Hospital Peoria, IL

Hopedale Medical Complex

Hopedale Medical Complex in Hopedale, IL publishes cash prices for 328 common procedures listed here, from its own machine-readable price file (the file does not say when it was last updated). Compared with other hospitals in the state, its outpatient cash prices are below the Illinois median for 246 of 325 procedures and above it for 77. By typical cash price it ranks #23 of 91 Illinois hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

107 Tremont Street, Hopedale, IL, 61747 Collected Sep 28, 2026 Source price file (309) 449-3321

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 141330 · CMS hospital register NPI 1174569438

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 DOPPLER ABI TBI PBI	$212.80	$304.00	$65.54–$76.17	47% below	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 VL ANKLE/BRACHIAL INDEX (ABI/TBI)	$703.57	$1,005.10	$76.17–$216.70	76% above	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 DOPPLER ABI TBI PBI	$212.80	$304.00	$65.54–$76.17	—	30%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 VL ANKLE/BRACHIAL INDEX (ABI/TBI)	$703.57	$1,005.10	$76.17–$216.70	—	30%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR BARIUM SWALLOW	$486.70	$695.28	$86.81–$149.90	8% below	30%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR BARIUM SWALLOW	$486.70	$695.28	$86.81–$149.90	—	30%
Bone scan, whole body (nuclear medicine) CPT 78306 NM BONE TOTAL	$979.17	$1,398.81	$236.00–$301.59	36% below	30%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM BONE TOTAL	$979.17	$1,398.81	$236.00–$301.59	—	30%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US BREAST UNILATERAL LIMITED	$224.00	$320.00	$35.45–$77.66	39% below	30%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US BREAST UNILATERAL LIMITED	$224.00	$320.00	$35.45–$77.66	—	30%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CTA CHEST	$2,568.95	$3,669.93	$259.05–$791.23	4% above	30%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST	$2,568.95	$3,669.93	$259.05–$791.23	—	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score CPT 75574 CTA HRT W 3D IMAGE	$2,579.69	$3,685.27	$301.45–$794.54	52% above	30%
CT angiography of the heart arteries with contrast dye (coronary CTA), including calcium score inpatient CPT 75574 CTA HRT W 3D IMAGE	$2,579.69	$3,685.27	$301.45–$794.54	—	30%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT CORONARY CALCIUM SCORING SCREEN	$105.00	$150.00	$32.34–$91.75	88% above	30%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CORONARY CALCIUM SCORING SCREEN	$105.00	$150.00	$32.34–$91.75	—	30%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST	$2,657.14	$3,795.91	$170.95–$818.40	12% below	30%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST	$2,657.14	$3,795.91	$170.95–$818.40	—	30%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN/PELVIS WITH IV CONTRAST	$3,064.73	$4,378.19	$276.48–$943.94	10% below	30%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS WITH IV CONTRAST	$3,064.73	$4,378.19	$276.48–$943.94	—	30%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABDOMEN/PELVIS WWO IV CONTRAST	$3,312.62	$4,732.31	$311.21–$1,020.29	23% below	30%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN/PELVIS WWO IV CONTRAST	$3,312.62	$4,732.31	$311.21–$1,020.29	—	30%
CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN WITH IV CONTRAST	$2,022.61	$2,889.44	$211.36–$622.97	2% above	30%
CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN WITH IV CONTRAST	$2,022.61	$2,889.44	$211.36–$622.97	—	30%
CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN WO IV CONTRAST	$1,795.13	$2,564.47	$126.94–$552.90	10% above	30%
CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN WO IV CONTRAST	$1,795.13	$2,564.47	$126.94–$552.90	—	30%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL WO IV CONTRAST	$894.67	$1,278.10	$118.40–$275.56	35% below	30%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLOFACIAL WO IV CONTRAST	$894.67	$1,278.10	$118.40–$275.56	—	30%
CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD WO IV CONTRAST	$1,640.09	$2,342.99	$98.97–$505.15	4% above	30%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD WO IV CONTRAST	$1,640.09	$2,342.99	$98.97–$505.15	—	30%
CT scan of the head with contrast CPT 70460 CT HEAD WITH IV CONTRAST	$1,914.58	$2,735.11	$137.74–$589.69	19% above	30%
CT scan of the head with contrast inpatient CPT 70460 CT HEAD WITH IV CONTRAST	$1,914.58	$2,735.11	$137.74–$589.69	—	30%
CT scan of the head without and with contrast CPT 70470 CT HEAD WWO IV CONTRAST	$2,156.43	$3,080.62	$160.25–$664.19	1% above	30%
CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD WWO IV CONTRAST	$2,156.43	$3,080.62	$160.25–$664.19	—	30%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT L SPINE WO CONTRAST	$1,795.13	$2,564.47	$120.53–$552.90	7% below	30%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT L SPINE WO CONTRAST	$1,795.13	$2,564.47	$120.53–$552.90	—	30%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT C SPINE WO CONTRAST	$1,819.71	$2,599.58	$121.13–$560.47	8% below	30%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT C SPINE WO CONTRAST	$1,819.71	$2,599.58	$121.13–$560.47	—	30%
CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS WITH IV CONTRAST	$2,022.61	$2,889.44	$207.15–$622.97	8% above	30%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS WITH IV CONTRAST	$2,022.61	$2,889.44	$207.15–$622.97	—	30%
Chest X-ray, 2 views CPT 71046 XR CHEST 2V INSP EXP	$151.25	$216.07	$30.61–$46.59	46% below	30%
Chest X-ray, 2 views CPT 71046 XR CHEST 2V PA LAT	$160.31	$229.01	$30.61–$49.37	43% below	30%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2V INSP EXP	$151.25	$216.07	$30.61–$46.59	—	30%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2V PA LAT	$160.31	$229.01	$30.61–$49.37	—	30%
Chest X-ray, single view CPT 71045 XR CHEST 1 VIEW	$179.62	$256.60	$23.65–$55.32	23% below	30%
Chest X-ray, single view inpatient CPT 71045 XR CHEST 1 VIEW	$179.62	$256.60	$23.65–$55.32	—	30%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 SONO RETROPEROTINEAL	$818.86	$1,169.80	$98.15–$252.21	4% above	30%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 SONO RETROPEROTINEAL	$818.86	$1,169.80	$98.15–$252.21	—	30%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL	$263.80	$376.86	$36.26–$81.25	37% below	30%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 DXA BONE DENSITY AXIAL	$263.80	$376.86	$36.26–$81.25	—	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT LUNG SCREEN DIAGNOSTIC	$1,795.13	$2,564.47	$123.13–$552.90	36% above	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST WO IV CONTRAST	$1,795.13	$2,564.47	$123.13–$552.90	36% above	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT CHEST HIGH RESOLUTION	$1,795.13	$2,564.47	$123.13–$552.90	36% above	30%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 DIAGNOSTIC CHEST LDLS	$1,795.13	$2,564.47	$123.13–$552.90	36% above	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST HIGH RESOLUTION	$1,795.13	$2,564.47	$123.13–$552.90	—	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST WO IV CONTRAST	$1,795.13	$2,564.47	$123.13–$552.90	—	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT LUNG SCREEN DIAGNOSTIC	$1,795.13	$2,564.47	$123.13–$552.90	—	30%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 DIAGNOSTIC CHEST LDLS	$1,795.13	$2,564.47	$123.13–$552.90	—	30%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT CHEST WITH IV CONTRAST	$2,073.18	$2,961.68	$154.26–$638.54	2% above	30%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST WITH IV CONTRAST	$2,073.18	$2,961.68	$154.26–$638.54	—	30%
Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO DIAGNOSTIC BILATERAL	$470.02	$671.46	$144.77–$144.95	—	30%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO DIAGNOSTIC BILATERAL	$470.02	$671.46	$144.77–$144.95	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 BYPASS GRAFT SURVEILLANCE BILATERAL	$497.70	$711.00	$153.29–$217.04	—	30%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 VL ARTERIAL DUPLEX LEG BILATERAL	$1,356.84	$1,938.34	$217.04–$417.90	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 BYPASS GRAFT SURVEILLANCE BILATERAL	$497.70	$711.00	$153.29–$217.04	—	30%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 VL ARTERIAL DUPLEX LEG BILATERAL	$1,356.84	$1,938.34	$217.04–$417.90	—	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 VL DEEP VEIN DUPLEX BIL. ARM	$1,297.52	$1,853.60	$168.52–$399.63	14% below	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 VL DEEP VEIN DUPLEX BIL. LEG	$1,297.52	$1,853.60	$168.52–$399.63	14% below	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 VL VENOUS REFLUX DUPLEX	$1,539.89	$2,199.84	$168.52–$474.28	3% above	30%
Duplex ultrasound of the leg veins, both legs CPT 93970 VL VEIN MAPPING COMPLETE	$1,539.89	$2,199.84	$168.52–$474.28	3% above	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL DEEP VEIN DUPLEX BIL. ARM	$1,297.52	$1,853.60	$168.52–$399.63	—	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL DEEP VEIN DUPLEX BIL. LEG	$1,297.52	$1,853.60	$168.52–$399.63	—	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL VEIN MAPPING COMPLETE	$1,539.89	$2,199.84	$168.52–$474.28	—	30%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 VL VENOUS REFLUX DUPLEX	$1,539.89	$2,199.84	$168.52–$474.28	—	30%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 ADULT ECHO COMPLETE W/O CONTRAST	$2,510.68	$3,586.69	$181.77–$773.29	31% above	30%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ADULT ECHO COMPLETE W/O CONTRAST	$2,510.68	$3,586.69	$181.77–$773.29	—	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY HIDA SCAN WO CCK	$1,145.12	$1,635.88	$258.89–$352.69	11% below	30%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY HIDA SCAN WO CCK	$1,145.12	$1,635.88	$258.89–$352.69	—	30%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HOME SLEEP TEST	$768.17	$1,097.39	$96.22–$236.60	5% below	30%
Home sleep apnea test, unattended, recording breathing and oxygen inpatient CPT 95806 HOME SLEEP TEST	$768.17	$1,097.39	$96.22–$236.60	—	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 TITRATION POLYSOMNOGRAPHY W/PAP	$5,016.80	$7,166.86	$646.46–$1,545.18	53% above	30%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 TITRATION POLYSOMNOGRAPHY W/PAP	$5,016.80	$7,166.86	$646.46–$1,545.18	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO LLQ RLQ	$707.67	$1,010.95	$79.61–$217.96	22% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO ABDMEN LMTD	$707.67	$1,010.95	$79.61–$217.96	22% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO LIVER	$707.67	$1,010.95	$79.61–$217.96	22% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO GALL BLADDR	$707.67	$1,010.95	$79.61–$217.96	22% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO PANCREAS	$707.67	$1,010.95	$79.61–$217.96	22% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 SONO SPLEEN	$707.67	$1,010.95	$79.61–$217.96	22% above	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO LIVER	$707.67	$1,010.95	$79.61–$217.96	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO GALL BLADDR	$707.67	$1,010.95	$79.61–$217.96	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO SPLEEN	$707.67	$1,010.95	$79.61–$217.96	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO PANCREAS	$707.67	$1,010.95	$79.61–$217.96	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO LLQ RLQ	$707.67	$1,010.95	$79.61–$217.96	—	30%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 SONO ABDMEN LMTD	$707.67	$1,010.95	$79.61–$217.96	—	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening	$364.54	$520.77	$112.28–$126.63	33% below	30%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screening	$364.54	$520.77	$112.28–$126.63	—	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE JT LEFT WO CONTRAST	$2,698.28	$3,854.68	$188.57–$831.07	11% above	30%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI ANKLE JT RIGHT WO CONTRAST	$2,698.33	$3,854.75	$188.57–$831.09	11% above	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE JT LEFT WO CONTRAST	$2,698.28	$3,854.68	$188.57–$831.07	—	30%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI ANKLE JT RIGHT WO CONTRAST	$2,698.33	$3,854.75	$188.57–$831.09	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE JT LEFT WOW CONTRAST	$3,104.61	$4,435.16	$350.46–$956.23	2% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI ANKLE JT RIGHT WOW CONTRAST	$3,104.61	$4,435.16	$350.46–$956.23	2% below	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE JT LEFT WOW CONTRAST	$3,104.61	$4,435.16	$350.46–$956.23	—	30%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI ANKLE JT RIGHT WOW CONTRAST	$3,104.61	$4,435.16	$350.46–$956.23	—	30%
MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN WO CONTRAST	$2,675.14	$3,821.63	$179.29–$823.94	28% above	30%
MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN WO CONTRAST	$2,675.14	$3,821.63	$179.29–$823.94	—	30%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABDOMEN WOW CONTRAST	$2,935.86	$4,194.09	$310.17–$904.25	4% below	30%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN WOW CONTRAST	$2,935.86	$4,194.09	$310.17–$904.25	—	30%
MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO CONTRAST	$2,264.33	$3,234.75	$181.06–$697.42	3% above	30%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO CONTRAST	$2,264.33	$3,234.75	$181.06–$697.42	—	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN /+CONT	$1,947.11	$2,781.59	$293.36–$599.71	40% below	30%
MRI of the brain, with and without contrast dye CPT 70553 MMRI BRAIN /+CONT	$1,947.11	$2,781.59	$293.36–$599.71	40% below	30%
MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WITH AND WITHOUT CONTRAST	$2,917.11	$4,167.30	$293.36–$898.47	10% below	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN /+CONT	$1,947.11	$2,781.59	$293.36–$599.71	—	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MMRI BRAIN /+CONT	$1,947.11	$2,781.59	$293.36–$599.71	—	30%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WITH AND WITHOUT CONTRAST	$2,917.11	$4,167.30	$293.36–$898.47	—	30%
MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO CONTRAST	$2,489.89	$3,556.98	$177.77–$766.89	2% below	30%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO CONTRAST	$2,489.89	$3,556.98	$177.77–$766.89	—	30%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR WOW CONTRAST	$3,081.93	$4,402.76	$294.56–$949.24	5% below	30%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR WOW CONTRAST	$3,081.93	$4,402.76	$294.56–$949.24	—	30%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,489.89	$3,556.98	$176.58–$766.89	2% below	30%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE WO CONTRAST	$2,489.89	$3,556.98	$176.58–$766.89	—	30%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI CERVICAL SPINE WOW CONTRAST	$3,081.93	$4,402.76	$294.26–$949.24	4% below	30%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE WOW CONTRAST	$3,081.93	$4,402.76	$294.26–$949.24	—	30%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,459.88	$3,514.12	$176.87–$757.65	3% above	30%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE WO CONTRAST	$2,459.88	$3,514.12	$176.87–$757.65	—	30%
MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS WOW CONTRAST	$3,341.83	$4,774.04	$308.68–$1,029.28	15% above	30%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS WOW CONTRAST	$3,341.83	$4,774.04	$308.68–$1,029.28	—	30%
MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS WO CONTRAST	$2,675.14	$3,821.63	$209.48–$823.94	24% above	30%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS WO CONTRAST	$2,675.14	$3,821.63	$209.48–$823.94	—	30%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 NM MYOCARDIAL SPECT STRESS TEST	$3,026.57	$4,323.67	$390.09–$932.19	6% below	30%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 NM MYOCARDIAL SPECT STRESS TEST	$3,026.57	$4,323.67	$390.09–$932.19	—	30%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 SONO POST VOID RESIDUAL	$487.90	$697.00	$47.97–$150.27	12% above	30%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 SONO POST VOID RESIDUAL	$487.90	$697.00	$47.97–$150.27	—	30%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 SONO PELVIC	$707.67	$1,010.95	$97.11–$217.96	11% above	30%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 SONO PELVIC	$707.67	$1,010.95	$97.11–$217.96	—	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US PREGNANT UTERUS LIMITED 1 > FETUSES	$247.88	$354.11	$75.77–$76.34	38% below	30%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US PREGNANT UTERUS LIMITED 1 > FETUSES	$247.88	$354.11	$75.77–$76.34	—	30%
Screening mammogram, both breasts both sides CPT 77067 MAMMO SCREENING BILATERAL W/CAD	$379.12	$541.60	$81.80–$116.14	—	30%
Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO SCREENING BILATERAL W/CAD	$379.12	$541.60	$81.80–$116.14	—	30%
Sleep study in a lab (polysomnography) CPT 95810 SPLIT NIGHT POLYSOMNOGRAPHY WO PAP	$5,016.80	$7,166.86	$615.26–$1,545.18	66% above	30%
Sleep study in a lab (polysomnography) inpatient CPT 95810 SPLIT NIGHT POLYSOMNOGRAPHY WO PAP	$5,016.80	$7,166.86	$615.26–$1,545.18	—	30%
Transvaginal pelvic ultrasound CPT 76830 SONO TRANSVAGINAL	$665.00	$950.00	$108.38–$204.82	21% above	30%
Transvaginal pelvic ultrasound inpatient CPT 76830 SONO TRANSVAGINAL	$665.00	$950.00	$108.38–$204.82	—	30%
Ultrasound of the abdomen, complete CPT 76700 SONO ABDOMEN COMPLETE	$951.30	$1,359.00	$105.73–$293.00	1% below	30%
Ultrasound of the abdomen, complete inpatient CPT 76700 SONO ABDOMEN COMPLETE	$951.30	$1,359.00	$105.73–$293.00	—	30%
Ultrasound of the scrotum and testicles CPT 76870 ULTRASOUND SCROTUM AND CONTENTS	$273.00	$390.00	$33.59–$90.99	57% below	30%
Ultrasound of the scrotum and testicles CPT 76870 SONO SCROTUM	$748.30	$1,069.00	$90.99–$230.48	17% above	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 ULTRASOUND SCROTUM AND CONTENTS	$273.00	$390.00	$33.59–$90.99	—	30%
Ultrasound of the scrotum and testicles inpatient CPT 76870 SONO SCROTUM	$748.30	$1,069.00	$90.99–$230.48	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 ULTRASOUND SOFT TISSUE OF NECK LIMITED (	$252.70	$361.00	$29.68–$99.55	59% below	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SONO THYROID	$685.30	$979.00	$99.55–$211.07	11% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 SONO PAROTID	$685.30	$979.00	$99.55–$211.07	11% above	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 ULTRASOUND SOFT TISSUE OF NECK LIMITED (	$252.70	$361.00	$29.68–$99.55	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SONO THYROID	$685.30	$979.00	$99.55–$211.07	—	30%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 SONO PAROTID	$685.30	$979.00	$99.55–$211.07	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 DEEP VEIN DUPLEX LIMITED (OFFICE)	$322.00	$460.00	$99.18–$106.32	49% below	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 VL VEIN MAPPING LIMITED	$965.10	$1,378.71	$106.32–$297.25	52% above	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 DEEP VEIN DUPLEX LIMITED (OFFICE)	$322.00	$460.00	$99.18–$106.32	—	30%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 VL VEIN MAPPING LIMITED	$965.10	$1,378.71	$106.32–$297.25	—	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR HIP UNILAT 2-3 VWS	$289.74	$413.91	$44.66–$89.24	6% above	30%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP UNILAT 2-3 VWS	$289.74	$413.91	$44.66–$89.24	—	30%
X-ray of the abdomen, 1 view CPT 74018 XR ABDOMEN 1 VIEW KUB	$247.89	$354.13	$27.54–$76.35	3% below	30%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN 1 VIEW KUB	$247.89	$354.13	$27.54–$76.35	—	30%
X-ray of the foot, 2 views CPT 73620 XR FOOT 2 VIEW	$213.16	$304.51	$26.58–$65.65	20% below	30%
X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEW	$213.16	$304.51	$26.58–$65.65	—	30%
X-ray of the hand, 3 or more views CPT 73130 XR HAND MIN 3 VWS	$169.81	$242.58	$34.98–$52.30	47% below	30%
X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND MIN 3 VWS	$169.81	$242.58	$34.98–$52.30	—	30%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR LUMBAR SPINE 2/3VWS	$302.74	$432.48	$37.18–$93.25	23% below	30%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2/3VWS	$302.74	$432.48	$37.18–$93.25	—	30%
X-ray of the lower back, 4 or more views CPT 72110 XR LUMBR SPINE 4/5VWS	$382.99	$547.13	$49.17–$117.96	27% below	30%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBR SPINE 4/5VWS	$382.99	$547.13	$49.17–$117.96	—	30%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR TSPINE 2VWS	$302.74	$432.48	$30.59–$93.25	14% below	30%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR TSPINE 2VWS	$302.74	$432.48	$30.59–$93.25	—	30%
X-ray of the nasal bones, 3 or more views CPT 70160 XR NASAL BONES COMPLETE	$214.42	$306.32	$34.38–$66.04	26% below	30%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES COMPLETE	$214.42	$306.32	$34.38–$66.04	—	30%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR C SPINE 2/3 VWS	$270.40	$386.28	$36.58–$83.28	17% below	30%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR C SPINE 2/3 VWS	$270.40	$386.28	$36.58–$83.28	—	30%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR PELVIS 1/2 VWS	$299.36	$427.65	$26.01–$92.20	6% below	30%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1/2 VWS	$299.36	$427.65	$26.01–$92.20	—	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR COCCYX AND SACRUM	$231.99	$331.41	$29.60–$71.45	18% below	30%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR COCCYX AND SACRUM	$231.99	$331.41	$29.60–$71.45	—	30%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT SERUM	$35.17	$50.24	$5.19–$10.83	33% below	30%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT SERUM	$35.17	$50.24	$5.19–$10.83	—	30%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST SERUM	$35.17	$50.24	$5.08–$10.83	33% below	30%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST SERUM	$35.17	$50.24	$5.08–$10.83	—	30%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HEPATITIS PANEL ACUTE	$261.21	$373.16	$46.68–$80.46	8% above	30%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL ACUTE	$261.21	$373.16	$46.68–$80.46	—	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS PISTACHIO	$23.34	$33.34	$5.12–$7.18	15% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 RAST TEST (ALLERGEN)	$23.34	$33.34	$5.12–$7.18	15% below	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGENS BRAZIL NUT	$58.37	$83.38	$5.12–$17.97	112% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 GALACTOSE ALPHA ALLERGEN	$58.37	$83.38	$5.12–$17.97	112% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN PENICILLIN	$58.37	$83.38	$5.12–$17.97	112% above	30%
Allergy blood test, specific IgE, per allergen CPT 86003 ALLERGEN APPLE	$58.37	$83.38	$5.12–$17.97	112% above	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS PISTACHIO	$23.34	$33.34	$5.12–$7.18	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 RAST TEST (ALLERGEN)	$23.34	$33.34	$5.12–$7.18	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN APPLE	$58.37	$83.38	$5.12–$17.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN PENICILLIN	$58.37	$83.38	$5.12–$17.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGENS BRAZIL NUT	$58.37	$83.38	$5.12–$17.97	—	30%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 GALACTOSE ALPHA ALLERGEN	$58.37	$83.38	$5.12–$17.97	—	30%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CYCLIC CITR PEPTIDE AB IGG	$92.83	$132.62	$12.69–$28.60	11% above	30%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CYCLIC CITR PEPTIDE AB IGG	$92.83	$132.62	$12.69–$28.60	—	30%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA SCREEN	$81.94	$117.05	$11.85–$25.24	9% below	30%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA SCREEN	$81.94	$117.05	$11.85–$25.24	—	30%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 BRAIN NATRIURETIC PEPTIDE	$235.90	$337.00	$38.47–$72.66	38% above	30%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BRAIN NATRIURETIC PEPTIDE	$235.90	$337.00	$38.47–$72.66	—	30%
Basic metabolic panel (blood test) CPT 80048 BASIC MET PANEL	$92.32	$131.88	$8.29–$28.43	28% below	30%
Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL POINT OF CARE	$92.32	$131.88	$8.29–$28.43	28% below	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC MET PANEL	$92.32	$131.88	$8.29–$28.43	—	30%
Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL POINT OF CARE	$92.32	$131.88	$8.29–$28.43	—	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 ARK TISSUE EXAM PATH	$179.71	$256.73	$65.27	25% below	30%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 LEVEL 4 GROSS MICRO	$186.28	$266.11	$65.27	22% below	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 ARK TISSUE EXAM PATH	$179.71	$256.73	$65.27	—	30%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 LEVEL 4 GROSS MICRO	$186.28	$266.11	$65.27	—	30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD 2	$84.87	$121.24	$10.11–$26.14	41% below	30%
Blood culture for bacteria CPT 87040 CULTURE BLOOD 1	$120.24	$171.77	$10.11–$37.03	17% below	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD 2	$84.87	$121.24	$10.11–$26.14	—	30%
Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD 1	$120.24	$171.77	$10.11–$37.03	—	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAWING	$12.52	$17.89	$3.86–$9.15	44% below	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 BLOOD DRAW VENIPUNCTURE	$14.70	$21.00	$4.53–$9.15	35% below	30%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 ROUTINE VENIPUNCTURE	$86.08	$122.97	$9.15–$26.51	283% above	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAWING	$12.52	$17.89	$3.86–$9.15	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 BLOOD DRAW VENIPUNCTURE	$14.70	$21.00	$4.53–$9.15	—	30%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 ROUTINE VENIPUNCTURE	$86.08	$122.97	$9.15–$26.51	—	30%
Blood glucose (sugar) test CPT 82947 GLUCOSE	$33.34	$47.63	$3.85–$10.27	at median	30%
Blood glucose (sugar) test inpatient CPT 82947 GLUCOSE	$33.34	$47.63	$3.85–$10.27	—	30%
Blood lead test CPT 83655 LEAD LEVEL	$55.57	$79.39	$11.87–$17.12	3% below	30%
Blood lead test inpatient CPT 83655 LEAD LEVEL	$55.57	$79.39	$11.87–$17.12	—	30%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 PREG TEST (HCG) SER	$80.19	$114.56	$7.37–$24.70	9% above	30%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 PREG TEST (HCG) SER	$80.19	$114.56	$7.37–$24.70	—	30%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING ABO ONLY	$142.99	$204.27	$2.93–$44.04	72% above	30%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 BLOOD TYPING ABO ONLY	$142.99	$204.27	$2.93–$44.04	—	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C REACTIVE PROTEIN	$81.73	$116.75	$5.08–$25.18	12% above	30%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C REACTIVE PROTEIN	$81.73	$116.75	$5.08–$25.18	—	30%
C. difficile toxin gene test (stool PCR) CPT 87493 C DIFFICILE TOXIC GENE	$142.12	$203.03	$36.52–$43.78	23% below	30%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C DIFFICILE TOXIC GENE	$142.12	$203.03	$36.52–$43.78	—	30%
CA 19-9 blood test (tumor marker) CPT 86301 CA-19-9	$112.74	$161.06	$20.39–$34.72	6% above	30%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA-19-9	$112.74	$161.06	$20.39–$34.72	—	30%
CA-125 blood test (ovarian cancer marker) CPT 86304 CA-125	$120.76	$172.52	$20.39–$37.19	23% below	30%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA-125	$120.76	$172.52	$20.39–$37.19	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 PCR	$134.44	$192.05	$41.40–$50.28	34% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 SARS-CoV-2 PCR (HMC)	$163.56	$233.66	$50.28–$50.38	63% above	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 PCR	$134.44	$192.05	$41.40–$50.28	—	30%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-CoV-2 PCR (HMC)	$163.56	$233.66	$50.28–$50.38	—	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLAMYDIA BY LCR	$90.39	$129.13	$27.84–$34.39	31% below	30%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA BY LCR	$90.39	$129.13	$27.84–$34.39	—	30%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PROFILE	$129.49	$184.98	$13.12–$39.89	15% above	30%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PROFILE	$129.49	$184.98	$13.12–$39.89	—	30%
Complete blood count (CBC) with differential CPT 85025 BACK UP CBC	$91.00	$130.00	$7.61–$28.03	16% above	30%
Complete blood count (CBC) with differential CPT 85025 CBC AUTOMATED DIFFERENTIAL	$91.00	$130.00	$7.61–$28.03	16% above	30%
Complete blood count (CBC) with differential CPT 85025 EMPLOYEE CBC	$125.96	$179.94	$7.61–$38.80	61% above	30%
Complete blood count (CBC) with differential inpatient CPT 85025 BACK UP CBC	$91.00	$130.00	$7.61–$28.03	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTOMATED DIFFERENTIAL	$91.00	$130.00	$7.61–$28.03	—	30%
Complete blood count (CBC) with differential inpatient CPT 85025 EMPLOYEE CBC	$125.96	$179.94	$7.61–$38.80	—	30%
Complete blood count (CBC), no differential CPT 85027 HEMOGRAM	$42.95	$61.35	$6.34–$13.23	32% below	30%
Complete blood count (CBC), no differential inpatient CPT 85027 HEMOGRAM	$42.95	$61.35	$6.34–$13.23	—	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMP METABOLIC PANEL POINT OF CARE	$175.28	$250.40	$10.35–$53.99	14% above	30%
Comprehensive metabolic panel (blood test) CPT 80053 COMP MET PANEL	$175.28	$250.40	$10.35–$53.99	14% above	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP METABOLIC PANEL POINT OF CARE	$175.28	$250.40	$10.35–$53.99	—	30%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMP MET PANEL	$175.28	$250.40	$10.35–$53.99	—	30%
D-dimer blood test (blood clot marker) CPT 85379 D-DIMER QUANTITATIVE	$116.31	$166.16	$9.98–$35.83	8% above	30%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER QUANTITATIVE	$116.31	$166.16	$9.98–$35.83	—	30%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA SULFATE	$84.05	$120.07	$21.79–$25.89	22% below	30%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA SULFATE	$84.05	$120.07	$21.79–$25.89	—	30%
Estradiol blood test CPT 82670 ESTRADIOL	$63.13	$90.18	$19.44–$27.38	40% below	30%
Estradiol blood test inpatient CPT 82670 ESTRADIOL	$63.13	$90.18	$19.44–$27.38	—	30%
FSH (follicle-stimulating hormone) test CPT 83001 FSH	$101.63	$145.18	$18.21–$31.30	12% below	30%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 FSH	$101.63	$145.18	$18.21–$31.30	—	30%
Fecal calprotectin (stool inflammation test) CPT 83993 CALPROTECTIN FECAL	$412.90	$589.86	$19.24–$127.17	143% above	30%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN FECAL	$412.90	$589.86	$19.24–$127.17	—	30%
Ferritin blood test (iron stores) CPT 82728 FERRITIN	$93.69	$133.84	$13.36–$28.85	27% below	30%
Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN	$93.69	$133.84	$13.36–$28.85	—	30%
Folate (folic acid) blood test CPT 82746 FOLIC ACID	$61.96	$88.51	$14.41–$19.08	41% below	30%
Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID	$61.96	$88.51	$14.41–$19.08	—	30%
Free T3 thyroid hormone test CPT 84481 FREE T3	$84.05	$120.07	$16.60–$25.89	10% below	30%
Free T3 thyroid hormone test inpatient CPT 84481 FREE T3	$84.05	$120.07	$16.60–$25.89	—	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 DIALYSIS FREE T4	$66.46	$94.94	$8.84–$20.47	42% below	30%
Free T4 (free thyroxine) thyroid blood test CPT 84439 T4 FREE	$91.20	$130.29	$8.84–$28.09	21% below	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 DIALYSIS FREE T4	$66.46	$94.94	$8.84–$20.47	—	30%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 T4 FREE	$91.20	$130.29	$8.84–$28.09	—	30%
Free testosterone test CPT 84402 FREE TESTOSTERONE-FEMALE	$71.58	$102.25	$22.05–$24.96	42% below	30%
Free testosterone test inpatient CPT 84402 FREE TESTOSTERONE-FEMALE	$71.58	$102.25	$22.05–$24.96	—	30%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL	$279.33	$399.04	$86.03	at median	30%
General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL	$279.33	$399.04	$86.03	—	30%
Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TLRNCE (1ST 3 SPEC.)	$93.66	$133.80	$12.61–$28.85	25% below	30%
Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TLRNCE (1ST 3 SPEC.)	$93.66	$133.80	$12.61–$28.85	—	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 NEIS GONOR BY LCR	$90.39	$129.13	$27.84–$34.39	35% below	30%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEIS GONOR BY LCR	$90.39	$129.13	$27.84–$34.39	—	30%
H. pylori antibody blood test CPT 86677 H PYLORI ANTIBODY	$83.43	$119.19	$16.51–$25.70	27% below	30%
H. pylori antibody blood test CPT 86677 H PYLORI IGM	$288.37	$411.96	$16.51–$88.82	152% above	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI ANTIBODY	$83.43	$119.19	$16.51–$25.70	—	30%
H. pylori antibody blood test inpatient CPT 86677 H PYLORI IGM	$288.37	$411.96	$16.51–$88.82	—	30%
H. pylori stool antigen test CPT 87338 H PYLORI AG FECES	$132.74	$189.63	$14.09–$40.89	37% above	30%
H. pylori stool antigen test inpatient CPT 87338 H PYLORI AG FECES	$132.74	$189.63	$14.09–$40.89	—	30%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV I RNA QUANT PCR	$576.66	$823.80	$83.40–$177.62	92% above	30%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV I RNA QUANT PCR	$576.66	$823.80	$83.40–$177.62	—	30%
HIV-1 and HIV-2 antibody test CPT 86703 HIV 1/2 AB	$105.00	$150.00	$13.44–$32.34	11% below	30%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 AB	$105.00	$150.00	$13.44–$32.34	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 EMPLOYEE HIV 1/2	$13.27	$18.96	$4.09–$18.58	88% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV 1/2 ANTIGEN ANTIBODY	$87.19	$124.56	$23.60–$26.85	22% below	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 EMPLOYEE HIV 1/2	$13.27	$18.96	$4.09–$18.58	—	30%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 ANTIGEN ANTIBODY	$87.19	$124.56	$23.60–$26.85	—	30%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA	$124.74	$178.20	$34.39–$38.42	15% below	30%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA	$124.74	$178.20	$34.39–$38.42	—	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 GLYCOHEMOGLOBIN	$88.79	$126.84	$9.52–$27.34	7% above	30%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCOHEMOGLOBIN	$88.79	$126.84	$9.52–$27.34	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SUR AB	$52.76	$75.37	$10.53–$16.25	37% below	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE AB QUANT	$72.23	$103.19	$10.53–$22.25	14% below	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 EMPLOYEE HEP B AB	$173.29	$247.56	$10.53–$53.37	106% above	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SUR AB	$52.76	$75.37	$10.53–$16.25	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE AB QUANT	$72.23	$103.19	$10.53–$22.25	—	30%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 EMPLOYEE HEP B AB	$173.29	$247.56	$10.53–$53.37	—	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 EMPLOYEE HEP B AG	$8.75	$12.50	$2.70–$10.12	89% below	30%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HEP B SUR AG	$50.50	$72.14	$10.12–$15.55	37% below	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 EMPLOYEE HEP B AG	$8.75	$12.50	$2.70–$10.12	—	30%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SUR AG	$50.50	$72.14	$10.12–$15.55	—	30%
Hepatitis C antibody blood test (screening) CPT 86803 EMPLOYEE HEP C AB	$9.50	$13.57	$2.93–$13.30	91% below	30%
Hepatitis C antibody blood test (screening) CPT 86803 HEP C AB	$63.59	$90.84	$13.98–$19.58	40% below	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 EMPLOYEE HEP C AB	$9.50	$13.57	$2.93–$13.30	—	30%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB	$63.59	$90.84	$13.98–$19.58	—	30%
Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C RNA PCR QUA	$290.79	$415.42	$41.98–$89.56	16% above	30%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C RNA PCR QUA	$290.79	$415.42	$41.98–$89.56	—	30%
Herpes blood test, HSV-1 antibody CPT 86695 HERP SIMPLX IGG I AND 2	$56.04	$80.05	$12.93–$17.26	14% below	30%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERP SIMPLX IGG I AND 2	$56.04	$80.05	$12.93–$17.26	—	30%
Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX IgG TYPE II	$48.17	$68.81	$14.84–$18.96	46% below	30%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 GLYCOPROTEIN G AB IGG	$128.19	$183.13	$18.96–$39.48	42% above	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX IgG TYPE II	$48.17	$68.81	$14.84–$18.96	—	30%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 GLYCOPROTEIN G AB IGG	$128.19	$183.13	$18.96–$39.48	—	30%
High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS	$81.10	$115.85	$12.69–$24.98	6% below	30%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 C-REACTIVE PROTEIN HS	$81.10	$115.85	$12.69–$24.98	—	30%
Homocysteine blood test CPT 83090 HOMOCYSTEINE	$119.09	$170.13	$17.56–$36.68	9% above	30%
Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE	$119.09	$170.13	$17.56–$36.68	—	30%
Insulin blood test CPT 83525 INSULIN SERUM	$71.95	$102.79	$11.20–$22.16	1% below	30%
Insulin blood test inpatient CPT 83525 INSULIN SERUM	$71.95	$102.79	$11.20–$22.16	—	30%
Iron blood test (serum iron) CPT 83540 IRON	$39.26	$56.09	$6.34–$12.09	43% below	30%
Iron blood test (serum iron) inpatient CPT 83540 IRON	$39.26	$56.09	$6.34–$12.09	—	30%
Kidney function blood test panel CPT 80069 RENAL PANEL	$102.90	$147.00	$8.51–$31.69	27% below	30%
Kidney function blood test panel inpatient CPT 80069 RENAL PANEL	$102.90	$147.00	$8.51–$31.69	—	30%
LH (luteinizing hormone) test CPT 83002 LEUTENIZ HRMN(LH)	$158.83	$226.90	$18.15–$48.92	67% above	30%
LH (luteinizing hormone) test inpatient CPT 83002 LEUTENIZ HRMN(LH)	$158.83	$226.90	$18.15–$48.92	—	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-BODY FLUID	$72.52	$103.60	$6.75–$22.33	9% below	30%
