Hospital

Sioux Center Health

Sioux Center Health in Sioux Center, IA publishes cash prices for 367 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 Iowa median for 183 of 367 procedures and above it for 179. By typical cash price it ranks #44 of 85 Iowa hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

1101 9th St SE, Sioux Center, IA, 51250 Collected Sep 28, 2026 Source price file (712) 722-1271

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 161346 · CMS hospital register

CMS price transparency record

The federal Centers for Medicare & Medicaid Services (CMS) enforces the rule that makes hospitals publish their prices. Its public enforcement list shows 3 actions for a hospital named Sioux Center Health in Sioux Center, IA:

Sep 17, 2024 Warning notice
Dec 20, 2024 Case closed
Jul 2, 2025 Met requirements

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Case closed: CMS closed the case after the hospital addressed the problems. Met requirements: CMS reviewed the hospital and found it met the requirements, so no further action was taken.

A notice records a step in a CMS review; it is not a court finding. Source: CMS, Hospital Price Transparency Enforcement Activities and Outcomes, actions through Jul 31, 2026.

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Abdominal CT scan without and with contrast CPT 74170	$1,746.97	$1,801.00	$58.22–$1,746.97	11% below	3%
Abdominal CT scan without and with contrast inpatient CPT 74170	$1,746.97	$1,801.00	$1,170.65–$1,746.97	—	3%
Abdominal X-ray, 2 views CPT 74019	$240.56	$248.00	$211.54–$660.48	4% below	3%
Abdominal X-ray, 2 views inpatient CPT 74019	$240.56	$248.00	$161.20–$240.56	—	3%
Ankle X-ray, complete, 3 or more views one side CPT 73610	$37.83	$39.00	$14.35–$85.33	83% below	3%
Ankle X-ray, complete, 3 or more views one side CPT 73610	$37.83	$39.00	$14.35–$85.33	83% below	3%
Ankle X-ray, complete, 3 or more views one side CPT 73610	$170.72	$176.00	$99.63–$170.72	23% below	3%
Ankle X-ray, complete, 3 or more views one side CPT 73610	$170.72	$176.00	$99.63–$170.72	23% below	3%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610	$37.83	$39.00	$14.35–$85.33	—	3%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610	$37.83	$39.00	$14.35–$85.33	—	3%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610	$170.72	$176.00	$114.40–$170.72	—	3%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610	$170.72	$176.00	$114.40–$170.72	—	3%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922	$419.04	$432.00	$287.28–$419.04	24% above	3%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922	$419.04	$432.00	$280.80–$419.04	—	3%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200	$228.92	$236.00	$80.96–$389.40	81% below	3%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200	$228.92	$236.00	$80.96–$389.40	81% below	3%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200	$978.73	$1,009.00	$70.19–$978.73	19% below	3%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200	$978.73	$1,009.00	$70.19–$978.73	19% below	3%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200	$228.92	$236.00	$80.96–$389.40	—	3%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200	$228.92	$236.00	$80.96–$389.40	—	3%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200	$978.73	$1,009.00	$655.85–$978.73	—	3%
Arm CT scan without contrast (shoulder to hand, any part) inpatient one side CPT 73200	$978.73	$1,009.00	$655.85–$978.73	—	3%
Barium swallow (esophagus X-ray with contrast) CPT 74220	$259.96	$268.00	$228.60–$357.53	28% below	3%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220	$259.96	$268.00	$174.20–$259.96	—	3%
Bone scan, whole body (nuclear medicine) CPT 78306	$1,007.83	$1,039.00	$690.93–$1,007.83	18% below	3%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306	$1,007.83	$1,039.00	$675.35–$1,007.83	—	3%
Breast ultrasound, complete, one breast one side CPT 76641	$121.25	$125.00	$59.76–$240.47	66% below	3%
Breast ultrasound, complete, one breast one side CPT 76641	$124.16	$128.00	$59.76–$240.47	65% below	3%
Breast ultrasound, complete, one breast one side CPT 76641	$349.20	$360.00	$239.40–$349.20	3% below	3%
Breast ultrasound, complete, one breast one side CPT 76641	$349.20	$360.00	$239.40–$349.20	3% below	3%
Breast ultrasound, complete, one breast inpatient one side CPT 76641	$121.25	$125.00	$59.76–$240.47	—	3%
Breast ultrasound, complete, one breast inpatient one side CPT 76641	$124.16	$128.00	$59.76–$240.47	—	3%
Breast ultrasound, complete, one breast inpatient one side CPT 76641	$349.20	$360.00	$234.00–$349.20	—	3%
Breast ultrasound, complete, one breast inpatient one side CPT 76641	$349.20	$360.00	$234.00–$349.20	—	3%
Breast ultrasound, limited (one breast or one area) one side CPT 76642	$176.54	$182.00	$55.64–$198.58	52% below	3%
Breast ultrasound, limited (one breast or one area) one side CPT 76642	$176.54	$182.00	$55.64–$198.58	52% below	3%
Breast ultrasound, limited (one breast or one area) one side CPT 76642	$288.09	$297.00	$197.50–$288.09	21% below	3%
Breast ultrasound, limited (one breast or one area) one side CPT 76642	$288.09	$297.00	$197.50–$288.09	21% below	3%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642	$176.54	$182.00	$55.64–$198.58	—	3%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642	$176.54	$182.00	$55.64–$198.58	—	3%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642	$288.09	$297.00	$193.05–$288.09	—	3%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642	$288.09	$297.00	$193.05–$288.09	—	3%
CT angiography (CTA) of the abdomen and pelvis CPT 74174	$2,709.21	$2,793.00	$71.13–$2,709.21	9% below	3%
CT angiography (CTA) of the abdomen and pelvis inpatient CPT 74174	$2,709.21	$2,793.00	$1,815.45–$2,709.21	—	3%
CT angiography (CTA) of the head CPT 70496	$1,845.91	$1,903.00	$246.84–$1,845.91	5% below	3%
CT angiography (CTA) of the head inpatient CPT 70496	$1,845.91	$1,903.00	$1,236.95–$1,845.91	—	3%
CT angiography (CTA) of the neck CPT 70498	$1,860.46	$1,918.00	$278.39–$1,860.46	11% below	3%
CT angiography (CTA) of the neck inpatient CPT 70498	$1,860.46	$1,918.00	$1,246.70–$1,860.46	—	3%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275	$2,151.46	$2,218.00	$65.60–$2,151.46	1% above	3%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275	$2,151.46	$2,218.00	$1,441.70–$2,151.46	—	3%
CT scan of abdomen and pelvis, no contrast dye CPT 74176	$1,487.98	$1,534.00	$95.04–$1,487.98	43% below	3%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176	$1,487.98	$1,534.00	$997.10–$1,487.98	—	3%
CT scan of abdomen and pelvis, with contrast dye CPT 74177	$1,338.60	$1,380.00	$227.52–$1,338.60	58% below	3%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177	$1,338.60	$1,380.00	$897.00–$1,338.60	—	3%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178	$2,004.99	$2,067.00	$479.88–$2,004.99	41% below	3%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178	$2,004.99	$2,067.00	$1,343.55–$2,004.99	—	3%
CT scan of the abdomen with contrast CPT 74160	$1,513.20	$1,560.00	$706.77–$1,513.20	10% below	3%
CT scan of the abdomen with contrast inpatient CPT 74160	$1,513.20	$1,560.00	$1,014.00–$1,513.20	—	3%
CT scan of the abdomen without contrast CPT 74150	$1,110.65	$1,145.00	$791.13–$1,110.65	16% below	3%
CT scan of the abdomen without contrast inpatient CPT 74150	$1,110.65	$1,145.00	$744.25–$1,110.65	—	3%
CT scan of the face and sinuses, no contrast dye CPT 70486	$1,606.32	$1,656.00	$187.95–$1,606.32	25% above	3%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486	$1,606.32	$1,656.00	$1,076.40–$1,606.32	—	3%
CT scan of the head or brain, no contrast dye CPT 70450	$1,255.18	$1,294.00	$24.20–$1,255.18	6% below	3%
CT scan of the head or brain, no contrast dye inpatient CPT 70450	$1,255.18	$1,294.00	$841.10–$1,255.18	—	3%
CT scan of the head without and with contrast CPT 70470	$1,810.02	$1,866.00	$241.32–$1,810.02	at median	3%
CT scan of the head without and with contrast inpatient CPT 70470	$1,810.02	$1,866.00	$1,212.90–$1,810.02	—	3%
CT scan of the lower back (lumbar spine) without contrast CPT 72131	$1,472.46	$1,518.00	$234.87–$1,472.46	3% below	3%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131	$1,472.46	$1,518.00	$986.70–$1,472.46	—	3%
CT scan of the neck (cervical spine), no contrast dye CPT 72125	$1,351.21	$1,393.00	$172.58–$1,351.21	10% below	3%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125	$1,351.21	$1,393.00	$905.45–$1,351.21	—	3%
CT scan of the pelvis, with contrast dye CPT 72193	$1,368.67	$1,411.00	$593.33–$1,368.67	21% below	3%
CT scan of the pelvis, with contrast dye inpatient CPT 72193	$1,368.67	$1,411.00	$917.15–$1,368.67	—	3%
Carotid artery ultrasound (duplex), both sides of the neck CPT 93880	$924.41	$953.00	$633.75–$924.41	6% above	3%
Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880	$924.41	$953.00	$619.45–$924.41	—	3%
Chest CT scan without and with contrast CPT 71270	$1,992.38	$2,054.00	$82.17–$1,992.38	3% above	3%
Chest CT scan without and with contrast inpatient CPT 71270	$1,992.38	$2,054.00	$1,335.10–$1,992.38	—	3%
Chest X-ray, 2 views CPT 71046	$157.14	$162.00	$138.19–$783.14	24% below	3%
Chest X-ray, 2 views inpatient CPT 71046	$157.14	$162.00	$105.30–$157.14	—	3%
Chest X-ray, single view CPT 71045	$170.72	$176.00	$150.13–$593.33	2% above	3%
Chest X-ray, single view inpatient CPT 71045	$170.72	$176.00	$114.40–$170.72	—	3%
Collarbone (clavicle) X-ray, complete one side CPT 73000	$36.86	$38.00	$13.76–$76.02	80% below	3%
Collarbone (clavicle) X-ray, complete one side CPT 73000	$36.86	$38.00	$13.76–$76.02	80% below	3%
Collarbone (clavicle) X-ray, complete one side CPT 73000	$130.95	$135.00	$115.16–$187.04	30% below	3%
Collarbone (clavicle) X-ray, complete one side CPT 73000	$130.95	$135.00	$115.16–$187.04	30% below	3%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000	$36.86	$38.00	$13.76–$76.02	—	3%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000	$36.86	$38.00	$13.76–$76.02	—	3%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000	$130.95	$135.00	$87.75–$130.95	—	3%
Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000	$130.95	$135.00	$87.75–$130.95	—	3%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770	$391.88	$404.00	$268.66–$391.88	36% below	3%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770	$391.88	$404.00	$262.60–$391.88	—	3%
DEXA bone density scan of the hip, pelvis or spine CPT 77080	$484.03	$499.00	$88.61–$484.03	22% above	3%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080	$484.03	$499.00	$324.35–$484.03	—	3%
Diagnostic CT scan of the chest, no contrast dye CPT 71250	$1,300.77	$1,341.00	$71.13–$1,300.77	6% below	3%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250	$1,300.77	$1,341.00	$871.65–$1,300.77	—	3%
Diagnostic CT scan of the chest, with contrast dye CPT 71260	$1,530.66	$1,578.00	$80.31–$1,530.66	14% below	3%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260	$1,530.66	$1,578.00	$1,025.70–$1,530.66	—	3%
Diagnostic mammogram, both breasts CPT 77066	$446.20	$460.00	$305.90–$446.20	25% above	3%
Diagnostic mammogram, both breasts inpatient CPT 77066	$446.20	$460.00	$299.00–$446.20	—	3%
Diagnostic mammogram, one breast one side CPT 77065	$308.46	$318.00	$211.47–$308.46	6% above	3%
Diagnostic mammogram, one breast one side CPT 77065	$308.46	$318.00	$211.47–$308.46	6% above	3%
Diagnostic mammogram, one breast inpatient one side CPT 77065	$308.46	$318.00	$206.70–$308.46	—	3%
Diagnostic mammogram, one breast inpatient one side CPT 77065	$308.46	$318.00	$206.70–$308.46	—	3%
Duplex ultrasound of the leg arteries, both legs CPT 93925	$879.79	$907.00	$603.15–$879.79	22% above	3%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925	$879.79	$907.00	$589.55–$879.79	—	3%
Duplex ultrasound of the leg veins, both legs CPT 93970	$1,011.71	$1,043.00	$693.60–$1,011.71	14% above	3%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970	$1,011.71	$1,043.00	$677.95–$1,011.71	—	3%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306	$1,044.69	$1,077.00	$716.21–$1,044.69	32% below	3%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306	$1,044.69	$1,077.00	$700.05–$1,044.69	—	3%
Elbow X-ray, 2 views one side CPT 73070	$32.01	$33.00	$13.76–$68.26	80% below	3%
Elbow X-ray, 2 views one side CPT 73070	$32.01	$33.00	$13.76–$68.26	80% below	3%
Elbow X-ray, 2 views one side CPT 73070	$131.92	$136.00	$41.69–$131.92	16% below	3%
Elbow X-ray, 2 views one side CPT 73070	$131.92	$136.00	$41.69–$131.92	16% below	3%
Elbow X-ray, 2 views inpatient one side CPT 73070	$32.01	$33.00	$13.76–$68.26	—	3%
Elbow X-ray, 2 views inpatient one side CPT 73070	$32.01	$33.00	$13.76–$68.26	—	3%
Elbow X-ray, 2 views inpatient one side CPT 73070	$131.92	$136.00	$88.40–$131.92	—	3%
Elbow X-ray, 2 views inpatient one side CPT 73070	$131.92	$136.00	$88.40–$131.92	—	3%
Elbow X-ray, complete, 3 or more views one side CPT 73080	$43.65	$45.00	$14.35–$76.79	80% below	3%
Elbow X-ray, complete, 3 or more views one side CPT 73080	$43.65	$45.00	$14.35–$76.79	80% below	3%
Elbow X-ray, complete, 3 or more views one side CPT 73080	$144.53	$149.00	$38.91–$144.53	33% below	3%
