Hospital

CHI LakeWood Health

CHI LakeWood Health in Baudette, MN publishes cash prices for 212 common procedures listed here, from its own machine-readable price file updated Aug 6, 2024. Compared with other hospitals in the state, its outpatient cash prices are below the Minnesota median for 105 of 209 procedures and above it for 104. Click a procedure to compare it with other hospitals nearby.

600 South Main, Baudette, MN 56623 Collected Sep 28, 2026 Source price file

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 3 actions for a hospital named CHI LakeWood Health in Baudette, MN:

Mar 9, 2023 Warning notice
Mar 14, 2024 Case closed
Jun 9, 2025 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. 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 Minnesota	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV ANKLE BRACHIAL INDEX (ABI)	$375.50	$502.00	$276.10–$491.96	1% above	25%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV ANKLE BRACHIAL INDEX (ABI)	$375.50	$502.00	$195.78–$491.96	—	25%
Barium swallow (esophagus X-ray with contrast) CPT 74220 ESOPHAGUS	$496.68	$664.00	$365.20–$650.72	70% above	25%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 ESOPHAGUS	$496.68	$664.00	$258.96–$650.72	—	25%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE SCAN WHOLE BODY	$1,747.33	$2,336.00	$1,284.80–$2,289.28	43% above	25%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE SCAN WHOLE BODY	$1,747.33	$2,336.00	$911.04–$2,289.28	—	25%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 ANG CHEST	$1,528.17	$2,043.00	$315.00–$2,002.14	8% below	25%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 ANG CHEST	$1,528.17	$2,043.00	$796.77–$2,002.14	—	25%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 ABDOMEN PELVIS WO CONT	$3,171.52	$4,240.00	$393.75–$4,155.20	66% above	25%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 ABDOMEN PELVIS WO CONT	$3,171.52	$4,240.00	$1,653.60–$4,155.20	—	25%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 ABDOMEN PELVIS W CONT	$3,742.25	$5,003.00	$393.75–$4,902.94	52% above	25%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 ABDOMEN PELVIS W CONT	$3,742.25	$5,003.00	$1,951.17–$4,902.94	—	25%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 ABDOMEN PELVIS W WO CONT	$5,073.69	$6,783.00	$393.75–$6,647.34	97% above	25%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 ABDOMEN PELVIS W WO CONT	$5,073.69	$6,783.00	$2,645.37–$6,647.34	—	25%
CT scan of the abdomen with contrast CPT 74160 ABDOMEN W CONT	$1,754.81	$2,346.00	$393.75–$2,299.08	20% above	25%
CT scan of the abdomen with contrast inpatient CPT 74160 ABDOMEN W CONT	$1,754.81	$2,346.00	$914.94–$2,299.08	—	25%
CT scan of the abdomen without contrast CPT 74150 ABDOMEN WO CONT	$1,482.54	$1,982.00	$315.00–$1,942.36	26% above	25%
CT scan of the abdomen without contrast inpatient CPT 74150 ABDOMEN WO CONT	$1,482.54	$1,982.00	$772.98–$1,942.36	—	25%
CT scan of the face and sinuses, no contrast dye CPT 70486 MAX FACIAL SINUS WO CONT	$1,340.42	$1,792.00	$315.00–$1,756.16	7% above	25%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 MAX FACIAL SINUS WO CONT	$1,340.42	$1,792.00	$698.88–$1,756.16	—	25%
CT scan of the head or brain, no contrast dye CPT 70450 HEAD WO CONT	$1,576.79	$2,108.00	$393.75–$2,065.84	25% above	25%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 HEAD WO CONT	$1,576.79	$2,108.00	$822.12–$2,065.84	—	25%
CT scan of the head with contrast CPT 70460 HEAD W CONT	$2,034.56	$2,720.00	$393.75–$2,665.60	57% above	25%
CT scan of the head with contrast inpatient CPT 70460 HEAD W CONT	$2,034.56	$2,720.00	$1,060.80–$2,665.60	—	25%
CT scan of the head without and with contrast CPT 70470 HEAD W WO CONT	$2,318.06	$3,099.00	$393.75–$3,037.02	46% above	25%
CT scan of the head without and with contrast inpatient CPT 70470 HEAD W WO CONT	$2,318.06	$3,099.00	$1,208.61–$3,037.02	—	25%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 LUMBAR SPINE WO CONT	$1,481.04	$1,980.00	$315.00–$1,940.40	9% above	25%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 LUMBAR SPINE WO CONT	$1,481.04	$1,980.00	$772.20–$1,940.40	—	25%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CERVICAL SPINE WO CONT	$1,582.02	$2,115.00	$315.00–$2,072.70	17% above	25%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CERVICAL SPINE WO CONT	$1,582.02	$2,115.00	$824.85–$2,072.70	—	25%
CT scan of the pelvis, with contrast dye CPT 72193 PELVIS W CONT	$1,711.43	$2,288.00	$393.75–$2,242.24	16% above	25%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 PELVIS W CONT	$1,711.43	$2,288.00	$892.32–$2,242.24	—	25%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CV CAROTID DUPLEX COMP	$1,015.04	$1,357.00	$746.35–$1,329.86	23% above	25%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 CAROTID COMP	$1,035.98	$1,385.00	$761.75–$1,357.30	25% above	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CV CAROTID DUPLEX COMP	$1,015.04	$1,357.00	$529.23–$1,329.86	—	25%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 CAROTID COMP	$1,035.98	$1,385.00	$540.15–$1,357.30	—	25%
Chest X-ray, 2 views CPT 71046 CHEST 2V	$445.81	$596.00	$327.80–$584.08	93% above	25%
Chest X-ray, 2 views inpatient CPT 71046 CHEST 2V	$445.81	$596.00	$232.44–$584.08	—	25%
Chest X-ray, single view CPT 71045 CHEST 1V FRONTAL	$424.87	$568.00	$312.40–$556.64	139% above	25%
Chest X-ray, single view inpatient CPT 71045 CHEST 1V FRONTAL	$424.87	$568.00	$221.52–$556.64	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 AORTA COMP DUPLEX	$630.57	$843.00	$463.65–$826.14	21% above	25%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 RENAL COMP	$647.02	$865.00	$475.75–$847.70	24% above	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 AORTA COMP DUPLEX	$630.57	$843.00	$328.77–$826.14	—	25%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 RENAL COMP	$647.02	$865.00	$337.35–$847.70	—	25%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA BONE DENSITY BODY	$483.21	$646.00	$355.30–$633.08	54% above	25%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA BONE DENSITY BODY	$483.21	$646.00	$251.94–$633.08	—	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA BONE DENSITY PERIPHERAL**	$473.49	$633.00	$348.15–$620.34	145% above	25%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA BONE DENSITY PERIPHERAL**	$473.49	$633.00	$246.87–$620.34	—	25%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CHEST WO CONT	$1,554.35	$2,078.00	$315.00–$2,036.44	24% above	25%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CHEST WO CONT	$1,554.35	$2,078.00	$810.42–$2,036.44	—	25%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CHEST W CONT	$2,176.68	$2,910.00	$393.75–$2,851.80	46% above	25%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CHEST W CONT	$2,176.68	$2,910.00	$1,134.90–$2,851.80	—	25%
Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMO DIGITAL BI	$372.51	$498.00	$273.90–$488.04	—	25%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMO DIGITAL BI	$372.51	$498.00	$194.22–$488.04	—	25%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 VL DUPLEX LWR EXT ART COMP BI	$1,103.30	$1,475.00	$811.25–$1,445.50	—	25%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 VL DUPLEX LWR EXT ART COMP BI	$1,103.30	$1,475.00	$575.25–$1,445.50	—	25%
Duplex ultrasound of the leg veins, both legs CPT 93970 VL DUPLEX LWR EXT VEINS COMP	$1,086.85	$1,453.00	$799.15–$1,423.94	22% above	25%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL DUPLEX LWR EXT VEINS COMP	$1,086.85	$1,453.00	$566.67–$1,423.94	—	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO PEDIATRIC COMP WO CONT	$1,448.88	$1,937.00	$1,065.35–$1,898.26	15% above	25%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ECHO COMP WO CONT	$1,478.80	$1,977.00	$1,087.35–$1,937.46	17% above	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO PEDIATRIC COMP WO CONT	$1,448.88	$1,937.00	$755.43–$1,898.26	—	25%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMP WO CONT	$1,478.80	$1,977.00	$771.03–$1,937.46	—	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 CHOLESCINTIGRAPHY	$1,337.43	$1,788.00	$983.40–$1,752.24	1% below	25%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 CHOLESCINTIGRAPHY	$1,337.43	$1,788.00	$697.32–$1,752.24	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 SLEEP STUDY W BIPAP OR CPAP	$2,268.69	$3,033.00	$1,668.15–$2,972.34	35% below	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOMNOGRAPHY	$2,268.69	$3,033.00	$1,668.15–$2,972.34	35% below	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 SLEEP STUDY W BIPAP OR CPAP	$2,268.69	$3,033.00	$1,182.87–$2,972.34	—	25%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOMNOGRAPHY	$2,268.69	$3,033.00	$1,182.87–$2,972.34	—	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ABDOMEN LTD	$456.28	$610.00	$335.50–$597.80	9% above	25%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ABDOMEN LTD	$456.28	$610.00	$237.90–$597.80	—	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 LUNG SCREEN PROTOCOL	$538.56	$720.00	$396.00–$705.60	7% below	25%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 LUNG SCREEN PROTOCOL	$538.56	$720.00	$280.80–$705.60	—	25%
MRI of the abdomen without contrast CPT 74181 ABDOMEN WO CONT	$3,143.85	$4,203.00	$472.50–$4,118.94	45% above	25%
MRI of the abdomen without contrast inpatient CPT 74181 ABDOMEN WO CONT	$3,143.85	$4,203.00	$1,639.17–$4,118.94	—	25%
MRI of the abdomen, without and then with contrast dye CPT 74183 ABDOMEN W WO CONT	$3,755.71	$5,021.00	$498.75–$4,920.58	27% above	25%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 ABDOMEN W WO CONT	$3,755.71	$5,021.00	$1,958.19–$4,920.58	—	25%
MRI of the brain, no contrast dye CPT 70551 BRAIN WO CONT	$3,446.79	$4,608.00	$472.50–$4,515.84	69% above	25%
MRI of the brain, no contrast dye inpatient CPT 70551 BRAIN WO CONT	$3,446.79	$4,608.00	$1,797.12–$4,515.84	—	25%
MRI of the brain, with and without contrast dye CPT 70553 BRAIN W WO CONT	$4,203.02	$5,619.00	$498.75–$5,506.62	56% above	25%
MRI of the brain, with and without contrast dye inpatient CPT 70553 BRAIN W WO CONT	$4,203.02	$5,619.00	$2,191.41–$5,506.62	—	25%
MRI of the lower back, no contrast dye CPT 72148 LUMBAR SPINE COMP WO CONT	$3,313.64	$4,430.00	$472.50–$4,341.40	58% above	25%
MRI of the lower back, no contrast dye inpatient CPT 72148 LUMBAR SPINE COMP WO CONT	$3,313.64	$4,430.00	$1,727.70–$4,341.40	—	25%
MRI of the lower back, without and then with contrast dye CPT 72158 LUMBAR SPINE COMP W WO CONT	$4,042.20	$5,404.00	$498.75–$5,295.92	58% above	25%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 LUMBAR SPINE COMP W WO CONT	$4,042.20	$5,404.00	$2,107.56–$5,295.92	—	25%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 THORACIC SPINE COMP WO CONT	$3,223.14	$4,309.00	$472.50–$4,222.82	52% above	25%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 THORACIC SPINE COMP WO CONT	$3,223.14	$4,309.00	$1,680.51–$4,222.82	—	25%
MRI of the neck (cervical spine) without and with contrast CPT 72156 CERVICAL SPINE COMP W WO CONT	$3,903.82	$5,219.00	$498.75–$5,114.62	56% above	25%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 CERVICAL SPINE COMP W WO CONT	$3,903.82	$5,219.00	$2,035.41–$5,114.62	—	25%
MRI of the neck (cervical spine), no contrast dye CPT 72141 CERVICAL SPINE COMP WO CONT	$3,394.43	$4,538.00	$472.50–$4,447.24	60% above	25%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 CERVICAL SPINE COMP WO CONT	$3,394.43	$4,538.00	$1,769.82–$4,447.24	—	25%
MRI of the pelvis without and with contrast CPT 72197 PELVIS W WO CONT	$3,485.68	$4,660.00	$498.75–$4,566.80	31% above	25%
