Hospital

Blue Ridge Medical Center

Blue Ridge Medical Center in Blue Ridge, GA publishes cash prices for 235 common procedures listed here, from its own machine-readable price file updated Apr 17, 2026. Compared with other hospitals in the state, its outpatient cash prices are above the Georgia median for 119 of 234 procedures and below it for 111. By typical cash price it ranks #41 of 64 Georgia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

2855 OLD HIGHWAY 5,BLUE RIDGE,GA,30513-6248 Collected Sep 28, 2026 Source price file (706) 632-3711

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 111338 · CMS hospital register

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 5 actions for a hospital named Blue Ridge Medical Center in Blue Ridge, GA:

Aug 17, 2023 Warning notice
Dec 15, 2023 Case closed
Jan 13, 2026 Warning notice
Apr 15, 2026 Corrective action plan requested
Jul 1, 2026 Case closed

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. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found.

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 Georgia	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 LE-ANKLE 3VWS BI CR	$242.93	$404.89	$15.33–$3,015.42	—	40%
Ankle X-ray, complete, 3 or more views both sides CPT 73610 LE-ANKLE 3VWS BI DR	$242.93	$404.89	$15.33–$3,015.42	—	40%
Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE	$178.15	$296.92	$15.33–$3,015.42	32% below	40%
Ankle X-ray, complete, 3 or more views CPT 73610 LE-ANKLE 3VPLUS DR	$242.93	$404.89	$15.33–$3,015.42	7% below	40%
Ankle X-ray, complete, 3 or more views CPT 73610 LE-ANKLE 3VPLUS CR	$242.93	$404.89	$15.33–$3,015.42	7% below	40%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 LE-ANKLE 3VWS BI DR	$242.93	$404.89	$15.33–$3,015.42	—	40%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 LE-ANKLE 3VWS BI CR	$242.93	$404.89	$15.33–$3,015.42	—	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 X-RAY EXAM OF ANKLE	$178.15	$296.92	$15.33–$3,015.42	—	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 LE-ANKLE 3VPLUS CR	$242.93	$404.89	$15.33–$3,015.42	—	40%
Ankle X-ray, complete, 3 or more views inpatient CPT 73610 LE-ANKLE 3VPLUS DR	$242.93	$404.89	$15.33–$3,015.42	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$370.95	$618.25	$35.49–$1,045.63	17% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 US-EXT ARTERIAL LTD	$370.95	$618.25	$35.49–$1,045.63	17% below	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 UPR/L XTREMITY ART 2 LEVELS	$370.95	$618.25	$35.49–$1,045.63	—	40%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US-EXT ARTERIAL LTD	$370.95	$618.25	$35.49–$1,045.63	—	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$560.48	$934.14	$33.33–$1,231.06	81% above	40%
Barium swallow (esophagus X-ray with contrast) CPT 74220 FL-ESOPHAGUS	$560.48	$934.14	$33.33–$1,231.06	81% above	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 X-RAY XM ESOPHAGUS 1CNTRST	$560.48	$934.14	$33.33–$1,231.06	—	40%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 FL-ESOPHAGUS	$560.48	$934.14	$33.33–$1,231.06	—	40%
Bone scan, whole body (nuclear medicine) CPT 78306 NM-BONE SCAN BODY	$1,422.92	$2,371.54	$120.94–$4,992.07	28% above	40%
Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY	$1,572.31	$2,620.53	$120.94–$4,992.07	41% above	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM-BONE SCAN BODY	$1,422.92	$2,371.54	$120.94–$4,992.07	—	40%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 BONE IMAGING WHOLE BODY	$1,572.31	$2,620.53	$120.94–$4,992.07	—	40%
Breast ultrasound, complete, one breast both sides CPT 76641 US-BREAST COMPLET BI	$357.97	$596.63	$52.32–$1,949.17	—	40%
Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE	$264.00	$440.01	$52.32–$1,949.17	31% below	40%
Breast ultrasound, complete, one breast CPT 76641 US-BREAST COMPLETE	$283.51	$472.52	$52.32–$1,949.17	26% below	40%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US-BREAST COMPLET BI	$357.97	$596.63	$52.32–$1,949.17	—	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 ULTRASOUND BREAST COMPLETE	$264.00	$440.01	$52.32–$1,949.17	—	40%
Breast ultrasound, complete, one breast inpatient CPT 76641 US-BREAST COMPLETE	$283.51	$472.52	$52.32–$1,949.17	—	40%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US-BREAST LIMITED BI	$357.97	$596.63	$40.06–$1,948.61	—	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED	$264.00	$440.01	$40.06–$1,948.61	31% below	40%
Breast ultrasound, limited (one breast or one area) CPT 76642 US-BREAST LIMITED	$275.25	$458.76	$40.06–$1,948.61	28% below	40%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US-BREAST LIMITED BI	$357.97	$596.63	$40.06–$1,948.61	—	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 ULTRASOUND BREAST LIMITED	$264.00	$440.01	$40.06–$1,948.61	—	40%
Breast ultrasound, limited (one breast or one area) inpatient CPT 76642 US-BREAST LIMITED	$275.25	$458.76	$40.06–$1,948.61	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST	$2,224.32	$3,707.21	$251.30–$5,325.64	20% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA-CHEST	$2,224.32	$3,707.21	$251.30–$5,325.64	20% above	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT ANGIOGRAPHY CHEST	$2,224.32	$3,707.21	$251.30–$5,325.64	—	40%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA-CHEST	$2,224.32	$3,707.21	$251.30–$5,325.64	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT ANGIO HRT W/3D IMAGE	$889.24	$1,482.08	$335.08–$3,149.06	30% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CT-HT CARD FUNC W	$889.24	$1,482.08	$335.08–$3,149.06	30% below	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT-HT CARD FUNC W	$889.24	$1,482.08	$335.08–$3,149.06	—	40%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CT ANGIO HRT W/3D IMAGE	$889.24	$1,482.08	$335.08–$3,149.06	—	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT-HEART WO QUAL	$971.05	$1,618.43	$44.48–$3,285.41	871% above	40%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT HRT W/O DYE W/CA TEST	$971.05	$1,618.43	$44.48–$3,285.41	871% above	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT HRT W/O DYE W/CA TEST	$971.05	$1,618.43	$44.48–$3,285.41	—	40%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT-HEART WO QUAL	$971.05	$1,618.43	$44.48–$3,285.41	—	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST	$971.05	$1,618.43	$101.11–$5,680.41	56% below	40%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT-ABD PELVIS WO	$2,437.18	$4,061.98	$101.11–$5,680.41	10% above	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD & PELVIS W/O CONTRAST	$971.05	$1,618.43	$101.11–$5,680.41	—	40%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT-ABD PELVIS WO	$2,437.18	$4,061.98	$101.11–$5,680.41	—	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST	$3,082.24	$5,137.08	$192.93–$6,755.51	3% below	40%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT-ABD PELVIS W	$3,082.24	$5,137.08	$192.93–$6,755.51	3% below	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD & PELVIS W/CONTRAST	$3,082.24	$5,137.08	$192.93–$6,755.51	—	40%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT-ABD PELVIS W	$3,082.24	$5,137.08	$192.93–$6,755.51	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$3,520.46	$5,867.44	$255.01–$7,485.87	12% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT-ABD PELVIS WWO	$3,520.46	$5,867.44	$255.01–$7,485.87	12% above	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR	$3,520.46	$5,867.44	$255.01–$7,485.87	—	40%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT-ABD PELVIS WWO	$3,520.46	$5,867.44	$255.01–$7,485.87	—	40%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST	$971.05	$1,618.43	$193.78–$4,786.25	43% below	40%
CT scan of the abdomen with contrast CPT 74160 CT-ABDOMEN W	$1,900.69	$3,167.82	$193.78–$4,786.25	11% above	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/CONTRAST	$971.05	$1,618.43	$193.78–$4,786.25	—	40%
CT scan of the abdomen with contrast inpatient CPT 74160 CT-ABDOMEN W	$1,900.69	$3,167.82	$193.78–$4,786.25	—	40%
CT scan of the abdomen without contrast CPT 74150 CT-ABDOMEN WO	$1,218.61	$2,031.02	$121.64–$3,698.00	10% below	40%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST	$1,218.61	$2,031.02	$121.64–$3,698.00	10% below	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST	$1,218.61	$2,031.02	$121.64–$3,698.00	—	40%
CT scan of the abdomen without contrast inpatient CPT 74150 CT-ABDOMEN WO	$1,218.61	$2,031.02	$121.64–$3,698.00	—	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE	$971.05	$1,618.43	$131.33–$4,161.24	16% below	40%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT-MAXILLOFACIAL WO	$1,525.68	$2,542.81	$131.33–$4,161.24	32% above	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL W/O DYE	$971.05	$1,618.43	$131.33–$4,161.24	—	40%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT-MAXILLOFACIAL WO	$1,525.68	$2,542.81	$131.33–$4,161.24	—	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE	$1,525.68	$2,542.81	$98.85–$4,161.24	12% above	40%
CT scan of the head or brain, no contrast dye CPT 70450 CT-HEAD WO	$1,525.68	$2,542.81	$98.85–$4,161.24	12% above	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O DYE	$1,525.68	$2,542.81	$98.85–$4,161.24	—	40%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT-HEAD WO	$1,525.68	$2,542.81	$98.85–$4,161.24	—	40%
CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE	$2,149.50	$3,582.50	$141.98–$5,249.48	35% above	40%
CT scan of the head with contrast CPT 70460 CT-HEAD W	$2,149.50	$3,582.50	$141.98–$5,249.48	35% above	40%
CT scan of the head with contrast inpatient CPT 70460 CT-HEAD W	$2,149.50	$3,582.50	$141.98–$5,249.48	—	40%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD/BRAIN W/DYE	$2,149.50	$3,582.50	$141.98–$5,249.48	—	40%
CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$2,619.31	$4,365.52	$172.50–$5,983.95	39% above	40%
CT scan of the head without and with contrast CPT 70470 CT-HEAD WWO	$2,619.31	$4,365.52	$172.50–$5,983.95	39% above	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT-HEAD WWO	$2,619.31	$4,365.52	$172.50–$5,983.95	—	40%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD/BRAIN W/O & W/DYE	$2,619.31	$4,365.52	$172.50–$5,983.95	—	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT-LUMB SPINE WO	$1,376.48	$2,294.14	$167.06–$3,961.12	8% below	40%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE	$1,376.48	$2,294.14	$167.06–$3,961.12	8% below	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT-LUMB SPINE WO	$1,376.48	$2,294.14	$167.06–$3,961.12	—	40%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O DYE	$1,376.48	$2,294.14	$167.06–$3,961.12	—	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE	$1,376.48	$2,294.14	$167.06–$3,961.12	7% above	40%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT-CERV SPINE WO	$1,376.48	$2,294.14	$167.06–$3,961.12	7% above	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT-CERV SPINE WO	$1,376.48	$2,294.14	$167.06–$3,961.12	—	40%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT NECK SPINE W/O DYE	$1,376.48	$2,294.14	$167.06–$3,961.12	—	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT-PELVIS W	$1,845.33	$3,075.55	$193.78–$4,742.53	15% above	40%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE	$1,845.33	$3,075.55	$193.78–$4,742.53	15% above	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT-PELVIS W	$1,845.33	$3,075.55	$193.78–$4,742.53	—	40%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/DYE	$1,845.33	$3,075.55	$193.78–$4,742.53	—	40%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$537.28	$895.47	$108.35–$2,687.67	—	40%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880 US-CAROTID DPLX SCAN	$1,075.32	$1,792.20	$108.35–$2,687.67	52% above	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 EXTRACRANIAL BILAT STUDY	$537.28	$895.47	$108.35–$2,687.67	—	40%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 US-CAROTID DPLX SCAN	$1,075.32	$1,792.20	$108.35–$2,687.67	—	40%
Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$183.49	$305.83	$14.38–$1,445.74	37% below	40%
Chest X-ray, 2 views CPT 71046 CH-CHEST 2V CR	$250.22	$417.04	$14.38–$1,445.74	13% below	40%
Chest X-ray, 2 views CPT 71046 CH-CHEST 2V DR	$250.22	$417.04	$14.38–$1,445.74	13% below	40%
Chest X-ray, 2 views inpatient CPT 71046 X-RAY EXAM CHEST 2 VIEWS	$183.49	$305.83	$14.38–$1,445.74	—	40%
Chest X-ray, 2 views inpatient CPT 71046 CH-CHEST 2V DR	$250.22	$417.04	$14.38–$1,445.74	—	40%
Chest X-ray, 2 views inpatient CPT 71046 CH-CHEST 2V CR	$250.22	$417.04	$14.38–$1,445.74	—	40%
Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW	$178.15	$296.92	$7.80–$1,303.56	17% below	40%
Chest X-ray, single view CPT 71045 CH-CHEST 1V DR	$212.91	$354.86	$7.80–$1,303.56	1% below	40%
Chest X-ray, single view CPT 71045 CH-CHEST 1V CR	$212.91	$354.86	$7.80–$1,303.56	1% below	40%
Chest X-ray, single view inpatient CPT 71045 X-RAY EXAM CHEST 1 VIEW	$178.15	$296.92	$7.80–$1,303.56	—	40%
Chest X-ray, single view inpatient CPT 71045 CH-CHEST 1V CR	$212.91	$354.86	$7.80–$1,303.56	—	40%
Chest X-ray, single view inpatient CPT 71045 CH-CHEST 1V DR	$212.91	$354.86	$7.80–$1,303.56	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP	$254.40	$424.01	$55.69–$1,564.77	56% below	40%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US-ABDOMEN RETROPER	$684.45	$1,140.76	$55.69–$1,564.77	17% above	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US EXAM ABDO BACK WALL COMP	$254.40	$424.01	$55.69–$1,564.77	—	40%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US-ABDOMEN RETROPER	$684.45	$1,140.76	$55.69–$1,564.77	—	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$186.31	$310.53	$42.17–$1,272.69	54% below	40%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DEXA AXIAL	$577.29	$962.16	$42.17–$1,272.69	42% above	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$186.31	$310.53	$42.17–$1,272.69	—	40%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DEXA AXIAL	$577.29	$962.16	$42.17–$1,272.69	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DEXA PERIPHERAL	$178.15	$296.92	$20.49–$296.92	25% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) CPT 77081 DXA BONE DENSITY APPENDICULR	$178.15	$296.92	$20.49–$296.92	25% below	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DXA BONE DENSITY APPENDICULR	$178.15	$296.92	$20.49–$296.92	—	40%