Elbow X-ray, complete, 3 or more views one side CPT 73080	$144.53	$149.00	$38.91–$144.53	33% below	3%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080	$43.65	$45.00	$14.35–$76.79	—	3%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080	$43.65	$45.00	$14.35–$76.79	—	3%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080	$144.53	$149.00	$96.85–$144.53	—	3%
Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080	$144.53	$149.00	$96.85–$144.53	—	3%
Eye socket (orbit) CT scan without contrast CPT 70480	$1,117.44	$1,152.00	$192.56–$1,117.44	14% below	3%
Eye socket (orbit) CT scan without contrast inpatient CPT 70480	$1,117.44	$1,152.00	$748.80–$1,117.44	—	3%
Facial bones X-ray, complete, 3 or more views CPT 70150	$204.67	$211.00	$82.17–$204.67	24% below	3%
Facial bones X-ray, complete, 3 or more views inpatient CPT 70150	$204.67	$211.00	$137.15–$204.67	—	3%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090	$37.83	$39.00	$13.18–$68.26	80% below	3%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090	$37.83	$39.00	$13.18–$68.26	80% below	3%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090	$140.65	$145.00	$123.69–$282.72	27% below	3%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090	$140.65	$145.00	$123.69–$282.72	27% below	3%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090	$37.83	$39.00	$13.18–$68.26	—	3%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090	$37.83	$39.00	$13.18–$68.26	—	3%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090	$140.65	$145.00	$94.25–$140.65	—	3%
Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090	$140.65	$145.00	$94.25–$140.65	—	3%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226	$1,392.92	$1,436.00	$954.94–$1,392.92	16% above	3%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226	$1,392.92	$1,436.00	$933.40–$1,392.92	—	3%
Hand X-ray, 2 views one side CPT 73120	$32.01	$33.00	$13.76–$73.69	80% below	3%
Hand X-ray, 2 views one side CPT 73120	$32.01	$33.00	$13.76–$73.69	80% below	3%
Hand X-ray, 2 views one side CPT 73120	$130.95	$135.00	$115.16–$198.99	19% below	3%
Hand X-ray, 2 views inpatient one side CPT 73120	$32.01	$33.00	$13.76–$73.69	—	3%
Hand X-ray, 2 views inpatient one side CPT 73120	$32.01	$33.00	$13.76–$73.69	—	3%
Hand X-ray, 2 views inpatient one side CPT 73120	$130.95	$135.00	$87.75–$130.95	—	3%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650	$32.98	$34.00	$13.18–$66.71	80% below	3%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650	$32.98	$34.00	$13.18–$66.71	80% below	3%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650	$131.92	$136.00	$64.68–$131.92	21% below	3%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650	$131.92	$136.00	$64.68–$131.92	21% below	3%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650	$32.98	$34.00	$13.18–$66.71	—	3%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650	$32.98	$34.00	$13.18–$66.71	—	3%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650	$131.92	$136.00	$88.40–$131.92	—	3%
Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650	$131.92	$136.00	$88.40–$131.92	—	3%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811	$3,528.86	$3,638.00	$2,419.27–$3,528.86	12% above	3%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811	$3,528.86	$3,638.00	$2,364.70–$3,528.86	—	3%
Knee X-ray, 3 views one side CPT 73562	$43.65	$45.00	$15.53–$95.41	80% below	3%
Knee X-ray, 3 views one side CPT 73562	$43.65	$45.00	$15.53–$95.41	80% below	3%
Knee X-ray, 3 views one side CPT 73562	$156.17	$161.00	$109.76–$156.17	27% below	3%
Knee X-ray, 3 views one side CPT 73562	$156.17	$161.00	$109.76–$156.17	27% below	3%
Knee X-ray, 3 views inpatient one side CPT 73562	$43.65	$45.00	$15.53–$95.41	—	3%
Knee X-ray, 3 views inpatient one side CPT 73562	$43.65	$45.00	$15.53–$95.41	—	3%
Knee X-ray, 3 views inpatient one side CPT 73562	$156.17	$161.00	$104.65–$156.17	—	3%
Knee X-ray, 3 views inpatient one side CPT 73562	$156.17	$161.00	$104.65–$156.17	—	3%
Knee X-ray, complete, 4 or more views one side CPT 73564	$58.20	$60.00	$19.06–$110.93	79% below	3%
Knee X-ray, complete, 4 or more views one side CPT 73564	$58.20	$60.00	$19.06–$110.93	79% below	3%
Knee X-ray, complete, 4 or more views one side CPT 73564	$194.00	$200.00	$129.06–$194.00	29% below	3%
Knee X-ray, complete, 4 or more views one side CPT 73564	$194.00	$200.00	$129.06–$194.00	29% below	3%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564	$58.20	$60.00	$19.06–$110.93	—	3%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564	$58.20	$60.00	$19.06–$110.93	—	3%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564	$194.00	$200.00	$130.00–$194.00	—	3%
Knee X-ray, complete, 4 or more views inpatient one side CPT 73564	$194.00	$200.00	$130.00–$194.00	—	3%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700	$194.00	$200.00	$80.96–$311.06	85% below	3%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700	$197.88	$204.00	$80.96–$311.06	85% below	3%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700	$1,153.33	$1,189.00	$76.65–$1,153.33	14% below	3%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700	$1,153.33	$1,189.00	$76.65–$1,153.33	14% below	3%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700	$194.00	$200.00	$80.96–$311.06	—	3%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700	$197.88	$204.00	$80.96–$311.06	—	3%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700	$1,153.33	$1,189.00	$772.85–$1,153.33	—	3%
Leg CT scan without contrast (hip to foot, any part) inpatient one side CPT 73700	$1,153.33	$1,189.00	$772.85–$1,153.33	—	3%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705	$410.31	$423.00	$281.30–$410.31	15% below	3%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705	$410.31	$423.00	$274.95–$410.31	—	3%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882	$111.55	$115.00	$56.23–$146.61	68% below	3%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882	$111.55	$115.00	$56.23–$146.61	68% below	3%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882	$395.76	$408.00	$271.32–$395.76	13% above	3%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882	$395.76	$408.00	$271.32–$395.76	13% above	3%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882	$111.55	$115.00	$56.23–$146.61	—	3%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882	$111.55	$115.00	$56.23–$146.61	—	3%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882	$395.76	$408.00	$265.20–$395.76	—	3%
Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882	$395.76	$408.00	$265.20–$395.76	—	3%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271	$1,545.21	$1,593.00	$101.48–$1,545.21	257% above	3%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271	$1,545.21	$1,593.00	$1,035.45–$1,545.21	—	3%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590	$37.83	$39.00	$13.18–$73.69	80% below	3%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590	$37.83	$39.00	$13.18–$73.69	80% below	3%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590	$185.27	$191.00	$73.88–$185.27	3% below	3%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590	$185.27	$191.00	$73.88–$185.27	3% below	3%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590	$37.83	$39.00	$13.18–$73.69	—	3%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590	$37.83	$39.00	$13.18–$73.69	—	3%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590	$185.27	$191.00	$124.15–$185.27	—	3%
Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590	$185.27	$191.00	$124.15–$185.27	—	3%
MR angiography (MRA) of the head without contrast CPT 70544	$2,635.49	$2,717.00	$408.12–$2,635.49	16% above	3%
MR angiography (MRA) of the head without contrast inpatient CPT 70544	$2,635.49	$2,717.00	$1,766.05–$2,635.49	—	3%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721	$2,275.62	$2,346.00	$315.18–$2,275.62	1% above	3%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721	$2,275.62	$2,346.00	$315.18–$2,275.62	1% above	3%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721	$2,275.62	$2,346.00	$1,524.90–$2,275.62	—	3%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721	$2,275.62	$2,346.00	$1,524.90–$2,275.62	—	3%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723	$3,199.06	$3,298.00	$657.06–$3,199.06	1% above	3%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723	$3,199.06	$3,298.00	$657.06–$3,199.06	1% above	3%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723	$3,199.06	$3,298.00	$2,143.70–$3,199.06	—	3%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723	$3,199.06	$3,298.00	$2,143.70–$3,199.06	—	3%
MRI of the abdomen without contrast CPT 74181	$2,342.55	$2,415.00	$544.29–$2,342.55	13% above	3%
MRI of the abdomen without contrast inpatient CPT 74181	$2,342.55	$2,415.00	$1,569.75–$2,342.55	—	3%
MRI of the abdomen, without and then with contrast dye CPT 74183	$4,016.77	$4,141.00	$619.08–$4,016.77	18% above	3%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183	$4,016.77	$4,141.00	$2,691.65–$4,016.77	—	3%
MRI of the brain, no contrast dye CPT 70551	$2,777.11	$2,863.00	$447.03–$2,777.11	21% above	3%
MRI of the brain, no contrast dye inpatient CPT 70551	$2,777.11	$2,863.00	$1,860.95–$2,777.11	—	3%
MRI of the brain, with and without contrast dye CPT 70553	$4,304.86	$4,438.00	$729.77–$4,304.86	22% above	3%
MRI of the brain, with and without contrast dye inpatient CPT 70553	$4,304.86	$4,438.00	$2,884.70–$4,304.86	—	3%
MRI of the lower back, no contrast dye CPT 72148	$2,655.86	$2,738.00	$315.18–$2,655.86	11% above	3%
MRI of the lower back, no contrast dye inpatient CPT 72148	$2,655.86	$2,738.00	$1,779.70–$2,655.86	—	3%
MRI of the lower back, without and then with contrast dye CPT 72158	$3,848.96	$3,968.00	$340.97–$3,848.96	12% above	3%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158	$3,848.96	$3,968.00	$2,579.20–$3,848.96	—	3%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146	$2,663.62	$2,746.00	$390.63–$2,663.62	15% above	3%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146	$2,663.62	$2,746.00	$1,784.90–$2,663.62	—	3%
MRI of the neck (cervical spine) without and with contrast CPT 72156	$3,915.89	$4,037.00	$340.05–$3,915.89	19% above	3%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156	$3,915.89	$4,037.00	$2,624.05–$3,915.89	—	3%
MRI of the neck (cervical spine), no contrast dye CPT 72141	$2,452.16	$2,528.00	$233.96–$2,452.16	8% above	3%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141	$2,452.16	$2,528.00	$1,643.20–$2,452.16	—	3%
MRI of the pelvis without and with contrast CPT 72197	$4,008.04	$4,132.00	$618.17–$4,008.04	24% above	3%
MRI of the pelvis without and with contrast inpatient CPT 72197	$4,008.04	$4,132.00	$2,685.80–$4,008.04	—	3%
MRI of the pelvis, no contrast dye CPT 72195	$2,549.16	$2,628.00	$53.64–$2,549.16	24% above	3%
MRI of the pelvis, no contrast dye inpatient CPT 72195	$2,549.16	$2,628.00	$1,708.20–$2,549.16	—	3%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221	$2,258.16	$2,328.00	$408.12–$2,258.16	2% above	3%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221	$2,258.16	$2,328.00	$408.12–$2,258.16	2% above	3%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221	$2,258.16	$2,328.00	$1,513.20–$2,258.16	—	3%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221	$2,258.16	$2,328.00	$1,513.20–$2,258.16	—	3%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050	$248.32	$256.00	$218.37–$746.06	24% below	3%
Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050	$248.32	$256.00	$166.40–$248.32	—	3%
Neck soft tissue CT scan with contrast CPT 70491	$1,363.82	$1,406.00	$357.53–$1,363.82	15% below	3%
Neck soft tissue CT scan with contrast inpatient CPT 70491	$1,363.82	$1,406.00	$913.90–$1,363.82	—	3%
Neck soft tissue CT scan without contrast CPT 70490	$1,071.85	$1,105.00	$277.47–$1,071.85	15% below	3%
Neck soft tissue CT scan without contrast inpatient CPT 70490	$1,071.85	$1,105.00	$718.25–$1,071.85	—	3%
Neck soft tissue X-ray CPT 70360	$129.01	$133.00	$70.19–$129.01	26% below	3%
Neck soft tissue X-ray inpatient CPT 70360	$129.01	$133.00	$86.45–$129.01	—	3%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452	$1,469.55	$1,515.00	$1,007.48–$1,469.55	48% below	3%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452	$1,469.55	$1,515.00	$984.75–$1,469.55	—	3%
Pelvic CT scan without contrast CPT 72192	$1,191.16	$1,228.00	$597.02–$1,191.16	8% below	3%
Pelvic CT scan without contrast inpatient CPT 72192	$1,191.16	$1,228.00	$798.20–$1,191.16	—	3%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857	$293.91	$303.00	$201.50–$293.91	16% below	3%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857	$293.91	$303.00	$196.95–$293.91	—	3%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856	$455.90	$470.00	$312.55–$455.90	16% below	3%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856	$455.90	$470.00	$305.50–$455.90	—	3%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805	$550.96	$568.00	$377.72–$550.96	at median	3%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805	$550.96	$568.00	$369.20–$550.96	—	3%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801	$546.11	$563.00	$374.39–$546.11	19% above	3%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801	$546.11	$563.00	$365.95–$546.11	—	3%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815	$416.13	$429.00	$285.29–$416.13	23% above	3%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815	$416.13	$429.00	$278.85–$416.13	—	3%
