | $5,908.20 | $9,847.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) both sides CPT 66821 BILATERAL YAG CAPSULOTOMY | $1,621.20 | $2,702.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 YAG CAPSULOTOMY | $1,246.80 | $2,078.00 | 40% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient both sides CPT 66821 BILATERAL YAG CAPSULOTOMY | $1,621.20 | $2,702.00 | 40% |
| Left heart catheterization, diagnostic CPT 93452 LHC W VGRAM W SI | $3,351.60 | $5,586.00 | 40% |
| Left heart catheterization, diagnostic inpatient CPT 93452 LHC W VGRAM W SI | $3,351.60 | $5,586.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 INJ, EPIDURAL SPACE W GUIDANCE | $1,186.20 | $1,977.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ, EPIDURAL SPACE W GUIDANCE | $1,186.20 | $1,977.00 | 40% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $721.80 | $1,203.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance both sides CPT 64483 BILAT INJ TRANSFORAM EPI LUMB | $2,260.80 | $3,768.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 IR INJ FORAMEN EPIDURAL L/S | $1,409.40 | $2,349.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 INJ TRANSFORAMINAL EPI LUMB | $1,740.00 | $2,900.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient both sides CPT 64483 BILAT INJ TRANSFORAM EPI LUMB | $2,260.80 | $3,768.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 IR INJ FORAMEN EPIDURAL L/S | $1,409.40 | $2,349.00 | 40% |
| Prostate biopsy CPT 55700 PROSTATE NEEDLE PUNCH BX | $1,455.60 | $2,426.00 | 40% |
| Removal of a breast lump, open surgery both sides CPT 19120 EXC BREAST LES 1+ BILAT | $6,409.80 | $10,683.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXCISION OF CYST(S) | $774.00 | $1,290.00 | 40% |
| Removal of a breast lump, open surgery CPT 19120 EXC BREAST LESION WO/NDLE LOC | $2,807.40 | $4,679.00 | 40% |
| Removal of a breast lump, open surgery inpatient both sides CPT 19120 EXC BREAST LES 1+ BILAT | $6,409.80 | $10,683.00 | 40% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXCISION OF CYST(S) | $774.00 | $1,290.00 | 40% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTH SHLDR SRG DECOMP W/RELEAS | $4,523.40 | $7,539.00 | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 TONSIL & ADENOID; <12 YO | $2,807.40 | $4,679.00 | 40% |
| Total knee replacement CPT 27447 TOTAL KNEE ARTHROPLASTY | $17,212.80 | $28,688.00 | 40% |
| Total knee replacement inpatient CPT 27447 TOTAL KNEE ARTHROPLASTY | $17,212.80 | $28,688.00 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY | $1,455.60 | $2,426.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY,DIAGNOSIS | $554.40 | $924.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPER GI ENDOSCOPY, DX | $1,455.60 | $2,426.00 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UPPER GI ENDOSCOPY,DIAGNOSIS | $554.40 | $924.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY THERAPY W PT | $190.20 | $317.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY THERAPY W PT | $190.20 | $317.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY GROUP WO PT | $190.20 | $317.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY GROUP WO PT | $190.20 | $317.00 | 40% |
| Group psychotherapy session CPT 90853 INTERACTIVE GRP THPY 45-50 MIN | $169.20 | $282.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP THERAPY 45-50 MIN | $169.20 | $282.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 INTERACTIVE GRP THPY 45-50 MIN | $169.20 | $282.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY 45-50 MIN | $169.20 | $282.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 PHY NEW PAT EVAL L3 | $133.20 | $222.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LVL 3 MOD 25 | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 PH II PULM REHAB EVAL L3 NP | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 LEVEL 3 NP | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PAT. EVAL. L3 | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PATIENT LEVEL 3 | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 NEW PAT EVAL L3 | $185.40 | $309.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 PH II PULM REHAB EVAL L3 NP | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LEVEL 3 | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PATIENT LVL 3 MOD 25 | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PAT. EVAL. L3 | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 LEVEL 3 NP | $138.00 | $230.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 NEW PAT EVAL L3 | $185.40 | $309.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LEVEL 4 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PATIENT LVL 4 MOD 25 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PAT. EVAL. L4 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 PH II PULM REHAB EVAL L4 NP | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 LEVEL 4 NP | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 PHY NEW PAT EVAL L4 | $226.80 | $378.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 NEW PAT EVAL L4 | $284.40 | $474.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LEVEL 4 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 LEVEL 4 NP | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 PH II PULM REHAB EVAL L4 NP | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PATIENT LVL 4 MOD 25 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PAT. EVAL. L4 | $175.20 | $292.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 NEW PAT EVAL L4 | $284.40 | $474.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LVL 5 MOD 25 | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 LEVEL 5 NP | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PAT. EVAL. L5 | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PATIENT LEVEL 5 | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 PHY NEW PAT EVAL L5 | $295.20 | $492.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 NEW PAT EVAL L5 | $356.40 | $594.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 LEVEL 5 NP | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LVL 5 MOD 25 | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PATIENT LEVEL 5 | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PAT. EVAL. L5 | $224.40 | $374.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 NEW PAT EVAL L5 | $356.40 | $594.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISE EA15M | $57.60 | $96.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EX EACH 15MIN | $57.60 | $96.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EX (PT) W HOTORCOLD PK | $77.40 | $129.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EX (OT) W HOTORCOLD PK | $77.40 | $129.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE EA15M | $57.60 | $96.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EX EACH 15MIN | $57.60 | $96.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EX (OT) W HOTORCOLD PK | $77.40 | $129.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EX (PT) W HOTORCOLD PK | $77.40 | $129.00 | 40% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE CONSULT LEVEL 3 | $172.20 | $287.00 | 40% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 OFFICE CONSULT LEVEL 3 | $172.20 | $287.00 | 40% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE CONSULT LEVEL 4 | $274.80 | $458.00 | 40% |
| Specialist consultation, moderate complexity or 40+ minutes inpatient CPT 99244 OFFICE CONSULT LEVEL 4 | $274.80 | $458.00 | 40% |