Share Medical Center
Share Medical Center in Alva, OK publishes cash prices for 363 common procedures listed here, from its own machine-readable price file updated Mar 18, 2026. Select a procedure to compare it with other hospitals nearby.
800 Share Drive Alva, OK 73717 Collected Sep 28, 2026 Source price file Check a bill from this hospital (580) 430-3355
Critical access hospital (rural, 25 beds or fewer) Government-owned hospital Emergency department CCN 371341 · CMS hospital register NPI 1679684682
Financial assistance
Public hospital: ask for its charity care or sliding-scale discount
Share Medical Center is government-owned (CMS register). The federal financial assistance rules for nonprofit hospitals do not always apply to public ones, but many public hospitals run charity care or sliding-scale discounts for uninsured and low-income patients. Ask the billing office for its financial assistance or charity care policy and application before you pay. Letters you can copy.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| Abdominal CT scan without and with contrast inpatient CPT 74170 CT ABDOMEN W/WO CONTRAST | $1,728.62 | $2,659.41 | $1,728.62–$2,659.41 | 35% |
| Abdominal X-ray, 2 views inpatient CPT 74019 XR ABDOMEN FLAT & UPRIGHT | $122.32 | $188.18 | $122.32–$188.18 | 35% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS LEFT | $151.14 | $232.52 | $151.14–$232.52 | 35% |
| Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR ANKLE 3 VIEWS RIGHT | $151.14 | $232.52 | $151.14–$232.52 | 35% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 US ABI (A/B INDEX) | $285.41 | $439.09 | $285.41–$439.09 | 35% |
| Arm CT scan without contrast (shoulder to hand, any part) inpatient CPT 73200 CT UPPER EXTREMITY W/O CONTR | $996.12 | $1,532.49 | $996.12–$1,532.49 | 35% |
| CT angiography (CTA) of the head inpatient CPT 70496 CTA BRAIN | $1,342.25 | $2,065.00 | $57.34–$1,342.25 | 35% |
| CT angiography (CTA) of the neck inpatient CPT 70498 CTA CAROTID/NECK | $1,326.00 | $2,040.00 | $1,326.00–$2,040.00 | 35% |
| CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CTA CHEST | $1,215.50 | $1,870.00 | $59.68–$1,215.50 | 35% |
| CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT CALCIUM SCORE W/O CONTRAST | $48.75 | $75.00 | $48.75–$75.00 | 35% |
| CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABDOMEN/PELVIS WO CONTRAST | $1,521.94 | $2,341.45 | $1,521.94–$2,341.45 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN/PELVIS-W/CONTRAST | $1,511.25 | $2,325.00 | $1,511.25–$2,325.00 | 35% |
| CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABDOMEN AND PELVIS W & W/O | $1,728.62 | $2,659.41 | $1,728.62–$2,659.41 | 35% |
| CT scan of the abdomen with contrast inpatient CPT 74160 CT ABDOMEN W/ CONTRAST | $1,546.54 | $2,379.30 | $59.85–$1,546.54 | 35% |
| CT scan of the abdomen without contrast inpatient CPT 74150 CT ABDOMEN W/O CONTRAST | $1,521.94 | $2,341.45 | $54.76–$1,521.94 | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT SINUSES W/O CONTRAST | $1,189.44 | $1,829.90 | $40.25–$1,189.44 | 35% |
| CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT MAXILLO FACIAL W/O CONTRAST | $1,189.44 | $1,829.90 | $1,189.44–$1,829.90 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD W/O CONTRAST | $1,169.04 | $1,798.53 | $38.95–$1,169.04 | 35% |
| CT scan of the head with contrast inpatient CPT 70460 CT HEAD W/ CONTRAST | $1,358.15 | $2,089.46 | $1,358.15–$2,089.46 | 35% |