DEXA bone density scan of the wrist, heel or finger (peripheral) inpatient CPT 77081 DEXA PERIPHERAL	$178.15	$296.92	$20.49–$296.92	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US-PLV PRG 2T DETAIL	$861.16	$1,435.28	$100.78–$1,875.29	60% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 OB US DETAILED SNGL FETUS	$861.16	$1,435.28	$100.78–$1,875.29	60% above	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US-PLV PRG 2T DETAIL	$861.16	$1,435.28	$100.78–$1,875.29	—	40%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 OB US DETAILED SNGL FETUS	$861.16	$1,435.28	$100.78–$1,875.29	—	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT-CHEST DIAG WO	$1,376.48	$2,294.14	$167.06–$3,961.12	7% above	40%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C-	$1,376.48	$2,294.14	$167.06–$3,961.12	7% above	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT-CHEST DIAG WO	$1,376.48	$2,294.14	$167.06–$3,961.12	—	40%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT THORAX DX C-	$1,376.48	$2,294.14	$167.06–$3,961.12	—	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT-CHEST DIAG W	$2,061.34	$3,435.58	$200.25–$5,102.56	32% above	40%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+	$2,061.34	$3,435.58	$200.25–$5,102.56	32% above	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT THORAX DX C+	$2,061.34	$3,435.58	$200.25–$5,102.56	—	40%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT-CHEST DIAG W	$2,061.34	$3,435.58	$200.25–$5,102.56	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI	$200.50	$334.18	$88.85–$1,090.15	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BI GG	$200.50	$334.18	$88.85–$1,090.15	—	40%
Diagnostic mammogram, both breasts both sides CPT 77066 BR-DIG MAMMO BILAT	$247.05	$411.76	$88.85–$1,090.15	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BI GG	$200.50	$334.18	$88.85–$1,090.15	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DX MAMMO INCL CAD BI	$200.50	$334.18	$88.85–$1,090.15	—	40%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 BR-DIG MAMMO BILAT	$247.05	$411.76	$88.85–$1,090.15	—	40%
Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI	$197.96	$329.94	$69.43–$1,008.33	43% below	40%
Diagnostic mammogram, one breast CPT 77065 BR-DIG MAMMO UNI GG	$206.52	$344.21	$69.43–$1,008.33	41% below	40%
Diagnostic mammogram, one breast one side CPT 77065 BR-DIG MAMMO UNILAT	$197.96	$329.94	$69.43–$1,008.33	43% below	40%
Diagnostic mammogram, one breast inpatient CPT 77065 DX MAMMO INCL CAD UNI	$197.96	$329.94	$69.43–$1,008.33	—	40%
Diagnostic mammogram, one breast inpatient CPT 77065 BR-DIG MAMMO UNI GG	$206.52	$344.21	$69.43–$1,008.33	—	40%
Diagnostic mammogram, one breast inpatient one side CPT 77065 BR-DIG MAMMO UNILAT	$197.96	$329.94	$69.43–$1,008.33	—	40%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US-LW EXT DPX ART BI	$990.34	$1,650.58	$108.35–$2,745.86	—	40%
Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY	$990.34	$1,650.58	$108.35–$2,745.86	73% above	40%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US-LW EXT DPX ART BI	$990.34	$1,650.58	$108.35–$2,745.86	—	40%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 LOWER EXTREMITY STUDY	$990.34	$1,650.58	$108.35–$2,745.86	—	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY	$513.87	$856.45	$108.35–$2,091.81	50% below	40%
Duplex ultrasound of the leg veins, both legs CPT 93970 US-EXT VEINS DPLX WC	$741.21	$1,235.36	$108.35–$2,091.81	28% below	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 EXTREMITY STUDY	$513.87	$856.45	$108.35–$2,091.81	—	40%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US-EXT VEINS DPLX WC	$741.21	$1,235.36	$108.35–$2,091.81	—	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 US-TTE 2D W DOPP WO	$1,620.46	$2,700.78	$148.77–$5,401.56	12% below	40%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE	$1,620.46	$2,700.78	$148.77–$5,401.56	12% below	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 TTE W/DOPPLER COMPLETE	$1,620.46	$2,700.78	$148.77–$5,401.56	—	40%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 US-TTE 2D W DOPP WO	$1,620.46	$2,700.78	$148.77–$5,401.56	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM-HEPATOBILIARY SYS	$1,341.61	$2,236.03	$213.75–$4,935.18	21% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,619.49	$2,699.15	$213.75–$4,935.18	46% above	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM-HEPATOBILIARY SYS	$1,341.61	$2,236.03	$213.75–$4,935.18	—	40%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 HEPATOBILIARY SYSTEM IMAGING	$1,619.49	$2,699.15	$213.75–$4,935.18	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLPSTDY UNATT RS EFF	$819.23	$1,365.39	$93.00–$1,365.39	11% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$819.23	$1,365.39	$93.00–$1,365.39	11% above	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLEEP STUDY UNATT&RESP EFFT	$819.23	$1,365.39	$93.00–$1,365.39	—	40%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 SLPSTDY UNATT RS EFF	$819.23	$1,365.39	$93.00–$1,365.39	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$2,874.38	$4,790.64	$209.96–$4,790.64	12% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 POLYS-CPAP GT4 GE6YO	$2,874.38	$4,790.64	$209.96–$4,790.64	12% below	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYS-CPAP GT4 GE6YO	$2,874.38	$4,790.64	$209.96–$4,790.64	—	40%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 POLYSOM 6/>YRS CPAP 4/> PARM	$2,874.38	$4,790.64	$209.96–$4,790.64	—	40%
Knee X-ray, 3 views both sides CPT 73562 LE-KNEE 3VWS BI CR	$273.84	$456.40	$16.30–$3,221.46	—	40%
Knee X-ray, 3 views both sides CPT 73562 LE-KNEE 3VWS BI DR	$273.84	$456.40	$16.30–$3,221.46	—	40%
Knee X-ray, 3 views CPT 73562 LE-KNEE 3V DR	$273.84	$456.40	$16.30–$3,221.46	1% above	40%
Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3	$273.84	$456.40	$16.30–$3,221.46	1% above	40%
Knee X-ray, 3 views CPT 73562 LE-KNEE 3V CR	$273.84	$456.40	$16.30–$3,221.46	1% above	40%
Knee X-ray, 3 views inpatient both sides CPT 73562 LE-KNEE 3VWS BI DR	$273.84	$456.40	$16.30–$3,221.46	—	40%
Knee X-ray, 3 views inpatient both sides CPT 73562 LE-KNEE 3VWS BI CR	$273.84	$456.40	$16.30–$3,221.46	—	40%
Knee X-ray, 3 views inpatient CPT 73562 X-RAY EXAM OF KNEE 3	$273.84	$456.40	$16.30–$3,221.46	—	40%
Knee X-ray, 3 views inpatient CPT 73562 LE-KNEE 3V CR	$273.84	$456.40	$16.30–$3,221.46	—	40%
Knee X-ray, 3 views inpatient CPT 73562 LE-KNEE 3V DR	$273.84	$456.40	$16.30–$3,221.46	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN	$262.03	$436.73	$40.08–$1,510.97	47% below	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US-ABDOMEN LTD WO	$644.54	$1,074.24	$40.08–$1,510.97	31% above	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 ECHO EXAM OF ABDOMEN	$262.03	$436.73	$40.08–$1,510.97	—	40%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US-ABDOMEN LTD WO	$644.54	$1,074.24	$40.08–$1,510.97	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-LOW DOSE CNCR SCR	$98.34	$163.91	$70.69–$1,830.89	65% below	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT-LUNG LOWDSE SC WO	$1,000.18	$1,666.98	$70.69–$1,830.89	259% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,000.18	$1,666.98	$70.69–$1,830.89	259% above	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-LOW DOSE CNCR SCR	$98.34	$163.91	$70.69–$1,830.89	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT-LUNG LOWDSE SC WO	$1,000.18	$1,666.98	$70.69–$1,830.89	—	40%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT THORAX LUNG CANCER SCR C-	$1,000.18	$1,666.98	$70.69–$1,830.89	—	40%
MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MR-LW JOINT WO BI	$4,334.14	$7,223.58	$225.81–$15,606.20	—	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MR-LW JOINT WO	$2,275.43	$3,792.39	$225.81–$15,606.20	30% above	40%
MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$4,334.14	$7,223.58	$225.81–$15,606.20	147% above	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MR-LW JOINT WO BI	$4,334.14	$7,223.58	$225.81–$15,606.20	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MR-LW JOINT WO	$2,275.43	$3,792.39	$225.81–$15,606.20	—	40%
MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI JNT OF LWR EXTRE W/O DYE	$4,334.14	$7,223.58	$225.81–$15,606.20	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MR-LW JOINT WWO BI	$3,157.66	$5,262.77	$491.36–$14,531.89	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MR-LW JOINT WWO	$1,947.05	$3,245.09	$491.36–$14,531.89	20% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$1,974.30	$3,290.50	$491.36–$14,531.89	19% below	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MR-LW JOINT WWO BI	$3,157.66	$5,262.77	$491.36–$14,531.89	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MR-LW JOINT WWO	$1,947.05	$3,245.09	$491.36–$14,531.89	—	40%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE	$1,974.30	$3,290.50	$491.36–$14,531.89	—	40%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST	$1,192.09	$1,986.83	$317.38–$5,254.51	37% below	40%
MRI of the abdomen without contrast CPT 74181 MR-ABDOMEN WO	$1,960.60	$3,267.68	$317.38–$5,254.51	4% above	40%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST	$1,192.09	$1,986.83	$317.38–$5,254.51	—	40%
MRI of the abdomen without contrast inpatient CPT 74181 MR-ABDOMEN WO	$1,960.60	$3,267.68	$317.38–$5,254.51	—	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$1,698.34	$2,830.58	$532.05–$8,184.14	38% below	40%
MRI of the abdomen, without and then with contrast dye CPT 74183 MR-ABDOMEN WWO	$3,212.13	$5,353.56	$532.05–$8,184.14	18% above	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABD W/O CNTR FLWD CNTR	$1,698.34	$2,830.58	$532.05–$8,184.14	—	40%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MR-ABDOMEN WWO	$3,212.13	$5,353.56	$532.05–$8,184.14	—	40%
MRI of the brain, no contrast dye CPT 70551 MR-BRAIN WO	$2,275.43	$3,792.39	$210.30–$5,779.22	33% above	40%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE	$2,275.43	$3,792.39	$210.30–$5,779.22	33% above	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN STEM W/O DYE	$2,275.43	$3,792.39	$210.30–$5,779.22	—	40%
MRI of the brain, no contrast dye inpatient CPT 70551 MR-BRAIN WO	$2,275.43	$3,792.39	$210.30–$5,779.22	—	40%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE	$1,692.69	$2,821.15	$354.71–$8,335.32	38% below	40%
MRI of the brain, with and without contrast dye CPT 70553 MR-BRAIN WWO	$3,308.50	$5,514.17	$354.71–$8,335.32	21% above	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN STEM W/O & W/DYE	$1,692.69	$2,821.15	$354.71–$8,335.32	—	40%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MR-BRAIN WWO	$3,308.50	$5,514.17	$354.71–$8,335.32	—	40%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,192.09	$1,986.83	$199.16–$5,892.99	33% below	40%
MRI of the lower back, no contrast dye CPT 72148 MR-LUMB SPINE WO	$2,343.69	$3,906.16	$199.16–$5,892.99	32% above	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O DYE	$1,192.09	$1,986.83	$199.16–$5,892.99	—	40%
MRI of the lower back, no contrast dye inpatient CPT 72148 MR-LUMB SPINE WO	$2,343.69	$3,906.16	$199.16–$5,892.99	—	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MR-LUMB SPINE WWO	$3,212.13	$5,353.56	$355.19–$8,150.79	11% above	40%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$3,212.13	$5,353.56	$355.19–$8,150.79	11% above	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/O & W/DYE	$3,212.13	$5,353.56	$355.19–$8,150.79	—	40%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MR-LUMB SPINE WWO	$3,212.13	$5,353.56	$355.19–$8,150.79	—	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MR-THOR SPINE WO	$2,275.43	$3,792.39	$201.09–$5,838.82	28% above	40%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE	$2,275.43	$3,792.39	$201.09–$5,838.82	28% above	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI CHEST SPINE W/O DYE	$2,275.43	$3,792.39	$201.09–$5,838.82	—	40%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MR-THOR SPINE WO	$2,275.43	$3,792.39	$201.09–$5,838.82	—	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE	$1,679.08	$2,798.47	$357.62–$8,312.64	35% below	40%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MR-CERV SPINE WWO	$3,308.50	$5,514.17	$357.62–$8,312.64	29% above	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI NECK SPINE W/O & W/DYE	$1,679.08	$2,798.47	$357.62–$8,312.64	—	40%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MR-CERV SPINE WWO	$3,308.50	$5,514.17	$357.62–$8,312.64	—	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE	$1,192.09	$1,986.83	$201.09–$5,779.22	32% below	40%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MR-CERV SPINE WO	$2,275.43	$3,792.39	$201.09–$5,779.22	29% above	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI NECK SPINE W/O DYE	$1,192.09	$1,986.83	$201.09–$5,779.22	—	40%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MR-CERV SPINE WO	$2,275.43	$3,792.39	$201.09–$5,779.22	—	40%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE	$1,748.54	$2,914.24	$530.60–$8,920.64	31% below	40%
MRI of the pelvis without and with contrast CPT 72197 MR-PELVIS WWO	$3,603.84	$6,006.40	$530.60–$8,920.64	41% above	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/O & W/DYE	$1,748.54	$2,914.24	$530.60–$8,920.64	—	40%
MRI of the pelvis without and with contrast inpatient CPT 72197 MR-PELVIS WWO	$3,603.84	$6,006.40	$530.60–$8,920.64	—	40%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE	$1,192.09	$1,986.83	$317.94–$5,892.99	34% below	40%