MRI of the pelvis without and with contrast inpatient CPT 72197 PELVIS W WO CONT	$3,485.68	$4,660.00	$1,817.40–$4,566.80	—	25%
MRI of the pelvis, no contrast dye CPT 72195 PELVIS WO CONT	$3,143.85	$4,203.00	$472.50–$4,118.94	49% above	25%
MRI of the pelvis, no contrast dye inpatient CPT 72195 PELVIS WO CONT	$3,143.85	$4,203.00	$1,639.17–$4,118.94	—	25%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 MYOCARDIAL PERF SPECT MULTI	$3,596.39	$4,808.00	$2,644.40–$4,711.84	27% above	25%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 MYOCARDIAL PERF SPECT MULTI	$3,596.39	$4,808.00	$1,875.12–$4,711.84	—	25%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 PELVIS NON OB LTD	$691.16	$924.00	$508.20–$905.52	126% above	25%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 PELVIS NON OB LTD	$691.16	$924.00	$360.36–$905.52	—	25%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 PELVIS NON OB COMP	$785.40	$1,050.00	$577.50–$1,029.00	68% above	25%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 PELVIS NON OB COMP	$785.40	$1,050.00	$409.50–$1,029.00	—	25%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST	$783.16	$1,047.00	$575.85–$1,026.06	64% above	25%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB 2 OR 3 TRI SGL 1ST GEST	$783.16	$1,047.00	$408.33–$1,026.06	—	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB 1ST TRI SGL 1ST GEST	$607.38	$812.00	$446.60–$795.76	45% above	25%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB 1ST TRI SGL 1ST GEST	$607.38	$812.00	$316.68–$795.76	—	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 AMNIO FLUID INDEX	$500.42	$669.00	$367.95–$655.62	56% above	25%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 AMNIO FLUID INDEX	$500.42	$669.00	$260.91–$655.62	—	25%
Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMO DIGITAL BI	$372.51	$498.00	$97.68–$488.04	—	25%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREEN DIG IMPLANT BI	$543.80	$727.00	$97.68–$712.46	—	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMO DIGITAL BI	$372.51	$498.00	$194.22–$488.04	—	25%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREEN DIG IMPLANT BI	$543.80	$727.00	$283.53–$712.46	—	25%
Sleep study in a lab (polysomnography) CPT 95810 SLEEP STUDY W MIN 4 PARAMETERS	$2,140.03	$2,861.00	$1,573.55–$2,803.78	31% below	25%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STUDY W MIN 4 PARAMETERS	$2,140.03	$2,861.00	$1,115.79–$2,803.78	—	25%
Swallow study (modified barium swallow, video X-ray) CPT 74230 SWALLOWING FUNCTION W VIDEO	$183.26	$245.00	$134.75–$240.10	38% below	25%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 SWALLOWING FUNCTION W VIDEO	$183.26	$245.00	$95.55–$240.10	—	25%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL NON OB	$596.16	$797.00	$438.35–$781.06	54% above	25%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL NON OB	$596.16	$797.00	$310.83–$781.06	—	25%
Transvaginal ultrasound during pregnancy CPT 76817 OB TRANSVAGINAL	$556.52	$744.00	$409.20–$729.12	64% above	25%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 OB TRANSVAGINAL	$556.52	$744.00	$290.16–$729.12	—	25%
Ultrasound of the abdomen, complete CPT 76700 ABDOMEN COMP	$785.40	$1,050.00	$577.50–$1,029.00	34% above	25%
Ultrasound of the abdomen, complete inpatient CPT 76700 ABDOMEN COMP	$785.40	$1,050.00	$409.50–$1,029.00	—	25%
Ultrasound of the scrotum and testicles CPT 76870 SCROTUM AND CONTENTS	$556.52	$744.00	$409.20–$729.12	22% above	25%
Ultrasound of the scrotum and testicles inpatient CPT 76870 SCROTUM AND CONTENTS	$556.52	$744.00	$290.16–$729.12	—	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HEAD NECK SOFT TISSUE	$221.41	$296.00	$162.80–$290.08	51% below	25%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 HEAD NECK SOFT TISSUE	$221.41	$296.00	$115.44–$290.08	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI	$505.65	$676.00	$371.80–$662.48	58% above	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 UGI WO KUB	$665.72	$890.00	$489.50–$872.20	108% above	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI	$505.65	$676.00	$263.64–$662.48	—	25%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 UGI WO KUB	$665.72	$890.00	$347.10–$872.20	—	25%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V CROSS TABLE LATERAL	$457.78	$612.00	$336.60–$599.76	117% above	25%
X-ray of the abdomen, 1 view CPT 74018 ABDOMEN 1V DECUBITIS	$471.24	$630.00	$346.50–$617.40	124% above	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1V CROSS TABLE LATERAL	$457.78	$612.00	$238.68–$599.76	—	25%
X-ray of the abdomen, 1 view inpatient CPT 74018 ABDOMEN 1V DECUBITIS	$471.24	$630.00	$245.70–$617.40	—	25%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 LUMBAR SPINE 2 OR 3V	$596.91	$798.00	$438.90–$782.04	127% above	25%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 LUMBAR SPINE 2 OR 3V	$596.91	$798.00	$311.22–$782.04	—	25%
X-ray of the lower back, 4 or more views CPT 72110 LUMBAR SPINE MIN 4V	$769.70	$1,029.00	$565.95–$1,008.42	125% above	25%
X-ray of the lower back, 4 or more views inpatient CPT 72110 LUMBAR SPINE MIN 4V	$769.70	$1,029.00	$401.31–$1,008.42	—	25%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 THORACIC SPINE 2V	$447.31	$598.00	$328.90–$586.04	82% above	25%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 THORACIC SPINE 2V	$447.31	$598.00	$233.22–$586.04	—	25%
X-ray of the nasal bones, 3 or more views CPT 70160 NASAL BONE MIN 3V	$379.99	$508.00	$279.40–$497.84	74% above	25%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 NASAL BONE MIN 3V	$379.99	$508.00	$198.12–$497.84	—	25%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 CERVICAL SPINE 2V OR 3V	$531.08	$710.00	$390.50–$695.80	114% above	25%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 CERVICAL SPINE 2V OR 3V	$531.08	$710.00	$276.90–$695.80	—	25%
X-ray of the pelvis, 1 or 2 views CPT 72170 PELVIS 1V OR 2V	$548.29	$733.00	$403.15–$718.34	174% above	25%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 PELVIS 1V OR 2V	$548.29	$733.00	$285.87–$718.34	—	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SACRUM COCCYX MIN 2V	$403.92	$540.00	$297.00–$529.20	78% above	25%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SACRUM COCCYX MIN 2V	$403.92	$540.00	$210.60–$529.20	—	25%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$46.38	$62.00	$5.30–$60.76	3% above	25%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$46.38	$62.00	$24.18–$60.76	—	25%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$46.38	$62.00	$5.18–$60.76	4% above	25%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$46.38	$62.00	$24.18–$60.76	—	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS; ACUTE W HCV NAA RFL	$74.06	$99.00	$47.63–$97.02	68% below	25%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL; ACUTE; REFLEX	$359.79	$481.00	$47.63–$471.38	54% above	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS; ACUTE W HCV NAA RFL	$74.06	$99.00	$38.61–$97.02	—	25%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL; ACUTE; REFLEX	$359.79	$481.00	$187.59–$471.38	—	25%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE EGG WHITE	$6.86	$9.16	$5.04–$8.98	55% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE SESAME SEED	$6.92	$9.24	$5.08–$9.06	54% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; FOOD; GLUTEN	$9.88	$13.20	$5.22–$12.94	35% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; ALMOND IGE	$10.48	$14.00	$5.22–$13.72	31% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; CAT DANDER IGE	$11.22	$15.00	$5.22–$14.70	26% below	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; ALTERN TENUIS IGE	$20.95	$28.00	$5.22–$27.44	38% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; APPLE IGE	$22.44	$30.00	$5.22–$29.40	48% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS DUST/MITE PROFILE 4	$44.88	$60.00	$5.22–$58.80	195% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; GLUTEN IGE	$52.36	$70.00	$5.22–$68.60	244% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS; MOLD PROFILE 5	$53.86	$72.00	$5.22–$70.56	254% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS (5)	$59.84	$80.00	$5.22–$78.40	294% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN; BETA-LACTOGLOB IGE	$61.34	$82.00	$5.22–$80.36	304% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 CATFISH AB; IGE	$78.54	$105.00	$5.22–$102.90	417% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 BLACK BEAN AB; IGE	$87.52	$117.00	$5.22–$114.66	476% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 FLAXSEED/LINSEED	$93.50	$125.00	$5.22–$122.50	515% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 IGE ASPERGILLUS FUMIGATUS	$97.24	$130.00	$5.22–$127.40	540% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 PEANUT; WHOLE W/COMP.X 5	$100.98	$135.00	$5.22–$132.30	564% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 QUINOA AB; IGE	$102.48	$137.00	$5.22–$134.26	574% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 FOOD ALLERGY PROFILE 12 X 11	$109.96	$147.00	$5.22–$144.06	623% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 CHILDHOOD ALLERGY 15 X14	$128.66	$172.00	$5.22–$168.56	746% above	25%
Allergy blood test, specific IgE, per allergen CPT 86003 ADULT COMP FOOD PROFILE X34	$325.38	$435.00	$5.22–$426.30	2041% above	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE EGG WHITE	$6.86	$9.16	$3.57–$8.98	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE SESAME SEED	$6.92	$9.24	$3.60–$9.06	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; FOOD; GLUTEN	$9.88	$13.20	$5.15–$12.94	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; ALMOND IGE	$10.48	$14.00	$5.46–$13.72	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; CAT DANDER IGE	$11.22	$15.00	$5.85–$14.70	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; ALTERN TENUIS IGE	$20.95	$28.00	$10.92–$27.44	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; APPLE IGE	$22.44	$30.00	$11.70–$29.40	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS DUST/MITE PROFILE 4	$44.88	$60.00	$23.40–$58.80	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; GLUTEN IGE	$52.36	$70.00	$27.30–$68.60	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS; MOLD PROFILE 5	$53.86	$72.00	$28.08–$70.56	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS (5)	$59.84	$80.00	$31.20–$78.40	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN; BETA-LACTOGLOB IGE	$61.34	$82.00	$31.98–$80.36	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CATFISH AB; IGE	$78.54	$105.00	$40.95–$102.90	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 BLACK BEAN AB; IGE	$87.52	$117.00	$45.63–$114.66	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FLAXSEED/LINSEED	$93.50	$125.00	$48.75–$122.50	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 IGE ASPERGILLUS FUMIGATUS	$97.24	$130.00	$50.70–$127.40	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 PEANUT; WHOLE W/COMP.X 5	$100.98	$135.00	$52.65–$132.30	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 QUINOA AB; IGE	$102.48	$137.00	$53.43–$134.26	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 FOOD ALLERGY PROFILE 12 X 11	$109.96	$147.00	$57.33–$144.06	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 CHILDHOOD ALLERGY 15 X14	$128.66	$172.00	$67.08–$168.56	—	25%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ADULT COMP FOOD PROFILE X34	$325.38	$435.00	$169.65–$426.30	—	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINAT PEPTIDE;IGG	$13.47	$18.00	$9.90–$17.64	68% below	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CTD; CCP	$112.20	$150.00	$12.95–$147.00	168% above	25%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITRULLINATE PEP AB IGG	$115.20	