| CT scan of the head without and with contrast inpatient CPT 70470 CT HEAD W/WO CONTRAST | $1,577.48 | $2,426.89 | $1,577.48–$2,426.89 | 35% |
| CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT LUMBAR SPINE W/O CONTRAST | $204.26 | $314.25 | $47.60–$204.26 | 35% |
| CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT CERVICAL SPINE WO CONTRAST | $204.26 | $314.25 | $47.60–$204.26 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/ CONTRAST | $1,159.91 | $1,784.48 | $1,159.91–$1,784.48 | 35% |
| Carotid artery ultrasound (duplex), both sides of the neck inpatient CPT 93880 DUP CAROTID DUPLEX | $275.57 | $423.95 | $275.57–$423.95 | 35% |
| Chest CT scan without and with contrast inpatient CPT 71270 CT CHEST W/WO CONTRAST | $1,265.36 | $1,946.70 | $1,265.36–$1,946.70 | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST 2 VIEWS | $126.54 | $194.67 | $10.50–$126.54 | 35% |
| Chest X-ray, 2 views inpatient CPT 71046 XR CHEST PA & LAT | $126.54 | $194.67 | $126.54–$194.67 | 35% |
| Chest X-ray, single view inpatient CPT 71045 XR CHEST ONLY 1 VIEW | $96.31 | $148.17 | $7.99–$96.31 | 35% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE RIGHT | $191.21 | $294.17 | $191.21–$294.17 | 35% |
| Collarbone (clavicle) X-ray, complete inpatient one side CPT 73000 XR CLAVICLE LEFT | $191.21 | $294.17 | $191.21–$294.17 | 35% |
| Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US RENAL/RETROPERITONEAL | $216.82 | $333.57 | $35.00–$216.82 | 35% |
| Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT CHEST W/O CONTRAST | $760.62 | $1,170.18 | $51.10–$760.62 | 35% |
| Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT CHEST W/ CONTRAST | $1,123.71 | $1,728.78 | $55.30–$1,123.71 | 35% |
| Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 DUP LOWER EXTR ARTERY BILAT | $392.26 | $603.48 | $392.26–$603.48 | 35% |
| Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US DUP BILAT U/L EXT VEINS | $530.74 | $816.53 | $32.55–$530.74 | 35% |
| Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 ECHO COMPL W DOP/COLOR | $852.01 | $1,310.78 | $60.99–$852.01 | 35% |
| Elbow X-ray, 2 views inpatient CPT 73070 XR ELBOW 2 VIEW | $103.34 | $158.98 | $8.05–$103.34 | 35% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW LEFT | $103.34 | $158.98 | $103.34–$158.98 | 35% |
| Elbow X-ray, 2 views inpatient one side CPT 73070 XR ELBOW 2 VIEW RIGHT | $103.34 | $158.98 | $103.34–$158.98 | 35% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 OR 4 VIEWS RIGHT | $205.97 | $316.88 | $205.97–$316.88 | 35% |
| Elbow X-ray, complete, 3 or more views inpatient one side CPT 73080 XR ELBOW 3 OR 4 VIEW LEFT | $205.97 | $316.88 | $205.97–$316.88 | 35% |
| Eye socket (orbit) CT scan without contrast inpatient CPT 70480 CT ORBITS W/O CONTRAST | $1,175.38 | $1,808.27 | $1,175.38–$1,808.27 | 35% |
| Facial bones X-ray, complete, 3 or more views inpatient CPT 70150 XR FACIAL BONES MIN 3 VIEWS | $237.61 | $365.55 | $237.61–$365.55 | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient CPT 73090 XR FOREARM 2 VIEW | $191.21 | $294.17 | $5.36–$191.21 | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEW LEFT | $191.21 | $294.17 | $191.21–$294.17 | 35% |
| Forearm X-ray (radius and ulna), 2 views inpatient one side CPT 73090 XR FOREARM 2 VIEW RIGHT | $191.21 | $294.17 | $191.21–$294.17 | 35% |
| Hand X-ray, 2 views inpatient both sides CPT 73120 XR BILATERAL HANDS 1 VIEW | $56.12 | $86.34 | $56.12–$86.34 | 35% |