Rib X-ray, one side, 2 views one side CPT 71100	$50.44	$52.00	$18.47–$85.33	76% below	3%
Rib X-ray, one side, 2 views one side CPT 71100	$50.44	$52.00	$18.47–$85.33	76% below	3%
Rib X-ray, one side, 2 views one side CPT 71100	$143.56	$148.00	$126.24–$3,616.49	32% below	3%
Rib X-ray, one side, 2 views one side CPT 71100	$143.56	$148.00	$126.24–$3,616.49	32% below	3%
Rib X-ray, one side, 2 views inpatient one side CPT 71100	$50.44	$52.00	$18.47–$85.33	—	3%
Rib X-ray, one side, 2 views inpatient one side CPT 71100	$50.44	$52.00	$18.47–$85.33	—	3%
Rib X-ray, one side, 2 views inpatient one side CPT 71100	$143.56	$148.00	$96.20–$143.56	—	3%
Rib X-ray, one side, 2 views inpatient one side CPT 71100	$143.56	$148.00	$96.20–$143.56	—	3%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101	$64.02	$66.00	$22.00–$98.51	78% below	3%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101	$64.02	$66.00	$22.00–$98.51	78% below	3%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101	$155.20	$160.00	$136.48–$3,427.98	46% below	3%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101	$155.20	$160.00	$136.48–$3,427.98	46% below	3%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101	$64.02	$66.00	$22.00–$98.51	—	3%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101	$64.02	$66.00	$22.00–$98.51	—	3%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101	$155.20	$160.00	$104.00–$155.20	—	3%
Rib X-ray, one side, with a chest view, 3 or more views inpatient one side CPT 71101	$155.20	$160.00	$104.00–$155.20	—	3%
Screening mammogram, both breasts CPT 77067	$384.12	$396.00	$263.34–$384.12	25% above	3%
Screening mammogram, both breasts one side CPT 77067	$93.12	$96.00	$62.12–$300.97	70% below	3%
Screening mammogram, both breasts one side CPT 77067	$318.16	$328.00	$218.12–$318.16	3% above	3%
Screening mammogram, both breasts one side CPT 77067	$318.16	$328.00	$218.12–$318.16	3% above	3%
Screening mammogram, both breasts inpatient CPT 77067	$384.12	$396.00	$257.40–$384.12	—	3%
Screening mammogram, both breasts inpatient one side CPT 77067	$93.12	$96.00	$62.12–$300.97	—	3%
Screening mammogram, both breasts inpatient one side CPT 77067	$318.16	$328.00	$213.20–$318.16	—	3%
Screening mammogram, both breasts inpatient one side CPT 77067	$318.16	$328.00	$213.20–$318.16	—	3%
Shoulder X-ray, complete, 2 or more views one side CPT 73030	$55.29	$57.00	$15.53–$81.45	76% below	3%
Shoulder X-ray, complete, 2 or more views one side CPT 73030	$55.29	$57.00	$15.53–$81.45	76% below	3%
Shoulder X-ray, complete, 2 or more views one side CPT 73030	$130.95	$135.00	$115.16–$237.65	43% below	3%
Shoulder X-ray, complete, 2 or more views one side CPT 73030	$130.95	$135.00	$115.16–$237.65	43% below	3%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030	$55.29	$57.00	$15.53–$81.45	—	3%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030	$55.29	$57.00	$15.53–$81.45	—	3%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030	$130.95	$135.00	$87.75–$130.95	—	3%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030	$130.95	$135.00	$87.75–$130.95	—	3%
Skull X-ray, fewer than 4 views CPT 70250	$131.92	$136.00	$94.25–$131.92	36% below	3%
Skull X-ray, fewer than 4 views inpatient CPT 70250	$131.92	$136.00	$88.40–$131.92	—	3%
Sleep study in a lab (polysomnography) CPT 95810	$3,012.82	$3,106.00	$2,065.49–$3,012.82	5% above	3%
Sleep study in a lab (polysomnography) inpatient CPT 95810	$3,012.82	$3,106.00	$2,018.90–$3,012.82	—	3%
Swallow study (modified barium swallow, video X-ray) CPT 74230	$295.85	$305.00	$260.17–$657.74	28% below	3%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230	$295.85	$305.00	$198.25–$295.85	—	3%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552	$46.56	$48.00	$14.94–$83.00	76% below	3%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552	$46.56	$48.00	$14.94–$83.00	76% below	3%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552	$102.82	$106.00	$90.42–$130.01	47% below	3%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552	$102.82	$106.00	$90.42–$130.01	47% below	3%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552	$46.56	$48.00	$14.94–$83.00	—	3%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552	$46.56	$48.00	$14.94–$83.00	—	3%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552	$102.82	$106.00	$68.90–$102.82	—	3%
Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552	$102.82	$106.00	$68.90–$102.82	—	3%
Thoracic spine (mid back) CT scan without contrast CPT 72128	$1,300.77	$1,341.00	$107.93–$1,300.77	6% below	3%
Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128	$1,300.77	$1,341.00	$871.65–$1,300.77	—	3%
Toe X-ray, 2 or more views one side CPT 73660	$29.10	$30.00	$10.82–$68.26	83% below	3%
Toe X-ray, 2 or more views one side CPT 73660	$30.07	$31.00	$10.82–$68.26	83% below	3%
Toe X-ray, 2 or more views one side CPT 73660	$126.10	$130.00	$66.51–$126.10	27% below	3%
Toe X-ray, 2 or more views one side CPT 73660	$126.10	$130.00	$66.51–$126.10	27% below	3%
Toe X-ray, 2 or more views inpatient one side CPT 73660	$29.10	$30.00	$10.82–$68.26	—	3%
Toe X-ray, 2 or more views inpatient one side CPT 73660	$30.07	$31.00	$10.82–$68.26	—	3%
Toe X-ray, 2 or more views inpatient one side CPT 73660	$126.10	$130.00	$84.50–$126.10	—	3%
Toe X-ray, 2 or more views inpatient one side CPT 73660	$126.10	$130.00	$84.50–$126.10	—	3%
Transvaginal pelvic ultrasound CPT 76830	$308.46	$318.00	$211.47–$308.46	40% below	3%
Transvaginal pelvic ultrasound inpatient CPT 76830	$308.46	$318.00	$206.70–$308.46	—	3%
Transvaginal ultrasound during pregnancy CPT 76817	$339.50	$350.00	$232.75–$339.50	25% below	3%
Transvaginal ultrasound during pregnancy inpatient CPT 76817	$339.50	$350.00	$227.50–$339.50	—	3%
Ultrasound of the abdomen, complete CPT 76700	$442.32	$456.00	$303.24–$442.32	36% below	3%
Ultrasound of the abdomen, complete inpatient CPT 76700	$442.32	$456.00	$296.40–$442.32	—	3%
Ultrasound of the scrotum and testicles CPT 76870	$454.93	$469.00	$311.88–$454.93	16% below	3%
Ultrasound of the scrotum and testicles inpatient CPT 76870	$454.93	$469.00	$304.85–$454.93	—	3%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536	$410.31	$423.00	$281.30–$410.31	12% below	3%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536	$410.31	$423.00	$274.95–$410.31	—	3%
Upper arm X-ray (humerus), 2 views one side CPT 73060	$43.65	$45.00	$13.18–$74.47	77% below	3%
Upper arm X-ray (humerus), 2 views one side CPT 73060	$43.65	$45.00	$13.18–$74.47	77% below	3%
Upper arm X-ray (humerus), 2 views one side CPT 73060	$183.33	$189.00	$67.44–$183.33	2% below	3%
Upper arm X-ray (humerus), 2 views one side CPT 73060	$183.33	$189.00	$67.44–$183.33	2% below	3%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060	$43.65	$45.00	$13.18–$74.47	—	3%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060	$43.65	$45.00	$13.18–$74.47	—	3%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060	$183.33	$189.00	$122.85–$183.33	—	3%
Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060	$183.33	$189.00	$122.85–$183.33	—	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971	$109.61	$113.00	$31.92–$261.48	83% below	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971	$112.52	$116.00	$31.92–$261.48	83% below	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971	$754.66	$778.00	$517.37–$754.66	16% above	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971	$754.66	$778.00	$517.37–$754.66	16% above	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971	$109.61	$113.00	$31.92–$261.48	—	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971	$112.52	$116.00	$31.92–$261.48	—	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971	$754.66	$778.00	$505.70–$754.66	—	3%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971	$754.66	$778.00	$505.70–$754.66	—	3%
Wrist X-ray, 2 views one side CPT 73100	$32.01	$33.00	$13.76–$79.12	82% below	3%
Wrist X-ray, 2 views one side CPT 73100	$32.01	$33.00	$13.76–$79.12	82% below	3%
Wrist X-ray, 2 views one side CPT 73100	$128.04	$132.00	$66.51–$128.04	30% below	3%
Wrist X-ray, 2 views one side CPT 73100	$128.04	$132.00	$66.51–$128.04	30% below	3%
Wrist X-ray, 2 views inpatient one side CPT 73100	$32.01	$33.00	$13.76–$79.12	—	3%
Wrist X-ray, 2 views inpatient one side CPT 73100	$32.01	$33.00	$13.76–$79.12	—	3%
Wrist X-ray, 2 views inpatient one side CPT 73100	$128.04	$132.00	$85.80–$128.04	—	3%
Wrist X-ray, 2 views inpatient one side CPT 73100	$128.04	$132.00	$85.80–$128.04	—	3%
Wrist X-ray, complete, 3 or more views one side CPT 73110	$36.86	$38.00	$14.35–$96.19	83% below	3%
Wrist X-ray, complete, 3 or more views one side CPT 73110	$36.86	$38.00	$14.35–$96.19	83% below	3%
Wrist X-ray, complete, 3 or more views one side CPT 73110	$161.02	$166.00	$58.22–$161.02	27% below	3%
Wrist X-ray, complete, 3 or more views one side CPT 73110	$161.02	$166.00	$58.22–$161.02	27% below	3%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110	$36.86	$38.00	$14.35–$96.19	—	3%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110	$36.86	$38.00	$14.35–$96.19	—	3%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110	$161.02	$166.00	$107.90–$161.02	—	3%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110	$161.02	$166.00	$107.90–$161.02	—	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502	$73.72	$76.00	$18.47–$111.70	65% below	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502	$73.72	$76.00	$18.47–$111.70	65% below	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502	$237.65	$245.00	$208.99–$860.42	14% above	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502	$237.65	$245.00	$208.99–$860.42	14% above	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502	$73.72	$76.00	$18.47–$111.70	—	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502	$73.72	$76.00	$18.47–$111.70	—	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502	$237.65	$245.00	$159.25–$237.65	—	3%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502	$237.65	$245.00	$159.25–$237.65	—	3%
X-ray of the abdomen, 1 view CPT 74018	$174.60	$180.00	$153.54–$523.40	1% below	3%
X-ray of the abdomen, 1 view inpatient CPT 74018	$174.60	$180.00	$117.00–$174.60	—	3%
X-ray of the ankle, 2 views one side CPT 73600	$35.89	$37.00	$13.18–$75.24	79% below	3%
X-ray of the ankle, 2 views one side CPT 73600	$35.89	$37.00	$13.18–$75.24	79% below	3%
X-ray of the ankle, 2 views one side CPT 73600	$161.02	$166.00	$86.75–$161.02	4% below	3%
X-ray of the ankle, 2 views one side CPT 73600	$161.02	$166.00	$86.75–$161.02	4% below	3%
X-ray of the ankle, 2 views inpatient one side CPT 73600	$35.89	$37.00	$13.18–$75.24	—	3%
X-ray of the ankle, 2 views inpatient one side CPT 73600	$35.89	$37.00	$13.18–$75.24	—	3%
X-ray of the ankle, 2 views inpatient one side CPT 73600	$161.02	$166.00	$107.90–$161.02	—	3%
X-ray of the ankle, 2 views inpatient one side CPT 73600	$161.02	$166.00	$107.90–$161.02	—	3%
X-ray of the finger(s), 2 or more views one side CPT 73140	$28.13	$29.00	$11.41–$89.21	83% below	3%
X-ray of the finger(s), 2 or more views one side CPT 73140	$28.13	$29.00	$11.41–$89.21	83% below	3%
X-ray of the finger(s), 2 or more views one side CPT 73140	$162.96	$168.00	$64.68–$162.96	3% below	3%
X-ray of the finger(s), 2 or more views one side CPT 73140	$162.96	$168.00	$64.68–$162.96	3% below	3%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140	$28.13	$29.00	$11.41–$89.21	—	3%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140	$28.13	$29.00	$11.41–$89.21	—	3%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140	$162.96	$168.00	$109.20–$162.96	—	3%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140	$162.96	$168.00	$109.20–$162.96	—	3%
X-ray of the foot, 2 views one side CPT 73620	$32.98	$34.00	$12.59–$66.71	80% below	3%
X-ray of the foot, 2 views one side CPT 73620	$32.98	$34.00	$12.59–$66.71	80% below	3%
X-ray of the foot, 2 views one side CPT 73620	$161.99	$167.00	$142.45–$212.82	at median	3%
X-ray of the foot, 2 views one side CPT 73620	$161.99	$167.00	$142.45–$212.82	at median	3%
X-ray of the foot, 2 views inpatient one side CPT 73620	$32.98	$34.00	$12.59–$66.71	—	3%
X-ray of the foot, 2 views inpatient one side CPT 73620	$32.98	$34.00	$12.59–$66.71	—	3%
X-ray of the foot, 2 views inpatient one side CPT 73620	$161.99	$167.00	$108.55–$161.99	—	3%
X-ray of the foot, 2 views inpatient one side CPT 73620	$161.99	$167.00	$108.55–$161.99	—	3%
X-ray of the foot, complete, 3 or more views one side CPT 73630	$37.83	$39.00	$13.76–$79.90	83% below	3%
X-ray of the foot, complete, 3 or more views one side CPT 73630	$37.83	$39.00	$13.76–$79.90	83% below	3%
X-ray of the foot, complete, 3 or more views one side CPT 73630	$170.72	$176.00	$65.60–$170.72	21% below	3%
X-ray of the foot, complete, 3 or more views one side CPT 73630	$170.72	$176.00	$65.60–$170.72	21% below	3%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630	$37.83	$39.00	$13.76–$79.90	—	3%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630	$37.83	$39.00	$13.76–$79.90	—	3%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630	$170.72	$176.00	$114.40–$170.72	—	3%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630	$170.72	$176.00	$114.40–$170.72	—	3%