MRI of the pelvis, no contrast dye CPT 72195 MR-PELVIS WO	$2,343.69	$3,906.16	$317.94–$5,892.99	29% above	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O DYE	$1,192.09	$1,986.83	$317.94–$5,892.99	—	40%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MR-PELVIS WO	$2,343.69	$3,906.16	$317.94–$5,892.99	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,192.09	$1,986.83	$225.81–$15,408.95	23% below	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR-UPPER JOINT WO	$2,343.69	$3,906.16	$225.81–$15,408.95	51% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MR-UPPER JNT BIL WO	$4,137.51	$6,895.85	$225.81–$15,408.95	167% above	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI JOINT UPR EXTREM W/O DYE	$1,192.09	$1,986.83	$225.81–$15,408.95	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR-UPPER JOINT WO	$2,343.69	$3,906.16	$225.81–$15,408.95	—	40%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MR-UPPER JNT BIL WO	$4,137.51	$6,895.85	$225.81–$15,408.95	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT	$1,614.35	$2,690.59	$217.02–$5,311.12	55% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM-MYOCRD SPECT MULT	$1,614.35	$2,690.59	$217.02–$5,311.12	55% below	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 HT MUSCLE IMAGE SPECT MULT	$1,614.35	$2,690.59	$217.02–$5,311.12	—	40%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM-MYOCRD SPECT MULT	$1,614.35	$2,690.59	$217.02–$5,311.12	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED	$262.03	$436.73	$29.66–$973.86	33% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US-PELVIS NON OB FU	$322.27	$537.13	$29.66–$973.86	18% below	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US EXAM PELVIC LIMITED	$262.03	$436.73	$29.66–$973.86	—	40%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US-PELVIS NON OB FU	$322.27	$537.13	$29.66–$973.86	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE	$262.03	$436.73	$43.30–$1,577.49	55% below	40%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US-PELVIS NON OB	$684.45	$1,140.76	$43.30–$1,577.49	17% above	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US EXAM PELVIC COMPLETE	$262.03	$436.73	$43.30–$1,577.49	—	40%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US-PELVIS NON OB	$684.45	$1,140.76	$43.30–$1,577.49	—	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 OB US >/= 14 WKS SNGL FETUS	$271.92	$453.21	$59.47–$1,931.55	52% below	40%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US-PELVIS PREG	$887.00	$1,478.34	$59.47–$1,931.55	55% above	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 OB US >/= 14 WKS SNGL FETUS	$271.92	$453.21	$59.47–$1,931.55	—	40%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US-PELVIS PREG	$887.00	$1,478.34	$59.47–$1,931.55	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 OB US < 14 WKS SINGLE FETUS	$861.16	$1,435.28	$29.75–$1,888.49	60% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US-PELV PREG 14 WKS	$861.16	$1,435.28	$29.75–$1,888.49	60% above	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 OB US < 14 WKS SINGLE FETUS	$861.16	$1,435.28	$29.75–$1,888.49	—	40%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US-PELV PREG 14 WKS	$861.16	$1,435.28	$29.75–$1,888.49	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S)	$264.00	$440.01	$40.08–$1,106.83	23% below	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US-PELVIS PREG LTD	$400.09	$666.82	$40.08–$1,106.83	17% above	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 OB US LIMITED FETUS(S)	$264.00	$440.01	$40.08–$1,106.83	—	40%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US-PELVIS PREG LTD	$400.09	$666.82	$40.08–$1,106.83	—	40%
Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD	$200.50	$334.18	$73.36–$1,376.21	—	40%
Screening mammogram, both breasts both sides CPT 77067 BR-DIG MAMMO SCRN BI	$237.51	$395.86	$73.36–$1,376.21	—	40%
Screening mammogram, both breasts CPT 77067 BR-DIG MAMMO SCRN UN	$203.90	$339.84	$73.36–$1,376.21	8% below	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 SCR MAMMO BI INCL CAD	$200.50	$334.18	$73.36–$1,376.21	—	40%
Screening mammogram, both breasts inpatient both sides CPT 77067 BR-DIG MAMMO SCRN BI	$237.51	$395.86	$73.36–$1,376.21	—	40%
Screening mammogram, both breasts inpatient CPT 77067 BR-DIG MAMMO SCRN UN	$203.90	$339.84	$73.36–$1,376.21	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 UE-SHOULDER 2V BI DR	$486.18	$810.30	$16.30–$4,589.86	—	40%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 UE-SHOULDER 2V BI CR	$486.18	$810.30	$16.30–$4,589.86	—	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER	$178.15	$296.92	$16.30–$4,589.86	43% below	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 UE-SHLDR 2VW PLUS DR	$472.02	$786.70	$16.30–$4,589.86	50% above	40%
Shoulder X-ray, complete, 2 or more views CPT 73030 UE-SHLDR 2VW PLUS CR	$472.02	$786.70	$16.30–$4,589.86	50% above	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 UE-SHOULDER 2V BI DR	$486.18	$810.30	$16.30–$4,589.86	—	40%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 UE-SHOULDER 2V BI CR	$486.18	$810.30	$16.30–$4,589.86	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 X-RAY EXAM OF SHOULDER	$178.15	$296.92	$16.30–$4,589.86	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 UE-SHLDR 2VW PLUS CR	$472.02	$786.70	$16.30–$4,589.86	—	40%
Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 UE-SHLDR 2VW PLUS DR	$472.02	$786.70	$16.30–$4,589.86	—	40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,577.04	$4,295.07	$156.45–$4,295.07	16% below	40%
Sleep study in a lab (polysomnography) CPT 95810 POLYSOMNO GT4 GE6YO	$2,577.04	$4,295.07	$156.45–$4,295.07	16% below	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOMNO GT4 GE6YO	$2,577.04	$4,295.07	$156.45–$4,295.07	—	40%
Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/> YRS 4/> PARAM	$2,577.04	$4,295.07	$156.45–$4,295.07	—	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 FL-MOD BA SWALLOW	$420.11	$700.19	$36.83–$700.19	33% below	40%
Swallow study (modified barium swallow, video X-ray) CPT 74230 X-RAY XM SWLNG FUNCJ C+	$420.11	$700.19	$36.83–$700.19	33% below	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 X-RAY XM SWLNG FUNCJ C+	$420.11	$700.19	$36.83–$700.19	—	40%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 FL-MOD BA SWALLOW	$420.11	$700.19	$36.83–$700.19	—	40%
Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB	$254.40	$424.01	$43.30–$1,498.25	50% below	40%
Transvaginal pelvic ultrasound CPT 76830 US-TRANSVAGINAL	$644.54	$1,074.24	$43.30–$1,498.25	26% above	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 TRANSVAGINAL US NON-OB	$254.40	$424.01	$43.30–$1,498.25	—	40%
Transvaginal pelvic ultrasound inpatient CPT 76830 US-TRANSVAGINAL	$644.54	$1,074.24	$43.30–$1,498.25	—	40%
Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC	$271.92	$453.21	$41.51–$1,931.55	15% below	40%
Transvaginal ultrasound during pregnancy CPT 76817 US-PLV PRG TRNSV	$887.00	$1,478.34	$41.51–$1,931.55	176% above	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 TRANSVAGINAL US OBSTETRIC	$271.92	$453.21	$41.51–$1,931.55	—	40%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US-PLV PRG TRNSV	$887.00	$1,478.34	$41.51–$1,931.55	—	40%
Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE	$254.40	$424.01	$55.69–$1,701.11	68% below	40%
Ultrasound of the abdomen, complete CPT 76700 US-ABDOMEN COMP WO	$766.26	$1,277.10	$55.69–$1,701.11	4% below	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US EXAM ABDOM COMPLETE	$254.40	$424.01	$55.69–$1,701.11	—	40%
Ultrasound of the abdomen, complete inpatient CPT 76700 US-ABDOMEN COMP WO	$766.26	$1,277.10	$55.69–$1,701.11	—	40%
Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM	$254.40	$424.01	$43.30–$1,629.61	54% below	40%
Ultrasound of the scrotum and testicles CPT 76870 US-SCROTUM	$723.36	$1,205.60	$43.30–$1,629.61	31% above	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US EXAM SCROTUM	$254.40	$424.01	$43.30–$1,629.61	—	40%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US-SCROTUM	$723.36	$1,205.60	$43.30–$1,629.61	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK	$254.40	$424.01	$40.08–$1,498.25	58% below	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US-HEAD NECK SFT TIS	$644.54	$1,074.24	$40.08–$1,498.25	6% above	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US EXAM OF HEAD AND NECK	$254.40	$424.01	$40.08–$1,498.25	—	40%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US-HEAD NECK SFT TIS	$644.54	$1,074.24	$40.08–$1,498.25	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$875.24	$1,458.74	$41.49–$1,458.74	78% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 FL-UPPER GI SINGLE	$875.24	$1,458.74	$41.49–$1,458.74	78% above	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 FL-UPPER GI SINGLE	$875.24	$1,458.74	$41.49–$1,458.74	—	40%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 X-RAY XM UPR GI TRC 1CNTRST	$875.24	$1,458.74	$41.49–$1,458.74	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 US-EXT VEINS DPX LTD	$741.21	$1,235.36	$108.35–$1,824.94	17% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY	$741.21	$1,235.36	$108.35–$1,824.94	17% above	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 EXTREMITY STUDY	$741.21	$1,235.36	$108.35–$1,824.94	—	40%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US-EXT VEINS DPX LTD	$741.21	$1,235.36	$108.35–$1,824.94	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 UE-WRIST 3VW BI DR	$250.22	$417.04	$15.33–$3,081.84	—	40%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 UE-WRIST 3VW BI CR	$250.22	$417.04	$15.33–$3,081.84	—	40%
Wrist X-ray, complete, 3 or more views CPT 73110 UE-WRIST 3V PLUS DR	$250.22	$417.04	$15.33–$3,081.84	5% above	40%
Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST	$250.22	$417.04	$15.33–$3,081.84	5% above	40%
Wrist X-ray, complete, 3 or more views CPT 73110 UE-WRIST 3V PLUS CR	$250.22	$417.04	$15.33–$3,081.84	5% above	40%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 UE-WRIST 3VW BI DR	$250.22	$417.04	$15.33–$3,081.84	—	40%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 UE-WRIST 3VW BI CR	$250.22	$417.04	$15.33–$3,081.84	—	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 UE-WRIST 3V PLUS DR	$250.22	$417.04	$15.33–$3,081.84	—	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 UE-WRIST 3V PLUS CR	$250.22	$417.04	$15.33–$3,081.84	—	40%
Wrist X-ray, complete, 3 or more views inpatient CPT 73110 X-RAY EXAM OF WRIST	$250.22	$417.04	$15.33–$3,081.84	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$178.15	$296.92	$21.83–$1,595.48	6% below	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 LE-HIP PV UN2OR3V DR	$300.49	$500.82	$21.83–$1,595.48	59% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 LE-HIP PV UN2OR3V CR	$300.49	$500.82	$21.83–$1,595.48	59% above	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS	$178.15	$296.92	$21.83–$1,595.48	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 LE-HIP PV UN2OR3V DR	$300.49	$500.82	$21.83–$1,595.48	—	40%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 LE-HIP PV UN2OR3V CR	$300.49	$500.82	$21.83–$1,595.48	—	40%
X-ray of the abdomen, 1 view CPT 74018 CH-ABDOMEN 1 VIEW DR	$387.86	$646.44	$13.33–$1,886.72	36% above	40%
X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW	$387.86	$646.44	$13.33–$1,886.72	36% above	40%
X-ray of the abdomen, 1 view CPT 74018 CH-ABDOMEN 1 VIEW CR	$387.86	$646.44	$13.33–$1,886.72	36% above	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 CH-ABDOMEN 1 VIEW DR	$387.86	$646.44	$13.33–$1,886.72	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 RADEX ABDOMEN 1 VIEW	$387.86	$646.44	$13.33–$1,886.72	—	40%
X-ray of the abdomen, 1 view inpatient CPT 74018 CH-ABDOMEN 1 VIEW CR	$387.86	$646.44	$13.33–$1,886.72	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 LE-ANKLE 2VW BI CR	$206.71	$344.52	$14.21–$2,771.26	—	40%
X-ray of the ankle, 2 views both sides CPT 73600 LE-ANKLE 2VW BI DR	$206.71	$344.52	$14.21–$2,771.26	—	40%
X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE	$206.71	$344.52	$14.21–$2,771.26	3% above	40%
X-ray of the ankle, 2 views CPT 73600 LE-ANKLE 2V DR	$212.91	$354.86	$14.21–$2,771.26	6% above	40%
X-ray of the ankle, 2 views CPT 73600 LE-ANKLE 2V CR	$212.91	$354.86	$14.21–$2,771.26	6% above	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 LE-ANKLE 2VW BI CR	$206.71	$344.52	$14.21–$2,771.26	—	40%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 LE-ANKLE 2VW BI DR	$206.71	$344.52	$14.21–$2,771.26	—	40%
X-ray of the ankle, 2 views inpatient CPT 73600 X-RAY EXAM OF ANKLE	$206.71	$344.52	$14.21–$2,771.26	—	40%
X-ray of the ankle, 2 views inpatient CPT 73600 LE-ANKLE 2V CR	$212.91	$354.86	$14.21–$2,771.26	—	40%
X-ray of the ankle, 2 views inpatient CPT 73600 LE-ANKLE 2V DR	$212.91	$354.86	$14.21–$2,771.26	—	40%
X-ray of the finger(s), 2 or more views both sides CPT 73140 UE-FINGER 2 VW BI CR	$233.59	$389.33	$11.95–$2,206.58	—	40%
X-ray of the finger(s), 2 or more views both sides CPT 73140 UE-FINGER 2 VW BI DR	$233.59	$389.33	$11.95–$2,206.58	—	40%
X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S)	$178.15	$296.92	$11.95–$2,206.58	2% below	40%
X-ray of the finger(s), 2 or more views CPT 73140 UE-FINGER S 2VPLS DR	$250.22	$417.04	$11.95–$2,206.58	37% above	40%
X-ray of the finger(s), 2 or more views CPT 73140 UE-FINGER S 2VPLS CR	$250.22	$417.04	$11.95–$2,206.58	37% above	40%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 UE-FINGER 2 VW BI CR	$233.59	$389.33	$11.95–$2,206.58	—	40%
X-ray of the finger(s), 2 or more views inpatient both sides CPT 73140 UE-FINGER 2 VW BI DR	$233.59	$389.33	$11.95–$2,206.58	—	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 X-RAY EXAM OF FINGER(S)	$178.15	$296.92	$11.95–$2,206.58	—	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 UE-FINGER S 2VPLS CR	$250.22	$417.04	$11.95–$2,206.58	—	40%
X-ray of the finger(s), 2 or more views inpatient CPT 73140 UE-FINGER S 2VPLS DR	$250.22	$417.04	$11.95–$2,206.58	—	40%
X-ray of the foot, 2 views both sides CPT 73620 LE-FOOT 2VWS BI CR	$206.71	$344.52	$14.21–$2,794.62	—	40%
X-ray of the foot, 2 views both sides CPT 73620 LE-FOOT 2VWS BI DR	$206.71	$344.52	$14.21–$2,794.62	—	40%
X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT	$206.71	$344.52	$14.21–$2,794.62	11% above	40%
X-ray of the foot, 2 views CPT 73620 LE-FOOT 2V CR	$212.91	$354.86	$14.21–$2,794.62	15% above	40%
X-ray of the foot, 2 views CPT 73620 LE-FOOT 2V DR	$212.91	$354.86	$14.21–$2,794.62	15% above	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 LE-FOOT 2VWS BI DR	$206.71	$344.52	$14.21–$2,794.62	—	40%
X-ray of the foot, 2 views inpatient both sides CPT 73620 LE-FOOT 2VWS BI CR	$206.71	$344.52	$14.21–$2,794.62	—	40%
X-ray of the foot, 2 views inpatient CPT 73620 X-RAY EXAM OF FOOT	$206.71	$344.52	$14.21–$2,794.62	—	40%
X-ray of the foot, 2 views inpatient CPT 73620 LE-FOOT 2V DR	$212.91	$354.86	$14.21–$2,794.62	—	40%
X-ray of the foot, 2 views inpatient CPT 73620 LE-FOOT 2V CR	$212.91	$354.86	$14.21–$2,794.62	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 LE-FOOT 3VWPLS BI CR	$242.93	$404.89	$15.33–$2,992.06	—	40%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 LE-FOOT 3VWPLS BI DR	$242.93	$404.89	$15.33–$2,992.06	—	40%
X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT	$178.15	$296.92	$15.33–$2,992.06	32% below	40%