$154.00	$12.95–$150.92	175% above	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINAT PEPTIDE;IGG	$13.47	$18.00	$7.02–$17.64	—	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CTD; CCP	$112.20	$150.00	$58.50–$147.00	—	25%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITRULLINATE PEP AB IGG	$115.20	$154.00	$60.06–$150.92	—	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA;IGG ELISA RFLX ANA;IGG IFA	$8.98	$12.00	$6.60–$12.00	80% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA MULTIPLEX W/ REFLEX	$41.14	$55.00	$12.09–$53.90	9% below	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES; IFA	$46.38	$62.00	$12.09–$60.76	3% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUC AB (ANA) EIA (REF)	$135.39	$181.00	$12.09–$177.38	201% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 CTD; ANA	$136.89	$183.00	$12.09–$179.34	204% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN (REFLEXIVE)	$139.88	$187.00	$12.09–$183.26	211% above	25%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTI-NUCLEAR AB (ANA); BY EIA	$142.12	$190.00	$12.09–$186.20	216% above	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA;IGG ELISA RFLX ANA;IGG IFA	$8.98	$12.00	$4.68–$11.76	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA MULTIPLEX W/ REFLEX	$41.14	$55.00	$21.45–$53.90	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES; IFA	$46.38	$62.00	$24.18–$60.76	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUC AB (ANA) EIA (REF)	$135.39	$181.00	$70.59–$177.38	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 CTD; ANA	$136.89	$183.00	$71.37–$179.34	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN (REFLEXIVE)	$139.88	$187.00	$72.93–$183.26	—	25%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR AB (ANA); BY EIA	$142.12	$190.00	$74.10–$186.20	—	25%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BNP	$367.27	$491.00	$39.26–$481.18	173% above	25%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP	$367.27	$491.00	$191.49–$481.18	—	25%
Basic metabolic panel (blood test) CPT 80048 BMP	$309.68	$414.00	$8.46–$405.72	247% above	25%
Basic metabolic panel (blood test) inpatient CPT 80048 BMP	$309.68	$414.00	$161.46–$405.72	—	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$181.19	$242.22	$133.22–$237.38	73% above	25%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS/MICRO L4	$270.78	$362.00	$199.10–$354.76	159% above	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$181.19	$242.22	$94.47–$237.38	—	25%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS/MICRO L4	$270.78	$362.00	$141.18–$354.76	—	25%
Blood culture for bacteria CPT 87040 BLOOD CULTURE; ROUTINE	$51.62	$69.00	$10.32–$67.62	53% below	25%
Blood culture for bacteria CPT 87040 CULT BLOOD AEROBIC	$271.53	$363.00	$10.32–$355.74	146% above	25%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE; ROUTINE	$51.62	$69.00	$26.91–$67.62	—	25%
Blood culture for bacteria inpatient CPT 87040 CULT BLOOD AEROBIC	$271.53	$363.00	$141.57–$355.74	—	25%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$28.43	$38.00	$3.00–$37.24	37% above	25%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$28.43	$38.00	$14.82–$37.24	—	25%
Blood glucose (sugar) test CPT 82947 MHPAN; GLUCOSE	$15.71	$21.00	$3.93–$20.58	65% below	25%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$43.39	$58.00	$3.93–$56.84	2% below	25%
Blood glucose (sugar) test CPT 82947 HRTMTB; GLUCOSE	$51.62	$69.00	$3.93–$67.62	16% above	25%
Blood glucose (sugar) test CPT 82947 GLUCOMETER NOVA	$89.76	$120.00	$3.93–$117.60	102% above	25%
Blood glucose (sugar) test inpatient CPT 82947 MHPAN; GLUCOSE	$15.71	$21.00	$8.19–$20.58	—	25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$43.39	$58.00	$22.62–$56.84	—	25%
Blood glucose (sugar) test inpatient CPT 82947 HRTMTB; GLUCOSE	$51.62	$69.00	$26.91–$67.62	—	25%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOMETER NOVA	$89.76	$120.00	$46.80–$117.60	—	25%
Blood lead test CPT 83655 LEAD; BLOOD (VENOUS)	$11.22	$15.00	$8.25–$14.70	64% below	25%
Blood lead test CPT 83655 LEAD; URINE 24 HR	$50.87	$68.00	$12.11–$66.64	63% above	25%
Blood lead test CPT 83655 LEAD; WHOLE BLOOD	$53.86	$72.00	$12.11–$70.56	73% above	25%
Blood lead test CPT 83655 LEAD	$55.36	$74.00	$12.11–$72.52	77% above	25%
Blood lead test inpatient CPT 83655 LEAD; BLOOD (VENOUS)	$11.22	$15.00	$5.85–$14.70	—	25%
Blood lead test inpatient CPT 83655 LEAD; URINE 24 HR	$50.87	$68.00	$26.52–$66.64	—	25%
Blood lead test inpatient CPT 83655 LEAD; WHOLE BLOOD	$53.86	$72.00	$28.08–$70.56	—	25%
Blood lead test inpatient CPT 83655 LEAD	$55.36	$74.00	$28.86–$72.52	—	25%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG QUAL. SERUM	$65.08	$87.00	$7.52–$85.26	6% below	25%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG QUAL. SERUM	$65.08	$87.00	$33.93–$85.26	—	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 OBPAN2; ABO	$19.45	$26.00	$2.99–$25.48	63% below	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 OBPAN1; ABO	$20.95	$28.00	$2.99–$27.44	60% below	25%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO	$173.54	$232.00	$2.99–$227.36	229% above	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 OBPAN2; ABO	$19.45	$26.00	$10.14–$25.48	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 OBPAN1; ABO	$20.95	$28.00	$10.92–$27.44	—	25%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO	$173.54	$232.00	$90.48–$227.36	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$17.96	$24.00	$5.18–$23.52	67% below	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 CRP	$83.03	$111.00	$5.18–$108.78	52% above	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$17.96	$24.00	$9.36–$23.52	—	25%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 CRP	$83.03	$111.00	$43.29–$108.78	—	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF TOXIN B GENE TCDB;RTPCR	$210.94	$282.00	$37.27–$276.36	59% above	25%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED	$228.14	$305.00	$37.27–$298.90	72% above	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF TOXIN B GENE TCDB;RTPCR	$210.94	$282.00	$109.98–$276.36	—	25%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED	$228.14	$305.00	$118.95–$298.90	—	25%
CA 19-9 blood test (tumor marker) CPT 86301 CANCER ANTIGEN-GI (CA 19-9)	$15.71	$21.00	$11.55–$20.81	85% below	25%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9	$285.74	$382.00	$20.81–$374.36	181% above	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CANCER ANTIGEN-GI (CA 19-9)	$15.71	$21.00	$8.19–$20.58	—	25%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9	$285.74	$382.00	$148.98–$374.36	—	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 CANCER ANTIGEN 125	$24.69	$33.00	$18.15–$32.34	76% below	25%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA 125	$285.74	$382.00	$20.81–$374.36	181% above	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CANCER ANTIGEN 125	$24.69	$33.00	$12.87–$32.34	—	25%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125	$285.74	$382.00	$148.98–$374.36	—	25%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 (COVID-19) BY NAA	$167.86	$224.40	$51.31–$219.91	40% above	25%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 (COVID-19) BY NAA	$167.86	$224.40	$87.52–$219.91	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SHPANM; CHLAMYDIA DNA	$17.96	$24.00	$13.20–$24.00	81% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 SHPANF; CHLAMYDIA DNA	$22.44	$30.00	$16.50–$30.00	76% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. TRACHOMATIS BY TMA	$44.88	$60.00	$33.00–$58.80	52% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA TRACHOMATIS; DNA PRO	$87.52	$117.00	$35.09–$114.66	7% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 APTCG; CHLAMYDIA	$89.02	$119.00	$35.09–$116.62	5% below	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 SHPANM; CHLAMYDIA DNA	$17.96	$24.00	$9.36–$23.52	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 SHPANF; CHLAMYDIA DNA	$22.44	$30.00	$11.70–$29.40	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. TRACHOMATIS BY TMA	$44.88	$60.00	$23.40–$58.80	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA TRACHOMATIS; DNA PRO	$87.52	$117.00	$45.63–$114.66	—	25%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 APTCG; CHLAMYDIA	$89.02	$119.00	$46.41–$116.62	—	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 BHPAN; LIPID	$17.21	$23.00	$12.65–$22.54	81% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HRTADV; LIPREF	$26.93	$36.00	$13.39–$35.28	71% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HRTMON; HRT LIPID PNL	$31.42	$42.00	$13.39–$41.16	66% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HRTMTB; LIPID PNL	$52.36	$70.00	$13.39–$68.60	43% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HEART LIPID PANEL (RFLX)	$53.86	$72.00	$13.39–$70.56	42% below	25%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$207.20	$277.00	$13.39–$271.46	124% above	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 BHPAN; LIPID	$17.21	$23.00	$8.97–$22.54	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HRTADV; LIPREF	$26.93	$36.00	$14.04–$35.28	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HRTMON; HRT LIPID PNL	$31.42	$42.00	$16.38–$41.16	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HRTMTB; LIPID PNL	$52.36	$70.00	$27.30–$68.60	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HEART LIPID PANEL (RFLX)	$53.86	$72.00	$28.08–$70.56	—	25%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$207.20	$277.00	$108.03–$271.46	—	25%
Complete blood count (CBC) with differential CPT 85025 BHPAN; CBC W/D	$14.96	$20.00	$7.77–$19.60	82% below	25%
Complete blood count (CBC) with differential CPT 85025 OBPAN1; CBC	$41.14	$55.00	$7.77–$53.90	51% below	25%
Complete blood count (CBC) with differential CPT 85025 CBC W/MANUAL DIFF	$141.38	$189.00	$7.77–$185.22	70% above	25%
Complete blood count (CBC) with differential inpatient CPT 85025 BHPAN; CBC W/D	$14.96	$20.00	$7.80–$19.60	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 OBPAN1; CBC	$41.14	$55.00	$21.45–$53.90	—	25%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/MANUAL DIFF	$141.38	$189.00	$73.71–$185.22	—	25%
Complete blood count (CBC), no differential CPT 85027 CBC W/O DIFF	$141.38	$189.00	$6.47–$185.22	116% above	25%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W/O DIFF	$141.38	$189.00	$73.71–$185.22	—	25%
Comprehensive metabolic panel (blood test) CPT 80053 BHPAN; CMP	$16.46	$22.00	$10.56–$21.56	83% below	25%
Comprehensive metabolic panel (blood test) CPT 80053 CMP	$538.56	$720.00	$10.56–$705.60	470% above	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 BHPAN; CMP	$16.46	$22.00	$8.58–$21.56	—	25%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP	$538.56	$720.00	$280.80–$705.60	—	25%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANT	$214.68	$287.00	$10.18–$281.26	117% above	25%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANT	$214.68	$287.00	$111.93–$281.26	—	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 WHOPAM; DEHYDRO.	$13.47	$18.00	$9.90–$18.00	77% below	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 MHOPAN; DEHYPORO	$17.96	$24.00	$13.20–$23.52	69% below	25%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-SO4	$153.34	$205.00	$22.23–$200.90	166% above	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 WHOPAM; DEHYDRO.	$13.47	$18.00	$7.02–$17.64	—	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 MHOPAN; DEHYPORO	$17.96	$24.00	$9.36–$23.52	—	25%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-SO4	$153.34	$205.00	$79.95–$200.90	—	25%
Estradiol blood test CPT 82670 WHOPAM; ESTRADIOL	$13.47	$18.00	$9.90–$18.00	80% below	25%