X-ray of the hand, 3 or more views one side CPT 73130	$43.65	$45.00	$14.35–$86.88	79% below	3%
X-ray of the hand, 3 or more views one side CPT 73130	$43.65	$45.00	$14.35–$86.88	79% below	3%
X-ray of the hand, 3 or more views one side CPT 73130	$131.92	$136.00	$59.16–$131.92	35% below	3%
X-ray of the hand, 3 or more views one side CPT 73130	$131.92	$136.00	$59.16–$131.92	35% below	3%
X-ray of the hand, 3 or more views inpatient one side CPT 73130	$43.65	$45.00	$14.35–$86.88	—	3%
X-ray of the hand, 3 or more views inpatient one side CPT 73130	$43.65	$45.00	$14.35–$86.88	—	3%
X-ray of the hand, 3 or more views inpatient one side CPT 73130	$131.92	$136.00	$88.40–$131.92	—	3%
X-ray of the hand, 3 or more views inpatient one side CPT 73130	$131.92	$136.00	$88.40–$131.92	—	3%
X-ray of the knee, 1 or 2 views one side CPT 73560	$37.83	$39.00	$13.76–$79.90	81% below	3%
X-ray of the knee, 1 or 2 views one side CPT 73560	$37.83	$39.00	$13.76–$79.90	81% below	3%
X-ray of the knee, 1 or 2 views one side CPT 73560	$139.68	$144.00	$84.00–$139.68	29% below	3%
X-ray of the knee, 1 or 2 views one side CPT 73560	$139.68	$144.00	$84.00–$139.68	29% below	3%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560	$37.83	$39.00	$13.76–$79.90	—	3%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560	$37.83	$39.00	$13.76–$79.90	—	3%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560	$139.68	$144.00	$93.60–$139.68	—	3%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560	$139.68	$144.00	$93.60–$139.68	—	3%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100	$191.09	$197.00	$90.44–$191.09	33% below	3%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100	$191.09	$197.00	$128.05–$191.09	—	3%
X-ray of the lower back, 4 or more views CPT 72110	$225.04	$232.00	$67.44–$225.04	36% below	3%
X-ray of the lower back, 4 or more views inpatient CPT 72110	$225.04	$232.00	$150.80–$225.04	—	3%
X-ray of the mid back (thoracic spine), 2 views CPT 72070	$188.18	$194.00	$165.48–$1,015.91	24% below	3%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070	$188.18	$194.00	$126.10–$188.18	—	3%
X-ray of the nasal bones, 3 or more views CPT 70160	$175.57	$181.00	$86.75–$175.57	11% below	3%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160	$175.57	$181.00	$117.65–$175.57	—	3%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040	$204.67	$211.00	$179.98–$551.93	17% below	3%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040	$204.67	$211.00	$137.15–$204.67	—	3%
X-ray of the pelvis, 1 or 2 views CPT 72170	$139.68	$144.00	$122.83–$341.88	29% below	3%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170	$139.68	$144.00	$93.60–$139.68	—	3%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220	$142.59	$147.00	$125.39–$447.69	35% below	3%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220	$142.59	$147.00	$95.55–$142.59	—	3%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
ACTH blood test CPT 82024	$232.80	$240.00	$159.60–$232.80	40% above	3%
ACTH blood test inpatient CPT 82024	$232.80	$240.00	$156.00–$232.80	—	3%
ALT (alanine aminotransferase) liver enzyme test CPT 84460	$54.32	$56.00	$37.24–$54.32	25% above	3%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460	$54.32	$56.00	$36.40–$54.32	—	3%
AST (aspartate aminotransferase) enzyme test CPT 84450	$62.08	$64.00	$42.56–$62.08	54% above	3%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450	$62.08	$64.00	$41.60–$62.08	—	3%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074	$336.59	$347.00	$230.75–$336.59	43% above	3%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074	$336.59	$347.00	$225.55–$336.59	—	3%
Albumin blood test CPT 82040	$46.56	$48.00	$31.92–$46.56	29% above	3%
Albumin blood test inpatient CPT 82040	$46.56	$48.00	$31.20–$46.56	—	3%
Aldosterone blood test CPT 82088	$202.73	$209.00	$138.99–$202.73	16% above	3%
Aldosterone blood test inpatient CPT 82088	$202.73	$209.00	$135.85–$202.73	—	3%
Alkaline phosphatase (ALP) blood test CPT 84075	$32.01	$33.00	$21.95–$32.01	22% below	3%
Alkaline phosphatase (ALP) blood test inpatient CPT 84075	$32.01	$33.00	$21.45–$32.01	—	3%
Allergy blood test, specific IgE, per allergen CPT 86003	$36.86	$38.00	$25.27–$36.86	5% below	3%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003	$36.86	$38.00	$24.70–$36.86	—	3%
Alpha-fetoprotein (AFP) blood test CPT 82105	$156.17	$161.00	$107.06–$156.17	74% above	3%
Alpha-fetoprotein (AFP) blood test inpatient CPT 82105	$156.17	$161.00	$104.65–$156.17	—	3%
Ammonia blood test CPT 82140	$144.53	$149.00	$99.08–$144.53	64% above	3%
Ammonia blood test inpatient CPT 82140	$144.53	$149.00	$96.85–$144.53	—	3%
Amylase blood test CPT 82150	$93.12	$96.00	$63.84–$93.12	74% above	3%
Amylase blood test inpatient CPT 82150	$93.12	$96.00	$62.40–$93.12	—	3%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200	$145.50	$150.00	$99.75–$145.50	84% above	3%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200	$145.50	$150.00	$97.50–$145.50	—	3%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880	$222.13	$229.00	$152.28–$222.13	42% above	3%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880	$222.13	$229.00	$148.85–$222.13	—	3%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070	$119.31	$123.00	$81.80–$119.31	98% above	3%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070	$119.31	$123.00	$79.95–$119.31	—	3%
Basic metabolic panel (blood test) CPT 80048	$145.50	$150.00	$99.75–$145.50	68% above	3%
Basic metabolic panel (blood test) inpatient CPT 80048	$145.50	$150.00	$97.50–$145.50	—	3%
Bilirubin blood test, total CPT 82247	$70.81	$73.00	$48.55–$70.81	55% above	3%
Bilirubin blood test, total inpatient CPT 82247	$70.81	$73.00	$47.45–$70.81	—	3%
Biopsy tissue exam by a pathologist (level IV) CPT 88305	$441.35	$455.00	$302.57–$441.35	148% above	3%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305	$441.35	$455.00	$295.75–$441.35	—	3%
Blood culture for bacteria CPT 87040	$164.90	$170.00	$113.05–$164.90	80% above	3%
Blood culture for bacteria inpatient CPT 87040	$164.90	$170.00	$110.50–$164.90	—	3%
Blood draw from a vein (venipuncture), collection fee only CPT 36415	$24.25	$25.00	$16.62–$24.25	15% above	3%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415	$24.25	$25.00	$16.25–$24.25	—	3%
Blood glucose (sugar) test CPT 82947	$65.96	$68.00	$45.22–$65.96	96% above	3%
Blood glucose (sugar) test inpatient CPT 82947	$65.96	$68.00	$44.20–$65.96	—	3%
Blood lead test CPT 83655	$92.15	$95.00	$63.17–$92.15	70% above	3%
Blood lead test inpatient CPT 83655	$92.15	$95.00	$61.75–$92.15	—	3%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703	$129.01	$133.00	$88.44–$129.01	108% above	3%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703	$129.01	$133.00	$86.45–$129.01	—	3%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900	$44.62	$46.00	$30.59–$44.62	22% below	3%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900	$44.62	$46.00	$29.90–$44.62	—	3%
Blood urea nitrogen (BUN) test CPT 84520	$61.11	$63.00	$41.90–$61.11	82% above	3%
Blood urea nitrogen (BUN) test inpatient CPT 84520	$61.11	$63.00	$40.95–$61.11	—	3%
C-peptide blood test CPT 84681	$218.25	$225.00	$149.62–$218.25	107% above	3%
C-peptide blood test inpatient CPT 84681	$218.25	$225.00	$146.25–$218.25	—	3%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140	$88.27	$91.00	$60.52–$88.27	51% above	3%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140	$88.27	$91.00	$59.15–$88.27	—	3%
C. difficile toxin gene test (stool PCR) CPT 87493	$159.08	$164.00	$109.06–$159.08	47% above	3%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493	$159.08	$164.00	$106.60–$159.08	—	3%
CA 19-9 blood test (tumor marker) CPT 86301	$182.36	$188.00	$125.02–$182.36	87% above	3%
CA 19-9 blood test (tumor marker) inpatient CPT 86301	$182.36	$188.00	$122.20–$182.36	—	3%
CA-125 blood test (ovarian cancer marker) CPT 86304	$190.12	$196.00	$130.34–$190.12	66% above	3%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304	$190.12	$196.00	$127.40–$190.12	—	3%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635	$135.80	$140.00	$93.10–$135.80	15% above	3%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635	$135.80	$140.00	$91.00–$135.80	—	3%
Calcium blood test, total CPT 82310	$56.26	$58.00	$38.57–$56.26	40% above	3%
Calcium blood test, total inpatient CPT 82310	$56.26	$58.00	$37.70–$56.26	—	3%
Carcinoembryonic antigen (CEA) test CPT 82378	$185.27	$191.00	$127.02–$185.27	75% above	3%
Carcinoembryonic antigen (CEA) test inpatient CPT 82378	$185.27	$191.00	$124.15–$185.27	—	3%
Chickenpox (varicella) immunity blood test CPT 86787	$129.98	$134.00	$89.11–$129.98	103% above	3%
Chickenpox (varicella) immunity blood test inpatient CPT 86787	$129.98	$134.00	$87.10–$129.98	—	3%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491	$139.68	$144.00	$95.76–$139.68	40% above	3%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491	$139.68	$144.00	$93.60–$139.68	—	3%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061	$132.89	$137.00	$91.11–$132.89	52% above	3%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061	$132.89	$137.00	$89.05–$132.89	—	3%
Complete blood count (CBC) with differential CPT 85025	$105.73	$109.00	$72.48–$105.73	68% above	3%
Complete blood count (CBC) with differential inpatient CPT 85025	$105.73	$109.00	$70.85–$105.73	—	3%
Complete blood count (CBC), no differential CPT 85027	$78.57	$81.00	$53.87–$78.57	72% above	3%
Complete blood count (CBC), no differential inpatient CPT 85027	$78.57	$81.00	$52.65–$78.57	—	3%
Comprehensive metabolic panel (blood test) CPT 80053	$171.69	$177.00	$117.70–$171.69	39% above	3%
Comprehensive metabolic panel (blood test) inpatient CPT 80053	$171.69	$177.00	$115.05–$171.69	—	3%
Cortisol blood test, total CPT 82533	$114.46	$118.00	$78.47–$114.46	14% above	3%
Cortisol blood test, total inpatient CPT 82533	$114.46	$118.00	$76.70–$114.46	—	3%
Creatine kinase (CK) blood test, total CPT 82550	$82.45	$85.00	$56.52–$82.45	69% above	3%
Creatine kinase (CK) blood test, total inpatient CPT 82550	$82.45	$85.00	$55.25–$82.45	—	3%
Creatinine blood test CPT 82565	$61.11	$63.00	$41.90–$61.11	71% above	3%
Creatinine blood test inpatient CPT 82565	$61.11	$63.00	$40.95–$61.11	—	3%
Cytomegalovirus (CMV) antibody test CPT 86644	$147.44	$152.00	$101.08–$147.44	118% above	3%
Cytomegalovirus (CMV) antibody test inpatient CPT 86644	$147.44	$152.00	$98.80–$147.44	—	3%
D-dimer blood test (blood clot marker) CPT 85379	$131.92	$136.00	$90.44–$131.92	55% above	3%
D-dimer blood test (blood clot marker) inpatient CPT 85379	$131.92	$136.00	$88.40–$131.92	—	3%
DHEA sulfate (DHEA-S) blood test CPT 82627	$193.03	$199.00	$132.34–$193.03	67% above	3%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627	$193.03	$199.00	$129.35–$193.03	—	3%
Drug screen by lab instrument (any number of drug classes) CPT 80307	$150.35	$155.00	$103.08–$150.35	19% above	3%
Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307	$150.35	$155.00	$100.75–$150.35	—	3%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051	$85.36	$88.00	$58.52–$85.36	25% above	3%
Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051	$85.36	$88.00	$57.20–$85.36	—	3%
Epstein-Barr virus (EBV) antibody test CPT 86665	$163.93	$169.00	$112.39–$163.93	128% above	3%
Epstein-Barr virus (EBV) antibody test inpatient CPT 86665	$163.93	$169.00	$109.85–$163.93	—	3%
Estradiol blood test CPT 82670	$202.73	$209.00	$138.99–$202.73	57% above	3%
Estradiol blood test inpatient CPT 82670	$202.73	$209.00	$135.85–$202.73	—	3%
FSH (follicle-stimulating hormone) test CPT 83001	$145.50	$150.00	$99.75–$145.50	42% above	3%
FSH (follicle-stimulating hormone) test inpatient CPT 83001	$145.50	$150.00	$97.50–$145.50	—	3%
Fecal calprotectin (stool inflammation test) CPT 83993	$331.74	$342.00	$227.43–$331.74	107% above	3%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993	$331.74	$342.00	$222.30–$331.74	—	3%
Ferritin blood test (iron stores) CPT 82728	$129.98	$134.00	$89.11–$129.98	45% above	3%
Ferritin blood test (iron stores) inpatient CPT 82728	$129.98	$134.00	$87.10–$129.98	—	3%
Fibrinogen blood test CPT 85384	$103.79	$107.00	$71.16–$103.79	57% above	3%
Fibrinogen blood test inpatient CPT 85384	$103.79	$107.00	$69.55–$103.79	—	3%
Folate (folic acid) blood test CPT 82746	$129.01	$133.00	$88.44–$129.01	47% above	3%
Folate (folic acid) blood test inpatient CPT 82746	$129.01	$133.00	$86.45–$129.01	—	3%
Free T3 thyroid hormone test CPT 84481	$188.18	$194.00	$129.01–$188.18	74% above	3%
Free T3 thyroid hormone test inpatient CPT 84481	$188.18	$194.00	$126.10–$188.18	—	3%
Free T4 (free thyroxine) thyroid blood test CPT 84439	$236.68	$244.00	$162.26–$236.68	261% above	3%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439	$236.68	$244.00	$158.60–$236.68	—	3%
Free testosterone test CPT 84402	$197.88	$204.00	$135.66–$197.88	92% above	3%
Free testosterone test inpatient CPT 84402	$197.88	$204.00	$132.60–$197.88	—	3%
Gamma-glutamyl transferase (GGT) blood test CPT 82977	$88.27	$91.00	$60.52–$88.27	74% above	3%
Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977	$88.27	$91.00	$59.15–$88.27	—	3%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950	$78.57	$81.00	$53.87–$78.57	96% above	3%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950	$78.57	$81.00	$52.65–$78.57	—	3%