| Hand X-ray, 2 views inpatient CPT 73120 XR HAND 2 VIEW | $175.75 | $270.38 | $7.34–$175.75 | 35% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HANDS 2 VIEWS LEFT | $175.75 | $270.38 | $175.75–$270.38 | 35% |
| Hand X-ray, 2 views inpatient one side CPT 73120 XR HAND 2 VIEW RIGHT | $175.75 | $270.38 | $175.75–$270.38 | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient CPT 73650 XR HEEL | $196.83 | $302.82 | $7.70–$196.83 | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL RIGHT | $196.83 | $302.82 | $196.83–$302.82 | 35% |
| Heel bone (calcaneus) X-ray, 2 or more views inpatient one side CPT 73650 XR HEEL LEFT | $196.83 | $302.82 | $196.83–$302.82 | 35% |
| Knee X-ray, 3 views inpatient CPT 73562 XR KNEE 3 VIEWS | $104.04 | $160.06 | $9.10–$104.04 | 35% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3VIEWS LEFT | $104.04 | $160.06 | $104.04–$160.06 | 35% |
| Knee X-ray, 3 views inpatient one side CPT 73562 XR KNEE 3 VIEWS RIGHT | $104.04 | $160.06 | $104.04–$160.06 | 35% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4 VIEW RIGHT | $120.21 | $184.94 | $120.21–$184.94 | 35% |
| Knee X-ray, complete, 4 or more views inpatient one side CPT 73564 XR KNEE 4 VIEW LEFT | $120.21 | $184.94 | $120.21–$184.94 | 35% |
| Leg CT scan without contrast (hip to foot, any part) inpatient CPT 73700 CT LOWER EXTREMITY W/O CONTR | $1,048.84 | $1,613.60 | $46.26–$1,048.84 | 35% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US ABDOMINAL LIMITED | $397.88 | $612.13 | $28.35–$397.88 | 35% |
| Limited ultrasound of an arm or leg (non-vascular) inpatient one side CPT 76882 ULTRASOUND, SOFT TISSUE UNILAT | $208.42 | $320.64 | $21.09–$208.42 | 35% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT LUNG CANCER | $130.00 | $200.00 | $130.00–$200.00 | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient CPT 73590 XR LOWER LEG | $210.19 | $323.37 | $7.70–$210.19 | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER LEG RIGHT | $210.19 | $323.37 | $210.19–$323.37 | 35% |
| Lower leg X-ray (tibia and fibula), 2 views inpatient one side CPT 73590 XR LOWER LEG LEFT | $210.19 | $323.37 | $210.19–$323.37 | 35% |
| MR angiography (MRA) of the head without contrast inpatient CPT 70544 MRA BRAIN W/O CONTRAST | $1,469.92 | $2,261.42 | $56.70–$1,469.92 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOWER EXTR W/O CONTR W/JNT | $1,474.84 | $2,268.99 | $1,474.84–$2,268.99 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOWER EXTR W/WO CONT W/JNT | $2,037.22 | $3,134.19 | $2,037.22–$3,134.19 | 35% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP WO CONTRAST | $458.25 | $705.00 | $458.25–$705.00 | 35% |
| MRI of the abdomen without contrast inpatient CPT 74181 MRI ABDOMEN W/O CONTRAST | $1,707.52 | $2,626.96 | $1,707.52–$2,626.96 | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI MRCP W/WO CONTRAST | $863.40 | $1,328.30 | $863.40–$1,328.30 | 35% |
| MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI ABDOMEN W/WO CONTRAST | $2,727.54 | $4,196.22 | $71.84–$2,727.54 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN W/O CONTRAST | $1,149.36 | $1,768.25 | $1,149.36–$1,768.25 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN W/WO CONTRAST | $2,311.38 | $3,555.97 | $2,311.38–$3,555.97 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE W/O CONTRAST | $970.11 | $1,492.47 | $68.58–$970.11 | 35% |
| MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI LUMBAR SPINE W/WO CONTRAST | $2,262.88 | $3,481.35 | $2,262.88–$3,481.35 | 35% |
| MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI THORACIC SPINE W/O CONT | $1,838.98 | $2,829.20 | $70.00–$1,838.98 | 35% |
| MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI CERVICAL SPINE W/WO CONTR | $2,238.28 | $3,443.50 | $2,238.28–$3,443.50 | 35% |
| MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI CERVICAL SPINE W/O CONTR | $1,614.03 | $2,483.12 | $48.91–$1,614.03 | 35% |
| MRI of the pelvis without and with contrast inpatient CPT 72197 MRI PELVIS W/WO CONTRAST | $2,560.23 | $3,938.82 | $2,560.23–$3,938.82 | 35% |
| MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI PELVIS W/O CONTRAST | $1,497.34 | $2,303.60 | $1,497.34–$2,303.60 | 35% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient CPT 73221 MRI UPPER EXTR JOINT W/O CONT | $1,519.83 | $2,338.20 | $1,519.83–$2,338.20 | 35% |
| Neck (cervical spine) X-ray, 4 or 5 views inpatient CPT 72050 XR CERVICAL SPINE 5 VIEWS | $321.26 | $494.25 | $321.26–$494.25 | 35% |
| Neck soft tissue CT scan with contrast inpatient CPT 70491 CT SOFT TISSUE NECK W/ CONTR | $1,483.28 | $2,281.97 | $1,483.28–$2,281.97 | 35% |
| Neck soft tissue CT scan without contrast inpatient CPT 70490 CT SOFT TISSUE NECK W/O CONTR | $1,219.66 | $1,876.40 | $1,219.66–$1,876.40 | 35% |
| Neck soft tissue X-ray inpatient CPT 70360 XR NECK SOFT TISSUE | $203.16 | $312.55 | $203.16–$312.55 | 35% |
| Pelvic CT scan without contrast inpatient CPT 72192 CT PELVIS W/O CONTRAST | $789.22 | $1,214.18 | $51.45–$789.22 | 35% |
| Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US PELVIC LIMITED | $279.79 | $430.44 | $23.45–$279.79 | 35% |
| Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIC ULTRASOUND (NON OB) | $456.23 | $701.89 | $32.46–$456.23 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB PREGNANCY COMPLETE | $439.36 | $675.94 | $439.36–$675.94 | 35% |
| Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB PREGNANCY < 14 weeks | $328.29 | $505.06 | $47.25–$328.29 | 35% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB PREGNANCY LIMITED | $328.29 | $505.06 | $328.29–$505.06 | 35% |
| Rib X-ray, one side, 2 views inpatient CPT 71100 XR RIBS | $113.88 | $175.20 | $7.45–$113.88 | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS LEFT | $113.88 | $175.20 | $113.88–$175.20 | 35% |
| Rib X-ray, one side, 2 views inpatient one side CPT 71100 XR RIBS RIGHT | $113.88 | $175.20 | $113.88–$175.20 | 35% |
| Rib X-ray, one side, with a chest view, 3 or more views inpatient CPT 71101 XR RIBS W/PA CXR | $319.85 | $492.08 | $319.85–$492.08 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 MAMMO BILATERAL-SCREENING | $202.11 | $310.94 | $35.16–$202.11 | 35% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO UNILATERAL-SCREENING RT | $178.75 | $275.00 | $178.75–$275.00 | 35% |
| Screening mammogram, both breasts inpatient one side CPT 77067 MAMMO UNILATERAL-SCREENING LT | $178.75 | $275.00 | $178.75–$275.00 | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient CPT 73030 XR SHOULDER MIN 2 VIEW | $151.14 | $232.52 | $9.10–$151.14 | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER MIN 2 VIEW RIGHT | $151.14 | $232.52 | $151.14–$232.52 | 35% |
| Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR SHOULDER MIN 2 VIEW LEFT | $151.14 | $232.52 | $151.14–$232.52 | 35% |