Lipase blood test (pancreas enzyme) CPT 83690 LIPASE-SERUM	$72.52	$103.60	$6.75–$22.33	9% below	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-BODY FLUID	$72.52	$103.60	$6.75–$22.33	—	30%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE-SERUM	$72.52	$103.60	$6.75–$22.33	—	30%
Liver function blood test panel CPT 80076 HEPATIC PANEL	$93.36	$133.37	$8.01–$28.75	22% below	30%
Liver function blood test panel inpatient CPT 80076 HEPATIC PANEL	$93.36	$133.37	$8.01–$28.75	—	30%
Lyme disease antibody test CPT 86618 LYME DISEASE AB	$82.81	$118.30	$16.69–$25.51	17% above	30%
Lyme disease antibody test inpatient CPT 86618 LYME DISEASE AB	$82.81	$118.30	$16.69–$25.51	—	30%
Magnesium blood test CPT 83735 MAGNESIUM 24 HR URINE	$25.77	$36.81	$6.57–$7.94	64% below	30%
Magnesium blood test CPT 83735 MAGNESIUM URINE	$57.17	$81.67	$6.57–$17.61	20% below	30%
Magnesium blood test CPT 83735 MAGNESIUM SERUM	$57.17	$81.67	$6.57–$17.61	20% below	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM 24 HR URINE	$25.77	$36.81	$6.57–$7.94	—	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM URINE	$57.17	$81.67	$6.57–$17.61	—	30%
Magnesium blood test inpatient CPT 83735 MAGNESIUM SERUM	$57.17	$81.67	$6.57–$17.61	—	30%
Measles (rubeola) antibody test CPT 86765 EMPLOYEE RUBEOLA	$14.65	$20.93	$4.51–$12.62	80% below	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA	$52.76	$75.37	$12.62–$16.25	27% below	30%
Measles (rubeola) antibody test CPT 86765 RUBEOLA IGM	$52.76	$75.37	$12.62–$16.25	27% below	30%
Measles (rubeola) antibody test inpatient CPT 86765 EMPLOYEE RUBEOLA	$14.65	$20.93	$4.51–$12.62	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA	$52.76	$75.37	$12.62–$16.25	—	30%
Measles (rubeola) antibody test inpatient CPT 86765 RUBEOLA IGM	$52.76	$75.37	$12.62–$16.25	—	30%
Mono test (heterophile antibody, Monospot) CPT 86308 MONO TEST	$54.78	$78.26	$5.08–$16.88	23% below	30%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONO TEST	$54.78	$78.26	$5.08–$16.88	—	30%
Obstetric blood test panel CPT 80055 OBSTETRIC PANEL	$339.85	$485.50	$46.85–$104.67	81% above	30%
Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL	$339.85	$485.50	$46.85–$104.67	—	30%
PSA (prostate-specific antigen) blood test, free CPT 84154 FREE AND TOTAL PSA	$91.30	$130.43	$18.02–$28.12	11% below	30%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 FREE AND TOTAL PSA	$91.30	$130.43	$18.02–$28.12	—	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING	$105.92	$151.32	$18.02–$32.62	1% below	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA - DIAGNOSTIC	$105.92	$151.32	$18.02–$32.62	1% below	30%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA - REFERRED	$105.92	$151.32	$18.02–$32.62	1% below	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA - REFERRED	$105.92	$151.32	$18.02–$32.62	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA - DIAGNOSTIC	$105.92	$151.32	$18.02–$32.62	—	30%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING	$105.92	$151.32	$18.02–$32.62	—	30%
Pap test (liquid-based, automated screening with review) CPT 88175 PAP AUTO REVIEW	$87.52	$125.03	$26.08–$26.96	34% below	30%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 PAP AUTO REVIEW	$87.52	$125.03	$26.08–$26.96	—	30%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 PAP SMEAR ROUTINE	$76.48	$109.26	$19.85–$23.56	30% below	30%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR ROUTINE	$76.48	$109.26	$19.85–$23.56	—	30%
Parathyroid hormone (PTH) blood test CPT 83970 PTH-PARTHYRD HRMN	$242.33	$346.19	$40.45–$74.64	11% above	30%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH-PARTHYRD HRMN	$242.33	$346.19	$40.45–$74.64	—	30%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT PARTL THRMBPLSTN	$61.84	$88.34	$5.89–$19.04	8% above	30%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT PARTL THRMBPLSTN	$61.84	$88.34	$5.89–$19.04	—	30%
Progesterone blood test CPT 84144 PROGESTERONE	$96.87	$138.38	$20.44–$29.83	26% below	30%
Progesterone blood test inpatient CPT 84144 PROGESTERONE	$96.87	$138.38	$20.44–$29.83	—	30%
Prolactin blood test CPT 84146 PROLACTIN	$80.98	$115.68	$18.99–$24.94	30% below	30%
Prolactin blood test inpatient CPT 84146 PROLACTIN	$80.98	$115.68	$18.99–$24.94	—	30%
Prothrombin time (PT/INR) clotting test CPT 85610 PT(PROTHROMBIN TIME)	$39.70	$56.71	$4.20–$12.23	27% above	30%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT(PROTHROMBIN TIME)	$39.70	$56.71	$4.20–$12.23	—	30%
Rapid flu test (influenza antigen) CPT 87804 INFLUENZA A/B ANTIGEN	$81.79	$116.84	$16.22–$25.19	39% above	30%
Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A/B ANTIGEN	$81.79	$116.84	$16.22–$25.19	—	30%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ANTIGEN	$51.61	$73.73	$15.90–$16.20	at median	30%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ANTIGEN	$51.61	$73.73	$15.90–$16.20	—	30%
Rheumatoid factor (RF) test CPT 86431 RA TITER QUANT	$57.04	$81.48	$5.56–$17.57	7% above	30%
Rheumatoid factor (RF) test inpatient CPT 86431 RA TITER QUANT	$57.04	$81.48	$5.56–$17.57	—	30%
Rubella antibody test (immunity check) CPT 86762 EMPLOYEE RUBELLA	$7.43	$10.61	$2.28–$10.40	90% below	30%
Rubella antibody test (immunity check) CPT 86762 RUBELLA	$25.97	$37.10	$8.00–$14.10	66% below	30%
Rubella antibody test (immunity check) inpatient CPT 86762 EMPLOYEE RUBELLA	$7.43	$10.61	$2.28–$10.40	—	30%
Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA	$25.97	$37.10	$8.00–$14.10	—	30%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 SED RATE ESR	$57.40	$82.00	$2.65–$17.68	28% above	30%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE ESR	$57.40	$82.00	$2.65–$17.68	—	30%
Stool ova and parasites exam CPT 87177 OVA & PARASITE SMEAR-DIRECT	$40.08	$57.25	$8.72–$12.35	44% below	30%
Stool ova and parasites exam inpatient CPT 87177 OVA & PARASITE SMEAR-DIRECT	$40.08	$57.25	$8.72–$12.35	—	30%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 BLD OCCULT FECAL IMMUNO DIAGNOSTIC	$55.57	$79.39	$15.60–$17.12	23% below	30%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 BLD OCCULT FECAL IMMUNO DIAGNOSTIC	$55.57	$79.39	$15.60–$17.12	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL	$28.01	$40.02	$4.18–$8.62	45% below	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 RPR QUAL	$36.40	$52.00	$4.18–$11.21	29% below	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL	$28.01	$40.02	$4.18–$8.62	—	30%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RPR QUAL	$36.40	$52.00	$4.18–$11.21	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 EMPLOYEE QUANTIFERON TB	$44.98	$64.26	$13.86–$60.74	81% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB QUANTIFERON	$146.20	$208.85	$45.03–$60.74	37% below	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 EMPLOYEE QUANTIFERON TB	$44.98	$64.26	$13.86–$60.74	—	30%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB QUANTIFERON	$146.20	$208.85	$45.03–$60.74	—	30%
Testosterone blood test, total (not free testosterone) CPT 84403 TESTOSTERONE TOTAL	$164.15	$234.50	$25.29–$50.56	30% above	30%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE TOTAL	$164.15	$234.50	$25.29–$50.56	—	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOME LIV/KID AB	$57.34	$81.91	$14.26–$17.66	34% below	30%
Thyroid peroxidase (TPO) antibody test CPT 86376 THYROID PEROXIDASE AB	$68.63	$98.04	$14.26–$21.14	21% below	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 MICROSOME LIV/KID AB	$57.34	$81.91	$14.26–$17.66	—	30%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB	$68.63	$98.04	$14.26–$21.14	—	30%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 TSH	$134.90	$192.72	$16.46–$41.55	3% above	30%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 TSH	$134.90	$192.72	$16.46–$41.55	—	30%
Uric acid blood test CPT 84550 URIC ACID SERUM	$41.76	$59.66	$4.43–$12.87	40% below	30%
Uric acid blood test CPT 84550 URIC ACID POINT OF CARE	$41.76	$59.66	$4.43–$12.87	40% below	30%
Uric acid blood test inpatient CPT 84550 URIC ACID SERUM	$41.76	$59.66	$4.43–$12.87	—	30%
Uric acid blood test inpatient CPT 84550 URIC ACID POINT OF CARE	$41.76	$59.66	$4.43–$12.87	—	30%
Urinalysis with microscope exam, automated CPT 81001 URINALYSIS/MICROSCOPIC CS IF INDICATED	$65.80	$94.00	$3.11–$20.27	10% above	30%
Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS/MICROSCOPIC CS IF INDICATED	$65.80	$94.00	$3.11–$20.27	—	30%
Urinalysis with microscope exam, manual CPT 81000 DIP UA URINALYSIS DIPSTICK	$3.50	$5.00	$1.08–$3.94	82% below	30%
Urinalysis with microscope exam, manual inpatient CPT 81000 DIP UA URINALYSIS DIPSTICK	$3.50	$5.00	$1.08–$3.94	—	30%
Urinalysis without microscope exam, automated CPT 81003 EMPLOYEE URINALYSIS	$4.08	$5.83	$1.25–$2.20	77% below	30%
Urinalysis without microscope exam, automated CPT 81003 URINALYSIS C/S IF INDICATED	$30.05	$42.93	$2.20–$9.25	73% above	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 EMPLOYEE URINALYSIS	$4.08	$5.83	$1.25–$2.20	—	30%
Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS C/S IF INDICATED	$30.05	$42.93	$2.20–$9.25	—	30%
Urinalysis without microscope exam, manual CPT 81002 URINE DIPSTICK MC	$10.50	$15.00	$3.23–$3.41	56% below	30%
Urinalysis without microscope exam, manual CPT 81002 URINE PH	$15.26	$21.80	$3.41–$4.70	36% below	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE DIPSTICK MC	$10.50	$15.00	$3.23–$3.41	—	30%
Urinalysis without microscope exam, manual inpatient CPT 81002 URINE PH	$15.26	$21.80	$3.41–$4.70	—	30%
Urine culture for bacteria, with colony count CPT 87086 CULTURE-URINE	$66.42	$94.88	$7.91–$20.45	28% below	30%
Urine culture for bacteria, with colony count inpatient CPT 87086 CULTURE-URINE	$66.42	$94.88	$7.91–$20.45	—	30%
Urine pregnancy test, read by color change CPT 81025 PREG TEST(UCG)UR	$80.19	$114.56	$8.44–$24.70	18% above	30%
Urine pregnancy test, read by color change inpatient CPT 81025 PREG TEST(UCG)UR	$80.19	$114.56	$8.44–$24.70	—	30%
Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B12	$95.27	$136.10	$14.78–$29.34	23% below	30%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12	$95.27	$136.10	$14.78–$29.34	—	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY	$138.94	$198.48	$29.01–$42.80	24% below	30%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D 25 HYDROXY	$138.94	$198.48	$29.01–$42.80	—	30%
Zinc blood test CPT 84630 ZINC	$48.46	$69.23	$11.16–$14.93	22% below	30%
Zinc blood test CPT 84630 ZINC RBC	$234.37	$334.81	$11.16–$72.19	275% above	30%
Zinc blood test CPT 84630 ZINC URINE 24 HOUR	$466.16	$665.94	$11.16–$143.58	646% above	30%
Zinc blood test inpatient CPT 84630 ZINC	$48.46	$69.23	$11.16–$14.93	—	30%
Zinc blood test inpatient CPT 84630 ZINC RBC	$234.37	$334.81	$11.16–$72.19	—	30%
Zinc blood test inpatient CPT 84630 ZINC URINE 24 HOUR	$466.16	$665.94	$11.16–$143.58	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG-QUANT	$61.54	$87.92	$14.75–$18.95	41% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 BHCG TUMOR MARKER	$61.54	$87.92	$14.75–$18.95	41% below	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG-QUANT	$61.54	$87.92	$14.75–$18.95	—	30%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 BHCG TUMOR MARKER	$61.54	$87.92	$14.75–$18.95	—	30%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Anterior cervical discectomy and fusion (ACDF), one level CPT 22551 ARTHRODESIS DISCECTOMY DECOMPRS; BELOW C	$6,064.80	$8,664.00	$1,680.73–$1,932.83	9% below	30%
Anterior cervical discectomy and fusion (ACDF), one level inpatient CPT 22551 ARTHRODESIS DISCECTOMY DECOMPRS; BELOW C	$6,064.80	$8,664.00	$1,680.73–$1,932.83	—	30%
Appendectomy for a ruptured appendix with abscess or peritonitis CPT 44960 APPENDECTOMY/RUPTURED/PERITONITIS	$2,216.20	$3,166.00	$856.73–$985.23	20% below	30%
Appendectomy for a ruptured appendix with abscess or peritonitis inpatient CPT 44960 APPENDECTOMY/RUPTURED/PERITONITIS	$2,216.20	$3,166.00	$856.73–$985.23	—	30%
Appendectomy, open surgery CPT 44950 APPENDECTOMY	$1,506.40	$2,152.00	$626.80–$720.82	49% below	30%
Appendectomy, open surgery inpatient CPT 44950 APPENDECTOMY	$1,506.40	$2,152.00	$626.80–$720.82	—	30%
Arthroscopic ACL reconstruction or repair of the knee CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE	$3,495.10	$4,993.00	$893.84–$1,027.91	76% below	30%
Arthroscopic ACL reconstruction or repair of the knee inpatient CPT 29888 ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE	$3,495.10	$4,993.00	$893.84–$1,027.91	—	30%