Glucose tolerance test, 3 samples CPT 82951	$158.11	$163.00	$108.39–$158.11	81% above	3%
Glucose tolerance test, 3 samples inpatient CPT 82951	$158.11	$163.00	$105.95–$158.11	—	3%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591	$127.07	$131.00	$87.11–$127.07	37% above	3%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591	$127.07	$131.00	$85.15–$127.07	—	3%
H. pylori stool antigen test CPT 87338	$115.43	$119.00	$79.14–$115.43	3% above	3%
H. pylori stool antigen test inpatient CPT 87338	$115.43	$119.00	$77.35–$115.43	—	3%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389	$127.07	$131.00	$87.11–$127.07	65% above	3%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389	$127.07	$131.00	$85.15–$127.07	—	3%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036	$110.58	$114.00	$75.81–$110.58	70% above	3%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036	$110.58	$114.00	$74.10–$110.58	—	3%
Hemoglobin blood test CPT 85018	$41.71	$43.00	$28.59–$41.71	47% above	3%
Hemoglobin blood test inpatient CPT 85018	$41.71	$43.00	$27.95–$41.71	—	3%
Hepatitis B core antibody test (total) CPT 86704	$113.49	$117.00	$77.81–$113.49	59% above	3%
Hepatitis B core antibody test (total) inpatient CPT 86704	$113.49	$117.00	$76.05–$113.49	—	3%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706	$98.94	$102.00	$67.83–$98.94	44% above	3%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706	$98.94	$102.00	$66.30–$98.94	—	3%
Hepatitis B surface antigen (HBsAg) test CPT 87340	$105.73	$109.00	$72.48–$105.73	51% above	3%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340	$105.73	$109.00	$70.85–$105.73	—	3%
Hepatitis C antibody blood test (screening) CPT 86803	$157.14	$162.00	$107.73–$157.14	97% above	3%
Hepatitis C antibody blood test (screening) inpatient CPT 86803	$157.14	$162.00	$105.30–$157.14	—	3%
Hepatitis C viral load (HCV RNA) test CPT 87522	$408.37	$421.00	$279.96–$408.37	55% above	3%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522	$408.37	$421.00	$273.65–$408.37	—	3%
Herpes blood test, HSV-1 antibody CPT 86695	$90.21	$93.00	$61.84–$90.21	34% above	3%
Herpes blood test, HSV-1 antibody inpatient CPT 86695	$90.21	$93.00	$60.45–$90.21	—	3%
Herpes blood test, HSV-2 antibody CPT 86696	$90.21	$93.00	$61.84–$90.21	56% above	3%
Herpes blood test, HSV-2 antibody inpatient CPT 86696	$90.21	$93.00	$60.45–$90.21	—	3%
High-sensitivity CRP (hs-CRP) test CPT 86141	$91.18	$94.00	$62.51–$91.18	14% above	3%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141	$91.18	$94.00	$61.10–$91.18	—	3%
Homocysteine blood test CPT 83090	$114.46	$118.00	$78.47–$114.46	19% above	3%
Homocysteine blood test inpatient CPT 83090	$114.46	$118.00	$76.70–$114.46	—	3%
Insulin blood test CPT 83525	$140.65	$145.00	$96.42–$140.65	84% above	3%
Insulin blood test inpatient CPT 83525	$140.65	$145.00	$94.25–$140.65	—	3%
Iron blood test (serum iron) CPT 83540	$78.57	$81.00	$53.87–$78.57	87% above	3%
Iron blood test (serum iron) inpatient CPT 83540	$78.57	$81.00	$52.65–$78.57	—	3%
Iron-binding capacity (TIBC) test CPT 83550	$80.51	$83.00	$55.20–$80.51	65% above	3%
Iron-binding capacity (TIBC) test inpatient CPT 83550	$80.51	$83.00	$53.95–$80.51	—	3%
Kidney function blood test panel CPT 80069	$164.90	$170.00	$113.05–$164.90	75% above	3%
Kidney function blood test panel inpatient CPT 80069	$164.90	$170.00	$110.50–$164.90	—	3%
LH (luteinizing hormone) test CPT 83002	$137.74	$142.00	$94.43–$137.74	51% above	3%
LH (luteinizing hormone) test inpatient CPT 83002	$137.74	$142.00	$92.30–$137.74	—	3%
Lactate (lactic acid) blood test CPT 83605	$121.25	$125.00	$83.12–$121.25	60% above	3%
Lactate (lactic acid) blood test inpatient CPT 83605	$121.25	$125.00	$81.25–$121.25	—	3%
Lactate dehydrogenase (LDH) blood test CPT 83615	$57.23	$59.00	$39.23–$57.23	33% above	3%
Lactate dehydrogenase (LDH) blood test inpatient CPT 83615	$57.23	$59.00	$38.35–$57.23	—	3%
Lipase blood test (pancreas enzyme) CPT 83690	$131.92	$136.00	$90.44–$131.92	101% above	3%
Lipase blood test (pancreas enzyme) inpatient CPT 83690	$131.92	$136.00	$88.40–$131.92	—	3%
Liver function blood test panel CPT 80076	$103.79	$107.00	$71.16–$103.79	17% above	3%
Liver function blood test panel inpatient CPT 80076	$103.79	$107.00	$69.55–$103.79	—	3%
Lyme disease antibody test CPT 86618	$162.96	$168.00	$111.72–$162.96	87% above	3%
Lyme disease antibody test inpatient CPT 86618	$162.96	$168.00	$109.20–$162.96	—	3%
Magnesium blood test CPT 83735	$80.51	$83.00	$55.20–$80.51	66% above	3%
Magnesium blood test inpatient CPT 83735	$80.51	$83.00	$53.95–$80.51	—	3%
Measles (rubeola) antibody test CPT 86765	$144.53	$149.00	$99.08–$144.53	154% above	3%
Measles (rubeola) antibody test inpatient CPT 86765	$144.53	$149.00	$96.85–$144.53	—	3%
Mumps immunity blood test CPT 86735	$129.98	$134.00	$89.11–$129.98	148% above	3%
Mumps immunity blood test inpatient CPT 86735	$129.98	$134.00	$87.10–$129.98	—	3%
PSA (prostate-specific antigen) blood test, free CPT 84154	$124.16	$128.00	$85.12–$124.16	27% above	3%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154	$124.16	$128.00	$83.20–$124.16	—	3%
PSA (prostate-specific antigen) blood test, total CPT 84153	$139.68	$144.00	$95.76–$139.68	44% above	3%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153	$139.68	$144.00	$93.60–$139.68	—	3%
Parathyroid hormone (PTH) blood test CPT 83970	$280.33	$289.00	$192.19–$280.33	57% above	3%
Parathyroid hormone (PTH) blood test inpatient CPT 83970	$280.33	$289.00	$187.85–$280.33	—	3%
Partial thromboplastin time (PTT) clotting test CPT 85730	$65.96	$68.00	$45.22–$65.96	43% above	3%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730	$65.96	$68.00	$44.20–$65.96	—	3%
Phosphorus (phosphate) blood test CPT 84100	$56.26	$58.00	$38.57–$56.26	58% above	3%
Phosphorus (phosphate) blood test inpatient CPT 84100	$56.26	$58.00	$37.70–$56.26	—	3%
Potassium blood test CPT 84132	$47.53	$49.00	$32.59–$47.53	38% above	3%
Potassium blood test inpatient CPT 84132	$47.53	$49.00	$31.85–$47.53	—	3%
Progesterone blood test CPT 84144	$165.87	$171.00	$113.72–$165.87	66% above	3%
Progesterone blood test inpatient CPT 84144	$165.87	$171.00	$111.15–$165.87	—	3%
Prolactin blood test CPT 84146	$155.20	$160.00	$106.40–$155.20	51% above	3%
Prolactin blood test inpatient CPT 84146	$155.20	$160.00	$104.00–$155.20	—	3%
Prothrombin time (PT/INR) clotting test CPT 85610	$51.41	$53.00	$35.24–$51.41	56% above	3%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610	$51.41	$53.00	$34.45–$51.41	—	3%
Renin blood test CPT 84244	$212.43	$219.00	$145.63–$212.43	95% above	3%
Renin blood test inpatient CPT 84244	$212.43	$219.00	$142.35–$212.43	—	3%
Rh blood typing CPT 86901	$44.62	$46.00	$30.59–$44.62	1% below	3%
Rh blood typing inpatient CPT 86901	$44.62	$46.00	$29.90–$44.62	—	3%
Rheumatoid factor (RF) test CPT 86431	$64.99	$67.00	$44.55–$64.99	34% above	3%
Rheumatoid factor (RF) test inpatient CPT 86431	$64.99	$67.00	$43.55–$64.99	—	3%
Rubella antibody test (immunity check) CPT 86762	$78.57	$81.00	$53.87–$78.57	22% above	3%
Rubella antibody test (immunity check) inpatient CPT 86762	$78.57	$81.00	$52.65–$78.57	—	3%
Sodium blood test CPT 84295	$42.68	$44.00	$29.26–$42.68	27% above	3%
Sodium blood test inpatient CPT 84295	$42.68	$44.00	$28.60–$42.68	—	3%
Stool ova and parasites exam CPT 87177	$94.09	$97.00	$64.50–$94.09	90% above	3%
Stool ova and parasites exam inpatient CPT 87177	$94.09	$97.00	$63.05–$94.09	—	3%
Syphilis antibody test (Treponema pallidum) CPT 86780	$79.54	$82.00	$54.53–$79.54	47% above	3%
Syphilis antibody test (Treponema pallidum) inpatient CPT 86780	$79.54	$82.00	$53.30–$79.54	—	3%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592	$56.26	$58.00	$38.57–$56.26	16% above	3%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592	$56.26	$58.00	$37.70–$56.26	—	3%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480	$194.97	$201.00	$133.66–$194.97	29% above	3%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480	$194.97	$201.00	$130.65–$194.97	—	3%
Testosterone blood test, total (not free testosterone) CPT 84403	$159.08	$164.00	$109.06–$159.08	54% above	3%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403	$159.08	$164.00	$106.60–$159.08	—	3%
Thyroid peroxidase (TPO) antibody test CPT 86376	$125.13	$129.00	$85.78–$125.13	57% above	3%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376	$125.13	$129.00	$83.85–$125.13	—	3%
Thyroid-stimulating hormone (TSH) blood test CPT 84443	$141.62	$146.00	$97.09–$141.62	42% above	3%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443	$141.62	$146.00	$94.90–$141.62	—	3%
Total IgE blood test CPT 82785	$112.52	$116.00	$77.14–$112.52	49% above	3%
Total IgE blood test inpatient CPT 82785	$112.52	$116.00	$75.40–$112.52	—	3%
Total cholesterol blood test CPT 82465	$68.87	$71.00	$47.22–$68.87	97% above	3%
Total cholesterol blood test inpatient CPT 82465	$68.87	$71.00	$46.15–$68.87	—	3%
Total thyroxine (T4) blood test CPT 84436	$89.24	$92.00	$61.18–$89.24	69% above	3%
Total thyroxine (T4) blood test inpatient CPT 84436	$89.24	$92.00	$59.80–$89.24	—	3%
Total triiodothyronine (T3) blood test CPT 84480	$141.62	$146.00	$97.09–$141.62	82% above	3%
Total triiodothyronine (T3) blood test inpatient CPT 84480	$141.62	$146.00	$94.90–$141.62	—	3%
Transferrin blood test CPT 84466	$107.67	$111.00	$73.81–$107.67	58% above	3%
Transferrin blood test inpatient CPT 84466	$107.67	$111.00	$72.15–$107.67	—	3%
Trichomonas test (NAAT) CPT 87661	$161.99	$167.00	$111.06–$161.99	70% above	3%
Trichomonas test (NAAT) inpatient CPT 87661	$161.99	$167.00	$108.55–$161.99	—	3%
Triglycerides blood test CPT 84478	$52.38	$54.00	$35.91–$52.38	25% above	3%
Triglycerides blood test inpatient CPT 84478	$52.38	$54.00	$35.10–$52.38	—	3%
Troponin test, quantitative CPT 84484	$136.77	$141.00	$93.77–$136.77	18% above	3%
Troponin test, quantitative inpatient CPT 84484	$136.77	$141.00	$91.65–$136.77	—	3%
Uric acid blood test CPT 84550	$54.32	$56.00	$37.24–$54.32	41% above	3%
Uric acid blood test inpatient CPT 84550	$54.32	$56.00	$36.40–$54.32	—	3%
Urinalysis with microscope exam, automated CPT 81001	$56.26	$58.00	$38.57–$56.26	31% above	3%
Urinalysis with microscope exam, automated inpatient CPT 81001	$56.26	$58.00	$37.70–$56.26	—	3%
Urinalysis without microscope exam, automated CPT 81003	$48.50	$50.00	$33.25–$48.50	85% above	3%
Urinalysis without microscope exam, automated inpatient CPT 81003	$48.50	$50.00	$32.50–$48.50	—	3%
Urine culture for bacteria, with colony count CPT 87086	$97.97	$101.00	$67.17–$97.97	67% above	3%
Urine culture for bacteria, with colony count inpatient CPT 87086	$97.97	$101.00	$65.65–$97.97	—	3%
Urine microalbumin (albumin) test CPT 82043	$91.18	$94.00	$62.51–$91.18	67% above	3%
Urine microalbumin (albumin) test inpatient CPT 82043	$91.18	$94.00	$61.10–$91.18	—	3%
Urine pregnancy test, read by color change CPT 81025	$85.36	$88.00	$58.52–$85.36	102% above	3%
Urine pregnancy test, read by color change inpatient CPT 81025	$85.36	$88.00	$57.20–$85.36	—	3%
Vitamin B12 (cobalamin) blood test CPT 82607	$116.40	$120.00	$79.80–$116.40	34% above	3%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607	$116.40	$120.00	$78.00–$116.40	—	3%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306	$263.84	$272.00	$180.88–$263.84	104% above	3%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306	$263.84	$272.00	$176.80–$263.84	—	3%
Vitamin D, 1,25-dihydroxy blood test CPT 82652	$281.30	$290.00	$192.85–$281.30	58% above	3%
Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652	$281.30	$290.00	$188.50–$281.30	—	3%
Zinc blood test CPT 84630	$141.62	$146.00	$97.09–$141.62	170% above	3%
Zinc blood test inpatient CPT 84630	$141.62	$146.00	$94.90–$141.62	—	3%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702	$141.62	$146.00	$97.09–$141.62	58% above	3%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702	$141.62	$146.00	$94.90–$141.62	—	3%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786	$896.28	$924.00	$614.46–$896.28	102% above	3%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786	$896.28	$924.00	$614.46–$896.28	102% above	3%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786	$896.28	$924.00	$600.60–$896.28	—	3%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786	$896.28	$924.00	$600.60–$896.28	—	3%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470	$608.19	$627.00	$416.95–$608.19	63% above	3%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470	$608.19	$627.00	$407.55–$608.19	—	3%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600	$932.17	$961.00	$639.07–$932.17	119% above	3%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600	$932.17	$961.00	$639.07–$932.17	119% above	3%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600	$945.75	$975.00	$662.90–$882.31	122% above	3%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600	$932.17	$961.00	$624.65–$932.17	—	3%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600	$932.17	$961.00	$624.65–$932.17	—	3%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600	$945.75	$975.00	$662.90–$882.31	—	3%
Colonoscopy with polyp removal CPT 45385	$1,318.23	$1,359.00	$482.00–$709.52	8% below	3%
Colonoscopy with polyp removal inpatient CPT 45385	$1,318.23	$1,359.00	$482.00–$709.52	—	3%