X-ray of the foot, complete, 3 or more views CPT 73630 LE-FOOT 3V PLUS DR	$242.93	$404.89	$15.33–$2,992.06	7% below	40%
X-ray of the foot, complete, 3 or more views CPT 73630 LE-FOOT 3V PLUS CR	$242.93	$404.89	$15.33–$2,992.06	7% below	40%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 LE-FOOT 3VWPLS BI CR	$242.93	$404.89	$15.33–$2,992.06	—	40%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 LE-FOOT 3VWPLS BI DR	$242.93	$404.89	$15.33–$2,992.06	—	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 X-RAY EXAM OF FOOT	$178.15	$296.92	$15.33–$2,992.06	—	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 LE-FOOT 3V PLUS CR	$242.93	$404.89	$15.33–$2,992.06	—	40%
X-ray of the foot, complete, 3 or more views inpatient CPT 73630 LE-FOOT 3V PLUS DR	$242.93	$404.89	$15.33–$2,992.06	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 UE-HAND 3VWS BI CR	$250.22	$417.04	$15.33–$3,058.48	—	40%
X-ray of the hand, 3 or more views both sides CPT 73130 UE-HAND 3VWS BI DR	$250.22	$417.04	$15.33–$3,058.48	—	40%
X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND	$233.59	$389.33	$15.33–$3,058.48	12% below	40%
X-ray of the hand, 3 or more views CPT 73130 UE-HAND 3V CR	$250.22	$417.04	$15.33–$3,058.48	5% below	40%
X-ray of the hand, 3 or more views CPT 73130 UE-HAND 3V DR	$250.22	$417.04	$15.33–$3,058.48	5% below	40%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 UE-HAND 3VWS BI CR	$250.22	$417.04	$15.33–$3,058.48	—	40%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 UE-HAND 3VWS BI DR	$250.22	$417.04	$15.33–$3,058.48	—	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 X-RAY EXAM OF HAND	$233.59	$389.33	$15.33–$3,058.48	—	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 UE-HAND 3V CR	$250.22	$417.04	$15.33–$3,058.48	—	40%
X-ray of the hand, 3 or more views inpatient CPT 73130 UE-HAND 3V DR	$250.22	$417.04	$15.33–$3,058.48	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 LE-KNEE 1TO2V BI DR	$359.99	$599.99	$15.04–$3,215.26	—	40%
X-ray of the knee, 1 or 2 views both sides CPT 73560 LE-KNEE 1TO2V BI CR	$359.99	$599.99	$15.04–$3,215.26	—	40%
X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$242.93	$404.89	$15.04–$3,215.26	33% above	40%
X-ray of the knee, 1 or 2 views CPT 73560 LE-KNEE 1 TO 2V CR	$242.93	$404.89	$15.04–$3,215.26	33% above	40%
X-ray of the knee, 1 or 2 views CPT 73560 LE-KNEE 1 TO 2V DR	$242.93	$404.89	$15.04–$3,215.26	33% above	40%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 LE-KNEE 1TO2V BI DR	$359.99	$599.99	$15.04–$3,215.26	—	40%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 LE-KNEE 1TO2V BI CR	$359.99	$599.99	$15.04–$3,215.26	—	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 LE-KNEE 1 TO 2V CR	$242.93	$404.89	$15.04–$3,215.26	—	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 LE-KNEE 1 TO 2V DR	$242.93	$404.89	$15.04–$3,215.26	—	40%
X-ray of the knee, 1 or 2 views inpatient CPT 73560 X-RAY EXAM OF KNEE 1 OR 2	$242.93	$404.89	$15.04–$3,215.26	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$466.71	$777.86	$19.13–$2,149.56	37% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP-LS SPN 2 TO 3V CR	$466.71	$777.86	$19.13–$2,149.56	37% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 SP-LS SPN 2 TO 3V DR	$466.71	$777.86	$19.13–$2,149.56	37% above	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP-LS SPN 2 TO 3V DR	$466.71	$777.86	$19.13–$2,149.56	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 SP-LS SPN 2 TO 3V CR	$466.71	$777.86	$19.13–$2,149.56	—	40%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS	$466.71	$777.86	$19.13–$2,149.56	—	40%
X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$178.15	$296.92	$25.87–$2,657.16	65% below	40%
X-ray of the lower back, 4 or more views CPT 72110 SP-LS SPNE 4VPLUS CR	$618.99	$1,031.66	$25.87–$2,657.16	22% above	40%
X-ray of the lower back, 4 or more views CPT 72110 SP-LS SPNE 4VPLUS DR	$618.99	$1,031.66	$25.87–$2,657.16	22% above	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS	$178.15	$296.92	$25.87–$2,657.16	—	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SP-LS SPNE 4VPLUS DR	$618.99	$1,031.66	$25.87–$2,657.16	—	40%
X-ray of the lower back, 4 or more views inpatient CPT 72110 SP-LS SPNE 4VPLUS CR	$618.99	$1,031.66	$25.87–$2,657.16	—	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SP-T SPINE 2 VIEW CR	$140.65	$234.42	$18.57–$1,062.68	57% below	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 SP-T SPINE 2 VIEW DR	$140.65	$234.42	$18.57–$1,062.68	57% below	40%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$140.65	$234.42	$18.57–$1,062.68	57% below	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 X-RAY EXAM THORAC SPINE 2VWS	$140.65	$234.42	$18.57–$1,062.68	—	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SP-T SPINE 2 VIEW DR	$140.65	$234.42	$18.57–$1,062.68	—	40%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 SP-T SPINE 2 VIEW CR	$140.65	$234.42	$18.57–$1,062.68	—	40%
X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES	$178.15	$296.92	$15.04–$1,790.80	30% below	40%
X-ray of the nasal bones, 3 or more views CPT 70160 HE-NASAL BONES CR	$359.08	$598.48	$15.04–$1,790.80	40% above	40%
X-ray of the nasal bones, 3 or more views CPT 70160 HE-NASAL BONES DR	$359.08	$598.48	$15.04–$1,790.80	40% above	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 X-RAY EXAM OF NASAL BONES	$178.15	$296.92	$15.04–$1,790.80	—	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HE-NASAL BONES DR	$359.08	$598.48	$15.04–$1,790.80	—	40%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 HE-NASAL BONES CR	$359.08	$598.48	$15.04–$1,790.80	—	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$178.15	$296.92	$17.15–$2,060.82	49% below	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP-CERV SP 2TO3VW CR	$440.09	$733.49	$17.15–$2,060.82	25% above	40%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 SP-CERV SP 2TO3VW DR	$440.09	$733.49	$17.15–$2,060.82	25% above	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW	$178.15	$296.92	$17.15–$2,060.82	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP-CERV SP 2TO3VW CR	$440.09	$733.49	$17.15–$2,060.82	—	40%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 SP-CERV SP 2TO3VW DR	$440.09	$733.49	$17.15–$2,060.82	—	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS	$387.86	$646.44	$15.04–$1,886.72	60% above	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 LE-PELVIS DR	$387.86	$646.44	$15.04–$1,886.72	60% above	40%
X-ray of the pelvis, 1 or 2 views CPT 72170 LE-PELVIS CR	$387.86	$646.44	$15.04–$1,886.72	60% above	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 LE-PELVIS CR	$387.86	$646.44	$15.04–$1,886.72	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 LE-PELVIS DR	$387.86	$646.44	$15.04–$1,886.72	—	40%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 X-RAY EXAM OF PELVIS	$387.86	$646.44	$15.04–$1,886.72	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE	$178.15	$296.92	$16.30–$2,060.82	38% below	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SP-SDRM COCCYX 2V DR	$440.09	$733.49	$16.30–$2,060.82	53% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 SP-SCRM COCCYX 2V CR	$440.09	$733.49	$16.30–$2,060.82	53% above	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 X-RAY EXAM SACRUM TAILBONE	$178.15	$296.92	$16.30–$2,060.82	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SP-SDRM COCCYX 2V DR	$440.09	$733.49	$16.30–$2,060.82	—	40%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 SP-SCRM COCCYX 2V CR	$440.09	$733.49	$16.30–$2,060.82	—	40%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT)	$12.24	$20.41	$5.30–$291.04	72% below	40%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 TRANSFERASE ALT	$162.37	$270.63	$5.30–$291.04	269% above	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALANINE AMINO (ALT) (SGPT)	$12.24	$20.41	$5.30–$291.04	—	40%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 TRANSFERASE ALT	$162.37	$270.63	$5.30–$291.04	—	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE AST	$157.65	$262.75	$5.18–$287.88	316% above	40%
AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT)	$157.65	$262.75	$5.18–$287.88	316% above	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE (AST) (SGOT)	$157.65	$262.75	$5.18–$287.88	—	40%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 TRANSFERASE AST	$157.65	$262.75	$5.18–$287.88	—	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL	$527.88	$879.81	$47.63–$996.51	47% above	40%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS ACUTE PANE	$527.88	$879.81	$47.63–$996.51	47% above	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 ACUTE HEPATITIS PANEL	$527.88	$879.81	$47.63–$996.51	—	40%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS ACUTE PANE	$527.88	$879.81	$47.63–$996.51	—	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$14.00	$23.34	$5.22–$84.38	62% below	40%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN IGE QUANT	$36.62	$61.04	$5.22–$84.38	1% below	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLG SPEC IGE CRUDE XTRC EA	$14.00	$23.34	$5.22–$84.38	—	40%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN IGE QUANT	$36.62	$61.04	$5.22–$84.38	—	40%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY	$295.98	$493.30	$12.95–$530.43	130% above	40%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP ANTIBODY	$295.98	$493.30	$12.95–$530.43	—	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES	$377.34	$628.90	$12.09–$643.94	192% above	40%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA	$377.34	$628.90	$12.09–$643.94	192% above	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTINUCLEAR ANTIBODIES	$377.34	$628.90	$12.09–$643.94	—	40%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA	$377.34	$628.90	$12.09–$643.94	—	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 NATRIURETIC PEPTIDE	$158.67	$264.45	$36.85–$286.04	15% above	40%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$158.67	$264.45	$36.85–$286.04	15% above	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 NATRIURETIC PEPTIDE	$158.67	$264.45	$36.85–$286.04	—	40%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 ASSAY OF NATRIURETIC PEPTIDE	$158.67	$264.45	$36.85–$286.04	—	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PNL TOTAL CA	$193.81	$323.02	$8.46–$339.41	137% above	40%
Basic metabolic panel (blood test) CPT 80048 BASIC METABO CA TOTA	$193.81	$323.02	$8.46–$339.41	137% above	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABO CA TOTA	$193.81	$323.02	$8.46–$339.41	—	40%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PNL TOTAL CA	$193.81	$323.02	$8.46–$339.41	—	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST	$86.52	$144.20	$15.18–$1,640.20	22% below	40%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 SURG PATH GROSS LVL4	$897.60	$1,496.00	$15.18–$1,640.20	705% above	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TISSUE EXAM BY PATHOLOGIST	$86.52	$144.20	$15.18–$1,640.20	—	40%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 SURG PATH GROSS LVL4	$897.60	$1,496.00	$15.18–$1,640.20	—	40%
Blood culture for bacteria CPT 87040 CULTURE BLOOD BACTER	$420.09	$700.16	$10.32–$731.11	362% above	40%
Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA	$420.09	$700.16	$10.32–$731.11	362% above	40%
Blood culture for bacteria inpatient CPT 87040 BLOOD CULTURE FOR BACTERIA	$420.09	$700.16	$10.32–$731.11	—	40%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD BACTER	$420.09	$700.16	$10.32–$731.11	—	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$30.51	$50.86	$4.06–$57.23	134% above	40%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE,ROUTINE	$30.51	$50.86	$4.06–$57.23	134% above	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE,ROUTINE	$30.51	$50.86	$4.06–$57.23	—	40%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLL VENOUS BLD VENIPUNCTURE	$30.51	$50.86	$4.06–$57.23	—	40%
Blood glucose (sugar) test CPT 82947 GLUCOSE, QUANT	$82.38	$137.30	$3.86–$176.55	125% above	40%
Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$82.38	$137.30	$3.86–$176.55	125% above	40%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE, QUANT	$82.38	$137.30	$3.86–$176.55	—	40%
Blood glucose (sugar) test inpatient CPT 82947 ASSAY GLUCOSE BLOOD QUANT	$82.38	$137.30	$3.86–$176.55	—	40%
Blood lead test CPT 83655 ASSAY OF LEAD	$13.11	$21.86	$12.11–$96.94	78% below	40%
Blood lead test CPT 83655 LEAD	$45.04	$75.08	$12.11–$96.94	25% below	40%
Blood lead test inpatient CPT 83655 ASSAY OF LEAD	$13.11	$21.86	$12.11–$96.94	—	40%
Blood lead test inpatient CPT 83655 LEAD	$45.04	$75.08	$12.11–$96.94	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG, QUAL	$230.48	$384.14	$7.52–$461.80	71% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$230.48	$384.14	$7.52–$461.80	71% above	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG, QUAL	$230.48	$384.14	$7.52–$461.80	—	40%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 CHORIONIC GONADOTROPIN ASSAY	$230.48	$384.14	$7.52–$461.80	—	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO	$136.29	$227.16	$2.99–$313.48	105% above	40%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO	$136.29	$227.16	$2.99–$313.48	105% above	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING SEROLOGIC ABO	$136.29	$227.16	$2.99–$313.48	—	40%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO	$136.29	$227.16	$2.99–$313.48	—	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN	$144.58	$240.97	$5.18–$384.19	4% above	40%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN	$144.58	$240.97	$5.18–$384.19	—	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLI PROBE	$99.58	$165.98	$30.99–$224.81	12% above	40%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE	$99.58	$165.98	$30.99–$224.81	12% above	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLI PROBE	$99.58	$165.98	$30.99–$224.81	—	40%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFF AMPLIFIED PROBE	$99.58	$165.98	$30.99–$224.81	—	40%
CA 19-9 blood test (tumor marker) CPT 86301 TUMOR AG CA 19-9	$36.81	$61.35	$16.92–$122.70	57% below	40%
CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$36.81	$61.35	$16.92–$122.70	57% below	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 IMMUNOASSAY TUMOR CA 19-9	$36.81	$61.35	$16.92–$122.70	—	40%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 TUMOR AG CA 19-9	$36.81	$61.35	$16.92–$122.70	—	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125	$36.81	$61.35	$17.17–$124.54	74% below	40%