Arthroscopic rotator cuff repair of the shoulder CPT 29827 ARTHROSCOPY W/ ROTATOR CUFF REPAIR	$3,385.20	$4,836.00	$981.72–$1,128.98	64% below	30%
Arthroscopic rotator cuff repair of the shoulder inpatient CPT 29827 ARTHROSCOPY W/ ROTATOR CUFF REPAIR	$3,385.20	$4,836.00	$981.72–$1,128.98	—	30%
Botox injections for chronic migraine CPT 64615 CHEMODENERVATION OF MUSCLE(S); FACIAL/CE	$401.10	$573.00	$133.45–$158.78	18% above	30%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERVATION OF MUSCLE(S); FACIAL/CE	$401.10	$573.00	$133.45–$158.78	—	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion CPT 19081 BX BREAST W/DEVICE 1ST LESION STEREOTACT	$1,802.50	$2,575.00	$161.37–$444.55	38% below	30%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient CPT 19081 BX BREAST W/DEVICE 1ST LESION STEREOTACT	$1,802.50	$2,575.00	$161.37–$444.55	—	30%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 CLO TR DISTAL FIBULA FX 90G	$790.30	$1,129.00	$324.94–$333.05	122% above	30%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 CLO TR DISTAL FIBULA FX 90G	$790.30	$1,129.00	$324.94–$333.05	—	30%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TRMT CLOSED METATARSAL FRACTURE	$522.20	$746.00	$223.99–$228.38	18% below	30%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 TRMT CLOSED METATARSAL FRACTURE	$522.20	$746.00	$223.99–$228.38	—	30%
Cardiac catheterization with coronary angiogram CPT 93458 ANG NATIVE CORONARY ANGIL W/L+ HEART	$7,209.98	$10,299.97	$943.32–$2,220.67	27% below	30%
Cardiac catheterization with coronary angiogram inpatient CPT 93458 ANG NATIVE CORONARY ANGIL W/L+ HEART	$7,209.98	$10,299.97	$943.32–$2,220.67	—	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION EXTERNAL	$473.90	$677.00	$107.66–$147.12	59% below	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTIVE, EXTERN	$1,214.80	$1,735.43	$147.12–$374.15	6% above	30%
Cardioversion, elective (restoring heart rhythm) CPT 92960 EXTERNAL ELECTRICAL CARDIOVERSION	$1,242.02	$1,774.32	$147.12–$382.54	8% above	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION EXTERNAL	$473.90	$677.00	$107.66–$147.12	—	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTIVE, EXTERN	$1,214.80	$1,735.43	$147.12–$374.15	—	30%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 EXTERNAL ELECTRICAL CARDIOVERSION	$1,242.02	$1,774.32	$147.12–$382.54	—	30%
Carpal tunnel release, open surgery CPT 64721 CARPAL TUNNEL NEUROPLASTY 90G	$1,331.40	$1,902.00	$466.72–$475.54	53% below	30%
Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL NEUROPLASTY 90G	$1,331.40	$1,902.00	$466.72–$475.54	—	30%
Cervical biopsy CPT 57500 EXCISION BIOPSY LESION CERVIX	$308.00	$440.00	$79.42–$143.18	66% below	30%
Cervical biopsy inpatient CPT 57500 EXCISION BIOPSY LESION CERVIX	$308.00	$440.00	$79.42–$143.18	—	30%
Circumcision by surgical excision, older than 28 days (children and adults) CPT 54161 CIRCUMCISION NOT NEWBORN W/O CLMP10	$506.10	$723.00	$180.14–$207.16	78% below	30%
Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION NOT NEWBORN W/O CLMP10	$506.10	$723.00	$180.14–$207.16	—	30%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLSDTRMT DIST RAD/ULN FX W/O MAN	$861.70	$1,231.00	$364.30–$374.25	63% above	30%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLSDTRMT DIST RAD/ULN FX W/O MAN	$861.70	$1,231.00	$364.30–$374.25	—	30%
Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/RM POLYS SNARE	$1,061.20	$1,516.00	$257.00–$470.93	56% below	30%
Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/RM POLYS SNARE	$1,061.20	$1,516.00	$257.00–$470.93	—	30%
Colonoscopy with tissue sample CPT 45380 COLONOSCOPY WITH BIOPSY (DIAGNOSTIC)	$938.70	$1,341.00	$204.49–$448.27	49% below	30%
Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY WITH BIOPSY (DIAGNOSTIC)	$938.70	$1,341.00	$204.49–$448.27	—	30%
Colonoscopy, diagnostic CPT 45378 COLONOSCOPY SCREENING	$795.20	$1,136.00	$189.88–$356.08	55% below	30%
Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY SCREENING	$795.20	$1,136.00	$189.88–$356.08	—	30%
Cystoscopy with ureteral stent placement CPT 52332 CYSTOURETHROSCOPY W/INSERTION OF URETERA	$1,090.60	$1,558.00	$161.47–$349.01	74% below	30%
Cystoscopy with ureteral stent placement inpatient CPT 52332 CYSTOURETHROSCOPY W/INSERTION OF URETERA	$1,090.60	$1,558.00	$161.47–$349.01	—	30%
Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY	$490.70	$701.00	$82.98–$201.56	55% below	30%
Cystoscopy, diagnostic look inside the bladder and urethra inpatient CPT 52000 CYSTOURETHROSCOPY	$490.70	$701.00	$82.98–$201.56	—	30%
D&C (dilation and curettage), not related to pregnancy CPT 58120 DILATION & CURRETAGE 10G	$697.90	$997.00	$243.20–$290.67	76% below	30%
D&C (dilation and curettage), not related to pregnancy inpatient CPT 58120 DILATION & CURRETAGE 10G	$697.90	$997.00	$243.20–$290.67	—	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTR LESION 10G	$119.70	$171.00	$52.54–$62.43	28% below	30%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTR LESION 10G	$119.70	$171.00	$52.54–$62.43	—	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 EAR LAVAGE	$37.80	$54.00	$15.45–$17.78	66% below	30%
Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI	$145.43	$207.76	$15.45–$44.80	29% above	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 EAR LAVAGE	$37.80	$54.00	$15.45–$17.78	—	30%
Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE IMPACTED EAR WAX UNI	$145.43	$207.76	$15.45–$44.80	—	30%
Earwax removal with instruments, one ear CPT 69210 EAR LAVAGE W/ INSTRUMENT	$102.90	$147.00	$31.49–$45.90	18% below	30%
Earwax removal with instruments, one ear inpatient CPT 69210 EAR LAVAGE W/ INSTRUMENT	$102.90	$147.00	$31.49–$45.90	—	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMET ENDOCERV SAMPLING W/O DILAT	$268.10	$383.00	$65.71–$95.69	20% below	30%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMET ENDOCERV SAMPLING W/O DILAT	$268.10	$383.00	$65.71–$95.69	—	30%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 INJECT OF THERAPEUTIC SUBSTNC CERVICAL/T	$669.20	$956.00	$108.92–$256.69	58% below	30%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321 INJECT OF THERAPEUTIC SUBSTNC CERVICAL/T	$669.20	$956.00	$108.92–$256.69	—	30%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 DIAGNOSTIC INJECT OF FACET JTS LUMBAR OR	$588.00	$840.00	$92.13–$177.54	59% below	30%
Facet joint injection, lower back, one level, with imaging guidance inpatient CPT 64493 DIAGNOSTIC INJECT OF FACET JTS LUMBAR OR	$588.00	$840.00	$92.13–$177.54	—	30%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593 REPAIR ANTERIOR ABD HERNIA W/MESH 3-10 C	$1,032.50	$1,475.00	$553.81–$636.88	85% below	30%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593 REPAIR ANTERIOR ABD HERNIA W/MESH 3-10 C	$1,032.50	$1,475.00	$553.81–$636.88	—	30%
First repair of a front abdominal hernia larger than 10 cm CPT 49595 REPAIR ANTERIOR ABD HERNIA W/MESH > 10CM	$1,388.10	$1,983.00	$742.81–$854.24	74% below	30%
First repair of a front abdominal hernia larger than 10 cm inpatient CPT 49595 REPAIR ANTERIOR ABD HERNIA W/MESH > 10CM	$1,388.10	$1,983.00	$742.81–$854.24	—	30%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591 REPAIR ANTERIOR ABDML HERNIA ANY APPRCH	$1,050.00	$1,500.00	$330.66–$380.26	72% below	30%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591 REPAIR ANTERIOR ABDML HERNIA ANY APPRCH	$1,050.00	$1,500.00	$330.66–$380.26	—	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330 FLEXI SIGMOIDOSCOPY DIAGNOSTIC	$338.80	$484.00	$60.96–$197.35	62% below	30%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330 FLEXI SIGMOIDOSCOPY DIAGNOSTIC	$338.80	$484.00	$60.96–$197.35	—	30%
Gallbladder removal, laparoscopic CPT 47562 LAP CHOLE 90	$1,930.60	$2,758.00	$651.31–$749.00	70% below	30%
Gallbladder removal, laparoscopic inpatient CPT 47562 LAP CHOLE 90	$1,930.60	$2,758.00	$651.31–$749.00	—	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563 LAP CHOLE W/ IOC 90G	$2,072.00	$2,960.00	$706.74–$812.74	80% below	30%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563 LAP CHOLE W/ IOC 90G	$2,072.00	$2,960.00	$706.74–$812.74	—	30%
Gallbladder removal, open surgery through a larger incision CPT 47600 CHOLECYSTECTOMY OPEN 90G	$2,603.30	$3,719.00	$1,045.10–$1,201.86	47% below	30%
Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY OPEN 90G	$2,603.30	$3,719.00	$1,045.10–$1,201.86	—	30%
Hemorrhoid banding (rubber band ligation) CPT 46221 HEMORRHOID BANDING 10G	$547.40	$782.00	$219.11–$305.59	29% below	30%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221 HEMORRHOID BANDING 10G	$547.40	$782.00	$219.11–$305.59	—	30%
Hemorrhoidectomy (internal and external), one area CPT 46255 HEMORROIDECTOMY INT EXT SIMPLE 90G	$1,028.30	$1,469.00	$398.98–$552.85	61% below	30%
Hemorrhoidectomy (internal and external), one area inpatient CPT 46255 HEMORROIDECTOMY INT EXT SIMPLE 90G	$1,028.30	$1,469.00	$398.98–$552.85	—	30%
Hysterectomy through an abdominal incision (total) CPT 58150 HYSTERECTOMY TOTAL ABDOMINAL 90G	$2,764.30	$3,949.00	$955.62–$1,098.96	49% below	30%
Hysterectomy through an abdominal incision (total) inpatient CPT 58150 HYSTERECTOMY TOTAL ABDOMINAL 90G	$2,764.30	$3,949.00	$955.62–$1,098.96	—	30%
Incision and drainage of a simple or single skin abscess CPT 10060 INCISION AND DRAINAGE 10G	$196.70	$281.00	$110.52–$121.22	50% below	30%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS; SIMPL/SNGL	$314.13	$448.75	$96.76–$121.22	20% below	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 INCISION AND DRAINAGE 10G	$196.70	$281.00	$110.52–$121.22	—	30%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS; SIMPL/SNGL	$314.13	$448.75	$96.76–$121.22	—	30%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 HERNIA REPAIR INGUINAL INITIAL 90G	$1,300.60	$1,858.00	$520.27–$598.31	66% below	30%
Inguinal (groin) hernia repair, age 5 or older CPT 49505 INGUINAL HERNIA REPAIR	$8,104.66	$11,578.08	$520.27–$2,496.24	112% above	30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 HERNIA REPAIR INGUINAL INITIAL 90G	$1,300.60	$1,858.00	$520.27–$598.31	—	30%
Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 INGUINAL HERNIA REPAIR	$8,104.66	$11,578.08	$520.27–$2,496.24	—	30%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 TRIGGER PNT INJ TEND LIG 00G	$130.20	$186.00	$38.96–$58.08	63% below	30%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 TRIGGER PNT INJ TEND LIG 00G	$130.20	$186.00	$38.96–$58.08	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 JOINT INJECTION LARGE	$174.30	$249.00	$46.60–$66.52	61% below	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCENTESIS MAJOR JT/BURSA	$581.96	$831.37	$66.52–$179.24	29% above	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 JOINT INJECTION LARGE	$174.30	$249.00	$46.60–$66.52	—	30%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCENTESIS MAJOR JT/BURSA	$581.96	$831.37	$66.52–$179.24	—	30%
Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$304.50	$435.00	$65.14–$103.86	65% above	30%
Insertion of a drug-delivery implant, such as the arm birth control implant inpatient CPT 11981 INSERTION DRUG DELIVERY IMPLANT	$304.50	$435.00	$65.14–$103.86	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 INTERMED JOINT BURSA GANG CYST	$132.30	$189.00	$37.11–$54.68	64% below	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS/ASPRI/INJ; INTERM JT	$581.96	$831.37	$54.68–$179.24	58% above	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 INTERMED JOINT BURSA GANG CYST	$132.30	$189.00	$37.11–$54.68	—	30%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS/ASPRI/INJ; INTERM JT	$581.96	$831.37	$54.68–$179.24	—	30%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 INJECT ASPIRAT ARTHOCENT SMALL JNT	$114.10	$163.00	$36.36–$53.73	61% below	30%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 INJECT ASPIRAT ARTHOCENT SMALL JNT	$114.10	$163.00	$36.36–$53.73	—	30%
Knee arthroscopy with meniscus repair (one side of the knee) CPT 29882 ARTHROSCOPY KNEE W/MENISCUS REPAIR (MEDI	$2,410.80	$3,444.00	$640.63–$736.72	42% below	30%
Knee arthroscopy with meniscus repair (one side of the knee) inpatient CPT 29882 ARTHROSCOPY KNEE W/MENISCUS REPAIR (MEDI	$2,410.80	$3,444.00	$640.63–$736.72	—	30%
Knee arthroscopy with meniscus trim CPT 29881 ARTHROSCOPY KNEE W/MENISCECTOMY MEDIAL O	$2,028.60	$2,898.00	$510.72–$587.32	51% below	30%
Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY KNEE W/MENISCECTOMY MEDIAL O	$2,028.60	$2,898.00	$510.72–$587.32	—	30%
Knee arthroscopy with removal of both torn meniscus parts CPT 29880 ARTHROSCOPY KNEE W/MENISCECTOMY MEDIAL &	$2,330.30	$3,329.00	$528.78–$608.10	44% below	30%