Estradiol blood test CPT 82670 MHOPAN; ESTRADIOL	$16.46	$22.00	$12.10–$22.00	75% below	25%
Estradiol blood test CPT 82670 ESTRADIOL BY IMMUNOASSAY	$20.20	$27.00	$14.85–$27.00	69% below	25%
Estradiol blood test CPT 82670 ESTRADIOL BY LC-MS/MS	$50.12	$67.00	$27.94–$65.66	24% below	25%
Estradiol blood test CPT 82670 ESTRADIOL BY MASS SPEC	$62.84	$84.00	$27.94–$82.32	5% below	25%
Estradiol blood test CPT 82670 ESTRADIOL	$74.80	$100.00	$27.94–$98.00	13% above	25%
Estradiol blood test inpatient CPT 82670 WHOPAM; ESTRADIOL	$13.47	$18.00	$7.02–$17.64	—	25%
Estradiol blood test inpatient CPT 82670 MHOPAN; ESTRADIOL	$16.46	$22.00	$8.58–$21.56	—	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL BY IMMUNOASSAY	$20.20	$27.00	$10.53–$26.46	—	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL BY LC-MS/MS	$50.12	$67.00	$26.13–$65.66	—	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL BY MASS SPEC	$62.84	$84.00	$32.76–$82.32	—	25%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$74.80	$100.00	$39.00–$98.00	—	25%
FSH (follicle-stimulating hormone) test CPT 83001 WHOPAM; FSH	$13.47	$18.00	$9.90–$18.00	81% below	25%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIMULATING HORMONE	$22.44	$30.00	$16.50–$29.40	68% below	25%
FSH (follicle-stimulating hormone) test CPT 83001 FSH; PITUITARY	$113.70	$152.00	$18.58–$148.96	61% above	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 WHOPAM; FSH	$13.47	$18.00	$7.02–$17.64	—	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE	$22.44	$30.00	$11.70–$29.40	—	25%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH; PITUITARY	$113.70	$152.00	$59.28–$148.96	—	25%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN;FECAL IMMUNOASSAY	$89.76	$120.00	$19.63–$117.60	7% above	25%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN; FECAL [ARUP]	$179.52	$240.00	$19.63–$235.20	113% above	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN;FECAL IMMUNOASSAY	$89.76	$120.00	$46.80–$117.60	—	25%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN; FECAL [ARUP]	$179.52	$240.00	$93.60–$235.20	—	25%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$20.20	$27.00	$13.63–$26.46	77% below	25%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$20.20	$27.00	$10.53–$26.46	—	25%
Folate (folic acid) blood test CPT 82746 FOLATE;SERUM	$11.22	$15.00	$8.25–$14.70	86% below	25%
Folate (folic acid) blood test CPT 82746 FOLATE	$166.81	$223.00	$14.70–$218.54	109% above	25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE;SERUM	$11.22	$15.00	$5.85–$14.70	—	25%
Folate (folic acid) blood test inpatient CPT 82746 FOLATE	$166.81	$223.00	$86.97–$218.54	—	25%
Free T3 thyroid hormone test CPT 84481 TRIIODOTHYRONINE;FREE FREE T3	$11.22	$15.00	$8.25–$15.00	89% below	25%
Free T3 thyroid hormone test CPT 84481 THPAN; FREE T3	$27.68	$37.00	$16.94–$36.26	73% below	25%
Free T3 thyroid hormone test CPT 84481 FREE T-3	$152.60	$204.00	$16.94–$199.92	49% above	25%
Free T3 thyroid hormone test inpatient CPT 84481 TRIIODOTHYRONINE;FREE FREE T3	$11.22	$15.00	$5.85–$14.70	—	25%
Free T3 thyroid hormone test inpatient CPT 84481 THPAN; FREE T3	$27.68	$37.00	$14.43–$36.26	—	25%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T-3	$152.60	$204.00	$79.56–$199.92	—	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE FREE	$17.96	$24.00	$9.02–$23.52	74% below	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T4 BY EQUIL DIALYSIS-TMS	$49.37	$66.00	$9.02–$64.68	28% below	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 FREE T-4	$90.51	$121.00	$9.02–$118.58	33% above	25%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE; EQUIL DIALY TMS	$92.01	$123.00	$9.02–$120.54	35% above	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE FREE	$17.96	$24.00	$9.36–$23.52	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 BY EQUIL DIALYSIS-TMS	$49.37	$66.00	$25.74–$64.68	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T-4	$90.51	$121.00	$47.19–$118.58	—	25%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE; EQUIL DIALY TMS	$92.01	$123.00	$47.97–$120.54	—	25%
Free testosterone test CPT 84402 TESTOSTERONE; FREE MASS SPEC	$13.47	$18.00	$9.90–$18.00	78% below	25%
Free testosterone test CPT 84402 TESTOSTERONE; FREE SERUM	$21.70	$29.00	$15.95–$28.42	65% below	25%
Free testosterone test CPT 84402 TESTOSTERONE; FREE ADULT MALES	$41.89	$56.00	$25.47–$54.88	33% below	25%
Free testosterone test CPT 84402 TESTOSTERONE; FREE BY DIALYSIS	$56.10	$75.00	$25.47–$73.50	10% below	25%
Free testosterone test CPT 84402 PTTMXS. PTT PATIENT	$111.46	$149.00	$25.47–$146.02	78% above	25%
Free testosterone test CPT 84402 TSTFM; TESTOSTERONE	$121.93	$163.00	$25.47–$159.74	95% above	25%
Free testosterone test CPT 84402 TESTOSTERONE	$125.67	$168.00	$25.47–$164.64	101% above	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE MASS SPEC	$13.47	$18.00	$7.02–$17.64	—	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE SERUM	$21.70	$29.00	$11.31–$28.42	—	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE ADULT MALES	$41.89	$56.00	$21.84–$54.88	—	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE; FREE BY DIALYSIS	$56.10	$75.00	$29.25–$73.50	—	25%
Free testosterone test inpatient CPT 84402 PTTMXS. PTT PATIENT	$111.46	$149.00	$58.11–$146.02	—	25%
Free testosterone test inpatient CPT 84402 TSTFM; TESTOSTERONE	$121.93	$163.00	$63.57–$159.74	—	25%
Free testosterone test inpatient CPT 84402 TESTOSTERONE	$125.67	$168.00	$65.52–$164.64	—	25%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$697.14	$932.00	$512.60–$913.36	181% above	25%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$697.14	$932.00	$363.48–$913.36	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE 2 HR	$77.05	$103.00	$4.75–$100.94	83% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE GESTATIONAL	$79.29	$106.00	$4.75–$103.88	88% above	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE 2 HR	$77.05	$103.00	$40.17–$100.94	—	25%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE GESTATIONAL	$79.29	$106.00	$41.34–$103.88	—	25%
Glucose tolerance test, 3 samples CPT 82951 GLU 3HR GESTATIONAL	$168.30	$225.00	$12.87–$220.50	75% above	25%
Glucose tolerance test, 3 samples CPT 82951 GTT2	$169.80	$227.00	$12.87–$222.46	77% above	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLU 3HR GESTATIONAL	$168.30	$225.00	$87.75–$220.50	—	25%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT2	$169.80	$227.00	$88.53–$222.46	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 SHPANM; N. GON. DNA	$17.96	$24.00	$13.20–$24.00	79% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 SHPANF; N.GON. DNA	$22.44	$30.00	$16.50–$30.00	73% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. GONORRHOEAE BY TMA	$44.88	$60.00	$33.00–$58.80	47% below	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEISSERIA GONORRHOEAE; DNA PRO	$87.52	$117.00	$35.09–$114.66	4% above	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 APTCG; GC	$89.02	$119.00	$35.09–$116.62	5% above	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 SHPANM; N. GON. DNA	$17.96	$24.00	$9.36–$23.52	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 SHPANF; N.GON. DNA	$22.44	$30.00	$11.70–$29.40	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. GONORRHOEAE BY TMA	$44.88	$60.00	$23.40–$58.80	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE; DNA PRO	$87.52	$117.00	$45.63–$114.66	—	25%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 APTCG; GC	$89.02	$119.00	$46.41–$116.62	—	25%
H. pylori antibody blood test CPT 86677 HELI PYLORI AB; IGG & IGG	$27.68	$37.00	$16.85–$36.26	76% below	25%
H. pylori antibody blood test CPT 86677 H.PYLORI AB IGA	$29.92	$40.00	$16.85–$39.20	75% below	25%
H. pylori antibody blood test CPT 86677 HELICOBACTER AB IGG	$95.75	$128.00	$16.85–$125.44	19% below	25%
H. pylori antibody blood test inpatient CPT 86677 HELI PYLORI AB; IGG & IGG	$27.68	$37.00	$14.43–$36.26	—	25%
H. pylori antibody blood test inpatient CPT 86677 H.PYLORI AB IGA	$29.92	$40.00	$15.60–$39.20	—	25%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER AB IGG	$95.75	$128.00	$49.92–$125.44	—	25%
H. pylori stool antigen test CPT 87338 HELICOBACT PYLORI AG;FECAL EIA	$38.15	$51.00	$14.38–$49.98	65% below	25%
H. pylori stool antigen test CPT 87338 HELI PYLORI ANTIGEN; STOOL	$162.32	$217.00	$14.38–$212.66	50% above	25%
H. pylori stool antigen test inpatient CPT 87338 HELICOBACT PYLORI AG;FECAL EIA	$38.15	$51.00	$19.89–$49.98	—	25%
H. pylori stool antigen test inpatient CPT 87338 HELI PYLORI ANTIGEN; STOOL	$162.32	$217.00	$84.63–$212.66	—	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANTITATIVE NAAT;PLASMA	$134.64	$180.00	$85.10–$176.40	17% above	25%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 ULTRA SENS VIRAL BY PCR	$207.95	$278.00	$85.10–$272.44	81% above	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANTITATIVE NAAT;PLASMA	$134.64	$180.00	$70.20–$176.40	—	25%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 ULTRA SENS VIRAL BY PCR	$207.95	$278.00	$108.42–$272.44	—	25%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1&2 ANTIBODY (REFLEXIVE)	$266.29	$356.00	$13.71–$348.88	301% above	25%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1&2 ANTIBODY (REFLEXIVE)	$266.29	$356.00	$138.84–$348.88	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 SHPANM; HIV1&2	$16.46	$22.00	$12.10–$22.00	74% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 SHPANF; HIV 1&2	$20.20	$27.00	$14.85–$26.46	68% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1;2 COMBO AG/AB;RFLX PNL	$22.44	$30.00	$16.50–$29.40	65% below	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 AG/AB RFX TO MULTISPOT	$164.56	$220.00	$24.08–$215.60	160% above	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 SHPANM; HIV1&2	$16.46	$22.00	$8.58–$21.56	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 SHPANF; HIV 1&2	$20.20	$27.00	$10.53–$26.46	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1;2 COMBO AG/AB;RFLX PNL	$22.44	$30.00	$11.70–$29.40	—	25%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 AG/AB RFX TO MULTISPOT	$164.56	$220.00	$85.80–$215.60	—	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 BILL ONLY HPV HIGH RISK REFLEX	$86.02	$115.00	$35.09–$112.70	33% below	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV NUCLEIC ACID AMPLIFICATION	$108.61	$145.20	$35.09–$142.30	16% below	25%