Colonoscopy with tissue sample CPT 45380	$1,267.79	$1,307.00	$382.50–$558.91	16% below	3%
Colonoscopy with tissue sample inpatient CPT 45380	$1,267.79	$1,307.00	$382.50–$558.91	—	3%
Colonoscopy, diagnostic CPT 45378	$983.58	$1,014.00	$351.70–$514.44	14% below	3%
Colonoscopy, diagnostic inpatient CPT 45378	$983.58	$1,014.00	$351.70–$514.44	—	3%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454	$206.61	$213.00	$141.65–$206.61	39% below	3%
Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454	$254.14	$262.00	$253.40–$369.46	25% below	3%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454	$206.61	$213.00	$138.45–$206.61	—	3%
Colposcopy with cervical biopsy and scraping of the cervical canal inpatient CPT 57454	$254.14	$262.00	$253.40–$369.46	—	3%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000	$79.54	$82.00	$54.53–$79.54	46% below	3%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000	$97.97	$101.00	$98.40–$150.78	33% below	3%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000	$79.54	$82.00	$53.30–$79.54	—	3%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000	$97.97	$101.00	$98.40–$150.78	—	3%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209	$29.10	$30.00	$19.95–$29.10	57% below	3%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209	$29.10	$30.00	$19.95–$29.10	57% below	3%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209	$29.10	$30.00	$19.50–$29.10	—	3%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209	$29.10	$30.00	$19.50–$29.10	—	3%
Earwax removal with instruments, one ear one side CPT 69210	$108.64	$112.00	$60.50–$91.25	3% above	3%
Earwax removal with instruments, one ear one side CPT 69210	$130.95	$135.00	$89.78–$130.95	25% above	3%
Earwax removal with instruments, one ear inpatient one side CPT 69210	$108.64	$112.00	$60.50–$91.25	—	3%
Earwax removal with instruments, one ear inpatient one side CPT 69210	$130.95	$135.00	$87.75–$130.95	—	3%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100	$125.13	$129.00	$85.78–$125.13	50% below	3%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100	$154.23	$159.00	$119.20–$175.81	38% below	3%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100	$125.13	$129.00	$83.85–$125.13	—	3%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100	$154.23	$159.00	$119.20–$175.81	—	3%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321	$802.19	$827.00	$206.00–$300.75	35% below	3%
Epidural steroid injection, neck or mid back, with imaging guidance inpatient CPT 62321	$802.19	$827.00	$206.00–$300.75	—	3%
Facet joint injection, lower back, one level, with imaging guidance one side CPT 64493	$323.01	$333.00	$175.20–$252.42	75% below	3%
Facet joint injection, lower back, one level, with imaging guidance inpatient one side CPT 64493	$323.01	$333.00	$175.20–$252.42	—	3%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm CPT 49593	$1,568.49	$1,617.00	$1,089.04–$1,568.59	14% above	3%
First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm inpatient CPT 49593	$1,568.49	$1,617.00	$1,089.04–$1,568.59	—	3%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm CPT 49591	$932.17	$961.00	$653.22–$938.11	21% below	3%
First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm inpatient CPT 49591	$932.17	$961.00	$653.22–$938.11	—	3%
Flexible sigmoidoscopy, diagnostic (lower colon only) CPT 45330	$516.04	$532.00	$109.70–$155.68	33% below	3%
Flexible sigmoidoscopy, diagnostic (lower colon only) inpatient CPT 45330	$516.04	$532.00	$109.70–$155.68	—	3%
Gallbladder removal, laparoscopic CPT 47562	$1,825.54	$1,882.00	$1,281.27–$1,779.51	14% below	3%
Gallbladder removal, laparoscopic inpatient CPT 47562	$1,825.54	$1,882.00	$1,281.27–$1,779.51	—	3%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery CPT 47563	$1,985.59	$2,047.00	$1,391.27–$1,935.98	2% below	3%
Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery inpatient CPT 47563	$1,985.59	$2,047.00	$1,391.27–$1,935.98	—	3%
Hemorrhoid banding (rubber band ligation) CPT 46221	$354.05	$365.00	$242.72–$354.05	43% below	3%
Hemorrhoid banding (rubber band ligation) CPT 46221	$434.56	$448.00	$378.00–$537.38	30% below	3%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221	$354.05	$365.00	$237.25–$354.05	—	3%
Hemorrhoid banding (rubber band ligation) inpatient CPT 46221	$434.56	$448.00	$378.00–$537.38	—	3%
Hysteroscopy with uterine lining sampling and/or polyp removal CPT 58558	$3,864.48	$3,984.00	$437.50–$640.22	4% above	3%
Hysteroscopy with uterine lining sampling and/or polyp removal inpatient CPT 58558	$3,864.48	$3,984.00	$437.50–$640.22	—	3%
IUD insertion (the device itself billed separately) CPT 58300	$136.77	$141.00	$93.77–$136.77	47% below	3%
IUD insertion (the device itself billed separately) CPT 58300	$167.81	$173.00	$95.20–$144.82	35% below	3%
IUD insertion (the device itself billed separately) inpatient CPT 58300	$136.77	$141.00	$91.65–$136.77	—	3%
IUD insertion (the device itself billed separately) inpatient CPT 58300	$167.81	$173.00	$95.20–$144.82	—	3%
Incision and drainage of a simple or single skin abscess CPT 10060	$189.15	$195.00	$192.10–$281.71	26% below	3%
Incision and drainage of a simple or single skin abscess CPT 10060	$279.36	$288.00	$191.52–$279.36	9% above	3%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060	$189.15	$195.00	$192.10–$281.71	—	3%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060	$279.36	$288.00	$187.20–$279.36	—	3%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505	$1,453.06	$1,498.00	$1,022.06–$1,412.24	2% below	3%
Inguinal (groin) hernia repair, age 5 or older one side CPT 49505	$1,453.06	$1,498.00	$1,022.06–$1,412.24	2% below	3%
Inguinal (groin) hernia repair, age 5 or older inpatient one side CPT 49505	$1,453.06	$1,498.00	$1,022.06–$1,412.24	—	3%
Inguinal (groin) hernia repair, age 5 or older inpatient one side CPT 49505	$1,453.06	$1,498.00	$1,022.06–$1,412.24	—	3%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550	$98.94	$102.00	$67.83–$98.94	64% below	3%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550	$98.94	$102.00	$67.83–$98.94	64% below	3%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550	$121.25	$125.00	$75.10–$108.44	55% below	3%
Injection into a tendon sheath or ligament (for example trigger finger) one side CPT 20550	$121.25	$125.00	$75.10–$108.44	55% below	3%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550	$98.94	$102.00	$66.30–$98.94	—	3%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550	$98.94	$102.00	$66.30–$98.94	—	3%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550	$121.25	$125.00	$75.10–$108.44	—	3%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient one side CPT 20550	$121.25	$125.00	$75.10–$108.44	—	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610	$196.91	$203.00	$87.30–$125.72	43% below	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610	$196.91	$203.00	$87.30–$125.72	43% below	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610	$253.17	$261.00	$173.56–$253.17	26% below	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610	$253.17	$261.00	$173.56–$253.17	26% below	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610	$196.91	$203.00	$87.30–$125.72	—	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610	$196.91	$203.00	$87.30–$125.72	—	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610	$253.17	$261.00	$169.65–$253.17	—	3%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610	$253.17	$261.00	$169.65–$253.17	—	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605	$67.90	$70.00	$46.55–$67.90	78% below	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605	$83.42	$86.00	$70.60–$103.38	73% below	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605	$98.94	$102.00	$67.83–$98.94	68% below	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) one side CPT 20605	$168.78	$174.00	$70.60–$103.38	46% below	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605	$67.90	$70.00	$45.50–$67.90	—	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605	$83.42	$86.00	$70.60–$103.38	—	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605	$98.94	$102.00	$66.30–$98.94	—	3%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient one side CPT 20605	$168.78	$174.00	$70.60–$103.38	—	3%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600	$65.96	$68.00	$45.22–$65.96	76% below	3%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600	$82.45	$85.00	$68.70–$99.34	70% below	3%
Joint injection or drainage, small joint (fingers, toes) one side CPT 20600	$82.45	$85.00	$68.70–$99.34	70% below	3%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600	$65.96	$68.00	$44.20–$65.96	—	3%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600	$82.45	$85.00	$68.70–$99.34	—	3%
Joint injection or drainage, small joint (fingers, toes) inpatient one side CPT 20600	$82.45	$85.00	$68.70–$99.34	—	3%
Laparoscopic appendectomy (appendix removal through small cuts) CPT 44970	$1,662.58	$1,714.00	$1,171.60–$1,625.60	5% below	3%
Laparoscopic appendectomy (appendix removal through small cuts) inpatient CPT 44970	$1,662.58	$1,714.00	$1,171.60–$1,625.60	—	3%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650	$1,173.70	$1,210.00	$848.40–$1,166.70	at median	3%
Laparoscopic inguinal (groin) hernia repair, first repair on that side one side CPT 49650	$1,202.80	$1,240.00	$848.40–$1,166.70	2% above	3%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient one side CPT 49650	$1,173.70	$1,210.00	$848.40–$1,166.70	—	3%
Laparoscopic inguinal (groin) hernia repair, first repair on that side inpatient one side CPT 49650	$1,202.80	$1,240.00	$848.40–$1,166.70	—	3%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia one side CPT 49651	$1,561.70	$1,610.00	$1,106.40–$1,518.66	2% above	3%
Laparoscopic inguinal (groin) hernia repair, recurrent hernia inpatient one side CPT 49651	$1,561.70	$1,610.00	$1,106.40–$1,518.66	—	3%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031	$323.01	$333.00	$221.44–$323.01	9% below	3%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031	$394.79	$407.00	$270.90–$423.98	11% above	3%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031	$323.01	$333.00	$216.45–$323.01	—	3%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031	$394.79	$407.00	$270.90–$423.98	—	3%
Lower-back epidural injection, with imaging guidance CPT 62323	$790.55	$815.00	$190.60–$277.51	35% below	3%
Lower-back epidural injection, with imaging guidance inpatient CPT 62323	$790.55	$815.00	$190.60–$277.51	—	3%
Lower-back epidural injection, without imaging guidance CPT 62322	$423.89	$437.00	$150.20–$235.98	48% below	3%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322	$423.89	$437.00	$150.20–$235.98	—	3%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483	$452.02	$466.00	$213.70–$312.87	66% below	3%
Lower-back nerve root steroid injection, with imaging guidance one side CPT 64483	$752.72	$776.00	$213.70–$312.87	43% below	3%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483	$452.02	$466.00	$213.70–$312.87	—	3%
Lower-back nerve root steroid injection, with imaging guidance inpatient one side CPT 64483	$752.72	$776.00	$213.70–$312.87	—	3%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400	$151.32	$156.00	$103.74–$151.32	44% below	3%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400	$186.24	$192.00	$152.40–$228.42	31% below	3%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400	$151.32	$156.00	$101.40–$151.32	—	3%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400	$186.24	$192.00	$152.40–$228.42	—	3%
Nail removal (partial or complete), one nail CPT 11730	$138.71	$143.00	$95.09–$138.71	32% below	3%
Nail removal (partial or complete), one nail CPT 11730	$175.57	$181.00	$95.50–$152.91	14% below	3%
Nail removal (partial or complete), one nail inpatient CPT 11730	$138.71	$143.00	$92.95–$138.71	—	3%
Nail removal (partial or complete), one nail inpatient CPT 11730	$175.57	$181.00	$95.50–$152.91	—	3%
Paracentesis with imaging guidance CPT 49083	$289.06	$298.00	$198.17–$289.06	74% below	3%
Paracentesis with imaging guidance CPT 49083	$814.80	$840.00	$202.20–$302.76	26% below	3%
Paracentesis with imaging guidance inpatient CPT 49083	$289.06	$298.00	$193.70–$289.06	—	3%
Paracentesis with imaging guidance inpatient CPT 49083	$814.80	$840.00	$202.20–$302.76	—	3%
Permanent removal of a nail and nail root (partial or complete) CPT 11750	$189.15	$195.00	$129.68–$189.15	56% below	3%
Permanent removal of a nail and nail root (partial or complete) CPT 11750	$231.83	$239.00	$182.00–$286.38	46% below	3%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750	$189.15	$195.00	$126.75–$189.15	—	3%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750	$231.83	$239.00	$182.00–$286.38	—	3%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635	$1,190.19	$1,227.00	$370.30–$621.35	46% below	3%
Radiofrequency ablation of facet joint nerves, lower back, one level one side CPT 64635	$1,190.19	$1,227.00	$370.30–$621.35	46% below	3%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635	$1,190.19	$1,227.00	$370.30–$621.35	—	3%
Radiofrequency ablation of facet joint nerves, lower back, one level inpatient one side CPT 64635	$1,190.19	$1,227.00	$370.30–$621.35	—	3%
Removal of a breast lump, open surgery one side CPT 19120	$793.46	$818.00	$756.50–$1,123.84	47% below	3%