| Sinus X-ray, complete, 3 or more views inpatient CPT 70220 XR SINUS SERIES 2 OR MORE VIEW | $262.21 | $403.40 | $262.21–$403.40 | 35% |
| Skull X-ray, fewer than 4 views inpatient CPT 70250 XR SKULL 2 VIEWS | $216.52 | $333.10 | $216.52–$333.10 | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient CPT 73552 XR FEMUR | $243.93 | $375.28 | $8.75–$243.93 | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR LEFT | $243.93 | $375.28 | $243.93–$375.28 | 35% |
| Thigh bone (femur) X-ray, 2 or more views inpatient one side CPT 73552 XR FEMUR RIGHT | $243.93 | $375.28 | $243.93–$375.28 | 35% |
| Thoracic spine (mid back) CT scan without contrast inpatient CPT 72128 CT THORACIC SPINE W/O CONTRAST | $1,305.43 | $2,008.35 | $32.87–$1,305.43 | 35% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) LEFT | $173.63 | $267.13 | $173.63–$267.13 | 35% |
| Toe X-ray, 2 or more views inpatient one side CPT 73660 XR TOE(S) RIGHT | $173.63 | $267.13 | $173.63–$267.13 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL PELVIS | $400.70 | $616.46 | $400.70–$616.46 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN UPPER COMPLETE | $253.07 | $389.34 | $26.58–$253.07 | 35% |
| Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM AND CONT | $401.40 | $617.54 | $21.18–$401.40 | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US SOFT TISSUE NECK | $754.99 | $1,161.53 | $754.99–$1,161.53 | 35% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US THYROID | $754.99 | $1,161.53 | $18.81–$754.99 | 35% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS RIGHT | $201.05 | $309.31 | $201.05–$309.31 | 35% |
| Upper arm X-ray (humerus), 2 views inpatient one side CPT 73060 XR HUMERUS LEFT | $201.05 | $309.31 | $201.05–$309.31 | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 US DUP UNI U/L EXT VEINS | $294.55 | $453.15 | $294.55–$453.15 | 35% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 DUP UPPER EXTR VEINS UNILAT | $461.32 | $709.73 | $461.32–$709.73 | 35% |
| Wrist X-ray, 2 views inpatient CPT 73100 XR WRIST 2 VIEW | $98.42 | $151.41 | $8.05–$98.42 | 35% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEW LEFT | $98.42 | $151.41 | $98.42–$151.41 | 35% |
| Wrist X-ray, 2 views inpatient one side CPT 73100 XR WRIST 2 VIEWS RIGHT | $98.42 | $151.41 | $98.42–$151.41 | 35% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEW LEFT | $101.23 | $155.74 | $101.23–$155.74 | 35% |
| Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR WRIST 3 VIEWS RIGHT | $101.23 | $155.74 | $101.23–$155.74 | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2-3 VIEWS RIGHT | $106.15 | $163.31 | $106.15–$163.31 | 35% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR HIP 2-3 VIEWS LEFT | $106.15 | $163.31 | $106.15–$163.31 | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR KUB | $108.52 | $166.95 | $108.52–$166.95 | 35% |
| X-ray of the abdomen, 1 view inpatient CPT 74018 XR ABDOMEN (FLAT PLATE) 1VIEW | $108.52 | $166.95 | $8.75–$108.52 | 35% |
| X-ray of the ankle, 2 views inpatient CPT 73600 XR ANKLE 2 VIEW | $103.34 | $158.98 | $8.05–$103.34 | 35% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEW RIGHT | $103.34 | $158.98 | $103.34–$158.98 | 35% |
| X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 2 VIEW LEFT | $103.34 | $158.98 | $103.34–$158.98 | 35% |
| X-ray of the finger(s), 2 or more views inpatient CPT 73140 XR FINGERS HAND | $174.34 | $268.21 | $6.65–$174.34 | 35% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS HAND LEFT | $174.34 | $268.21 | $174.34–$268.21 | 35% |