CA-125 blood test (ovarian cancer marker) CPT 86304 TUMOR AG CA 125	$37.91	$63.19	$17.17–$124.54	73% below	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 IMMUNOASSAY TUMOR CA 125	$36.81	$61.35	$17.17–$124.54	—	40%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 TUMOR AG CA 125	$37.91	$63.19	$17.17–$124.54	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 COVID19 PRB	$95.13	$158.55	$21.86–$158.55	22% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$95.13	$158.55	$21.86–$158.55	22% below	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 COVID19 PRB	$95.13	$158.55	$21.86–$158.55	—	40%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB	$95.13	$158.55	$21.86–$158.55	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP	$182.30	$303.84	$24.67–$623.59	143% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 L183160 C TRACH AMP	$182.30	$303.84	$24.67–$623.59	143% above	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 L183160 C TRACH AMP	$182.30	$303.84	$24.67–$623.59	—	40%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLMYD TRACH DNA AMP	$182.30	$303.84	$24.67–$623.59	—	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL	$379.24	$632.08	$13.14–$1,292.57	349% above	40%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 L123638 LIPID PNL	$379.24	$632.08	$13.14–$1,292.57	349% above	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 L123638 LIPID PNL	$379.24	$632.08	$13.14–$1,292.57	—	40%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL	$379.24	$632.08	$13.14–$1,292.57	—	40%
Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$7.63	$12.73	$7.77–$749.57	88% below	40%
Complete blood count (CBC) with differential CPT 85025 L402145 - CBC W DIFF	$221.05	$368.42	$7.77–$749.57	239% above	40%
Complete blood count (CBC) with differential CPT 85025 CBC W-PLT AUTO COMPD	$221.05	$368.42	$7.77–$749.57	239% above	40%
Complete blood count (CBC) with differential inpatient CPT 85025 COMPLETE CBC W/AUTO DIFF WBC	$7.63	$12.73	$7.77–$749.57	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 L402145 - CBC W DIFF	$221.05	$368.42	$7.77–$749.57	—	40%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W-PLT AUTO COMPD	$221.05	$368.42	$7.77–$749.57	—	40%
Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED	$12.73	$21.22	$6.47–$379.79	73% below	40%
Complete blood count (CBC), no differential CPT 85027 CBC W-PLT	$215.14	$358.57	$6.47–$379.79	352% above	40%
Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE CBC AUTOMATED	$12.73	$21.22	$6.47–$379.79	—	40%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC W-PLT	$215.14	$358.57	$6.47–$379.79	—	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METAB PANEL	$472.95	$788.25	$10.53–$810.11	341% above	40%
Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL	$472.95	$788.25	$10.53–$810.11	341% above	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHEN METABOLIC PANEL	$472.95	$788.25	$10.53–$810.11	—	40%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METAB PANEL	$472.95	$788.25	$10.53–$810.11	—	40%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER, QUANT	$294.38	$490.64	$10.18–$583.53	177% above	40%
D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT	$294.38	$490.64	$10.18–$583.53	177% above	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER, QUANT	$294.38	$490.64	$10.18–$583.53	—	40%
D-dimer blood test (blood clot marker) inpatient CPT 85379 FIBRIN DEGRADATION QUANT	$294.38	$490.64	$10.18–$583.53	—	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S	$193.26	$322.10	$20.19–$344.72	13% above	40%
DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE	$193.26	$322.10	$20.19–$344.72	13% above	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S	$193.26	$322.10	$20.19–$344.72	—	40%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE	$193.26	$322.10	$20.19–$344.72	—	40%
Estradiol blood test CPT 82670 ESTRADIOL TOTAL	$422.10	$703.50	$27.94–$735.17	301% above	40%
Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL	$422.10	$703.50	$27.94–$735.17	301% above	40%
Estradiol blood test inpatient CPT 82670 ASSAY OF TOTAL ESTRADIOL	$422.10	$703.50	$27.94–$735.17	—	40%
Estradiol blood test inpatient CPT 82670 ESTRADIOL TOTAL	$422.10	$703.50	$27.94–$735.17	—	40%
FSH (follicle-stimulating hormone) test CPT 83001 FOLLICLE STIM HORM	$507.05	$845.09	$18.58–$894.26	230% above	40%
FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$507.05	$845.09	$18.58–$894.26	230% above	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIM HORM	$507.05	$845.09	$18.58–$894.26	—	40%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 ASSAY OF GONADOTROPIN (FSH)	$507.05	$845.09	$18.58–$894.26	—	40%
Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$34.28	$57.14	$19.63–$368.74	91% below	40%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$186.96	$311.60	$19.63–$368.74	49% below	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 ASSAY FOR CALPROTECTIN FECAL	$34.28	$57.14	$19.63–$368.74	—	40%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$186.96	$311.60	$19.63–$368.74	—	40%
Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN	$269.52	$449.21	$13.63–$464.68	102% above	40%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$269.52	$449.21	$13.63–$464.68	102% above	40%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$269.52	$449.21	$13.63–$464.68	—	40%
Ferritin blood test (iron stores) inpatient CPT 82728 ASSAY OF FERRITIN	$269.52	$449.21	$13.63–$464.68	—	40%
Folate (folic acid) blood test CPT 82746 FOLIC ACID SERUM	$148.77	$247.95	$14.70–$261.06	at median	40%
Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM	$148.77	$247.95	$14.70–$261.06	at median	40%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID SERUM	$148.77	$247.95	$14.70–$261.06	—	40%
Folate (folic acid) blood test inpatient CPT 82746 ASSAY OF FOLIC ACID SERUM	$148.77	$247.95	$14.70–$261.06	—	40%
Free T3 thyroid hormone test CPT 84481 T3,FREE	$413.97	$689.95	$16.94–$728.19	152% above	40%
Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3)	$413.97	$689.95	$16.94–$728.19	152% above	40%
Free T3 thyroid hormone test inpatient CPT 84481 T3,FREE	$413.97	$689.95	$16.94–$728.19	—	40%
Free T3 thyroid hormone test inpatient CPT 84481 FREE ASSAY (FT-3)	$413.97	$689.95	$16.94–$728.19	—	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE	$7.86	$13.11	$9.02–$776.14	94% below	40%
Free T4 (free thyroxine) thyroid blood test CPT 84439 THYROXINE T4, FREE	$457.81	$763.03	$9.02–$776.14	233% above	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 ASSAY OF FREE THYROXINE	$7.86	$13.11	$9.02–$776.14	—	40%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 THYROXINE T4, FREE	$457.81	$763.03	$9.02–$776.14	—	40%
Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE	$208.51	$347.52	$25.47–$396.69	at median	40%
Free testosterone test CPT 84402 TESTOSTERONE, FREE	$208.51	$347.52	$25.47–$396.69	at median	40%
Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE	$208.51	$347.52	$25.47–$396.69	—	40%
Free testosterone test inpatient CPT 84402 ASSAY OF FREE TESTOSTERONE	$208.51	$347.52	$25.47–$396.69	—	40%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$625.24	$1,042.08	$11.27–$1,137.56	90% above	40%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$625.24	$1,042.08	$11.27–$1,137.56	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST	$91.54	$152.57	$4.65–$201.74	18% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE, POST DOSE	$91.54	$152.57	$4.65–$201.74	18% above	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE, POST DOSE	$91.54	$152.57	$4.65–$201.74	—	40%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GLUCOSE TEST	$91.54	$152.57	$4.65–$201.74	—	40%
Glucose tolerance test, 3 samples CPT 82951 GTT 3 SPEC	$274.62	$457.70	$12.62–$528.73	154% above	40%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$274.62	$457.70	$12.62–$528.73	154% above	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GTT 3 SPEC	$274.62	$457.70	$12.62–$528.73	—	40%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST (GTT)	$274.62	$457.70	$12.62–$528.73	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 L183160 N GONO AMP	$182.30	$303.84	$16.45–$618.01	143% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHO,DNA,AMPPR	$182.30	$303.84	$16.45–$618.01	143% above	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N.GONORRHO,DNA,AMPPR	$182.30	$303.84	$16.45–$618.01	—	40%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 L183160 N GONO AMP	$182.30	$303.84	$16.45–$618.01	—	40%
H. pylori antibody blood test CPT 86677 HELICOBACTER PYLORI ANTIBODY	$401.25	$668.75	$16.85–$722.29	310% above	40%
H. pylori antibody blood test CPT 86677 H PYLORI AB QL	$401.25	$668.75	$16.85–$722.29	310% above	40%
H. pylori antibody blood test inpatient CPT 86677 HELICOBACTER PYLORI ANTIBODY	$401.25	$668.75	$16.85–$722.29	—	40%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI AB QL	$401.25	$668.75	$16.85–$722.29	—	40%
H. pylori stool antigen test CPT 87338 HPYLORI,STOOL,EIA	$29.40	$49.01	$12.98–$98.02	83% below	40%
H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA	$29.40	$49.01	$12.98–$98.02	83% below	40%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI STOOL AG IA	$29.40	$49.01	$12.98–$98.02	—	40%
H. pylori stool antigen test inpatient CPT 87338 HPYLORI,STOOL,EIA	$29.40	$49.01	$12.98–$98.02	—	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$442.45	$737.42	$43.51–$892.98	59% above	40%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1, DNA, QUANT	$442.45	$737.42	$43.51–$892.98	59% above	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1, DNA, QUANT	$442.45	$737.42	$43.51–$892.98	—	40%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ	$442.45	$737.42	$43.51–$892.98	—	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HIGH RISK TYPES	$53.97	$89.96	$19.63–$142.41	51% below	40%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT	$53.97	$89.96	$19.63–$142.41	51% below	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HIGH RISK TYPES	$53.97	$89.96	$19.63–$142.41	—	40%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HI-RISK TYP POOLED RSLT	$53.97	$89.96	$19.63–$142.41	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN A1C	$328.53	$547.56	$9.71–$567.06	254% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$328.53	$547.56	$9.71–$567.06	254% above	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN A1C	$328.53	$547.56	$9.71–$567.06	—	40%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C	$328.53	$547.56	$9.71–$567.06	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY	$338.70	$564.50	$10.74–$619.14	318% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURF AB	$338.70	$564.50	$10.74–$619.14	318% above	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY	$338.70	$564.50	$10.74–$619.14	—	40%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURF AB	$338.70	$564.50	$10.74–$619.14	—	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HBSAG	$310.21	$517.03	$10.33–$571.67	374% above	40%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA	$310.21	$517.03	$10.33–$571.67	374% above	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEPATITIS B SURFACE AG IA	$310.21	$517.03	$10.33–$571.67	—	40%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HBSAG	$310.21	$517.03	$10.33–$571.67	—	40%
Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST	$929.25	$1,548.76	$14.27–$1,619.79	564% above	40%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C AB TEST	$929.25	$1,548.76	$14.27–$1,619.79	—	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$1,040.51	$1,734.19	$40.58–$1,892.63	404% above	40%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C,RNA,QUAN	$1,040.51	$1,734.19	$40.58–$1,892.63	404% above	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C REVRS TRNSCRPJ	$1,040.51	$1,734.19	$40.58–$1,892.63	—	40%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C,RNA,QUAN	$1,040.51	$1,734.19	$40.58–$1,892.63	—	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$28.00	$46.68	$13.19–$777.30	71% below	40%
Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMP TYPE 1	$438.37	$730.62	$13.19–$777.30	355% above	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 TEST	$28.00	$46.68	$13.19–$777.30	—	40%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMP TYPE 1	$438.37	$730.62	$13.19–$777.30	—	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$38.19	$63.65	$19.35–$255.72	60% below	40%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMP TYPE 2	$115.24	$192.07	$19.35–$255.72	20% above	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 TEST	$38.19	$63.65	$19.35–$255.72	—	40%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMP TYPE 2	$115.24	$192.07	$19.35–$255.72	—	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$156.64	$261.07	$12.95–$315.71	71% above	40%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP,HIGHLY SENS	$156.64	$261.07	$12.95–$315.71	71% above	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$156.64	$261.07	$12.95–$315.71	—	40%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP,HIGHLY SENS	$156.64	$261.07	$12.95–$315.71	—	40%
Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE	$440.41	$734.03	$6.58–$772.27	52% above	40%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$440.41	$734.03	$6.58–$772.27	52% above	40%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$440.41	$734.03	$6.58–$772.27	—	40%
Homocysteine blood test inpatient CPT 83090 ASSAY OF HOMOCYSTEINE	$440.41	$734.03	$6.58–$772.27	—	40%
Insulin blood test CPT 83525 INSULIN, TOTAL	$306.15	$510.25	$11.43–$568.60	382% above	40%
Insulin blood test CPT 83525 ASSAY OF INSULIN	$306.15	$510.25	$11.43–$568.60	382% above	40%
Insulin blood test inpatient CPT 83525 ASSAY OF INSULIN	$306.15	$510.25	$11.43–$568.60	—	40%
Insulin blood test inpatient CPT 83525 INSULIN, TOTAL	$306.15	$510.25	$11.43–$568.60	—	40%
Iron blood test (serum iron) CPT 83540 IRON	$162.73	$271.22	$6.47–$287.61	233% above	40%
Iron blood test (serum iron) CPT 83540 ASSAY OF IRON	$162.73	$271.22	$6.47–$287.61	233% above	40%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$162.73	$271.22	$6.47–$287.61	—	40%