Knee arthroscopy with removal of both torn meniscus parts inpatient CPT 29880 ARTHROSCOPY KNEE W/MENISCECTOMY MEDIAL &	$2,330.30	$3,329.00	$528.78–$608.10	—	30%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970 LAP APPENDECTOMY 90G	$1,467.20	$2,096.00	$594.17–$683.30	77% below	30%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970 LAP APPENDECTOMY 90G	$1,467.20	$2,096.00	$594.17–$683.30	—	30%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAP NISSEN 90G	$2,919.00	$4,170.00	$1,053.66–$1,211.70	91% below	30%
Laparoscopic fundoplication (anti-reflux surgery) CPT 43280 LAP NISSEN	$23,336.99	$33,338.55	$1,053.66–$7,187.79	26% below	30%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAP NISSEN 90G	$2,919.00	$4,170.00	$1,053.66–$1,211.70	—	30%
Laparoscopic fundoplication (anti-reflux surgery) inpatient CPT 43280 LAP NISSEN	$23,336.99	$33,338.55	$1,053.66–$7,187.79	—	30%
Laparoscopic inguinal (groin) hernia repair, first repair on that side CPT 49650 LAPAROSCOPY SURIGCAL; REPAIR INITIAL ING	$1,145.20	$1,636.00	$431.88–$496.65	82% below	30%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient CPT 49650 LAPAROSCOPY SURIGCAL; REPAIR INITIAL ING	$1,145.20	$1,636.00	$431.88–$496.65	—	30%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia CPT 49651 LAP INGUINAL HERNIA REPAIR RECURRENT	$1,450.40	$2,072.00	$561.22–$645.40	77% below	30%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient CPT 49651 LAP INGUINAL HERNIA REPAIR RECURRENT	$1,450.40	$2,072.00	$561.22–$645.40	—	30%
Laparoscopic removal of fallopian tubes and/or ovaries CPT 58661 LAP LOA W/EXC ADNEX 10G	$1,856.40	$2,652.00	$601.33–$691.53	65% below	30%
Laparoscopic removal of fallopian tubes and/or ovaries inpatient CPT 58661 LAP LOA W/EXC ADNEX 10G	$1,856.40	$2,652.00	$601.33–$691.53	—	30%
Laparoscopic sleeve gastrectomy for weight loss CPT 43775 LAP SLEEVE GASTRECTOMY	$11,512.44	$16,446.34	$1,063.26–$3,545.83	80% below	30%
Laparoscopic sleeve gastrectomy for weight loss inpatient CPT 43775 LAP SLEEVE GASTRECTOMY	$11,512.44	$16,446.34	$1,063.26–$3,545.83	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTERMEDIATE LAYER CLOSURE <2.6 SCALP TR	$416.50	$595.00	$149.15–$242.95	30% below	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLO SCLP/TRUNK; 2.5 CM/LESS	$885.59	$1,265.13	$242.95–$272.76	49% above	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 INTERMEDIATE LAYER CLOSURE <2.6 SCALP TR	$416.50	$595.00	$149.15–$242.95	—	30%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLO SCLP/TRUNK; 2.5 CM/LESS	$885.59	$1,265.13	$242.95–$272.76	—	30%
Left heart catheterization, diagnostic one side CPT 93452 ANG LEFT HEART CATH WITH VENTRICLE	$7,209.98	$10,299.97	$815.54–$2,220.67	1% below	30%
Left heart catheterization, diagnostic inpatient one side CPT 93452 ANG LEFT HEART CATH WITH VENTRICLE	$7,209.98	$10,299.97	$815.54–$2,220.67	—	30%
Lower-back epidural injection, with imaging guidance CPT 62323 EPIDURAL STEROID INJECTION LUMBAR OR SAC	$665.00	$950.00	$101.68–$253.08	53% below	30%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323 EPIDURAL STEROID INJECTION LUMBAR OR SAC	$665.00	$950.00	$101.68–$253.08	—	30%
Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC	$621.24	$887.48	$84.91–$137.79	57% below	30%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX INTERLAMINAR LMBR/SAC	$621.24	$887.48	$84.91–$137.79	—	30%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 TRANSFORAMINAL STEROID INJ LUMBAR OR SAC	$756.00	$1,080.00	$112.63–$245.87	43% below	30%
Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 TRANSFORAMINAL STEROID INJ LUMBAR OR SAC	$756.00	$1,080.00	$112.63–$245.87	—	30%
Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LAMINOTOMYW/DCMPSN NRV ROOT 1 INTERSPACE	$3,682.00	$5,260.00	$918.63–$1,056.43	61% below	30%
Lumbar discectomy or laminotomy to free a nerve root, one level inpatient CPT 63030 LAMINOTOMYW/DCMPSN NRV ROOT 1 INTERSPACE	$3,682.00	$5,260.00	$918.63–$1,056.43	—	30%
Lumbar laminectomy (spinal decompression), one level CPT 63047 LAMINECTOMY W/SPINAL CORD DECOMPRESSION	$4,585.70	$6,551.00	$1,099.85–$1,264.84	49% below	30%
Lumbar laminectomy (spinal decompression), one level inpatient CPT 63047 LAMINECTOMY W/SPINAL CORD DECOMPRESSION	$4,585.70	$6,551.00	$1,099.85–$1,264.84	—	30%
Lumbar spinal fusion (posterior), one level CPT 22612 ARTHRODESIS; POSTRR OR POSTEROLATERAL TE	$5,559.40	$7,942.00	$1,519.33–$1,747.23	5% below	30%
Lumbar spinal fusion (posterior), one level inpatient CPT 22612 ARTHRODESIS; POSTRR OR POSTEROLATERAL TE	$5,559.40	$7,942.00	$1,519.33–$1,747.23	—	30%
Lumpectomy (partial mastectomy) CPT 19301 MASTECTOMY PARTIAL/LUMPECTOMY 90G	$1,546.30	$2,209.00	$648.20–$745.43	63% below	30%
Lumpectomy (partial mastectomy) inpatient CPT 19301 MASTECTOMY PARTIAL/LUMPECTOMY 90G	$1,546.30	$2,209.00	$648.20–$745.43	—	30%
Mastectomy (total removal of the breast) CPT 19303 MASTECTOMY SIMPLE COMPLETE 90G	$2,450.70	$3,501.00	$940.90–$1,082.04	41% below	30%
Mastectomy (total removal of the breast) one side CPT 19303 MASTECTOMY SIMPLE UNILATERAL	$15,201.52	$21,716.46	$940.90–$4,682.07	268% above	30%
Mastectomy (total removal of the breast) inpatient CPT 19303 MASTECTOMY SIMPLE COMPLETE 90G	$2,450.70	$3,501.00	$940.90–$1,082.04	—	30%
Mastectomy (total removal of the breast) inpatient one side CPT 19303 MASTECTOMY SIMPLE UNILATERAL	$15,201.52	$21,716.46	$940.90–$4,682.07	—	30%
Miscarriage treatment with D&C, first trimester CPT 59820 SURG TX MISSED ABORTION 90	$933.10	$1,333.00	$413.71–$431.47	73% below	30%
Miscarriage treatment with D&C, first trimester inpatient CPT 59820 SURG TX MISSED ABORTION 90	$933.10	$1,333.00	$413.71–$431.47	—	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC BEN LES TAL <=0.5CM 10G	$205.80	$294.00	$84.28–$119.31	70% below	30%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC BEN LES TAL <=0.5CM 10G	$205.80	$294.00	$84.28–$119.31	—	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm CPT 11440 EXC LESION FEENLM <=.5CM 10G	$236.60	$338.00	$106.73–$132.26	56% below	30%
Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm inpatient CPT 11440 EXC LESION FEENLM <=.5CM 10G	$236.60	$338.00	$106.73–$132.26	—	30%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PLATE 00G	$149.80	$214.00	$55.47–$104.42	48% below	30%
Nail removal (partial or complete), one nail CPT 11730 AVULS OF NAIL PLATE PART OR COMPL SIMPLE	$306.45	$437.79	$94.38–$104.42	5% above	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PLATE 00G	$149.80	$214.00	$55.47–$104.42	—	30%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULS OF NAIL PLATE PART OR COMPL SIMPLE	$306.45	$437.79	$94.38–$104.42	—	30%
Occipital nerve block (injection for headaches) CPT 64405 INJJ ANESTHETIC AGENT GREATER OPTICAL NE	$270.20	$386.00	$55.59–$77.62	43% below	30%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJJ ANESTHETIC AGENT GREATER OPTICAL NE	$270.20	$386.00	$55.59–$77.62	—	30%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS ABD W/IMAG GUIDANCE 00	$425.60	$608.00	$107.06–$264.35	69% below	30%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS ABD W/IMAG GUIDANCE 00	$425.60	$608.00	$107.06–$264.35	—	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXCISION NAIL/MATRIX 10G	$323.40	$462.00	$105.39–$148.42	39% below	30%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/MATRIX PART/COMPLT PERM	$608.53	$869.33	$148.42–$187.42	15% above	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXCISION NAIL/MATRIX 10G	$323.40	$462.00	$105.39–$148.42	—	30%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/MATRIX PART/COMPLT PERM	$608.53	$869.33	$148.42–$187.42	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 MEDIAL BRANCH DESTRCTN BY NEUROLYTIC AGE	$1,079.40	$1,542.00	$195.74–$431.40	53% below	30%
Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 LUMBAR OR SACRAL RF ABLAT	$4,530.33	$6,471.90	$431.40–$1,395.34	97% above	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 MEDIAL BRANCH DESTRCTN BY NEUROLYTIC AGE	$1,079.40	$1,542.00	$195.74–$431.40	—	30%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient CPT 64635 LUMBAR OR SACRAL RF ABLAT	$4,530.33	$6,471.90	$431.40–$1,395.34	—	30%
Removal of a breast lump, open surgery CPT 19120 BREAST BIOPSY EXCISIONAL 90G	$1,025.50	$1,465.00	$474.01–$560.11	41% below	30%
Removal of a breast lump, open surgery inpatient CPT 19120 BREAST BIOPSY EXCISIONAL 90G	$1,025.50	$1,465.00	$474.01–$560.11	—	30%
Removal of a foreign object under the skin, simple CPT 10120 REMOVAL FB W/ INCISION 10G	$250.60	$358.00	$112.48–$147.13	46% below	30%
Removal of a foreign object under the skin, simple CPT 10120 INCS & REMOV FB SUBQ TISS; SIMPL	$576.52	$823.60	$147.13–$177.57	24% above	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVAL FB W/ INCISION 10G	$250.60	$358.00	$112.48–$147.13	—	30%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCS & REMOV FB SUBQ TISS; SIMPL	$576.52	$823.60	$147.13–$177.57	—	30%
Removal of one lobe of the thyroid (lobectomy) CPT 60220 TOTAL THYROID LOBECTOMY W/WO ISTH 90G	$1,970.50	$2,815.00	$649.29–$746.68	69% below	30%
Removal of one lobe of the thyroid (lobectomy) inpatient CPT 60220 TOTAL THYROID LOBECTOMY W/WO ISTH 90G	$1,970.50	$2,815.00	$649.29–$746.68	—	30%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121 MC SCREENING COLONOSCOPY LOW RISK	$910.00	$1,300.00	$190.46–$356.59	61% below	30%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121 MC SCREENING COLONOSCOPY LOW RISK	$910.00	$1,300.00	$190.46–$356.59	—	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105 MC COLONOSCOPY SCREENING HIGH RISK	$910.00	$1,300.00	$189.88–$356.08	62% below	30%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105 MC COLONOSCOPY SCREENING HIGH RISK	$910.00	$1,300.00	$189.88–$356.08	—	30%
Shock-wave lithotripsy to break up kidney stones (from outside the body) CPT 50590 LITHOTRIPSEY	$1,992.20	$2,846.00	$597.45–$733.49	69% below	30%
Shock-wave lithotripsy to break up kidney stones (from outside the body) inpatient CPT 50590 LITHOTRIPSEY	$1,992.20	$2,846.00	$597.45–$733.49	—	30%
Short arm cast (elbow to hand) CPT 29075 CAST SHORT-ARM ELBOW TO FINGER 00G	$207.90	$297.00	$66.37–$92.37	32% below	30%
Short arm cast (elbow to hand) CPT 29075 APPLIC; ELBOW TO FINGER	$554.17	$791.67	$92.37–$170.69	80% above	30%
Short arm cast (elbow to hand) inpatient CPT 29075 CAST SHORT-ARM ELBOW TO FINGER 00G	$207.90	$297.00	$66.37–$92.37	—	30%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLIC; ELBOW TO FINGER	$554.17	$791.67	$92.37–$170.69	—	30%
Short arm splint (forearm and hand) CPT 29125 APPLICATION OF SPLINT SHORT ARM SPLINT S	$166.60	$238.00	$46.08–$74.14	33% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLIC; SHORT ARM SPLINT; STATIC	$190.09	$271.56	$46.08–$74.14	24% below	30%
Short arm splint (forearm and hand) CPT 29125 APPLIC; SHORT ARM SPLINT; STATOC	$283.70	$405.29	$74.14–$87.38	14% above	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION OF SPLINT SHORT ARM SPLINT S	$166.60	$238.00	$46.08–$74.14	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLIC; SHORT ARM SPLINT; STATIC	$190.09	$271.56	$46.08–$74.14	—	30%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLIC; SHORT ARM SPLINT; STATOC	$283.70	$405.29	$74.14–$87.38	—	30%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST	$207.90	$297.00	$63.13–$83.58	33% below	30%
Short leg cast (below the knee) CPT 29405 APPLIC SHORT LEG CAST	$279.71	$399.58	$63.13–$83.58	10% below	30%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST	$207.90	$297.00	$63.13–$83.58	—	30%
Short leg cast (below the knee) inpatient CPT 29405 APPLIC SHORT LEG CAST	$279.71	$399.58	$63.13–$83.58	—	30%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT FOOT	$161.00	$230.00	$56.48–$78.39	37% below	30%
Short leg splint (calf to foot) CPT 29515 APPLIC SHORT LEG SPLINT	$350.00	$500.00	$78.39–$107.80	37% above	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT FOOT	$161.00	$230.00	$56.48–$78.39	—	30%
Short leg splint (calf to foot) inpatient CPT 29515 APPLIC SHORT LEG SPLINT	$350.00	$500.00	$78.39–$107.80	—	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 ARTHROSCOPY SHOULDER DECOMPRESSION OF SU	$1,915.20	$2,736.00	$152.77–$175.68	96% below	30%
Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 ARTHROSCOPY SHOULDER DECOMPRESSION OF SU	$1,915.20	$2,736.00	$152.77–$175.68	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPLE CLOSURE SNAXGENTREX <2.6 10	$324.10	$463.00	$52.45–$108.07	10% below	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS	$444.64	$635.20	$108.07–$136.95	23% above	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPLE CLOSURE SNAXGENTREX <2.6 10	$324.10	$463.00	$52.45–$108.07	—	30%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS	$444.64	$635.20	$108.07–$136.95	—	30%