| X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGERS HAND RIGHT | $174.34 | $268.21 | $174.34–$268.21 | 35% |
| X-ray of the foot, 2 views inpatient CPT 73620 XR FOOT 2 VIEW | $103.34 | $158.98 | $7.35–$103.34 | 35% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW RIGHT | $103.34 | $158.98 | $103.34–$158.98 | 35% |
| X-ray of the foot, 2 views inpatient one side CPT 73620 XR FOOT 2 VIEW LEFT | $103.34 | $158.98 | $103.34–$158.98 | 35% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEW LEFT | $101.23 | $155.74 | $101.23–$155.74 | 35% |
| X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR FOOT 3 VIEWS RIGHT | $101.23 | $155.74 | $101.23–$155.74 | 35% |
| X-ray of the hand, 3 or more views inpatient CPT 73130 XR HAND 3 VIEW | $205.97 | $316.88 | $5.81–$205.97 | 35% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW RIGHT | $205.97 | $316.88 | $205.97–$316.88 | 35% |
| X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR HAND 3 VIEW LEFT | $205.97 | $316.88 | $205.97–$316.88 | 35% |
| X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR BILATERAL KNEES 1-2 VIEWS | $61.39 | $94.44 | $61.39–$94.44 | 35% |
| X-ray of the knee, 1 or 2 views inpatient CPT 73560 XR KNEE 1-2 VIEWS | $97.01 | $149.25 | $8.05–$97.01 | 35% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEWS RIGHT | $97.01 | $149.25 | $97.01–$149.25 | 35% |
| X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR KNEE 1-2 VIEWS LEFT | $97.01 | $149.25 | $97.01–$149.25 | 35% |
| X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR LUMBAR SPINE 2 OR 3 VIEWS | $175.75 | $270.38 | $175.75–$270.38 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR LUMBAR SPINE 4-5 VIEWS | $158.17 | $243.34 | $12.60–$158.17 | 35% |
| X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR THORAC SPINE AP&LAT-2 VIEWS | $241.12 | $370.95 | $241.12–$370.95 | 35% |
| X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR NASAL BONES | $213.00 | $327.69 | $213.00–$327.69 | 35% |
| X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR CERVICL SPINE - 2 OR 3 VIEW | $103.08 | $158.58 | $103.08–$158.58 | 35% |
| X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR PELVIS 1 TO 2 VIEWS | $118.10 | $181.69 | $8.15–$118.10 | 35% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR SACRUM & COCCYX | $201.05 | $309.31 | $201.05–$309.31 | 35% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| ACTH blood test inpatient CPT 82024 ACTH | $113.88 | $175.20 | $113.88–$175.20 | 35% |
| ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT/SGPT | $24.49 | $37.67 | $24.49–$37.67 | 35% |
| AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST/SGOT | $24.21 | $37.24 | $24.21–$37.24 | 35% |
| Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 HEPATITIS PANEL | $199.36 | $306.71 | $20.00–$199.36 | 35% |
| Albumin blood test inpatient CPT 82040 ALBUMIN | $30.23 | $46.50 | $30.23–$46.50 | 35% |
| Aldosterone blood test inpatient CPT 82088 ALDOSTERONE | $167.31 | $257.40 | $167.31–$257.40 | 35% |
| Alkaline phosphatase (ALP) blood test inpatient CPT 84075 ALKALINE PHOSPHATASE | $44.28 | $68.13 | $44.28–$68.13 | 35% |
| Allergy blood test, specific IgE, per allergen inpatient CPT 86003 ALLERGEN | $9.75 | $15.00 | $9.75–$15.00 | 35% |
| Alpha-fetoprotein (AFP) blood test inpatient CPT 82105 ALPHA-FETOPROTEIN | $123.02 | $189.26 | $123.02–$189.26 | 35% |