Iron blood test (serum iron) inpatient CPT 83540 ASSAY OF IRON	$162.73	$271.22	$6.47–$287.61	—	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING TEST	$204.43	$340.73	$8.74–$356.64	74% above	40%
Iron-binding capacity (TIBC) test CPT 83550 IRON BINDING CAPACIT	$204.43	$340.73	$8.74–$356.64	74% above	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING CAPACIT	$204.43	$340.73	$8.74–$356.64	—	40%
Iron-binding capacity (TIBC) test inpatient CPT 83550 IRON BINDING TEST	$204.43	$340.73	$8.74–$356.64	—	40%
Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL	$379.24	$632.08	$8.68–$658.11	163% above	40%
Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL	$379.24	$632.08	$8.68–$658.11	—	40%
LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH)	$446.49	$744.16	$18.52–$815.19	410% above	40%
LH (luteinizing hormone) test CPT 83002 LEUTEINIZING HORMONE	$446.49	$744.16	$18.52–$815.19	410% above	40%
LH (luteinizing hormone) test inpatient CPT 83002 ASSAY OF GONADOTROPIN (LH)	$446.49	$744.16	$18.52–$815.19	—	40%
LH (luteinizing hormone) test inpatient CPT 83002 LEUTEINIZING HORMONE	$446.49	$744.16	$18.52–$815.19	—	40%
Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE	$281.75	$469.59	$6.89–$513.30	126% above	40%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE	$281.75	$469.59	$6.89–$513.30	126% above	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 ASSAY OF LIPASE	$281.75	$469.59	$6.89–$513.30	—	40%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE	$281.75	$469.59	$6.89–$513.30	—	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL	$28.64	$47.74	$8.17–$1,367.78	73% below	40%
Liver function blood test panel CPT 80076 L402145 - HFP	$396.01	$660.02	$8.17–$1,367.78	271% above	40%
Liver function blood test panel CPT 80076 HEPATIC FUNCTION PAN	$396.01	$660.02	$8.17–$1,367.78	271% above	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL	$28.64	$47.74	$8.17–$1,367.78	—	40%
Liver function blood test panel inpatient CPT 80076 L402145 - HFP	$396.01	$660.02	$8.17–$1,367.78	—	40%
Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PAN	$396.01	$660.02	$8.17–$1,367.78	—	40%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$452.61	$754.35	$17.03–$796.79	480% above	40%
Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY	$452.61	$754.35	$17.03–$796.79	480% above	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODY	$452.61	$754.35	$17.03–$796.79	—	40%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$452.61	$754.35	$17.03–$796.79	—	40%
Magnesium blood test CPT 83735 MAGNESIUM	$37.63	$62.73	$6.70–$113.52	42% below	40%
Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM	$37.63	$62.73	$6.70–$113.52	42% below	40%
Magnesium blood test inpatient CPT 83735 ASSAY OF MAGNESIUM	$37.63	$62.73	$6.70–$113.52	—	40%
Magnesium blood test inpatient CPT 83735 MAGNESIUM	$37.63	$62.73	$6.70–$113.52	—	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY	$130.48	$217.48	$12.88–$475.16	117% above	40%
Measles (rubeola) antibody test CPT 86765 RUBEOLA AB	$154.60	$257.68	$12.88–$475.16	158% above	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA ANTIBODY	$130.48	$217.48	$12.88–$475.16	—	40%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA AB	$154.60	$257.68	$12.88–$475.16	—	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN	$274.62	$457.70	$5.18–$485.02	245% above	40%
Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE AB SCREE	$274.62	$457.70	$5.18–$485.02	245% above	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE AB SCREE	$274.62	$457.70	$5.18–$485.02	—	40%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 HETEROPHILE ANTIBODY SCREEN	$274.62	$457.70	$5.18–$485.02	—	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE	$88.49	$147.49	$18.39–$245.83	33% below	40%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA, FREE	$88.49	$147.49	$18.39–$245.83	33% below	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, FREE	$88.49	$147.49	$18.39–$245.83	—	40%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 ASSAY OF PSA FREE	$88.49	$147.49	$18.39–$245.83	—	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL	$294.97	$491.62	$13.41–$557.18	72% above	40%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA, TOTAL	$294.97	$491.62	$13.41–$557.18	72% above	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA, TOTAL	$294.97	$491.62	$13.41–$557.18	—	40%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 ASSAY OF PSA TOTAL	$294.97	$491.62	$13.41–$557.18	—	40%
Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$76.44	$127.41	$17.56–$127.41	35% below	40%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP DIAG AUTO MAN RS	$76.44	$127.41	$17.56–$127.41	35% below	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP DIAG AUTO MAN RS	$76.44	$127.41	$17.56–$127.41	—	40%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 CYTOPATH C/V AUTO FLUID REDO	$76.44	$127.41	$17.56–$127.41	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP THINLAY LIQ DIAG	$290.41	$484.02	$20.26–$484.02	299% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER	$290.41	$484.02	$20.26–$484.02	299% above	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP THINLAY LIQ DIAG	$290.41	$484.02	$20.26–$484.02	—	40%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 CYTOPATH C/V THIN LAYER	$290.41	$484.02	$20.26–$484.02	—	40%
Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE	$63.65	$106.09	$41.28–$1,118.12	70% below	40%
Parathyroid hormone (PTH) blood test CPT 83970 PARATHORMONE PTH	$607.21	$1,012.03	$41.28–$1,118.12	183% above	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 ASSAY OF PARATHORMONE	$63.65	$106.09	$41.28–$1,118.12	—	40%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PARATHORMONE PTH	$607.21	$1,012.03	$41.28–$1,118.12	—	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLAST TIMEPTT	$143.56	$239.27	$6.01–$308.47	209% above	40%
Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL	$143.56	$239.27	$6.01–$308.47	209% above	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PARTIAL	$143.56	$239.27	$6.01–$308.47	—	40%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLAST TIMEPTT	$143.56	$239.27	$6.01–$308.47	—	40%
Progesterone blood test CPT 84144 L503658 PROGESTERONE	$438.37	$730.62	$20.86–$1,489.50	164% above	40%
Progesterone blood test CPT 84144 PROGESTERONE	$438.37	$730.62	$20.86–$1,489.50	164% above	40%
Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE	$438.37	$730.62	$20.86–$1,489.50	164% above	40%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$438.37	$730.62	$20.86–$1,489.50	—	40%
Progesterone blood test inpatient CPT 84144 L503658 PROGESTERONE	$438.37	$730.62	$20.86–$1,489.50	—	40%
Progesterone blood test inpatient CPT 84144 ASSAY OF PROGESTERONE	$438.37	$730.62	$20.86–$1,489.50	—	40%
Prolactin blood test CPT 84146 ASSAY OF PROLACTIN	$27.12	$45.20	$19.38–$1,007.29	85% below	40%
Prolactin blood test CPT 84146 PROLACTIN	$577.25	$962.09	$19.38–$1,007.29	210% above	40%
Prolactin blood test inpatient CPT 84146 ASSAY OF PROLACTIN	$27.12	$45.20	$19.38–$1,007.29	—	40%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$577.25	$962.09	$19.38–$1,007.29	—	40%
Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME	$185.12	$308.54	$4.29–$350.98	381% above	40%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME	$185.12	$308.54	$4.29–$350.98	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 PRS DRG IA VIS	$488.47	$814.13	$12.15–$845.47	392% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$488.47	$814.13	$12.15–$845.47	392% above	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 PRS DRG IA VIS	$488.47	$814.13	$12.15–$845.47	—	40%
Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS	$488.47	$814.13	$12.15–$845.47	—	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC	$16.39	$27.32	$11.40–$82.76	78% below	40%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W-OP	$33.26	$55.44	$11.40–$82.76	54% below	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC	$16.39	$27.32	$11.40–$82.76	—	40%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W-OP	$33.26	$55.44	$11.40–$82.76	—	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT	$275.64	$459.41	$5.67–$534.81	246% above	40%
Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACT QUAN	$275.64	$459.41	$5.67–$534.81	246% above	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACTOR QUANT	$275.64	$459.41	$5.67–$534.81	—	40%
Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID FACT QUAN	$275.64	$459.41	$5.67–$534.81	—	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY	$35.01	$58.35	$9.33–$485.55	51% below	40%
Rubella antibody test (immunity check) CPT 86762 RUBELLA AB	$256.32	$427.20	$9.33–$485.55	255% above	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA ANTIBODY	$35.01	$58.35	$9.33–$485.55	—	40%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA AB	$256.32	$427.20	$9.33–$485.55	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE, AUTOMATED	$218.94	$364.91	$2.70–$364.91	461% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED	$218.94	$364.91	$2.70–$364.91	461% above	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 RBC SED RATE AUTOMATED	$218.94	$364.91	$2.70–$364.91	—	40%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE, AUTOMATED	$218.94	$364.91	$2.70–$364.91	—	40%
Stool ova and parasites exam CPT 87177 OVA-PARASITES SMEARS	$321.40	$535.68	$8.90–$721.34	238% above	40%
Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS	$321.40	$535.68	$8.90–$721.34	238% above	40%
Stool ova and parasites exam inpatient CPT 87177 OVA-PARASITES SMEARS	$321.40	$535.68	$8.90–$721.34	—	40%
Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITES SMEARS	$321.40	$535.68	$8.90–$721.34	—	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES	$9.54	$15.91	$3.87–$169.58	74% below	40%
Stool test for hidden blood (guaiac FOBT) CPT 82270 BLD OCCULT FECES 1-3	$92.20	$153.67	$3.87–$169.58	149% above	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECES	$9.54	$15.91	$3.87–$169.58	—	40%
Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 BLD OCCULT FECES 1-3	$92.20	$153.67	$3.87–$169.58	—	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL	$28.61	$47.69	$15.92–$125.47	72% below	40%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD OCCULT FECES EIA	$46.66	$77.78	$15.92–$125.47	55% below	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 ASSAY TEST FOR BLOOD FECAL	$28.61	$47.69	$15.92–$125.47	—	40%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD OCCULT FECES EIA	$46.66	$77.78	$15.92–$125.47	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL	$208.51	$347.52	$3.58–$396.69	421% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST, QUAL	$208.51	$347.52	$3.58–$396.69	421% above	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST NON-TREP QUAL	$208.51	$347.52	$3.58–$396.69	—	40%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 SYPHILIS TEST, QUAL	$208.51	$347.52	$3.58–$396.69	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE	$59.53	$99.22	$53.18–$385.70	66% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IM MEAS	$171.88	$286.48	$53.18–$385.70	3% below	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IMMUN MEASURE	$59.53	$99.22	$53.18–$385.70	—	40%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB TEST CELL IM MEAS	$171.88	$286.48	$53.18–$385.70	—	40%
Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$15.21	$25.36	$25.81–$383.31	91% below	40%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE, TOTAL	$214.77	$357.95	$25.81–$383.31	27% above	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 ASSAY OF TOTAL TESTOSTERONE	$15.21	$25.36	$25.81–$383.31	—	40%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL	$214.77	$357.95	$25.81–$383.31	—	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH	$147.48	$245.80	$14.55–$335.40	21% above	40%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL AB	$147.48	$245.80	$14.55–$335.40	21% above	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL ANTIBODY EACH	$147.48	$245.80	$14.55–$335.40	—	40%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOMAL AB	$147.48	$245.80	$14.55–$335.40	—	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE	$442.45	$737.42	$16.80–$753.81	182% above	40%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIM TSH	$442.45	$737.42	$16.80–$753.81	182% above	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIM TSH	$442.45	$737.42	$16.80–$753.81	—	40%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 ASSAY THYROID STIM HORMONE	$442.45	$737.42	$16.80–$753.81	—	40%
Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$117.08	$195.14	$29.84–$434.36	21% above	40%
Trichomonas test (NAAT) CPT 87661 T VAGINALIS AMP	$117.08	$195.14	$29.84–$434.36	21% above	40%
Trichomonas test (NAAT) CPT 87661 L183160 T VAG AMP	$117.08	$195.14	$29.84–$434.36	21% above	40%
Trichomonas test (NAAT) inpatient CPT 87661 T VAGINALIS AMP	$117.08	$195.14	$29.84–$434.36	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 TRICHOMONAS VAGINALIS AMPLIF	$117.08	$195.14	$29.84–$434.36	—	40%
Trichomonas test (NAAT) inpatient CPT 87661 L183160 T VAG AMP	$117.08	$195.14	$29.84–$434.36	—	40%
Uric acid blood test CPT 84550 URIC ACID, BLOOD	$209.54	$349.24	$4.52–$422.51	181% above	40%
Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID	$209.54	$349.24	$4.52–$422.51	181% above	40%
Uric acid blood test inpatient CPT 84550 ASSAY OF BLOOD/URIC ACID	$209.54	$349.24	$4.52–$422.51	—	40%
Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD	$209.54	$349.24	$4.52–$422.51	—	40%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE	$43.28	$72.14	$2.22–$273.84	5% above	40%
Urinalysis with microscope exam, automated CPT 81001 UA, AUTO W-SCOPE	$121.02	$201.70	$2.22–$273.84	193% above	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W/SCOPE	$43.28	$72.14	$2.22–$273.84	—	40%
Urinalysis with microscope exam, automated inpatient CPT 81001 UA, AUTO W-SCOPE	$121.02	$201.70	$2.22–$273.84	—	40%
Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W/SCOPE	$14.26	$23.78	$3.95–$118.08	1% below	40%
Urinalysis with microscope exam, manual CPT 81000 UA, NONAUTO W-SCOPE	$56.58	$94.30	$3.95–$118.08	291% above	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W/SCOPE	$14.26	$23.78	$3.95–$118.08	—	40%
Urinalysis with microscope exam, manual inpatient CPT 81000 UA, NONAUTO W-SCOPE	$56.58	$94.30	$3.95–$118.08	—	40%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE	$11.46	$19.10	$1.79–$202.43	59% below	40%