HPV test for high-risk types, one combined (pooled) result CPT 87624 PRIMARY HRHPV W/ PAP RFLX	$228.14	$305.00	$35.09–$298.90	77% above	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 BILL ONLY HPV HIGH RISK REFLEX	$86.02	$115.00	$44.85–$112.70	—	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV NUCLEIC ACID AMPLIFICATION	$108.61	$145.20	$56.63–$142.30	—	25%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 PRIMARY HRHPV W/ PAP RFLX	$228.14	$305.00	$118.95–$298.90	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 MHPAN; GLYCO HGB	$17.21	$23.00	$9.71–$22.54	70% below	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HRTMTB; GLYCO HGB	$51.62	$69.00	$9.71–$67.62	10% below	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCO HGB	$118.94	$159.00	$9.71–$155.82	106% above	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 MHPAN; GLYCO HGB	$17.21	$23.00	$8.97–$22.54	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HRTMTB; GLYCO HGB	$51.62	$69.00	$26.91–$67.62	—	25%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCO HGB	$118.94	$159.00	$62.01–$155.82	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEPATITIS B VIRUS SURFACE AB	$14.59	$19.50	$10.73–$19.11	78% below	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HB SURFACE AB	$51.62	$69.00	$10.74–$67.62	22% below	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEPATITIS B VIRUS SURFACE AB	$14.59	$19.50	$7.61–$19.11	—	25%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HB SURFACE AB	$51.62	$69.00	$26.91–$67.62	—	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBV SURFACE AG W/RFLX TO CONF	$11.22	$15.00	$8.25–$14.70	79% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 SHPANM; HBSAG	$14.96	$20.00	$10.33–$19.60	72% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 SHPANF; HBSAG	$18.70	$25.00	$10.33–$24.50	65% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 OBPAN2; HBSAG	$45.63	$61.00	$10.33–$59.78	14% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 OBPAN1; HBSAG	$46.38	$62.00	$10.33–$60.76	13% below	25%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HB SURFACE ANTIGEN; REFLEXIVE	$98.74	$132.00	$10.33–$129.36	85% above	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBV SURFACE AG W/RFLX TO CONF	$11.22	$15.00	$5.85–$14.70	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 SHPANM; HBSAG	$14.96	$20.00	$7.80–$19.60	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 SHPANF; HBSAG	$18.70	$25.00	$9.75–$24.50	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 OBPAN2; HBSAG	$45.63	$61.00	$23.79–$59.78	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 OBPAN1; HBSAG	$46.38	$62.00	$24.18–$60.76	—	25%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HB SURFACE ANTIGEN; REFLEXIVE	$98.74	$132.00	$51.48–$129.36	—	25%
Hepatitis C antibody blood test (screening) CPT 86803 SHPANM; HCV	$14.96	$20.00	$11.00–$19.60	81% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 SHPANF; HCV	$20.95	$28.00	$14.27–$27.44	74% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C VIRUS ANTIBODY CIA	$22.44	$30.00	$14.27–$29.40	72% below	25%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C	$163.82	$219.00	$14.27–$214.62	105% above	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 SHPANM; HCV	$14.96	$20.00	$7.80–$19.60	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 SHPANF; HCV	$20.95	$28.00	$10.92–$27.44	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY CIA	$22.44	$30.00	$11.70–$29.40	—	25%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C	$163.82	$219.00	$85.41–$214.62	—	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV BY QUANTITATIVE NAAT	$86.80	$116.04	$42.84–$113.72	30% below	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV GENOTYPE BY PCR/LIPA REF	$177.28	$237.00	$42.84–$232.26	43% above	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRAL RNA QT BDNA	$264.05	$353.00	$42.84–$345.94	113% above	25%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C VIRUS RNA QT PCR	$270.78	$362.00	$42.84–$354.76	118% above	25%
Hepatitis C viral load (HCV RNA) test one side CPT 87522 HCV RT PCR QNT REFLEX	$454.79	$608.00	$42.84–$595.84	267% above	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV BY QUANTITATIVE NAAT	$86.80	$116.04	$45.26–$113.72	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV GENOTYPE BY PCR/LIPA REF	$177.28	$237.00	$92.43–$232.26	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRAL RNA QT BDNA	$264.05	$353.00	$137.67–$345.94	—	25%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C VIRUS RNA QT PCR	$270.78	$362.00	$141.18–$354.76	—	25%
Hepatitis C viral load (HCV RNA) test inpatient one side CPT 87522 HCV RT PCR QNT REFLEX	$454.79	$608.00	$237.12–$595.84	—	25%
Herpes blood test, HSV-1 antibody CPT 86695 SHPANM; HS1	$14.96	$20.00	$11.00–$19.60	68% below	25%
Herpes blood test, HSV-1 antibody CPT 86695 SHPANF; HS1	$18.70	$25.00	$13.19–$24.50	60% below	25%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 GLYCOPROTEIN G AB; IGG	$30.30	$40.50	$13.19–$39.69	35% below	25%
Herpes blood test, HSV-1 antibody CPT 86695 HSV; TYPE I; IGG	$133.15	$178.00	$13.19–$174.44	187% above	25%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 TYPE-SPECIFIC IGG AB	$251.33	$336.00	$13.19–$329.28	442% above	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 SHPANM; HS1	$14.96	$20.00	$7.80–$19.60	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 SHPANF; HS1	$18.70	$25.00	$9.75–$24.50	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 GLYCOPROTEIN G AB; IGG	$30.30	$40.50	$15.80–$39.69	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV; TYPE I; IGG	$133.15	$178.00	$69.42–$174.44	—	25%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 TYPE-SPECIFIC IGG AB	$251.33	$336.00	$131.04–$329.28	—	25%
Herpes blood test, HSV-2 antibody CPT 86696 SHPANM; HS2	$14.22	$19.00	$10.45–$19.00	75% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 SHPANF; HS2	$17.96	$24.00	$13.20–$23.52	69% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 GLYCOPROTEIN G AB; IGG	$30.30	$40.50	$19.35–$39.69	47% below	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG SUPPLEMENTAL CHG	$97.99	$131.00	$19.35–$128.38	70% above	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV; TYPE 2; IGG	$133.15	$178.00	$19.35–$174.44	131% above	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 TYPE-SPECIFIC IGG AB	$257.32	$344.00	$19.35–$337.12	346% above	25%
Herpes blood test, HSV-2 antibody CPT 86696 HSV-2 IGG INHIBITION; BY ELISA	$322.58	$431.25	$19.35–$422.63	460% above	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 SHPANM; HS2	$14.22	$19.00	$7.41–$18.62	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 SHPANF; HS2	$17.96	$24.00	$9.36–$23.52	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 GLYCOPROTEIN G AB; IGG	$30.30	$40.50	$15.80–$39.69	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG SUPPLEMENTAL CHG	$97.99	$131.00	$51.09–$128.38	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV; TYPE 2; IGG	$133.15	$178.00	$69.42–$174.44	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 TYPE-SPECIFIC IGG AB	$257.32	$344.00	$134.16–$337.12	—	25%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV-2 IGG INHIBITION; BY ELISA	$322.58	$431.25	$168.19–$422.63	—	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 CHPAN; CRPHS	$26.18	$35.00	$12.95–$34.30	63% below	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HRTINF; HCRP	$32.17	$43.00	$12.95–$42.14	55% below	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP;HIGH SENSITIVITY	$35.91	$48.00	$12.95–$47.04	49% below	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 HIGH SENSITIVITY CRP	$115.20	$154.00	$12.95–$150.92	62% above	25%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP-HS	$118.94	$159.00	$12.95–$155.82	68% above	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CHPAN; CRPHS	$26.18	$35.00	$13.65–$34.30	—	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HRTINF; HCRP	$32.17	$43.00	$16.77–$42.14	—	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP;HIGH SENSITIVITY	$35.91	$48.00	$18.72–$47.04	—	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 HIGH SENSITIVITY CRP	$115.20	$154.00	$60.06–$150.92	—	25%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP-HS	$118.94	$159.00	$62.01–$155.82	—	25%
Homocysteine blood test CPT 83090 CHPAN; HOMCY	$23.19	$31.00	$17.05–$30.38	74% below	25%
Homocysteine blood test CPT 83090 HOMOCYSTEINE;TOTAL	$29.18	$39.00	$17.92–$38.22	67% below	25%
Homocysteine blood test CPT 83090 HOMOCYSTEINE; CARDIAC RISK	$375.50	$502.00	$17.92–$491.96	318% above	25%
Homocysteine blood test inpatient CPT 83090 CHPAN; HOMCY	$23.19	$31.00	$12.09–$30.38	—	25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE;TOTAL	$29.18	$39.00	$15.21–$38.22	—	25%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE; CARDIAC RISK	$375.50	$502.00	$195.78–$491.96	—	25%
Insulin blood test CPT 83525 INSULIN;FASTING	$17.96	$24.00	$11.43–$23.52	67% below	25%
Insulin blood test CPT 83525 INSULIN ASSAY	$216.18	$289.00	$11.43–$283.22	295% above	25%
Insulin blood test inpatient CPT 83525 INSULIN;FASTING	$17.96	$24.00	$9.36–$23.52	—	25%
Insulin blood test inpatient CPT 83525 INSULIN ASSAY	$216.18	$289.00	$112.71–$283.22	—	25%
Iron blood test (serum iron) CPT 83540 IRON;SERUM OR PLASMA	$10.48	$14.01	$6.47–$13.73	80% below	25%
Iron blood test (serum iron) CPT 83540 IRON;PLASMA OR SERUM	$13.69	$18.30	$6.47–$17.93	73% below	25%
Iron blood test (serum iron) CPT 83540 IRON	$58.35	$78.00	$6.47–$76.44	13% above	25%
Iron blood test (serum iron) CPT 83540 IRON; TOTAL	$60.59	$81.00	$6.47–$79.38	18% above	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON;SERUM OR PLASMA	$10.48	$14.01	$5.46–$13.73	—	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON;PLASMA OR SERUM	$13.69	$18.30	$7.14–$17.93	—	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$58.35	$78.00	$30.42–$76.44	—	25%
Iron blood test (serum iron) inpatient CPT 83540 IRON; TOTAL	$60.59	$81.00	$31.59–$79.38	—	25%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY TOTAL	$10.48	$14.01	$7.71–$13.73	84% below	25%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACITY	$60.59	$81.00	$8.74–$79.38	6% below	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY TOTAL	$10.48	$14.01	$5.46–$13.73	—	25%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACITY	$60.59	$81.00	$31.59–$79.38	—	25%
Kidney function blood test panel CPT 80069 RENAL PROFILE	$416.64	$557.00	$8.68–$545.86	295% above	25%
Kidney function blood test panel inpatient CPT 80069 RENAL PROFILE	$416.64	$557.00	$217.23–$545.86	—	25%
LH (luteinizing hormone) test CPT 83002 WHOPAM; LH	$13.47	$18.00	$9.90–$18.00	83% below	25%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE;SERUM	$18.50	$24.72	$13.60–$24.23	77% below	25%
LH (luteinizing hormone) test CPT 83002 LUTEINIZING HORMONE (LH)	$122.68	$164.00	$18.52–$160.72	51% above	25%
LH (luteinizing hormone) test inpatient CPT 83002 WHOPAM; LH	$13.47	$18.00	$7.02–$17.64	—	25%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE;SERUM	$18.50	$24.72	$9.64–$24.23	—	25%
LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE (LH)	$122.68	$164.00	$63.96–$160.72	—	25%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$100.98	$135.00	$6.89–$132.30	71% above	25%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$100.98	$135.00	$52.65–$132.30	—	25%
Liver function blood test panel CPT 80076 LHPAN; HFP	$29.92	$40.00	$8.17–$39.20	71% below	25%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION	$268.54	$359.00	$8.17–$351.82	163% above	25%
Liver function blood test panel inpatient CPT 80076 LHPAN; HFP	$29.92	$40.00	$15.60–$39.20	—	25%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION	$268.54	$359.00	$140.01–$351.82	—	25%
Lyme disease antibody test CPT 86618 LYME DISEASE ACUTE REFLEXIVE	$11.22	$15.00	$8.25–$15.00	83% below	25%
Lyme disease antibody test CPT 86618 LYME EIA IGG	$56.10	$75.00	$17.03–$73.50	13% below	25%
Lyme disease antibody test CPT 86618 LYME IGG CIA	$61.34	$82.00	$17.03–$80.36	5% below	25%
Lyme disease antibody test CPT 86618 LYME MODIFIED 2-TIER TESTING	$108.86	$145.53	$17.03–$142.62	69% above	25%
Lyme disease antibody test CPT 86618 LYME IGG/IGM AB	$145.86	$195.00	$17.03–$191.10	126% above	25%
Lyme disease antibody test CPT 86618 LYME DISEASE TOTAL AB/REFLEX	$151.85	$203.00	$17.03–$198.94	135% above	25%
Lyme disease antibody test CPT 86618 LYME(B.BURGDO AB;IGG/IGM)	$309.68	$414.00	$17.03–$405.72	379% above	25%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ACUTE REFLEXIVE	$11.22	$15.00	$5.85–$14.70	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME EIA IGG	$56.10	$75.00	$29.25–$73.50	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME IGG CIA	$61.34	$82.00	$31.98–$80.36	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME MODIFIED 2-TIER TESTING	$108.86	$145.53	$56.76–$142.62	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME IGG/IGM AB	$145.86	$195.00	$76.05–$191.10	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE TOTAL AB/REFLEX	$151.85	$203.00	$79.17–$198.94	—	25%