Removal of a breast lump, open surgery inpatient one side CPT 19120	$793.46	$818.00	$756.50–$1,123.84	—	3%
Removal of a foreign object under the skin, simple CPT 10120	$287.12	$296.00	$189.70–$288.79	4% below	3%
Removal of a foreign object under the skin, simple CPT 10120	$303.61	$313.00	$208.15–$303.61	2% above	3%
Removal of a foreign object under the skin, simple inpatient CPT 10120	$287.12	$296.00	$189.70–$288.79	—	3%
Removal of a foreign object under the skin, simple inpatient CPT 10120	$303.61	$313.00	$203.45–$303.61	—	3%
Screening colonoscopy for a person at average risk (Medicare code) HCPCS G0121	$591.70	$610.00	$171.02–$514.81	43% below	3%
Screening colonoscopy for a person at average risk (Medicare code) inpatient HCPCS G0121	$591.70	$610.00	$171.02–$514.81	—	3%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) HCPCS G0105	$601.40	$620.00	$170.90–$514.08	50% below	3%
Screening colonoscopy, high risk of colorectal cancer (Medicare code) inpatient HCPCS G0105	$601.40	$620.00	$170.90–$514.08	—	3%
Short arm splint (forearm and hand) one side CPT 29125	$105.73	$109.00	$78.90–$108.44	40% below	3%
Short arm splint (forearm and hand) one side CPT 29125	$113.49	$117.00	$77.81–$113.49	35% below	3%
Short arm splint (forearm and hand) one side CPT 29125	$113.49	$117.00	$77.81–$113.49	35% below	3%
Short arm splint (forearm and hand) one side CPT 29125	$142.59	$147.00	$78.90–$108.44	19% below	3%
Short arm splint (forearm and hand) inpatient one side CPT 29125	$105.73	$109.00	$78.90–$108.44	—	3%
Short arm splint (forearm and hand) inpatient one side CPT 29125	$113.49	$117.00	$76.05–$113.49	—	3%
Short arm splint (forearm and hand) inpatient one side CPT 29125	$113.49	$117.00	$76.05–$113.49	—	3%
Short arm splint (forearm and hand) inpatient one side CPT 29125	$142.59	$147.00	$78.90–$108.44	—	3%
Short leg splint (calf to foot) one side CPT 29515	$141.62	$146.00	$97.09–$141.62	18% below	3%
Short leg splint (calf to foot) one side CPT 29515	$141.62	$146.00	$97.09–$141.62	18% below	3%
Short leg splint (calf to foot) one side CPT 29515	$150.35	$155.00	$97.50–$136.47	13% below	3%
Short leg splint (calf to foot) one side CPT 29515	$150.35	$155.00	$97.50–$136.47	13% below	3%
Short leg splint (calf to foot) inpatient one side CPT 29515	$141.62	$146.00	$94.90–$141.62	—	3%
Short leg splint (calf to foot) inpatient one side CPT 29515	$141.62	$146.00	$94.90–$141.62	—	3%
Short leg splint (calf to foot) inpatient one side CPT 29515	$150.35	$155.00	$97.50–$136.47	—	3%
Short leg splint (calf to foot) inpatient one side CPT 29515	$150.35	$155.00	$97.50–$136.47	—	3%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001	$143.56	$148.00	$79.40–$121.80	37% below	3%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001	$757.57	$781.00	$519.37–$757.57	231% above	3%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001	$143.56	$148.00	$79.40–$121.80	—	3%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001	$757.57	$781.00	$507.65–$757.57	—	3%
Skin biopsy, punch, one lesion CPT 11104	$148.41	$153.00	$101.75–$148.41	44% below	3%
Skin biopsy, punch, one lesion CPT 11104	$183.33	$189.00	$83.00–$135.72	30% below	3%
Skin biopsy, punch, one lesion inpatient CPT 11104	$148.41	$153.00	$99.45–$148.41	—	3%
Skin biopsy, punch, one lesion inpatient CPT 11104	$183.33	$189.00	$83.00–$135.72	—	3%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600	$232.80	$240.00	$159.60–$232.80	39% below	3%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm CPT 11600	$285.18	$294.00	$218.80–$336.22	26% below	3%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600	$232.80	$240.00	$156.00–$232.80	—	3%
Skin cancer removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11600	$285.18	$294.00	$218.80–$336.22	—	3%
Skin tag removal, up to 15 tags CPT 11200	$110.58	$114.00	$75.81–$110.58	36% below	3%
Skin tag removal, up to 15 tags CPT 11200	$136.77	$141.00	$138.10–$206.47	21% below	3%
Skin tag removal, up to 15 tags inpatient CPT 11200	$110.58	$114.00	$74.10–$110.58	—	3%
Skin tag removal, up to 15 tags inpatient CPT 11200	$136.77	$141.00	$138.10–$206.47	—	3%
Spinal tap (lumbar puncture), diagnostic CPT 62270	$406.43	$419.00	$122.07–$170.66	13% below	3%
Spinal tap (lumbar puncture), diagnostic CPT 62270	$668.33	$689.00	$458.19–$668.33	43% above	3%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270	$406.43	$419.00	$122.07–$170.66	—	3%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270	$668.33	$689.00	$447.85–$668.33	—	3%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002	$149.38	$154.00	$102.41–$149.38	39% below	3%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002	$173.63	$179.00	$104.30–$160.78	29% below	3%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002	$149.38	$154.00	$100.10–$149.38	—	3%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002	$173.63	$179.00	$104.30–$160.78	—	3%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011	$141.62	$146.00	$97.09–$141.62	44% below	3%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011	$171.69	$177.00	$99.00–$151.31	32% below	3%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011	$141.62	$146.00	$94.90–$141.62	—	3%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011	$171.69	$177.00	$99.00–$151.31	—	3%
Tangential (shave-style) skin biopsy, one lesion CPT 11102	$117.37	$121.00	$80.47–$117.37	44% below	3%
Tangential (shave-style) skin biopsy, one lesion CPT 11102	$144.53	$149.00	$66.40–$108.08	31% below	3%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102	$117.37	$121.00	$78.65–$117.37	—	3%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102	$144.53	$149.00	$66.40–$108.08	—	3%
Thoracentesis with imaging guidance one side CPT 32555	$287.12	$296.00	$196.84–$287.12	70% below	3%
Thoracentesis with imaging guidance one side CPT 32555	$877.85	$905.00	$197.80–$313.24	7% below	3%
Thoracentesis with imaging guidance one side CPT 32555	$877.85	$905.00	$197.80–$313.24	7% below	3%
Thoracentesis with imaging guidance inpatient one side CPT 32555	$287.12	$296.00	$192.40–$287.12	—	3%
Thoracentesis with imaging guidance inpatient one side CPT 32555	$877.85	$905.00	$197.80–$313.24	—	3%
Thoracentesis with imaging guidance inpatient one side CPT 32555	$877.85	$905.00	$197.80–$313.24	—	3%
Trigger point injections, 1 or 2 muscles CPT 20552	$64.99	$67.00	$44.55–$64.99	78% below	3%
Trigger point injections, 1 or 2 muscles CPT 20552	$161.99	$167.00	$70.00–$106.43	46% below	3%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552	$64.99	$67.00	$43.55–$64.99	—	3%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552	$161.99	$167.00	$70.00–$106.43	—	3%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083	$889.49	$917.00	$268.60–$440.36	57% below	3%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083	$1,430.75	$1,475.00	$980.88–$1,430.75	31% below	3%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083	$889.49	$917.00	$268.60–$440.36	—	3%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083	$1,430.75	$1,475.00	$958.75–$1,430.75	—	3%
Upper endoscopy (EGD) with balloon widening of the esophagus CPT 43249	$3,099.15	$3,195.00	$292.00–$426.86	51% above	3%
Upper endoscopy (EGD) with balloon widening of the esophagus inpatient CPT 43249	$3,099.15	$3,195.00	$292.00–$426.86	—	3%
Upper endoscopy (EGD) with biopsy CPT 43239	$1,057.30	$1,090.00	$263.10–$385.31	19% below	3%
Upper endoscopy (EGD) with biopsy inpatient CPT 43239	$1,057.30	$1,090.00	$263.10–$385.31	—	3%
Upper endoscopy (EGD) with polyp removal by snare CPT 43251	$1,390.98	$1,434.00	$372.20–$546.39	41% above	3%
Upper endoscopy (EGD) with polyp removal by snare inpatient CPT 43251	$1,390.98	$1,434.00	$372.20–$546.39	—	3%
Upper endoscopy (EGD), diagnostic CPT 43235	$826.44	$852.00	$234.20–$341.12	12% below	3%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235	$826.44	$852.00	$234.20–$341.12	—	3%
Wart removal, up to 14 warts CPT 17110	$133.86	$138.00	$91.77–$133.86	34% below	3%
Wart removal, up to 14 warts CPT 17110	$163.93	$169.00	$123.90–$187.91	19% below	3%
Wart removal, up to 14 warts inpatient CPT 17110	$133.86	$138.00	$89.70–$133.86	—	3%
Wart removal, up to 14 warts inpatient CPT 17110	$163.93	$169.00	$123.90–$187.91	—	3%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042	$185.27	$191.00	$127.02–$185.27	57% below	3%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042	$194.00	$200.00	$107.90–$169.18	54% below	3%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042	$185.27	$191.00	$124.15–$185.27	—	3%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042	$194.00	$200.00	$107.90–$169.18	—	3%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Blood transfusion (giving blood or blood components) CPT 36430	$539.32	$556.00	$369.74–$539.32	8% below	3%
Blood transfusion (giving blood or blood components) inpatient CPT 36430	$539.32	$556.00	$361.40–$539.32	—	3%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640	$110.58	$114.00	$12.41–$37.42	5% below	3%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640	$371.51	$383.00	$254.69–$371.51	220% above	3%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640	$110.58	$114.00	$12.41–$37.42	—	3%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640	$371.51	$383.00	$248.95–$371.51	—	3%
Chemotherapy IV infusion, first hour CPT 96413	$758.54	$782.00	$520.03–$758.54	40% above	3%
Chemotherapy IV infusion, first hour inpatient CPT 96413	$758.54	$782.00	$508.30–$758.54	—	3%
Critical care, first 30 to 74 minutes CPT 99291	$454.93	$469.00	$311.88–$454.93	55% below	3%
Critical care, first 30 to 74 minutes CPT 99291	$591.70	$610.00	$329.00–$444.51	41% below	3%
Critical care, first 30 to 74 minutes inpatient CPT 99291	$454.93	$469.00	$304.85–$454.93	—	3%
Critical care, first 30 to 74 minutes inpatient CPT 99291	$591.70	$610.00	$329.00–$444.51	—	3%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005	$189.15	$195.00	$129.68–$189.15	19% above	3%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005	$189.15	$195.00	$126.75–$189.15	—	3%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281	$107.67	$111.00	$73.81–$107.67	30% below	3%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281	$107.67	$111.00	$72.15–$107.67	—	3%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282	$167.81	$173.00	$64.21–$86.57	36% below	3%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282	$292.94	$302.00	$200.83–$292.94	11% above	3%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282	$167.81	$173.00	$64.21–$86.57	—	3%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282	$292.94	$302.00	$196.30–$292.94	—	3%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283	$252.20	$260.00	$108.68–$146.53	39% below	3%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283	$515.07	$531.00	$353.12–$515.07	24% above	3%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283	$252.20	$260.00	$108.68–$146.53	—	3%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283	$515.07	$531.00	$345.15–$515.07	—	3%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284	$682.88	$704.00	$468.16–$682.88	5% above	3%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284	$682.88	$704.00	$457.60–$682.88	—	3%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285	$568.42	$586.00	$267.73–$360.63	42% below	3%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285	$1,108.71	$1,143.00	$760.10–$1,108.71	13% above	3%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285	$568.42	$586.00	$267.73–$360.63	—	3%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285	$1,108.71	$1,143.00	$742.95–$1,108.71	—	3%
Exercise stress test, tracing only, the hospital charge CPT 93017	$672.21	$693.00	$460.85–$672.21	at median	3%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017	$672.21	$693.00	$450.45–$672.21	—	3%
Group psychotherapy session CPT 90853	$18.43	$19.00	$12.63–$18.43	92% below	3%
Group psychotherapy session CPT 90853	$24.25	$25.00	$30.28–$53.89	89% below	3%
Group psychotherapy session inpatient CPT 90853	$18.43	$19.00	$12.35–$18.43	—	3%
Group psychotherapy session inpatient CPT 90853	$24.25	$25.00	$30.28–$53.89	—	3%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360	$262.87	$271.00	$180.22–$262.87	6% below	3%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360	$262.87	$271.00	$176.15–$262.87	—	3%
IV infusion of a medicine, first hour CPT 96365	$291.97	$301.00	$200.16–$291.97	7% below	3%
IV infusion of a medicine, first hour inpatient CPT 96365	$291.97	$301.00	$195.65–$291.97	—	3%
IV push of a medicine, first drug CPT 96374	$163.93	$169.00	$112.39–$163.93	14% below	3%
IV push of a medicine, first drug inpatient CPT 96374	$163.93	$169.00	$109.85–$163.93	—	3%
Injection under the skin or into a muscle, for treatment or testing CPT 96372	$72.75	$75.00	$49.88–$72.75	20% below	3%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372	$72.75	$75.00	$48.75–$72.75	—	3%
Mental health diagnostic evaluation (intake), without medical services CPT 90791	$130.95	$135.00	$89.78–$130.95	45% below	3%
Mental health diagnostic evaluation (intake), without medical services CPT 90791	$161.99	$167.00	$149.10–$318.51	32% below	3%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791	$130.95	$135.00	$87.75–$130.95	—	3%