Skin biopsy, punch, one lesion CPT 11104 PUNCH BIOPSY OF SKIN SNG LESN SIMPLE CLO	$218.40	$312.00	$44.03–$112.70	32% below	30%
Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BIOPSY OF SKIN SNG LESN SIMPLE CLO	$218.40	$312.00	$44.03–$112.70	—	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600 EXC MAL LES TAL <=0.5CM 10G	$308.00	$440.00	$122.04–$186.51	28% below	30%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600 EXC MAL LES TAL <=0.5CM 10G	$308.00	$440.00	$122.04–$186.51	—	30%
Skin tag removal, up to 15 tags CPT 11200 SKIN TAGS REMOVAL UP TO 15 10G	$146.30	$209.00	$75.72–$86.47	41% below	30%
Skin tag removal, up to 15 tags inpatient CPT 11200 SKIN TAGS REMOVAL UP TO 15 10G	$146.30	$209.00	$75.72–$86.47	—	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$385.70	$551.00	$71.48–$157.19	51% below	30%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCT LUMBAR DX	$1,319.09	$1,884.41	$157.19–$406.28	67% above	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DIAGNOSTIC	$385.70	$551.00	$71.48–$157.19	—	30%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCT LUMBAR DX	$1,319.09	$1,884.41	$157.19–$406.28	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 PRI/CLOSE SNAXGENTREX 2.6-7.5	$389.20	$556.00	$68.62–$132.89	3% below	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM	$444.64	$635.20	$132.89–$136.95	11% above	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 PRI/CLOSE SNAXGENTREX 2.6-7.5	$389.20	$556.00	$68.62–$132.89	—	30%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM	$444.64	$635.20	$132.89–$136.95	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPLE REPAIR FEENLM </=2.5 10	$390.60	$558.00	$65.05–$132.77	3% below	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 SIMPL REPR FACE/MUCOUS; 2.5/LESS	$444.64	$635.20	$132.77–$136.95	10% above	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPLE REPAIR FEENLM </=2.5 10	$390.60	$558.00	$65.05–$132.77	—	30%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 SIMPL REPR FACE/MUCOUS; 2.5/LESS	$444.64	$635.20	$132.77–$136.95	—	30%
TURP (transurethral resection of the prostate) CPT 52601 TRANSURETHRAL RESECTION OF PROSTATE	$1,956.50	$2,795.00	$525.26–$604.05	66% below	30%
TURP (transurethral resection of the prostate) inpatient CPT 52601 TRANSURETHRAL RESECTION OF PROSTATE	$1,956.50	$2,795.00	$525.26–$604.05	—	30%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION	$170.80	$244.00	$34.50–$88.57	34% below	30%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY OF SKIN SINGLE LESION	$170.80	$244.00	$34.50–$88.57	—	30%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/ IMAGING 00	$476.70	$681.00	$109.19–$289.21	56% below	30%
Thoracentesis with imaging guidance CPT 32555 LUNG CYST ASPRI	$1,265.00	$1,807.14	$289.21–$389.62	16% above	30%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/ IMAGING 00	$476.70	$681.00	$109.19–$289.21	—	30%
Thoracentesis with imaging guidance inpatient CPT 32555 LUNG CYST ASPRI	$1,265.00	$1,807.14	$289.21–$389.62	—	30%
Total hip replacement CPT 27130 ARTHROPLASTY HIP (TOTAL HIP REPLACEMENT)	$4,846.80	$6,924.00	$1,180.29–$1,357.34	17% below	30%
Total hip replacement inpatient CPT 27130 ARTHROPLASTY HIP (TOTAL HIP REPLACEMENT)	$4,846.80	$6,924.00	$1,180.29–$1,357.34	—	30%
Total knee replacement CPT 27447 ARTHORPLASTY KNEE (TOTAL KNEE REPLACEMEN	$4,511.50	$6,445.00	$1,177.26–$1,353.85	17% below	30%
Total knee replacement inpatient CPT 27447 ARTHORPLASTY KNEE (TOTAL KNEE REPLACEMEN	$4,511.50	$6,445.00	$1,177.26–$1,353.85	—	30%
Total thyroid removal (thyroidectomy) CPT 60240 TOTAL THYROIDECTOMY 90	$2,615.20	$3,736.00	$848.56–$975.84	86% below	30%
Total thyroid removal (thyroidectomy) inpatient CPT 60240 TOTAL THYROIDECTOMY 90	$2,615.20	$3,736.00	$848.56–$975.84	—	30%
Trigger finger release surgery CPT 26055 TRIGGER FING TENDON SHEATH INCISION	$1,263.50	$1,805.00	$320.02–$584.31	at median	30%
Trigger finger release surgery inpatient CPT 26055 TRIGGER FING TENDON SHEATH INCISION	$1,263.50	$1,805.00	$320.02–$584.31	—	30%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER PT INJ 1 OR 2 MUSC GRPS	$137.90	$197.00	$40.58–$49.64	70% below	30%
Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$600.79	$858.27	$49.64–$185.04	30% above	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER PT INJ 1 OR 2 MUSC GRPS	$137.90	$197.00	$40.58–$49.64	—	30%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJ TRIGGER POINT 1/2 MUSCL	$600.79	$858.27	$49.64–$185.04	—	30%
Tubal ligation, laparoscopic (tubes sealed by cautery) CPT 58670 LAP TUBAL LIGATION/FULGURATION	$1,047.90	$1,497.00	$336.06–$386.47	60% below	30%
Tubal ligation, laparoscopic (tubes sealed by cautery) inpatient CPT 58670 LAP TUBAL LIGATION/FULGURATION	$1,047.90	$1,497.00	$336.06–$386.47	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BREAST BX CORE W/US	$1,739.50	$2,485.00	$152.59–$441.40	21% below	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 BX BREAST 1st LES US GUID	$3,239.89	$4,628.42	$441.40–$997.88	47% above	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BREAST BX CORE W/US	$1,739.50	$2,485.00	$152.59–$441.40	—	30%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 BX BREAST 1st LES US GUID	$3,239.89	$4,628.42	$441.40–$997.88	—	30%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249 UGI ENDOSCOPY WITH BALLOON DILATION	$715.40	$1,022.00	$156.07–$1,001.56	66% below	30%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249 UGI ENDOSCOPY WITH BALLOON DILATION	$715.40	$1,022.00	$156.07–$1,001.56	—	30%
Upper endoscopy (EGD) with biopsy CPT 43239 UGI ENDOSCOPY BIOPSY	$711.20	$1,016.00	$141.39–$387.14	57% below	30%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239 UGI ENDOSCOPY BIOPSY	$711.20	$1,016.00	$141.39–$387.14	—	30%
Upper endoscopy (EGD) with injection into the lining CPT 43236 UGI W INJECTION	$763.70	$1,091.00	$141.39–$411.65	64% below	30%
Upper endoscopy (EGD) with injection into the lining inpatient CPT 43236 UGI W INJECTION	$763.70	$1,091.00	$141.39–$411.65	—	30%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251 UGI W/REMOV OF TUMORS POLYPS	$800.10	$1,143.00	$198.64–$506.25	73% below	30%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251 UGI W/REMOV OF TUMORS POLYPS	$800.10	$1,143.00	$198.64–$506.25	—	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire CPT 43248 UGI W DIL OF ESOPH OVER GUIDE WIRE	$683.20	$976.00	$169.87–$425.05	73% below	30%
Upper endoscopy (EGD) with widening of the esophagus over a guide wire inpatient CPT 43248 UGI W DIL OF ESOPH OVER GUIDE WIRE	$683.20	$976.00	$169.87–$425.05	—	30%
Upper endoscopy (EGD), diagnostic CPT 43235 UGI ENDOSCOPY DIAGNOSTIC	$625.10	$893.00	$126.31–$299.61	69% below	30%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 UGI ENDOSCOPY DIAGNOSTIC	$625.10	$893.00	$126.31–$299.61	—	30%
Ureteroscopy with laser stone breaking (lithotripsy) both sides CPT 52353 CYSTOSCOPY W/ STENT PLACEMENT BILAT	$11,591.24	$16,558.91	$348.13–$3,570.10	—	30%
Ureteroscopy with laser stone breaking (lithotripsy) both sides CPT 52353 CYSTO W/ LITHOTRIPSY BILAT	$17,378.21	$24,826.01	$348.13–$5,352.49	—	30%
Ureteroscopy with laser stone breaking (lithotripsy) CPT 52353 CYSTO WITH URETEROSCOPY &/OR PYELOSCOPY;	$1,253.70	$1,791.00	$348.13–$400.34	94% below	30%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient both sides CPT 52353 CYSTOSCOPY W/ STENT PLACEMENT BILAT	$11,591.24	$16,558.91	$348.13–$3,570.10	—	30%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient both sides CPT 52353 CYSTO W/ LITHOTRIPSY BILAT	$17,378.21	$24,826.01	$348.13–$5,352.49	—	30%
Ureteroscopy with laser stone breaking (lithotripsy) inpatient CPT 52353 CYSTO WITH URETEROSCOPY &/OR PYELOSCOPY;	$1,253.70	$1,791.00	$348.13–$400.34	—	30%
Ureteroscopy with laser stone breaking and stent placement CPT 52356 CYSTO/URETERO W/LITHOTRIPSY INCLUDING ST	$1,232.00	$1,760.00	$370.56–$426.14	90% below	30%
Ureteroscopy with laser stone breaking and stent placement inpatient CPT 52356 CYSTO/URETERO W/LITHOTRIPSY INCLUDING ST	$1,232.00	$1,760.00	$370.56–$426.14	—	30%
Vasectomy, one or both sides, including follow-up semen testing CPT 55250 VASECTOMY	$4,481.30	$6,401.86	$328.52–$1,380.24	253% above	30%
Vasectomy, one or both sides, including follow-up semen testing inpatient CPT 55250 VASECTOMY	$4,481.30	$6,401.86	$328.52–$1,380.24	—	30%
Vein ablation, radiofrequency, first vein CPT 36475 RF RADIO-FREQUENCY ABLATION 1ST VEIN	$3,744.30	$5,349.00	$298.70–$984.16	19% below	30%
Vein ablation, radiofrequency, first vein inpatient CPT 36475 RF RADIO-FREQUENCY ABLATION 1ST VEIN	$3,744.30	$5,349.00	$298.70–$984.16	—	30%
Wart removal, up to 14 warts CPT 17110 DESTR HYFERCAT LESIONS 1-14 G10	$177.10	$253.00	$68.21–$102.94	24% below	30%
Wart removal, up to 14 warts inpatient CPT 17110 DESTR HYFERCAT LESIONS 1-14 G10	$177.10	$253.00	$68.21–$102.94	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SKIN SUBQ 1ST 20 SQ 00G	$222.60	$318.00	$63.79–$124.21	67% below	30%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM	$847.13	$1,210.19	$124.21–$260.92	27% above	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SKIN SUBQ 1ST 20 SQ 00G	$222.60	$318.00	$63.79–$124.21	—	30%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM	$847.13	$1,210.19	$124.21–$260.92	—	30%
Wrist fracture surgery (plate and screws), distal radius CPT 25607 DISTAL RADIAL (WRIST) EXTRA-ARTICULAR FX	$1,806.70	$2,581.00	$690.54–$794.11	67% below	30%
Wrist fracture surgery (plate and screws), distal radius inpatient CPT 25607 DISTAL RADIAL (WRIST) EXTRA-ARTICULAR FX	$1,806.70	$2,581.00	$690.54–$794.11	—	30%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLOOD PRODUCTS	$964.12	$1,377.32	$43.07–$296.95	3% above	30%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLOOD PRODUCTS	$964.12	$1,377.32	$43.07–$296.95	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEBULIZER TREATMENT	$39.90	$57.00	$7.99–$12.29	79% below	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB/MDI INITIAL	$490.62	$700.88	$7.99–$151.11	162% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 NEB/MDI SUB	$490.62	$700.88	$7.99–$151.11	162% above	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEBULIZER TREATMENT	$39.90	$57.00	$7.99–$12.29	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB/MDI SUB	$490.62	$700.88	$7.99–$151.11	—	30%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 NEB/MDI INITIAL	$490.62	$700.88	$7.99–$151.11	—	30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 1ST HOUR	$504.70	$721.00	$230.82–$299.04	72% below	30%
Critical care, first 30 to 74 minutes CPT 99291 ER PHYSICIAN CRITICAL CARE 1ST HOUR	$1,306.93	$1,867.04	$230.82–$299.04	27% below	30%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE, 1ST 30-74 MIN	$1,970.81	$2,815.44	$299.04–$607.01	11% above	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 1ST HOUR	$504.70	$721.00	$230.82–$299.04	—	30%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE, 1ST 30-74 MIN	$1,970.81	$2,815.44	$299.04–$607.01	—	30%
Electrocardiogram (ECG/EKG) with interpretation CPT 93000 EKG TOTAL SERVICE	$54.60	$78.00	$14.66–$16.86	at median	30%
Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 EKG TOTAL SERVICE	$54.60	$78.00	$14.66–$16.86	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 RHYTHM STRIP	$37.80	$54.00	$6.49–$11.64	83% below	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD	$242.55	$346.50	$6.49–$74.71	12% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 EKG 12 LEAD SUBSEQUENT	$242.55	$346.50	$6.49–$74.71	12% above	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 RHYTHM STRIP	$37.80	$54.00	$6.49–$11.64	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD	$242.55	$346.50	$6.49–$74.71	—	30%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 EKG 12 LEAD SUBSEQUENT	$242.55	$346.50	$6.49–$74.71	—	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER PHYSICIAN LEVEL 1	$177.81	$254.02	$11.21–$12.90	at median	30%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER VISIT, LEVEL 1	$197.18	$281.68	$11.21–$60.73	11% above	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER PHYSICIAN LEVEL 2	$267.40	$382.00	$41.15–$47.32	29% below	30%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER VISIT, LEVEL 2	$363.24	$518.91	$41.15–$111.88	3% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER PHYSICIAN LEVEL 3	$534.81	$764.01	$70.97–$81.61	14% below	30%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER VISIT, LEVEL 3	$633.68	$905.26	$70.97–$195.18	1% above	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER PHYSICIAN LEVEL 4	$840.51	$1,200.73	$121.04–$139.20	12% below	30%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER VISIT, LEVEL 4	$983.68	$1,405.26	$121.04–$302.98	3% above	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER PHYSICIAN LEVEL 5	$1,352.06	$1,931.52	$174.91–$201.14	8% below	30%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER VISIT, LEVEL 5	$1,433.55	$2,047.93	$174.91–$441.53	3% below	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 DOBUTAMINE STRESS TEST EKG ONLY	$1,131.18	$1,615.97	$35.39–$348.40	33% above	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 Treadmill ECHO Stress Test	$1,131.18	$1,615.97	$35.39–$348.40	33% above	30%