Lyme disease antibody test inpatient CPT 86618 LYME(B.BURGDO AB;IGG/IGM)	$309.68	$414.00	$161.46–$405.72	—	25%
Magnesium blood test CPT 83735 MAGNESIUM; URINE	$10.48	$14.00	$6.70–$13.72	66% below	25%
Magnesium blood test CPT 83735 MAGNESIUM; RBC	$53.86	$72.00	$6.70–$70.56	73% above	25%
Magnesium blood test CPT 83735 MAGNESIUM; URINE (RANDOM)	$78.54	$105.00	$6.70–$102.90	152% above	25%
Magnesium blood test CPT 83735 MAGNESIUM	$117.44	$157.00	$6.70–$153.86	276% above	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM; URINE	$10.48	$14.00	$5.46–$13.72	—	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM; RBC	$53.86	$72.00	$28.08–$70.56	—	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM; URINE (RANDOM)	$78.54	$105.00	$40.95–$102.90	—	25%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$117.44	$157.00	$61.23–$153.86	—	25%
Measles (rubeola) antibody test CPT 86765 MEASLES (RUBEOLA) AB;IGG	$11.22	$15.00	$8.25–$14.70	69% below	25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA; IGM	$58.35	$78.00	$12.88–$76.44	60% above	25%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$59.84	$80.00	$12.88–$78.40	64% above	25%
Measles (rubeola) antibody test inpatient CPT 86765 MEASLES (RUBEOLA) AB;IGG	$11.22	$15.00	$5.85–$14.70	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA; IGM	$58.35	$78.00	$30.42–$76.44	—	25%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$59.84	$80.00	$31.20–$78.40	—	25%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$106.97	$143.00	$5.18–$140.14	109% above	25%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$106.97	$143.00	$55.77–$140.14	—	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 PROSTATE SPECIFIC AG; FREE	$11.22	$15.00	$8.25–$15.00	69% below	25%
PSA (prostate-specific antigen) blood test, free CPT 84154 RATPSA; PSA FREE	$137.64	$184.00	$18.39–$180.32	283% above	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PROSTATE SPECIFIC AG; FREE	$11.22	$15.00	$5.85–$14.70	—	25%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 RATPSA; PSA FREE	$137.64	$184.00	$71.76–$180.32	—	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC ANTIGEN	$11.22	$15.00	$8.25–$15.00	86% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 MHOPAN; PSA	$18.70	$25.00	$13.75–$24.50	77% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATIC SPEC AG (WITH REF)	$46.38	$62.00	$18.39–$60.76	43% below	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 RATPSA; PSA TOTAL	$148.11	$198.00	$18.39–$194.04	83% above	25%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSITC	$164.56	$220.00	$18.39–$215.60	104% above	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC ANTIGEN	$11.22	$15.00	$5.85–$14.70	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 MHOPAN; PSA	$18.70	$25.00	$9.75–$24.50	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATIC SPEC AG (WITH REF)	$46.38	$62.00	$24.18–$60.76	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 RATPSA; PSA TOTAL	$148.11	$198.00	$77.22–$194.04	—	25%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSITC	$164.56	$220.00	$85.80–$215.60	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOLOGY;THINPREP PAP W/ HPV	$79.40	$106.14	$20.26–$104.02	3% above	25%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH CER/VAG IN OR B	$89.02	$119.00	$20.26–$116.62	15% above	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOLOGY;THINPREP PAP W/ HPV	$79.40	$106.14	$41.39–$104.02	—	25%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH CER/VAG IN OR B	$89.02	$119.00	$46.41–$116.62	—	25%
Parathyroid hormone (PTH) blood test CPT 83970 MBHPAN; PTH	$20.95	$28.00	$15.40–$28.00	82% below	25%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE; C-TERMINAL	$284.24	$380.00	$41.28–$372.40	142% above	25%
Parathyroid hormone (PTH) blood test CPT 83970 PTH INTACT NO CALCIUM	$290.23	$388.00	$41.28–$380.24	148% above	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 MBHPAN; PTH	$20.95	$28.00	$10.92–$27.44	—	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE; C-TERMINAL	$284.24	$380.00	$148.20–$372.40	—	25%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH INTACT NO CALCIUM	$290.23	$388.00	$151.32–$380.24	—	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-LA SCREEN (PTT-D)	$14.97	$20.01	$6.01–$19.61	75% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 APP1R; PTT	$16.46	$22.00	$6.01–$21.56	72% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT; INHIBITOR SCREEN; 1-HOUR	$21.77	$29.10	$6.01–$28.52	63% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-D	$24.40	$32.61	$6.01–$31.96	59% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 LAP - (PTT); ACTIVATED	$36.66	$49.00	$6.01–$48.02	38% below	25%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$37.40	$50.00	$6.01–$49.00	36% below	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-LA SCREEN (PTT-D)	$14.97	$20.01	$7.80–$19.61	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 APP1R; PTT	$16.46	$22.00	$8.58–$21.56	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT; INHIBITOR SCREEN; 1-HOUR	$21.77	$29.10	$11.35–$28.52	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-D	$24.40	$32.61	$12.72–$31.96	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 LAP - (PTT); ACTIVATED	$36.66	$49.00	$19.11–$48.02	—	25%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$37.40	$50.00	$19.50–$49.00	—	25%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 PRENATAL ANEUPLOIDY	$925.28	$1,237.00	$680.35–$1,212.26	33% below	25%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 PRENATAL ANEUPLOIDY	$925.28	$1,237.00	$482.43–$1,212.26	—	25%
Progesterone blood test CPT 84144 WHOPAM; PROGESTERONE	$13.47	$18.00	$9.90–$18.00	83% below	25%
Progesterone blood test CPT 84144 MHOPAN; PROGESTERONE	$16.46	$22.00	$12.10–$21.56	80% below	25%
Progesterone blood test CPT 84144 PROGESTERONE QUANT;SER/PLAS	$53.86	$72.00	$20.86–$70.56	33% below	25%
Progesterone blood test CPT 84144 PROGESTERONE	$183.26	$245.00	$20.86–$240.10	127% above	25%
Progesterone blood test inpatient CPT 84144 WHOPAM; PROGESTERONE	$13.47	$18.00	$7.02–$17.64	—	25%
Progesterone blood test inpatient CPT 84144 MHOPAN; PROGESTERONE	$16.46	$22.00	$8.58–$21.56	—	25%
Progesterone blood test inpatient CPT 84144 PROGESTERONE QUANT;SER/PLAS	$53.86	$72.00	$28.08–$70.56	—	25%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$183.26	$245.00	$95.55–$240.10	—	25%
Prolactin blood test CPT 84146 PROLACTIN	$26.93	$36.00	$19.38–$35.28	57% below	25%
Prolactin blood test CPT 84146 PROLACTIN; SERUM	$152.60	$204.00	$19.38–$199.92	141% above	25%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$26.93	$36.00	$14.04–$35.28	—	25%
Prolactin blood test inpatient CPT 84146 PROLACTIN; SERUM	$152.60	$204.00	$79.56–$199.92	—	25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$14.97	$20.01	$4.29–$19.61	51% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 APP1R; PT	$16.46	$22.00	$4.29–$21.56	46% below	25%
Prothrombin time (PT/INR) clotting test CPT 85610 LAP - PROTHROMBIN TIME (PT)	$37.40	$50.00	$4.29–$49.00	24% above	25%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME/INR	$106.97	$143.00	$4.29–$140.14	253% above	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$14.97	$20.01	$7.80–$19.61	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 APP1R; PT	$16.46	$22.00	$8.58–$21.56	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 LAP - PROTHROMBIN TIME (PT)	$37.40	$50.00	$19.50–$49.00	—	25%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME/INR	$106.97	$143.00	$55.77–$140.14	—	25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A AG	$116.69	$156.00	$16.55–$152.88	109% above	25%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A AG SOFIA	$124.92	$167.00	$16.55–$163.66	123% above	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A AG	$116.69	$156.00	$60.84–$152.88	—	25%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A AG SOFIA	$124.92	$167.00	$65.13–$163.66	—	25%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR	$15.71	$21.00	$5.67–$20.58	68% below	25%
Rheumatoid factor (RF) test CPT 86431 RHEUMA FACT (IGG; IGA; IGM) X1	$56.10	$75.00	$5.67–$73.50	16% above	25%
Rheumatoid factor (RF) test CPT 86431 RHEUMA FACT (IGG; IGA; IGM) X2	$109.21	$146.00	$5.67–$143.08	125% above	25%
Rheumatoid factor (RF) test CPT 86431 CTD; RA	$127.16	$170.00	$5.67–$166.60	162% above	25%
Rheumatoid factor (RF) test CPT 86431 RHEUMA FACTOR; BODY FLUID	$128.66	$172.00	$5.67–$168.56	165% above	25%
Rheumatoid factor (RF) test CPT 86431 RA; SERUM	$130.16	$174.00	$5.67–$170.52	169% above	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR	$15.71	$21.00	$8.19–$20.58	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMA FACT (IGG; IGA; IGM) X1	$56.10	$75.00	$29.25–$73.50	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMA FACT (IGG; IGA; IGM) X2	$109.21	$146.00	$56.94–$143.08	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 CTD; RA	$127.16	$170.00	$66.30–$166.60	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMA FACTOR; BODY FLUID	$128.66	$172.00	$67.08–$168.56	—	25%
Rheumatoid factor (RF) test inpatient CPT 86431 RA; SERUM	$130.16	$174.00	$67.86–$170.52	—	25%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY;IGG	$15.71	$21.00	$11.55–$20.58	67% below	25%
Rubella antibody test (immunity check) CPT 86762 OBPAN2; RUBELLA	$58.35	$78.00	$14.39–$76.44	23% above	25%
Rubella antibody test (immunity check) CPT 86762 OBPAN1; RUBELLA	$59.84	$80.00	$14.39–$78.40	26% above	25%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY;IGG	$15.71	$21.00	$8.19–$20.58	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 OBPAN2; RUBELLA	$58.35	$78.00	$30.42–$76.44	—	25%
Rubella antibody test (immunity check) inpatient CPT 86762 OBPAN1; RUBELLA	$59.84	$80.00	$31.20–$78.40	—	25%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$26.93	$36.00	$8.90–$35.28	24% below	25%
Stool ova and parasites exam CPT 87177 O/P;CONCENTRATION	$136.14	$182.00	$8.90–$178.36	286% above	25%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$26.93	$36.00	$14.04–$35.28	—	25%
Stool ova and parasites exam inpatient CPT 87177 O/P;CONCENTRATION	$136.14	$182.00	$70.98–$178.36	—	25%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD SCREEN	$44.14	$59.00	$4.38–$57.82	25% above	25%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD SCREEN	$44.14	$59.00	$23.01–$57.82	—	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FECAL OCCULT BLOOD BY IA	$55.99	$74.85	$15.92–$73.35	3% below	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 FERN TEST	$79.29	$106.00	$15.92–$103.88	38% above	25%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 OCCULT BLOOD IMMUNOASSAY-DIAG.	$119.68	$160.00	$15.92–$156.80	108% above	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FECAL OCCULT BLOOD BY IA	$55.99	$74.85	$29.19–$73.35	—	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 FERN TEST	$79.29	$106.00	$41.34–$103.88	—	25%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 OCCULT BLOOD IMMUNOASSAY-DIAG.	$119.68	$160.00	$62.40–$156.80	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR WITH REFLEX TO TITER	$10.10	$13.50	$4.27–$13.23	66% below	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 TREPONEMAL CONFIRM PROF (REF)	$39.65	$53.00	$4.27–$51.94	34% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR	$93.50	$125.00	$4.27–$122.50	216% above	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR WITH REFLEX TO TITER	$10.10	$13.50	$5.27–$13.23	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 TREPONEMAL CONFIRM PROF (REF)	$39.65	$53.00	$20.67–$51.94	—	25%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR	$93.50	$125.00	$48.75–$122.50	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS;4TUBE	$67.32	$90.00	$49.50–$88.20	45% below	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON-TB GOLD PLUS;1TUBE	$78.54	$105.00	$57.75–$102.90	36% below	25%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QUANTIFERON TB GOLD IN-TUBE	$222.16	$297.00	$61.98–$291.06	80% above	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS;4TUBE	$67.32	$90.00	$35.10–$88.20	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON-TB GOLD PLUS;1TUBE	$78.54	$105.00	$40.95–$102.90	—	25%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD IN-TUBE	$222.16	$297.00	$115.83–$291.06	—	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE BY MASS SPEC	$13.47	$18.00	$9.90–$18.00	78% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 WHOPAM; TESTOSTERONE	$15.71	$21.00	$11.55–$21.00	75% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 MHOPAN; TOTAL TEST.	$20.20	$27.00	$14.85–$26.46	68% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL SERUM	$21.70	$29.00	$15.95–$28.42	65% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE; TOTAL MASS SPEC	$56.10	$75.00	$25.81–$73.50	10% below	25%