Mental health diagnostic evaluation (intake), without medical services inpatient CPT 90791	$161.99	$167.00	$149.10–$318.51	—	3%
New patient office visit, about 30 minutes CPT 99203	$209.52	$216.00	$116.00–$171.98	28% above	3%
New patient office visit, about 30 minutes CPT 99203	$214.37	$221.00	$146.97–$214.37	31% above	3%
New patient office visit, about 30 minutes inpatient CPT 99203	$209.52	$216.00	$116.00–$171.98	—	3%
New patient office visit, about 30 minutes inpatient CPT 99203	$214.37	$221.00	$143.65–$214.37	—	3%
New patient office visit, about 45 minutes CPT 99204	$140.65	$145.00	$96.42–$140.65	43% below	3%
New patient office visit, about 45 minutes CPT 99204	$314.28	$324.00	$188.80–$281.18	28% above	3%
New patient office visit, about 45 minutes inpatient CPT 99204	$140.65	$145.00	$94.25–$140.65	—	3%
New patient office visit, about 45 minutes inpatient CPT 99204	$314.28	$324.00	$188.80–$281.18	—	3%
New patient office visit, about 60 minutes CPT 99205	$178.48	$184.00	$122.36–$178.48	44% below	3%
New patient office visit, about 60 minutes CPT 99205	$397.70	$410.00	$257.00–$382.02	25% above	3%
New patient office visit, about 60 minutes inpatient CPT 99205	$178.48	$184.00	$119.60–$178.48	—	3%
New patient office visit, about 60 minutes inpatient CPT 99205	$397.70	$410.00	$257.00–$382.02	—	3%
New patient office visit, straightforward problem or 15+ minutes CPT 99202	$64.99	$67.00	$44.55–$64.99	38% below	3%
New patient office visit, straightforward problem or 15+ minutes CPT 99202	$82.45	$85.00	$66.30–$99.38	21% below	3%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202	$64.99	$67.00	$43.55–$64.99	—	3%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202	$82.45	$85.00	$66.30–$99.38	—	3%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802	$44.62	$46.00	$30.59–$44.62	1% above	3%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802	$44.62	$46.00	$29.90–$44.62	—	3%
Preventive checkup, new patient aged 18–39 CPT 99385	$122.22	$126.00	$83.79–$122.22	39% below	3%
Preventive checkup, new patient aged 18–39 CPT 99385	$150.35	$155.00	$146.97–$199.18	25% below	3%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385	$122.22	$126.00	$81.90–$122.22	—	3%
Preventive checkup, new patient aged 18–39 inpatient CPT 99385	$150.35	$155.00	$146.97–$199.18	—	3%
Preventive checkup, new patient aged 40–64 CPT 99386	$139.68	$144.00	$95.76–$139.68	35% below	3%
Preventive checkup, new patient aged 40–64 CPT 99386	$171.69	$177.00	$178.19–$241.53	20% below	3%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386	$139.68	$144.00	$93.60–$139.68	—	3%
Preventive checkup, new patient aged 40–64 inpatient CPT 99386	$171.69	$177.00	$178.19–$241.53	—	3%
Preventive checkup, new patient aged 65 or older CPT 99387	$152.29	$157.00	$104.41–$152.29	34% below	3%
Preventive checkup, new patient aged 65 or older CPT 99387	$187.21	$193.00	$191.36–$259.40	19% below	3%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387	$152.29	$157.00	$102.05–$152.29	—	3%
Preventive checkup, new patient aged 65 or older inpatient CPT 99387	$187.21	$193.00	$191.36–$259.40	—	3%
Preventive checkup, returning patient aged 18–39 CPT 99395	$109.61	$113.00	$75.14–$109.61	32% below	3%
Preventive checkup, returning patient aged 18–39 CPT 99395	$135.80	$140.00	$134.33–$182.06	16% below	3%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395	$109.61	$113.00	$73.45–$109.61	—	3%
Preventive checkup, returning patient aged 18–39 inpatient CPT 99395	$135.80	$140.00	$134.33–$182.06	—	3%
Preventive checkup, returning patient aged 40–64 CPT 99396	$117.37	$121.00	$80.47–$117.37	36% below	3%
Preventive checkup, returning patient aged 40–64 CPT 99396	$143.56	$148.00	$145.89–$197.72	22% below	3%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396	$117.37	$121.00	$78.65–$117.37	—	3%
Preventive checkup, returning patient aged 40–64 inpatient CPT 99396	$143.56	$148.00	$145.89–$197.72	—	3%
Preventive checkup, returning patient aged 65 or older CPT 99397	$125.13	$129.00	$85.78–$125.13	41% below	3%
Preventive checkup, returning patient aged 65 or older CPT 99397	$154.23	$159.00	$153.46–$208.02	27% below	3%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397	$125.13	$129.00	$83.85–$125.13	—	3%
Preventive checkup, returning patient aged 65 or older inpatient CPT 99397	$154.23	$159.00	$153.46–$208.02	—	3%
Psychiatric evaluation with medical services CPT 90792	$147.44	$152.00	$101.08–$147.44	36% below	3%
Psychiatric evaluation with medical services CPT 90792	$181.39	$187.00	$222.62–$362.65	21% below	3%
Psychiatric evaluation with medical services inpatient CPT 90792	$147.44	$152.00	$98.80–$147.44	—	3%
Psychiatric evaluation with medical services inpatient CPT 90792	$181.39	$187.00	$222.62–$362.65	—	3%
Psychotherapy session, 30 minutes CPT 90832	$57.23	$59.00	$39.23–$57.23	66% below	3%
Psychotherapy session, 30 minutes CPT 90832	$70.81	$73.00	$69.00–$153.91	58% below	3%
Psychotherapy session, 30 minutes inpatient CPT 90832	$57.23	$59.00	$38.35–$57.23	—	3%
Psychotherapy session, 30 minutes inpatient CPT 90832	$70.81	$73.00	$69.00–$153.91	—	3%
Psychotherapy session, 45 minutes CPT 90834	$74.69	$77.00	$51.20–$74.69	66% below	3%
Psychotherapy session, 45 minutes CPT 90834	$93.12	$96.00	$114.30–$203.20	58% below	3%
Psychotherapy session, 45 minutes inpatient CPT 90834	$74.69	$77.00	$50.05–$74.69	—	3%
Psychotherapy session, 45 minutes inpatient CPT 90834	$93.12	$96.00	$114.30–$203.20	—	3%
Psychotherapy session, 60 minutes CPT 90837	$111.55	$115.00	$76.47–$111.55	59% below	3%
Psychotherapy session, 60 minutes CPT 90837	$137.74	$142.00	$134.72–$300.50	49% below	3%
Psychotherapy session, 60 minutes inpatient CPT 90837	$111.55	$115.00	$74.75–$111.55	—	3%
Psychotherapy session, 60 minutes inpatient CPT 90837	$137.74	$142.00	$134.72–$300.50	—	3%
Returning patient office visit, high complexity or 40+ minutes CPT 99215	$310.40	$320.00	$203.00–$304.86	32% above	3%
Returning patient office visit, high complexity or 40+ minutes CPT 99215	$310.40	$320.00	$212.80–$310.40	32% above	3%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215	$310.40	$320.00	$203.00–$304.86	—	3%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215	$310.40	$320.00	$208.00–$310.40	—	3%
Returning patient office visit, low complexity or 20+ minutes CPT 99213	$157.14	$162.00	$107.73–$157.14	33% above	3%
Returning patient office visit, low complexity or 20+ minutes CPT 99213	$185.27	$191.00	$93.20–$139.78	57% above	3%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213	$157.14	$162.00	$105.30–$157.14	—	3%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213	$185.27	$191.00	$93.20–$139.78	—	3%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214	$220.19	$227.00	$137.30–$205.61	33% above	3%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214	$220.19	$227.00	$150.96–$220.19	33% above	3%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214	$220.19	$227.00	$147.55–$220.19	—	3%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214	$220.19	$227.00	$137.30–$205.61	—	3%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212	$97.00	$100.00	$66.50–$97.00	20% above	3%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212	$97.00	$100.00	$49.14–$74.66	20% above	3%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212	$97.00	$100.00	$49.14–$74.66	—	3%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212	$97.00	$100.00	$65.00–$97.00	—	3%
Spirometry before and after a bronchodilator CPT 94060	$320.10	$330.00	$219.45–$320.10	19% below	3%
Spirometry before and after a bronchodilator inpatient CPT 94060	$320.10	$330.00	$214.50–$320.10	—	3%
Therapeutic activities (functional training), 15 minutes CPT 97530	$90.21	$93.00	$61.84–$90.21	11% below	3%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530	$90.21	$93.00	$60.45–$90.21	—	3%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195	$166.84	$172.00	$114.38–$166.84	13% below	3%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195	$166.84	$172.00	$111.80–$166.84	—	3%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Iowa	Off list
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653	$56.26	$58.00	$44.03–$83.49	1% below	3%
Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653	$56.26	$58.00	$37.70–$56.26	—	3%
COVID-19 vaccine (Moderna), age 12 and older CPT 91322	$195.94	$202.00	$54.56–$195.94	25% below	3%
COVID-19 vaccine (Moderna), age 12 and older inpatient CPT 91322	$195.94	$202.00	$131.30–$195.94	—	3%
Chickenpox (varicella) vaccine, live (Varivax) CPT 90716	$542.51	$559.00	$99.14–$542.51	231% above	3%
Chickenpox (varicella) vaccine, live (Varivax) inpatient CPT 90716	$542.51	$559.00	$363.54–$542.51	—	3%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696	$53.35	$55.00	$16.49–$62.82	36% below	3%
DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696	$53.35	$55.00	$35.75–$53.35	—	3%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700	$20.37	$21.00	$17.91–$219.86	54% below	3%
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700	$20.37	$21.00	$13.65–$20.37	—	3%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) CPT 90697	$91.90	$94.00	$32.97–$156.62	35% below	2%
DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697	$91.90	$94.00	$61.58–$91.90	—	2%
Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656	$23.28	$24.00	$18.80–$23.28	4% above	3%
Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656	$23.28	$24.00	$15.60–$23.28	—	3%
HPV vaccine, 9-valent (Gardasil 9) CPT 90651	$284.21	$293.00	$189.30–$307.61	9% below	3%
HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651	$284.21	$293.00	$190.45–$284.21	—	3%
Hepatitis A vaccine, adult dose CPT 90632	$108.64	$112.00	$72.16–$345.69	12% below	3%
Hepatitis A vaccine, adult dose inpatient CPT 90632	$108.64	$112.00	$72.80–$108.64	—	3%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746	$109.61	$113.00	$70.38–$328.58	at median	3%
Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746	$109.61	$113.00	$73.45–$109.61	—	3%
High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662	$77.60	$80.00	$19.32–$83.49	at median	3%
High-dose flu shot, preservative-free, mainly for age 65 and older inpatient CPT 90662	$77.60	$80.00	$52.00–$77.60	—	3%
MMR vaccine (measles, mumps and rubella), live CPT 90707	$290.34	$299.00	$0.02–$290.34	138% above	3%
MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707	$290.34	$299.00	$194.56–$290.34	—	3%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710	$294.88	$304.00	$98.13–$294.88	21% below	3%
MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) inpatient CPT 90710	$294.88	$304.00	$197.60–$294.88	—	3%
Meningococcal ACWY (MenACWY) vaccine CPT 90734	$95.06	$98.00	$57.95–$166.75	58% below	3%
Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734	$95.06	$98.00	$63.70–$95.06	—	3%
Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620	$199.82	$206.00	$175.72–$254.82	19% below	3%
Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620	$199.82	$206.00	$133.90–$199.82	—	3%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671	$237.65	$245.00	$16.40–$261.15	50% below	3%
Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671	$237.65	$245.00	$159.25–$237.65	—	3%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677	$267.95	$276.00	$235.63–$380.34	46% below	3%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) inpatient CPT 90677	$267.95	$276.00	$179.56–$267.95	—	3%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684	$396.73	$409.00	$327.89–$474.00	25% below	3%
Pneumonia vaccine, 21-valent conjugate (Capvaxive) inpatient CPT 90684	$396.73	$409.00	$265.85–$396.73	—	3%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381	$588.19	$606.00	$219.47–$588.19	1% above	3%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381	$588.19	$606.00	$394.15–$588.19	—	3%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678	$311.20	$320.00	$41.69–$311.20	1% below	3%
RSV vaccine (Abrysvo), one dose for older adults or during pregnancy inpatient CPT 90678	$311.20	$320.00	$208.53–$311.20	—	3%
Rabies vaccine, one dose CPT 90675	$913.38	$941.00	$125.24–$913.38	28% above	3%
Rabies vaccine, one dose inpatient CPT 90675	$913.38	$941.00	$612.06–$913.38	—	3%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680	$91.18	$94.00	$51.26–$98.82	14% below	3%
Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680	$91.18	$94.00	$61.10–$91.18	—	3%
Shingles vaccine (Shingrix), recombinant, one dose CPT 90750	$216.31	$223.00	$190.22–$237.23	1% below	3%
Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750	$216.31	$223.00	$144.95–$216.31	—	3%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715	$146.86	$151.00	$39.07–$146.86	73% above	3%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715	$146.86	$151.00	$98.41–$146.86	—	3%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471	$19.09	$19.00	$13.09–$19.09	45% below	—
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471	$19.09	$19.00	$12.79–$19.09	—	—
Vaccine administration fee, each additional vaccine at the same visit CPT 90472	$26.19	$27.00	$17.95–$26.19	9% below	3%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472	$26.19	$27.00	$17.55–$26.19	—	3%

Source file: https://org-siouxcenterhealth-cdn-2025.s3.amazonaws.com/general-uploads/Sioux-Price-Transparency-2026.csv