Urinalysis without microscope exam, automated CPT 81003 UA, AUTO, W-O SCOPE	$109.99	$183.33	$1.79–$202.43	292% above	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO W/O SCOPE	$11.46	$19.10	$1.79–$202.43	—	40%
Urinalysis without microscope exam, automated inpatient CPT 81003 UA, AUTO, W-O SCOPE	$109.99	$183.33	$1.79–$202.43	—	40%
Urinalysis without microscope exam, manual CPT 81002 UA NONAUTO W-O SCOPE	$37.63	$62.73	$3.19–$99.88	at median	40%
Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$37.63	$62.73	$3.19–$99.88	at median	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINALYSIS NONAUTO W/O SCOPE	$37.63	$62.73	$3.19–$99.88	—	40%
Urinalysis without microscope exam, manual inpatient CPT 81002 UA NONAUTO W-O SCOPE	$37.63	$62.73	$3.19–$99.88	—	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST	$25.46	$42.44	$6.72–$393.35	68% below	40%
Urine pregnancy test, read by color change CPT 81025 URINE PREG TEST QL	$210.54	$350.91	$6.72–$393.35	169% above	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST	$25.46	$42.44	$6.72–$393.35	—	40%
Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREG TEST QL	$210.54	$350.91	$6.72–$393.35	—	40%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12	$161.72	$269.54	$15.08–$303.64	40% above	40%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12	$161.72	$269.54	$15.08–$303.64	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$32.12	$53.54	$29.60–$898.63	85% below	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25OH	$507.05	$845.09	$29.60–$898.63	130% above	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$32.12	$53.54	$29.60–$898.63	—	40%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25OH	$507.05	$845.09	$29.60–$898.63	—	40%
Zinc blood test CPT 84630 ASSAY OF ZINC	$31.83	$53.05	$11.39–$383.61	71% below	40%
Zinc blood test CPT 84630 ZINC	$198.33	$330.56	$11.39–$383.61	78% above	40%
Zinc blood test inpatient CPT 84630 ASSAY OF ZINC	$31.83	$53.05	$11.39–$383.61	—	40%
Zinc blood test inpatient CPT 84630 ZINC	$198.33	$330.56	$11.39–$383.61	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST	$39.46	$65.78	$8.07–$292.78	75% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG QUANT	$136.20	$227.00	$8.07–$292.78	14% below	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 CHORIONIC GONADOTROPIN TEST	$39.46	$65.78	$8.07–$292.78	—	40%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG QUANT	$136.20	$227.00	$8.07–$292.78	—	40%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,471.75	$2,452.92	$119.61–$5,250.16	28% below	40%
Cardioversion, elective (restoring heart rhythm) CPT 92960 NI-CARDIOVERSION	$1,678.34	$2,797.24	$119.61–$5,250.16	18% below	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT	$1,471.75	$2,452.92	$119.61–$5,250.16	—	40%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 NI-CARDIOVERSION	$1,678.34	$2,797.24	$119.61–$5,250.16	—	40%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL SURGERY	$4,808.50	$8,014.18	$311.31–$10,625.00	198% above	40%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL SURGERY	$4,808.50	$8,014.18	$311.31–$10,625.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 CT-DI C-T INJ W IM	$827.50	$1,379.17	$96.44–$2,969.00	75% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 IR-DI C-T INJ W IM	$852.33	$1,420.55	$96.44–$2,969.00	74% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,932.94	$3,221.58	$96.44–$2,969.00	41% below	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 CT-DI C-T INJ W IM	$827.50	$1,379.17	$96.44–$2,969.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 IR-DI C-T INJ W IM	$852.33	$1,420.55	$96.44–$2,969.00	—	40%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 NJX INTERLAMINAR CRV/THRC	$1,932.94	$3,221.58	$96.44–$2,969.00	—	40%
Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$7,212.27	$12,020.45	$222.84–$23,350.00	56% below	40%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY	$7,212.27	$12,020.45	$222.84–$23,350.00	—	40%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHRS KNE SRG MNISECTMY M&L	$7,212.27	$12,020.45	$1,037.00–$13,806.00	17% below	40%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHRS KNE SRG MNISECTMY M&L	$7,212.27	$12,020.45	$1,037.00–$13,806.00	—	40%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAPAROSCOPY APPENDECTOMY	$7,212.27	$12,020.45	$222.84–$23,350.00	32% below	40%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAPAROSCOPY APPENDECTOMY	$7,212.27	$12,020.45	$222.84–$23,350.00	—	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAP ING HERNIA REPAIR INIT	$191.01	$318.35	$1,042.80–$23,350.00	98% below	40%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAP ING HERNIA REPAIR INIT	$191.01	$318.35	$1,042.80–$23,350.00	—	40%
Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC	$827.50	$1,379.17	$87.92–$2,969.00	53% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 IR-DI L-S INJ W IM	$827.50	$1,379.17	$87.92–$2,969.00	53% below	40%
Lower-back epidural injection, with imaging guidance CPT 62323 CT-DI L-S INJ W IM	$827.50	$1,379.17	$87.92–$2,969.00	53% below	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 IR-DI L-S INJ W IM	$827.50	$1,379.17	$87.92–$2,969.00	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX INTERLAMINAR LMBR/SAC	$827.50	$1,379.17	$87.92–$2,969.00	—	40%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 CT-DI L-S INJ W IM	$827.50	$1,379.17	$87.92–$2,969.00	—	40%
Lumpectomy (partial mastectomy) CPT 19301 PARTIAL MASTECTOMY	$1,574.94	$2,624.91	$761.74–$10,625.00	80% below	40%
Lumpectomy (partial mastectomy) inpatient CPT 19301 PARTIAL MASTECTOMY	$1,574.94	$2,624.91	$761.74–$10,625.00	—	40%
Paracentesis with imaging guidance CPT 49083 IR-ABD PARACEN W IMG	$659.06	$1,098.44	$91.32–$4,783.00	54% below	40%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING	$697.44	$1,162.41	$91.32–$4,783.00	51% below	40%
Paracentesis with imaging guidance CPT 49083 US-ABD PARACEN W IMG	$697.44	$1,162.41	$91.32–$4,783.00	51% below	40%
Paracentesis with imaging guidance inpatient CPT 49083 IR-ABD PARACEN W IMG	$659.06	$1,098.44	$91.32–$4,783.00	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 US-ABD PARACEN W IMG	$697.44	$1,162.41	$91.32–$4,783.00	—	40%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING	$697.44	$1,162.41	$91.32–$4,783.00	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 FRAGMENTING OF KIDNEY STONE	$14,940.91	$24,901.52	$548.36–$24,901.52	2% above	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSY	$14,940.91	$24,901.52	$548.36–$24,901.52	2% above	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 FRAGMENTING OF KIDNEY STONE	$14,940.91	$24,901.52	$548.36–$24,901.52	—	40%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSY	$14,940.91	$24,901.52	$548.36–$24,901.52	—	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 DX LMBR SPI PNXR	$334.18	$556.97	$29.77–$2,969.00	84% below	40%
Spinal tap (lumbar puncture), diagnostic CPT 62270 S-SPINAL TAP DIAGNST	$334.18	$556.97	$29.77–$2,969.00	84% below	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 S-SPINAL TAP DIAGNST	$334.18	$556.97	$29.77–$2,969.00	—	40%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 DX LMBR SPI PNXR	$334.18	$556.97	$29.77–$2,969.00	—	40%
Thoracentesis with imaging guidance CPT 32555 US-THORACNTSIS W IMG	$562.72	$937.88	$95.17–$4,505.86	78% below	40%
Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING	$905.72	$1,509.54	$95.17–$4,505.86	64% below	40%
Thoracentesis with imaging guidance CPT 32555 IR-THORACNTSIS W IMG	$905.72	$1,509.54	$95.17–$4,505.86	64% below	40%
Thoracentesis with imaging guidance CPT 32555 CT-THORACNTSIS W IMG	$971.05	$1,618.43	$95.17–$4,505.86	61% below	40%
Thoracentesis with imaging guidance inpatient CPT 32555 US-THORACNTSIS W IMG	$562.72	$937.88	$95.17–$4,505.86	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 ASPIRATE PLEURA W/ IMAGING	$905.72	$1,509.54	$95.17–$4,505.86	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 IR-THORACNTSIS W IMG	$905.72	$1,509.54	$95.17–$4,505.86	—	40%
Thoracentesis with imaging guidance inpatient CPT 32555 CT-THORACNTSIS W IMG	$971.05	$1,618.43	$95.17–$4,505.86	—	40%
Total hip replacement CPT 27130 TOTAL HIP ARTHROPLASTY	$8,667.08	$14,445.14	$260.58–$28,629.00	33% below	40%
Total hip replacement inpatient CPT 27130 TOTAL HIP ARTHROPLASTY	$8,667.08	$14,445.14	$260.58–$28,629.00	—	40%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 0 2 HRS	$289.84	$483.08	$26.15–$8,766.34	63% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 2 4 HRS	$433.20	$722.00	$26.15–$8,766.34	44% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSFUSION	$489.17	$815.29	$26.15–$8,766.34	37% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 4 6 HRS	$594.93	$991.55	$26.15–$8,766.34	23% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT	$594.93	$991.55	$26.15–$8,766.34	23% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 6 8 HRS	$723.03	$1,205.06	$26.15–$8,766.34	7% below	40%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD TRANSF 8 10 HR	$868.47	$1,447.46	$26.15–$8,766.34	12% above	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 0 2 HRS	$289.84	$483.08	$26.15–$8,766.34	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 2 4 HRS	$433.20	$722.00	$26.15–$8,766.34	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION	$489.17	$815.29	$26.15–$8,766.34	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPNT	$594.93	$991.55	$26.15–$8,766.34	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 4 6 HRS	$594.93	$991.55	$26.15–$8,766.34	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 6 8 HRS	$723.03	$1,205.06	$26.15–$8,766.34	—	40%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSF 8 10 HR	$868.47	$1,447.46	$26.15–$8,766.34	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT	$103.17	$171.96	$10.52–$698.16	45% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT SUB	$106.27	$177.12	$10.52–$698.16	44% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 INHALATION TRTMT INI	$106.27	$177.12	$10.52–$698.16	44% below	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT	$103.17	$171.96	$10.52–$698.16	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT SUB	$106.27	$177.12	$10.52–$698.16	—	40%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TRTMT INI	$106.27	$177.12	$10.52–$698.16	—	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR	$396.60	$661.01	$91.15–$661.01	43% below	40%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFU 1ST HR	$396.60	$661.01	$91.15–$661.01	43% below	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFU 1ST HR	$396.60	$661.01	$91.15–$661.01	—	40%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO IV INFUSION 1 HR	$396.60	$661.01	$91.15–$661.01	—	40%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR	$2,059.98	$3,433.30	$159.62–$4,772.00	11% below	40%
Critical care, first 30 to 74 minutes one side CPT 99291 CRITICAL CARE LT 74M	$2,059.98	$3,433.30	$159.62–$4,772.00	11% below	40%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST HOUR	$2,059.98	$3,433.30	$159.62–$4,772.00	—	40%
Critical care, first 30 to 74 minutes inpatient one side CPT 99291 CRITICAL CARE LT 74M	$2,059.98	$3,433.30	$159.62–$4,772.00	—	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE DROWSY	$1,575.09	$2,625.16	$40.40–$2,625.16	96% above	40%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG AWAKE AND DROWSY	$1,575.09	$2,625.16	$40.40–$2,625.16	96% above	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE AND DROWSY	$1,575.09	$2,625.16	$40.40–$2,625.16	—	40%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG AWAKE DROWSY	$1,575.09	$2,625.16	$40.40–$2,625.16	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 NI-EKG, 12 LEADS	$267.45	$445.76	$13.71–$891.52	1% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING	$267.45	$445.76	$13.71–$891.52	1% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD ED STAFF	$267.45	$445.76	$13.71–$891.52	1% below	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM TRACING	$267.45	$445.76	$13.71–$891.52	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD ED STAFF	$267.45	$445.76	$13.71–$891.52	—	40%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 NI-EKG, 12 LEADS	$267.45	$445.76	$13.71–$891.52	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 BRIEF ED VISIT	$215.12	$358.54	$33.83–$866.00	4% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$215.12	$358.54	$33.83–$866.00	4% below	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 EMR DPT VST MAYX REQ PHY/QHP	$215.12	$358.54	$33.83–$866.00	—	40%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 BRIEF ED VISIT	$215.12	$358.54	$33.83–$866.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 LIMITED ED VISIT	$395.39	$658.99	$33.83–$1,407.00	16% above	40%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM	$395.39	$658.99	$33.83–$1,407.00	16% above	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 EMERGENCY DEPT VISIT SF MDM	$395.39	$658.99	$33.83–$1,407.00	—	40%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 LIMITED ED VISIT	$395.39	$658.99	$33.83–$1,407.00	—	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$710.82	$1,184.71	$74.42–$1,407.00	10% above	40%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 INTERMEDIATE ED VIST	$710.82	$1,184.71	$74.42–$1,407.00	10% above	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 EMERGENCY DEPT VISIT LOW MDM	$710.82	$1,184.71	$74.42–$1,407.00	—	40%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 INTERMEDIATE ED VIST	$710.82	$1,184.71	$74.42–$1,407.00	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$1,087.03	$1,811.72	$115.01–$2,969.00	24% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EXTENDED ED VISIT	$1,087.03	$1,811.72	$115.01–$2,969.00	24% above	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EMERGENCY DEPT VISIT MOD MDM	$1,087.03	$1,811.72	$115.01–$2,969.00	—	40%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 EXTENDED ED VISIT	$1,087.03	$1,811.72	$115.01–$2,969.00	—	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 COMPREHENSIVE ED VST	$1,558.93	$2,598.23	$200.00–$3,711.00	29% above	40%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,558.93	$2,598.23	$200.00–$3,711.00	29% above	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 COMPREHENSIVE ED VST	$1,558.93	$2,598.23	$200.00–$3,711.00	—	40%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 EMERGENCY DEPT VISIT HI MDM	$1,558.93	$2,598.23	$200.00–$3,711.00	—	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV STRESS TEST TRACING ONLY	$614.89	$1,024.83	$51.25–$5,570.36	at median	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 NM-STRESS TEST	$1,303.69	$2,172.82	$51.25–$5,570.36	112% above	40%