Exercise stress test, tracing only, the hospital charge CPT 93017 STRESS TEST WITH EKG	$1,131.18	$1,615.97	$35.39–$348.40	33% above	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Treadmill ECHO Stress Test	$1,131.18	$1,615.97	$35.39–$348.40	—	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 DOBUTAMINE STRESS TEST EKG ONLY	$1,131.18	$1,615.97	$35.39–$348.40	—	30%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 STRESS TEST WITH EKG	$1,131.18	$1,615.97	$35.39–$348.40	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT 31-60 MINS	$311.28	$444.69	$30.59–$95.87	3% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV,INITIAL,31MIN TO 1HR	$311.28	$444.69	$30.59–$95.87	3% below	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV,INITIAL,31MIN TO 1HR	$311.28	$444.69	$30.59–$95.87	—	30%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 HYDRATION IV INFUSION INIT 31-60 MINS	$311.28	$444.69	$30.59–$95.87	—	30%
IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$450.42	$643.45	$61.51–$138.73	15% above	30%
IV infusion of a medicine, first hour CPT 96365 IV INFUSION, INITIAL, UP TO 1 HR	$450.42	$643.45	$61.51–$138.73	15% above	30%
IV infusion of a medicine, first hour inpatient CPT 96365 THER/PROPH/DIAG IV INF INIT =<1 HR	$450.42	$643.45	$61.51–$138.73	—	30%
IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION, INITIAL, UP TO 1 HR	$450.42	$643.45	$61.51–$138.73	—	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ADMIN THERAPEUTIC IM INJECTION	$43.40	$62.00	$13.37–$14.45	58% below	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM	$112.78	$161.12	$14.45–$34.74	8% above	30%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION SC/IM	$156.45	$223.50	$14.45–$48.19	50% above	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ADMIN THERAPEUTIC IM INJECTION	$43.40	$62.00	$13.37–$14.45	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ SC/IM	$112.78	$161.12	$14.45–$34.74	—	30%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION SC/IM	$156.45	$223.50	$14.45–$48.19	—	30%
New patient office visit, about 30 minutes CPT 99203 NEW OV DETAILED 99203	$149.10	$213.00	$82.70–$113.16	28% below	30%
New patient office visit, about 45 minutes CPT 99204 NEW OV COMPREHENSIVE 99204	$231.00	$330.00	$134.68–$171.20	17% below	30%
New patient office visit, about 60 minutes CPT 99205 NEW OV EXTENSIVE 99205	$306.60	$438.00	$185.23–$229.52	16% below	30%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 NEW OV EXPANDED 99202	$101.50	$145.00	$47.03–$71.38	30% below	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 MNT INDIVIDUAL ASSESSMENT	$48.97	$69.96	$15.08–$34.59	10% below	30%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 MNT INDIVIDUAL ASSESSMENT	$48.97	$69.96	$15.08–$34.59	—	30%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT MYOFACIAL RELEASE	$144.94	$207.05	$26.24–$44.64	27% above	30%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT MYOFACIAL RELEASE	$144.94	$207.05	$26.24–$44.64	—	30%
Preventive checkup, new patient aged 18–39 CPT 99385 WELL NEW PHYSICAL AGES 18-39 99385	$182.00	$260.00	$56.06	1% above	30%
Preventive checkup, new patient aged 40–64 CPT 99386 WELL EXAM NEW PT 40-64 99386	$205.10	$293.00	$63.17	8% below	30%
Preventive checkup, new patient aged 65 or older CPT 99387 WELL EXAM NEW PT AGE 65+ 99387	$210.70	$301.00	$64.90	22% above	30%
Preventive checkup, returning patient aged 18–39 CPT 99395 WELL PREV EST 18-39 YR 99395	$161.00	$230.00	$49.59	10% below	30%
Preventive checkup, returning patient aged 40–64 CPT 99396 WELL PREV EST AGE 40-64 99396	$170.80	$244.00	$52.61	13% below	30%
Preventive checkup, returning patient aged 65 or older CPT 99397 WELL PREV EST AGE 65 + 99397	$170.80	$244.00	$52.61	15% below	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING-TOB USE CESS COUNSEL 3-10	$20.30	$29.00	$12.27–$14.86	38% below	30%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 SMOKING CESSATION	$79.35	$113.36	$14.86–$24.44	140% above	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING-TOB USE CESS COUNSEL 3-10	$20.30	$29.00	$12.27–$14.86	—	30%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 SMOKING CESSATION	$79.35	$113.36	$14.86–$24.44	—	30%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 EST OV COMPLEX 99215	$213.50	$305.00	$143.53–$184.58	17% below	30%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 EST OV COMPLEX 99215	$213.50	$305.00	$143.53–$184.58	—	30%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 EST OV DETAILED 99213	$102.90	$147.00	$65.57–$90.79	30% below	30%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 EST OV COMPREHENSIVE 99214	$151.20	$216.00	$96.67–$129.78	15% below	30%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 EST OV COMPREHENSIVE 99214	$151.20	$216.00	$96.67–$129.78	—	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 EST OV EXPANDED 99212	$61.60	$88.00	$35.73–$56.47	43% below	30%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP VISIT, EST PT 10 MIN OR MORE	$61.60	$88.00	$18.97–$56.47	43% below	30%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP VISIT, EST PT 10 MIN OR MORE	$61.60	$88.00	$18.97–$56.47	—	30%
Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OUT PATIENT CONSULT COMPREHENSIVE	$270.20	$386.00	—	17% below	30%
Spirometry (breathing test) CPT 94010 SPIROMTRY PRE ONLY	$355.62	$508.03	$27.51–$109.53	18% above	30%
Spirometry (breathing test) inpatient CPT 94010 SPIROMTRY PRE ONLY	$355.62	$508.03	$27.51–$109.53	—	30%
Spirometry before and after a bronchodilator CPT 94060 SPIROMETRY P & P	$633.27	$904.67	$39.88–$195.05	21% above	30%
Spirometry before and after a bronchodilator inpatient CPT 94060 SPIROMETRY P & P	$633.27	$904.67	$39.88–$195.05	—	30%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY THERAPEUTIC	$242.39	$346.27	$74.66–$88.93	17% above	30%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEBOTOMY THERAPEUTIC	$242.39	$346.27	$74.66–$88.93	—	30%
Treadmill or drug stress test with ECG, supervision and report CPT 93015 EKG STRESS TEST TREADMILL DON'T USE (IN	$242.20	$346.00	$68.68–$78.98	44% below	30%
Treadmill or drug stress test with ECG, supervision and report inpatient CPT 93015 EKG STRESS TEST TREADMILL DON'T USE (IN	$242.20	$346.00	$68.68–$78.98	—	30%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Illinois	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 CL-FLU HI-DOSE FLUAD	$105.00	$150.00	$32.34–$96.20	21% above	30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 INFLUENZA HIGH DOSE VACCINE	$264.53	$377.90	$81.48–$96.20	205% above	30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 CL-FLU HI-DOSE FLUAD	$105.00	$150.00	$32.34–$96.20	—	30%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 INFLUENZA HIGH DOSE VACCINE	$264.53	$377.90	$81.48–$96.20	—	30%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 CL-VARICELLA VACCINE (CHICKEN POX)	$158.90	$227.00	$48.94	32% below	30%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716 CL-VARICELLA VACCINE (CHICKEN POX)	$158.90	$227.00	$48.94	—	30%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 CL-FLU VACCINE NO PRESERVATIVE 3&>	$40.60	$58.00	$12.50–$22.76	14% above	30%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 CL-FLU VACCINE NO PRESERVATIVE 3&>	$40.60	$58.00	$12.50–$22.76	—	30%
Hepatitis A vaccine, adult dose CPT 90632 CL-HEPATITIS A VACCINE, ADULT DOSE	$100.80	$144.00	$31.05–$72.07	6% below	30%
Hepatitis A vaccine, adult dose inpatient CPT 90632 CL-HEPATITIS A VACCINE, ADULT DOSE	$100.80	$144.00	$31.05–$72.07	—	30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 CL-HEPATITIS B VACCINE ADULT 20 MCG	$107.10	$153.00	$32.99–$73.64	10% above	30%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEP B VAC RECOMB 20MCG/ML 1ML INJ	$211.78	$302.54	$65.23–$73.64	117% above	30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 CL-HEPATITIS B VACCINE ADULT 20 MCG	$107.10	$153.00	$32.99–$73.64	—	30%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 HEP B VAC RECOMB 20MCG/ML 1ML INJ	$211.78	$302.54	$65.23–$73.64	—	30%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 CL-FLU AGE 65+	$73.50	$105.00	$22.64–$96.20	4% above	30%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662 CL-FLU AGE 65+	$73.50	$105.00	$22.64–$96.20	—	30%
MMR vaccine (measles, mumps and rubella), live CPT 90707 CL-MMR VACCINE	$95.90	$137.00	$29.54	52% below	30%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 CL-MMR VACCINE	$95.90	$137.00	$29.54	—	30%
Meningococcal ACWY (MenACWY) vaccine CPT 90734 CL-MENINGOCOCCAL CONJ VACCINE (MENACTRA)	$174.30	$249.00	$53.68	27% below	30%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 CL-MENINGOCOCCAL CONJ VACCINE (MENACTRA)	$174.30	$249.00	$53.68	—	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 CL-PREVNAR 20 VACCINE, IM	$239.40	$342.00	$73.74–$306.64	33% below	30%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677 CL-PREVNAR 20 VACCINE, IM	$239.40	$342.00	$73.74–$306.64	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 CL-PNEUMOVAX 23 PNEUMOCOCCAL VACCINE	$165.20	$236.00	$50.88–$130.80	at median	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PNEUMOVAX 23 INJ 0.5ML	$410.77	$586.82	$126.52–$130.80	150% above	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 CL-PNEUMOVAX 23 PNEUMOCOCCAL VACCINE	$165.20	$236.00	$50.88–$130.80	—	30%
Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX 23 INJ 0.5ML	$410.77	$586.82	$126.52–$130.80	—	30%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 CL-SHINGRIX VACCINE	$193.20	$276.00	$59.51	4% above	30%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 CL-SHINGRIX VACCINE	$193.20	$276.00	$59.51	—	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 CL-TD PRESERV FREE >7	$43.40	$62.00	$13.37–$38.19	44% below	30%
Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 CL-TD PRESERV FREE >7	$43.40	$62.00	$13.37–$38.19	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 CL-BOOSTRIX (TET-DIPTH-PERTUSS) >7 YRS	$65.10	$93.00	$20.05–$38.90	35% below	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TETANUS TOX/DIPHTH/PERTUS INJ (BOOSTRIX)	$187.95	$268.50	$38.90–$57.89	88% above	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 CL-BOOSTRIX (TET-DIPTH-PERTUSS) >7 YRS	$65.10	$93.00	$20.05–$38.90	—	30%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TETANUS TOX/DIPHTH/PERTUS INJ (BOOSTRIX)	$187.95	$268.50	$38.90–$57.89	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ADMIN SINGLE IMMUNIZATION	$31.50	$45.00	$9.70–$20.42	44% below	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUN ADMIN, ONE VACCINE	$112.78	$161.12	$20.42–$34.74	102% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$112.78	$161.12	$20.42–$34.74	102% above	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ADMIN SINGLE IMMUNIZATION	$31.50	$45.00	$9.70–$20.42	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUN ADMIN, ONE VACCINE	$112.78	$161.12	$20.42–$34.74	—	30%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN 1 VACCINE	$112.78	$161.12	$20.42–$34.74	—	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 ADMIN ADDITIONAL VACCINE EACH	$20.30	$29.00	$6.25–$14.98	45% below	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMINISTRATION EA ADDL	$68.12	$97.31	$14.98–$20.98	86% above	30%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EA ADDL	$68.12	$97.31	$14.98–$20.98	86% above	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 ADMIN ADDITIONAL VACCINE EACH	$20.30	$29.00	$6.25–$14.98	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EA ADDL	$68.12	$97.31	$14.98–$20.98	—	30%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMINISTRATION EA ADDL	$68.12	$97.31	$14.98–$20.98	—	30%

Source file: https://hopedalemc.com/docs/370808925_hopedale-medical-foundation_standardcharges.csv