Testosterone blood test, total (not free testosterone) CPT 84403 QDSCR; AFP	$124.92	$167.00	$25.81–$163.66	100% above	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TSTFM; TOTAL TESTOSTERONE	$135.39	$181.00	$25.81–$177.38	116% above	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL ADULT MALES	$139.88	$187.00	$25.81–$183.26	124% above	25%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOST BY LCMS/MS FEM&CHILD	$144.37	$193.00	$25.81–$189.14	131% above	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE BY MASS SPEC	$13.47	$18.00	$7.02–$17.64	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 WHOPAM; TESTOSTERONE	$15.71	$21.00	$8.19–$20.58	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 MHOPAN; TOTAL TEST.	$20.20	$27.00	$10.53–$26.46	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL SERUM	$21.70	$29.00	$11.31–$28.42	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE; TOTAL MASS SPEC	$56.10	$75.00	$29.25–$73.50	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 QDSCR; AFP	$124.92	$167.00	$65.13–$163.66	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TSTFM; TOTAL TESTOSTERONE	$135.39	$181.00	$70.59–$177.38	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL ADULT MALES	$139.88	$187.00	$72.93–$183.26	—	25%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOST BY LCMS/MS FEM&CHILD	$144.37	$193.00	$75.27–$189.14	—	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 TTA - THYROID ANTIBODIES	$16.43	$21.96	$12.08–$21.52	69% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE (TPO) AB	$17.96	$24.00	$13.20–$23.52	66% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 LIVER-KIDNEY MICROSOME ABS;IGG	$31.42	$42.00	$14.55–$41.16	40% below	25%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$116.69	$156.00	$14.55–$152.88	121% above	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 TTA - THYROID ANTIBODIES	$16.43	$21.96	$8.56–$21.52	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE (TPO) AB	$17.96	$24.00	$9.36–$23.52	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LIVER-KIDNEY MICROSOME ABS;IGG	$31.42	$42.00	$16.38–$41.16	—	25%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$116.69	$156.00	$60.84–$152.88	—	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TTA - TSH	$16.46	$22.00	$12.10–$21.56	82% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE	$20.45	$27.33	$15.03–$26.78	78% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 CONG HYPOTHYROIDISM	$27.68	$37.00	$16.80–$36.26	70% below	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$113.70	$152.00	$16.80–$148.96	21% above	25%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH (WITH REFLEX)	$121.18	$162.00	$16.80–$158.76	29% above	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TTA - TSH	$16.46	$22.00	$8.58–$21.56	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE	$20.45	$27.33	$10.66–$26.78	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 CONG HYPOTHYROIDISM	$27.68	$37.00	$14.43–$36.26	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$113.70	$152.00	$59.28–$148.96	—	25%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH (WITH REFLEX)	$121.18	$162.00	$63.18–$158.76	—	25%
Trichomonas test (NAAT) CPT 87661 T. VAGINALIS BY TMA	$44.88	$60.00	$33.00–$58.80	10% below	25%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS; DNA PRO	$62.84	$84.00	$35.09–$82.32	25% above	25%
Trichomonas test (NAAT) CPT 87661 TRICHAMONAS VAG AMP DET(TMA)	$66.58	$89.00	$35.09–$87.22	33% above	25%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS BY TMA	$89.76	$120.00	$35.09–$117.60	79% above	25%
Trichomonas test (NAAT) inpatient CPT 87661 T. VAGINALIS BY TMA	$44.88	$60.00	$23.40–$58.80	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS; DNA PRO	$62.84	$84.00	$32.76–$82.32	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHAMONAS VAG AMP DET(TMA)	$66.58	$89.00	$34.71–$87.22	—	25%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS BY TMA	$89.76	$120.00	$46.80–$117.60	—	25%
Uric acid blood test CPT 84550 URIC ACID	$62.84	$84.00	$4.52–$82.32	44% above	25%
Uric acid blood test inpatient CPT 84550 URIC ACID	$62.84	$84.00	$32.76–$82.32	—	25%
Urinalysis with microscope exam, automated CPT 81001 BHPAN; UA	$14.96	$20.00	$3.17–$19.60	70% below	25%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS W/MICROSCOPIC	$83.03	$111.00	$3.17–$108.78	67% above	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 BHPAN; UA	$14.96	$20.00	$7.80–$19.60	—	25%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS W/MICROSCOPIC	$83.03	$111.00	$43.29–$108.78	—	25%
Urinalysis without microscope exam, automated CPT 81003 SPECIFIC GRAVITY URINE	$43.39	$58.00	$2.25–$56.84	70% above	25%
Urinalysis without microscope exam, automated CPT 81003 KETONES URINE	$48.62	$65.00	$2.25–$63.70	90% above	25%
Urinalysis without microscope exam, automated CPT 81003 UA W/O MICROSCOPIC	$59.84	$80.00	$2.25–$78.40	134% above	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY URINE	$43.39	$58.00	$22.62–$56.84	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 KETONES URINE	$48.62	$65.00	$25.35–$63.70	—	25%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA W/O MICROSCOPIC	$59.84	$80.00	$31.20–$78.40	—	25%
Urine culture for bacteria, with colony count CPT 87086 CULTURE; URINE (NO SMEAR); REF	$48.62	$65.00	$8.07–$63.70	12% below	25%
Urine culture for bacteria, with colony count CPT 87086 CULT URINE	$130.16	$174.00	$8.07–$170.52	136% above	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE; URINE (NO SMEAR); REF	$48.62	$65.00	$25.35–$63.70	—	25%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULT URINE	$130.16	$174.00	$67.86–$170.52	—	25%
Urine pregnancy test, read by color change CPT 81025 HCG QUAL; URINE	$70.32	$94.00	$8.61–$92.12	81% above	25%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG QUAL; URINE	$70.32	$94.00	$36.66–$92.12	—	25%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$11.22	$15.00	$8.25–$15.00	87% below	25%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12 REFLEX	$63.58	$85.00	$15.08–$83.30	28% below	25%
Vitamin B12 (cobalamin) blood test CPT 82607 B 12 ASSAY	$187.00	$250.00	$15.08–$245.00	111% above	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$11.22	$15.00	$5.85–$14.70	—	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 REFLEX	$63.58	$85.00	$33.15–$83.30	—	25%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 B 12 ASSAY	$187.00	$250.00	$97.50–$245.00	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D;25-HYDROXY	$17.96	$24.00	$13.20–$24.00	82% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 MBHPAN; VDHYDROXY	$21.70	$29.00	$15.95–$29.00	78% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25-HYDROXYVITAMIN D2 D3;SERUM	$44.88	$60.00	$29.60–$58.80	54% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 BIO25D; VD25HY	$62.84	$84.00	$29.60–$82.32	35% below	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D; 25-HYDROXY	$195.23	$261.00	$29.60–$255.78	101% above	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D;25-HYDROXY	$17.96	$24.00	$9.36–$23.52	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 MBHPAN; VDHYDROXY	$21.70	$29.00	$11.31–$28.42	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25-HYDROXYVITAMIN D2 D3;SERUM	$44.88	$60.00	$23.40–$58.80	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 BIO25D; VD25HY	$62.84	$84.00	$32.76–$82.32	—	25%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D; 25-HYDROXY	$195.23	$261.00	$101.79–$255.78	—	25%
Zinc blood test CPT 84630 ZINC;SERUM OR PLASMA	$11.22	$15.00	$8.25–$14.70	63% below	25%
Zinc blood test CPT 84630 ZINC; RBC	$71.06	$95.00	$11.39–$93.10	136% above	25%
Zinc blood test CPT 84630 ZINC; SERUM/PLASMA	$94.25	$126.00	$11.39–$123.48	213% above	25%
Zinc blood test CPT 84630 ZINC; RED BLOOD CELLS	$103.23	$138.00	$11.39–$135.24	243% above	25%
Zinc blood test inpatient CPT 84630 ZINC;SERUM OR PLASMA	$11.22	$15.00	$5.85–$14.70	—	25%
Zinc blood test inpatient CPT 84630 ZINC; RBC	$71.06	$95.00	$37.05–$93.10	—	25%
Zinc blood test inpatient CPT 84630 ZINC; SERUM/PLASMA	$94.25	$126.00	$49.14–$123.48	—	25%
Zinc blood test inpatient CPT 84630 ZINC; RED BLOOD CELLS	$103.23	$138.00	$53.82–$135.24	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 ITG1; HCG	$47.88	$64.00	$15.05–$62.72	48% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 QDSCR; HCG QUANT	$58.35	$78.00	$15.05–$76.44	37% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 FTSNT; HCG	$66.58	$89.00	$15.05–$87.22	28% below	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BETA HCG; QUANTITATIVE	$129.41	$173.00	$15.05–$169.54	40% above	25%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT; SERUM	$132.40	$177.00	$15.05–$173.46	43% above	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 ITG1; HCG	$47.88	$64.00	$24.96–$62.72	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 QDSCR; HCG QUANT	$58.35	$78.00	$30.42–$76.44	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 FTSNT; HCG	$66.58	$89.00	$34.71–$87.22	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BETA HCG; QUANTITATIVE	$129.41	$173.00	$67.47–$169.54	—	25%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT; SERUM	$132.40	$177.00	$69.03–$173.46	—	25%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL ER	$810.09	$1,083.00	$595.65–$1,061.34	21% below	25%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL ER	$810.09	$1,083.00	$422.37–$1,061.34	—	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DEST LESION PREMALIG 1ST ER	$71.06	$95.00	$52.25–$93.10	61% below	25%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DEST LESION PREMALIG 1ST ER	$71.06	$95.00	$37.05–$93.10	—	25%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX ER	$71.81	$96.00	$52.80–$94.08	7% below	25%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX ER	$71.81	$96.00	$37.44–$94.08	—	25%
Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI ER	$151.10	$202.00	$111.10–$197.96	23% above	25%
Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE IMPACTED EAR WAX UNI ER	$151.10	$202.00	$78.78–$197.96	—	25%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJ EPID ;CERV/THORA W IMAG	$1,799.69	$2,406.00	$1,323.30–$2,357.88	79% above	25%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJ EPID ;CERV/THORA W IMAG	$1,799.69	$2,406.00	$938.34–$2,357.88	—	25%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE ER	$317.90	$425.00	$233.75–$416.50	10% above	25%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS SIMPLE ER	$317.90	$425.00	$165.75–$416.50	—	25%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH LIGA ER	$319.40	$427.00	$234.85–$418.46	14% below	25%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH LIGA ER	$319.40	$427.00	$166.53–$418.46	—	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ASP/INJ JOINT MAJOR WO US ER	$395.70	$529.00	$290.95–$518.42	9% above	25%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ JOINT MAJOR WO US ER	$395.70	$529.00	$206.31–$518.42	—	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ASP/INJ INTR JNT/BUR WO US ER	$275.27	$368.00	$202.40–$360.64	10% below	25%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTR JNT/BUR WO US ER	$275.27	$368.00	$143.52–$360.64	—	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 RPR LAC INT SCLP AXIL <2.5C ER	$313.42	$419.00	$230.45–$410.62	31% below	25%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 RPR LAC INT SCLP AXIL <2.5C ER	$313.42	$419.00	$163.41–$410.62	—	25%
Lower-back epidural injection, with imaging guidance CPT 62323 INJ EPIDURAL ;LUM/SAC W IMAG	$1,817.64	$2,430.00	$1,336.50–$2,381.40	86% above	25%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 INJ EPIDURAL ;LUM/SAC W IMAG	$1,817.64	$2,430.00	$947.70–$2,381.40	—	25%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ EPIDURAL ;LUM/SAC W/O IMAG	$1,199.80	$1,604.00	$882.20–$1,571.92	15% above	25%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ EPIDURAL ;LUM/SAC W/O IMAG	$1,199.80	$1,604.00	$625.56–$1,571.92	—	25%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE SINGLE ER	$209.44	$280.00	$154.00–$274.40	25% below	25%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE SINGLE ER	$209.44	$280.00	$109.20–$274.40	—	25%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES NERVE GR OCCIP ER	$476.48	$637.00	$350.35–$624.26	21% below	25%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES NERVE GR OCCIP ER	$476.48	$637.00	$248.43–$624.26	—	25%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W GUIDE ER	$166.06	$222.00	$122.10–$217.56	81% below	25%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W GUIDE ER	$166.06	$222.00	$86.58–$217.56	—	25%
Removal of a foreign object under the skin, simple CPT 10120 INCISION/REM FB SIMPLE ER	$461.52	$617.00	$339.35–$604.66	15% above	25%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCISION/REM FB SIMPLE ER	$461.52	$617.00	$240.63–$604.66	—	25%
Short arm cast (elbow to hand) CPT 29075 APPLICATION CAST SHORT ARM ER	$222.91	$298.00	$163.90–$292.04	6% below	25%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLICATION CAST SHORT ARM ER	$222.91	$298.00	$116.22–$292.04	—	25%
Short arm splint (forearm and hand) CPT 29125 APPL SPLINT SHORT ARM ER	$244.60	$327.00	$179.85–$320.46	23% above	25%
Short arm splint (forearm and hand) inpatient CPT 29125 APPL SPLINT SHORT ARM ER	$244.60	$327.00	$127.53–$320.46	—	25%
Short leg cast (below the knee) CPT 29405 APPL CAST SHORT LEG ER	$272.28	$364.00	$200.20–$356.72	at median	25%
Short leg cast (below the knee) inpatient CPT 29405 APPL CAST SHORT LEG ER	$272.28	$364.00	$141.96–$356.72	—	25%
Short leg splint (calf to foot) CPT 29515 APPL SPLINT SHORT LEG ER	$213.93	$286.00	$157.30–$280.28	4% below	25%
Short leg splint (calf to foot) inpatient CPT 29515 APPL SPLINT SHORT LEG ER	$213.93	$286.00	$111.54–$280.28	—	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR LAC SMP SCALP <2.5CM ER	$368.02	$492.00	$270.60–$482.16	36% above	25%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 RPR LAC SMP SCALP <2.5CM ER	$368.02	$492.00	$191.88–$482.16	—	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAG	$590.18	$789.00	$433.95–$773.22	19% below	25%
Spinal tap (lumbar puncture), diagnostic CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC ER	$610.37	$816.00	$448.80–$799.68	16% below	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAG	$590.18	$789.00	$307.71–$773.22	—	25%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 LUMBAR PUNCTURE DIAGNOSTIC ER	$610.37	$816.00	$318.24–$799.68	—	25%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR LAC SMP SCALP 2.6-7.5CM ER	$397.19	$531.00	$292.05–$520.38	29% above	25%
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 LAC SMP SCALP 2.6-7.5CM ER	$397.19	$531.00	$207.09–$520.38	—	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR LAC SMP FACE <2.5CM ER	$213.18	$285.00	$156.75–$279.30	22% below	25%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 RPR LAC SMP FACE <2.5CM ER	$213.18	$285.00	$111.15–$279.30	—	25%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER PT 1-2 MUSC ER	$397.19	$531.00	$292.05–$520.38	28% above	25%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER PT 1-2 MUSC ER	$397.19	$531.00	$207.09–$520.38	—	25%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBR SKIN/SUBQ TISS<20SQCM ER	$854.97	$1,143.00	$628.65–$1,120.14	91% above	25%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBR SKIN/SUBQ TISS<20SQCM ER	$854.97	$1,143.00	$445.77–$1,120.14	—	25%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMINISTRATION	$200.47	$268.00	$147.40–$262.64	72% below	25%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMINISTRATION	$200.47	$268.00	$104.52–$262.64	—	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER SMALL VOL ER	$69.57	$93.00	$51.15–$91.14	41% below	25%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER SMALL VOL ER	$69.57	$93.00	$36.27–$91.14	—	25%
Critical care, first 30 to 74 minutes CPT 99291 CRIT CARE 1ST 30-74 MIN-25 ER	$1,586.51	$2,121.00	$1,166.55–$2,078.58	3% above	25%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRIT CARE 1ST 30-74 MIN-25 ER	$1,586.51	$2,121.00	$827.19–$2,078.58	—	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD	$345.58	$462.00	$254.10–$452.76	101% above	25%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD	$345.58	$462.00	$180.18–$452.76	—	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 LEVEL 1 ER	$175.04	$234.00	$128.70–$229.32	9% below	25%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 LEVEL 1 ER	$175.04	$234.00	$91.26–$229.32	—	25%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LEVEL 2 ER	$233.38	$312.00	$171.60–$305.76	6% below	25%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LEVEL 2 ER	$233.38	$312.00	$121.68–$305.76	—	25%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 LEVEL 3 ER	$480.97	$643.00	$353.65–$630.14	15% above	25%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 LEVEL 3 ER	$480.97	$643.00	$250.77–$630.14	—	25%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 LEVEL 4 ER	$729.30	$975.00	$536.25–$955.50	15% above	25%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 LEVEL 4 ER	$729.30	$975.00	$380.25–$955.50	—	25%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 LEVEL 5 ER	$1,166.14	$1,559.00	$857.45–$1,527.82	23% above	25%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 LEVEL 5 ER	$1,166.14	$1,559.00	$608.01–$1,527.82	—	25%
Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIAC STRESS TEST TRACING	$1,057.68	$1,414.00	$777.70–$1,385.72	47% above	25%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CARDIAC STRESS TEST TRACING	$1,057.68	$1,414.00	$551.46–$1,385.72	—	25%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYD 1ST HR (31-90M) ER	$314.91	$421.00	$231.55–$412.58	16% above	25%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYD 1ST HR (31-90M) ER	$314.91	$421.00	$164.19–$412.58	—	25%
IV infusion of a medicine, first hour CPT 96365 IV INF TX/DX 1ST 16-90M ER	$327.63	$438.00	$240.90–$429.24	at median	25%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INF TX/DX 1ST 16-90M ER	$327.63	$438.00	$170.82–$429.24	—	25%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJ SUBQ/IM ER	$65.08	$87.00	$47.85–$85.26	16% below	25%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJ SUBQ/IM ER	$65.08	$87.00	$33.93–$85.26	—	25%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 THERAPUTIC PHLEBOTOMY	$290.98	$389.00	$213.95–$381.22	38% above	25%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 THERAPUTIC PHLEBOTOMY	$290.98	$389.00	$151.71–$381.22	—	25%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Minnesota	Off list
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VARICELLA VACLIVE1;350 U/.5ML	$222.01	$296.80	$163.24–$290.86	7% below	25%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 VARICELLA VACLIVE1;350 U/.5ML	$222.01	$296.80	$115.75–$290.86	—	25%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VIRUS VAC PF 20 MCG/ML	$89.99	$120.30	$66.17–$117.89	20% below	25%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VIRUS VAC PF 20 MCG/ML	$89.99	$120.30	$46.92–$117.89	—	25%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 FLUZONE HIGH-DOSE QUAD	$66.88	$89.41	$49.18–$87.62	11% below	25%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 FLUZONE HIGH-DOSE QUAD	$66.88	$89.41	$34.87–$87.62	—	25%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES; MU & RUB VAC.5 ML	$122.86	$164.24	$90.33–$160.96	1% below	25%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MEASLES; MU & RUB VAC.5 ML	$122.86	$164.24	$64.05–$160.96	—	25%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENINGOCOCCAL VACC 4MCG/0.5ML	$189.31	$253.08	$139.19–$248.02	3% below	25%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACC 4MCG/0.5ML	$189.31	$253.08	$98.70–$248.02	—	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOL 20-VAL CONJUG 0.5 ML	$254.30	$339.96	$186.98–$333.16	37% below	25%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 PNEUMOL 20-VAL CONJUG 0.5 ML	$254.30	$339.96	$132.58–$333.16	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEU 23-VAL P-SAC VAC 0.5ML	$149.76	$200.21	$110.12–$196.21	13% above	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEU 23-VAL P-SAC VAC 2.5ML	$462.90	$618.85	$340.37–$606.47	251% above	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEU 23-VAL P-SAC VAC 0.5ML	$149.76	$200.21	$78.08–$196.21	—	25%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEU 23-VAL P-SAC VAC 2.5ML	$462.90	$618.85	$241.35–$606.47	—	25%
Rabies vaccine, one dose CPT 90675 RABIES VAC HUM DIPLOID PF2.5	$509.06	$680.56	$374.31–$666.95	8% below	25%
Rabies vaccine, one dose CPT 90675 RABIES VAC (AVIAN) 2.5 INJ KIT	$610.75	$816.51	$449.08–$800.18	11% above	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC HUM DIPLOID PF2.5	$509.06	$680.56	$265.42–$666.95	—	25%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC (AVIAN) 2.5 INJ KIT	$610.75	$816.51	$318.44–$800.18	—	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TET/DIP TOXOIDS;ADULT TD0.5ML	$40.41	$54.02	$29.71–$52.94	35% below	25%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TET/DIP TOXOIDS;ADULT TD0.5ML	$40.41	$54.02	$21.07–$52.94	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIP;PERT(ACELL);TET VAC. 5 ML	$114.76	$153.41	$84.38–$150.34	46% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP 10+YRS 0.5ML SYRNG	$143.58	$191.94	$105.57–$188.10	83% above	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIP;PERT(ACELL);TET VAC. 5 ML	$114.76	$153.41	$59.83–$150.34	—	25%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP 10+YRS 0.5ML SYRNG	$143.58	$191.94	$74.86–$188.10	—	25%
Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYP VI POLY VACC 25 MCG/0.5ML	$156.00	$208.55	$114.70–$204.38	7% above	25%
Typhoid vaccine, injectable (Vi polysaccharide) inpatient CPT 90691 TYP VI POLY VACC 25 MCG/0.5ML	$156.00	$208.55	$81.33–$204.38	—	25%

Source file: https://chilakewoodhealth.com/MRF/410758434_chi-lakewood-health_standardcharges.csv