Exercise stress test, tracing only, the hospital charge CPT 93017 NI-STRESS TEST	$1,423.62	$2,372.71	$51.25–$5,570.36	132% above	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV STRESS TEST TRACING ONLY	$614.89	$1,024.83	$51.25–$5,570.36	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NM-STRESS TEST	$1,303.69	$2,172.82	$51.25–$5,570.36	—	40%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 NI-STRESS TEST	$1,423.62	$2,372.71	$51.25–$5,570.36	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT	$260.06	$433.44	$43.83–$2,194.56	12% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 IV HYDRATION 1 HR	$267.86	$446.44	$43.83–$2,194.56	9% below	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT	$260.06	$433.44	$43.83–$2,194.56	—	40%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION 1 HR	$267.86	$446.44	$43.83–$2,194.56	—	40%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT	$373.84	$623.07	$53.47–$2,465.16	26% above	40%
IV infusion of a medicine, first hour CPT 96365 IV THERAPY DX 1 HR	$385.05	$641.76	$53.47–$2,465.16	30% above	40%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT	$373.84	$623.07	$53.47–$2,465.16	—	40%
IV infusion of a medicine, first hour inpatient CPT 96365 IV THERAPY DX 1 HR	$385.05	$641.76	$53.47–$2,465.16	—	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$82.28	$137.14	$16.71–$553.99	2% above	40%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAPEUTIC DX SQ IM	$84.75	$141.25	$16.71–$553.99	5% above	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$82.28	$137.14	$16.71–$553.99	—	40%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAPEUTIC DX SQ IM	$84.75	$141.25	$16.71–$553.99	—	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$1,010.41	$1,684.02	$62.15–$1,684.02	26% above	40%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 MTR-SENS 7-8 NRV TST	$1,010.41	$1,684.02	$62.15–$1,684.02	26% above	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 MTR-SENS 7-8 NRV TST	$1,010.41	$1,684.02	$62.15–$1,684.02	—	40%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 NRV CNDJ TEST 7-8 STUDIES	$1,010.41	$1,684.02	$62.15–$1,684.02	—	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MN COTA	$119.55	$199.26	$15.11–$824.14	36% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN OT	$119.55	$199.26	$15.11–$824.14	36% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PT	$127.68	$212.81	$15.11–$824.14	45% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUR RE-ED-15MIN PTA	$127.68	$212.81	$15.11–$824.14	45% above	40%
Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION	$127.68	$212.81	$15.11–$824.14	45% above	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN OT	$119.55	$199.26	$15.11–$824.14	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MN COTA	$119.55	$199.26	$15.11–$824.14	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSCULAR REEDUCATION	$127.68	$212.81	$15.11–$824.14	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PT	$127.68	$212.81	$15.11–$824.14	—	40%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUR RE-ED-15MIN PTA	$127.68	$212.81	$15.11–$824.14	—	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL- LOW CMP OT	$394.67	$657.79	$64.77–$1,335.31	158% above	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$394.67	$657.79	$64.77–$1,335.31	158% above	40%
Occupational therapy evaluation, low complexity CPT 97165 OT EVAL-LOW CMP COTA	$406.51	$677.52	$64.77–$1,335.31	166% above	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL LOW COMPLEX 30 MIN	$394.67	$657.79	$64.77–$1,335.31	—	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL- LOW CMP OT	$394.67	$657.79	$64.77–$1,335.31	—	40%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT EVAL-LOW CMP COTA	$406.51	$677.52	$64.77–$1,335.31	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH CMP PTA	$378.62	$631.04	$66.74–$1,354.60	85% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$378.62	$631.04	$66.74–$1,354.60	85% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT EVAL- HGH CMP PT	$434.13	$723.56	$66.74–$1,354.60	112% above	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH CMP PTA	$378.62	$631.04	$66.74–$1,354.60	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL HIGH COMPLEX 45 MIN	$378.62	$631.04	$66.74–$1,354.60	—	40%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT EVAL- HGH CMP PT	$434.13	$723.56	$66.74–$1,354.60	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW CMP PT	$434.13	$723.56	$66.74–$1,447.12	161% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL- LOW CMP PTA	$434.13	$723.56	$66.74–$1,447.12	161% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$434.13	$723.56	$66.74–$1,447.12	161% above	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL LOW COMPLEX 20 MIN	$434.13	$723.56	$66.74–$1,447.12	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW CMP PTA	$434.13	$723.56	$66.74–$1,447.12	—	40%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT EVAL- LOW CMP PT	$434.13	$723.56	$66.74–$1,447.12	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD CMP PT	$434.13	$723.56	$66.74–$1,447.12	130% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$434.13	$723.56	$66.74–$1,447.12	130% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT EVAL- MOD CMP PTA	$434.13	$723.56	$66.74–$1,447.12	130% above	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL MOD COMPLEX 30 MIN	$434.13	$723.56	$66.74–$1,447.12	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD CMP PT	$434.13	$723.56	$66.74–$1,447.12	—	40%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT EVAL- MOD CMP PTA	$434.13	$723.56	$66.74–$1,447.12	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15MIN COTA	$94.32	$157.20	$19.99–$665.43	3% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS	$94.32	$157.20	$19.99–$665.43	3% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN OT	$94.32	$157.20	$19.99–$665.43	3% below	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PT	$103.75	$172.92	$19.99–$665.43	6% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MNL THRPY-15 MIN PTA	$106.86	$178.11	$19.99–$665.43	10% above	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY 1/> REGIONS	$94.32	$157.20	$19.99–$665.43	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN OT	$94.32	$157.20	$19.99–$665.43	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15MIN COTA	$94.32	$157.20	$19.99–$665.43	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PT	$103.75	$172.92	$19.99–$665.43	—	40%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MNL THRPY-15 MIN PTA	$106.86	$178.11	$19.99–$665.43	—	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MN COTA	$76.70	$127.84	$20.07–$592.00	13% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN OT	$76.70	$127.84	$20.07–$592.00	13% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES	$84.37	$140.63	$20.07–$592.00	4% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PT	$84.37	$140.63	$20.07–$592.00	4% below	40%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EXRCS-15MIN PTA	$86.91	$144.85	$20.07–$592.00	1% below	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN OT	$76.70	$127.84	$20.07–$592.00	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MN COTA	$76.70	$127.84	$20.07–$592.00	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PT	$84.37	$140.63	$20.07–$592.00	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISES	$84.37	$140.63	$20.07–$592.00	—	40%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXRCS-15MIN PTA	$86.91	$144.85	$20.07–$592.00	—	40%
Speech and language evaluation CPT 92523 EVAL SP SND PROD CMP	$369.44	$615.74	$84.91–$615.74	51% above	40%
Speech and language evaluation CPT 92523 SPEECH SOUND LANG COMPREHEN	$369.44	$615.74	$84.91–$615.74	51% above	40%
Speech and language evaluation inpatient CPT 92523 SPEECH SOUND LANG COMPREHEN	$369.44	$615.74	$84.91–$615.74	—	40%
Speech and language evaluation inpatient CPT 92523 EVAL SP SND PROD CMP	$369.44	$615.74	$84.91–$615.74	—	40%
Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV	$197.51	$329.19	$23.85–$329.19	17% above	40%
Speech therapy session, individual CPT 92507 SP-HEAR-TX-INDI VIST	$197.51	$329.19	$23.85–$329.19	17% above	40%
Speech therapy session, individual inpatient CPT 92507 SP-HEAR-TX-INDI VIST	$197.51	$329.19	$23.85–$329.19	—	40%
Speech therapy session, individual inpatient CPT 92507 TX SP LANG VOICE COMM INDIV	$197.51	$329.19	$23.85–$329.19	—	40%
Spirometry (breathing test) CPT 94010 SPIROMETRY	$927.00	$1,545.00	$12.81–$3,018.14	123% above	40%
Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST	$927.00	$1,545.00	$12.81–$3,018.14	123% above	40%
Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY	$927.00	$1,545.00	$12.81–$3,018.14	—	40%
Spirometry (breathing test) inpatient CPT 94010 BREATHING CAPACITY TEST	$927.00	$1,545.00	$12.81–$3,018.14	—	40%
Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING	$417.06	$695.11	$28.35–$695.11	32% below	40%
Spirometry before and after a bronchodilator CPT 94060 BRONCHO EVAL PRE/PST	$417.06	$695.11	$28.35–$695.11	32% below	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 EVALUATION OF WHEEZING	$417.06	$695.11	$28.35–$695.11	—	40%
Spirometry before and after a bronchodilator inpatient CPT 94060 BRONCHO EVAL PRE/PST	$417.06	$695.11	$28.35–$695.11	—	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTV-15MIN COTA	$76.70	$127.84	$19.52–$536.94	2% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN OT	$76.70	$127.84	$19.52–$536.94	2% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES	$76.70	$127.84	$19.52–$536.94	2% below	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PT	$84.37	$140.63	$19.52–$536.94	8% above	40%
Therapeutic activities (functional training), 15 minutes CPT 97530 THER ACTVT-15MIN PTA	$84.37	$140.63	$19.52–$536.94	8% above	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN OT	$76.70	$127.84	$19.52–$536.94	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTV-15MIN COTA	$76.70	$127.84	$19.52–$536.94	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES	$76.70	$127.84	$19.52–$536.94	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PTA	$84.37	$140.63	$19.52–$536.94	—	40%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THER ACTVT-15MIN PT	$84.37	$140.63	$19.52–$536.94	—	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY	$214.61	$357.69	$13.42–$357.69	39% above	40%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUT	$214.61	$357.69	$13.42–$357.69	39% above	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUT	$214.61	$357.69	$13.42–$357.69	—	40%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY	$214.61	$357.69	$13.42–$357.69	—	40%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 FLUVACC NO PRES OV3Y	$146.88	$244.81	$19.77–$244.81	104% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$146.88	$244.81	$19.77–$244.81	104% above	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM	$146.88	$244.81	$19.77–$244.81	—	40%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUVACC NO PRES OV3Y	$146.88	$244.81	$19.77–$244.81	—	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC	$508.56	$847.60	$10.00–$847.60	49% above	40%
MMR vaccine (measles, mumps and rubella), live CPT 90707 M-M-R II INJ	$508.56	$847.60	$10.00–$847.60	49% above	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VACCINE SC	$508.56	$847.60	$10.00–$847.60	—	40%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 M-M-R II INJ	$508.56	$847.60	$10.00–$847.60	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$932.80	$1,554.67	$8.00–$1,554.67	99% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMO-VAC 2YR-ADULT	$932.80	$1,554.67	$8.00–$1,554.67	99% above	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM	$932.80	$1,554.67	$8.00–$1,554.67	—	40%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMO-VAC 2YR-ADULT	$932.80	$1,554.67	$8.00–$1,554.67	—	40%
Rabies vaccine, one dose CPT 90675 RABIES VAC IM	$1,968.18	$3,280.30	$148.73–$3,280.30	92% above	40%
Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM	$1,968.18	$3,280.30	$148.73–$3,280.30	92% above	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VAC IM	$1,968.18	$3,280.30	$148.73–$3,280.30	—	40%
Rabies vaccine, one dose inpatient CPT 90675 RABIES VACCINE IM	$1,968.18	$3,280.30	$148.73–$3,280.30	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD IM NO PRSRV GE 7Y	$297.71	$496.19	$10.00–$496.19	114% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$297.71	$496.19	$10.00–$496.19	114% above	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACC NO PRESV 7 YRS+ IM	$297.71	$496.19	$10.00–$496.19	—	40%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD IM NO PRSRV GE 7Y	$297.71	$496.19	$10.00–$496.19	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM	$429.71	$716.19	$38.75–$716.19	117% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPH/TET/ACPERT .5ML	$429.71	$716.19	$38.75–$716.19	117% above	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DIPH/TET/ACPERT .5ML	$429.71	$716.19	$38.75–$716.19	—	40%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE 7 YRS/> IM	$429.71	$716.19	$38.75–$716.19	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN	$82.42	$137.38	$4.47–$433.39	31% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMM ADM 1ST VACCINE	$84.90	$141.50	$4.47–$433.39	35% above	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN	$82.42	$137.38	$4.47–$433.39	—	40%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMM ADM 1ST VACCINE	$84.90	$141.50	$4.47–$433.39	—	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD	$53.79	$89.66	$4.57–$372.25	58% above	40%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMM ADM EA ADD VACC	$57.07	$95.12	$4.57–$372.25	68% above	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD	$53.79	$89.66	$4.57–$372.25	—	40%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMM ADM EA ADD VACC	$57.07	$95.12	$4.57–$372.25	—	40%

Source file: https://cea75026-66bc-472a-a0d7-7ec217c282dd.usrfiles.com/ugd/cea750_3d1a07e929f64bdc83235feb963c7ab6.csv?dn=760350464_BLUE-RIDGE-MEDICAL-CENTER_standardcharges.csv