| Ammonia blood test inpatient CPT 82140 Ammonia | $80.14 | $123.29 | $6.12–$80.14 | 35% |
| Ammonia blood test inpatient CPT 82140 AMMONIA | $80.14 | $123.29 | $80.14–$123.29 | 35% |
| Amylase blood test inpatient CPT 82150 AMYLASE | $39.36 | $60.56 | $2.72–$39.36 | 35% |
| Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP | $84.36 | $129.78 | $84.36–$129.78 | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-CENTROMERE ANTIBODY | $23.90 | $36.77 | $23.90–$36.77 | 35% |
| Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANTI-NUCLEAR ANTIBODY SCREEN | $73.11 | $112.48 | $73.11–$112.48 | 35% |
| BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 BNP (B TYPE NATRIURETIC PEPTID | $126.70 | $194.92 | $16.49–$126.70 | 35% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) inpatient CPT 87070 CULTURE | $45.70 | $70.30 | $45.70–$70.30 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BMP | $58.34 | $89.76 | $3.55–$58.34 | 35% |
| Bilirubin blood test, total inpatient CPT 82247 Bilirubin Total | $52.02 | $80.03 | $2.11–$52.02 | 35% |
| Bilirubin blood test, total inpatient CPT 82247 BILIRUBIN TOTAL | $52.02 | $80.03 | $52.02–$80.03 | 35% |
| Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 TECH COMP | $83.66 | $128.70 | $83.66–$128.70 | 35% |
| Blood culture for bacteria inpatient CPT 87040 CULTURE BLOOD | $42.88 | $65.97 | $4.33–$42.88 | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 DLO Collection Fee | $8.34 | $12.83 | $8.34–$12.83 | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE | $8.34 | $12.83 | $8.34–$12.83 | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE SIMPLE | $9.75 | $15.00 | $9.75–$15.00 | 35% |
| Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture | $9.75 | $15.00 | $1.26–$9.75 | 35% |
| Blood lead test inpatient CPT 83655 LEAD | $58.34 | $89.76 | $5.09–$58.34 | 35% |
| Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO | $21.79 | $33.53 | $1.26–$21.79 | 35% |
| Blood urea nitrogen (BUN) test inpatient CPT 84520 BLOOD UREA NITROGEN | $20.38 | $31.36 | $20.38–$31.36 | 35% |
| C-peptide blood test inpatient CPT 84681 C-PEPTIDE | $45.83 | $70.50 | $45.83–$70.50 | 35% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-REACTIVE PROTEIN | $52.45 | $80.69 | $2.18–$52.45 | 35% |
| C. difficile toxin gene test (stool PCR) inpatient CPT 87493 CLOSTRIDIUM DIFFICLE PCR | $146.22 | $224.95 | $146.22–$224.95 | 35% |
| CA 19-9 blood test (tumor marker) inpatient CPT 86301 CA 19-9 | $106.15 | $163.31 | $106.15–$163.31 | 35% |
| CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 CA 125 | $117.40 | $180.61 | $117.40–$180.61 | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SAR-COV-2 RNA QT PCR PRIORITY1 | $97.50 | $150.00 | $97.50–$150.00 | 35% |
| COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 SARS-COV-2 COVID-19 AMP PRB | $97.50 | $150.00 | $97.50–$150.00 | 35% |
| Calcium blood test, total inpatient CPT 82310 Calcium | $49.21 | $75.71 | $2.17–$49.21 | 35% |
| Calcium blood test, total inpatient CPT 82310 CALCIUM | $49.21 | $75.71 | $49.21–$75.71 | 35% |
| Carcinoembryonic antigen (CEA) test inpatient CPT 82378 CARCINOEMBRYONIC ANTIGEN | $88.48 | $136.12 | $88.48–$136.12 | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IgG AB | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER IgG AB- NWOSU | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Chickenpox (varicella) immunity blood test inpatient CPT 86787 VARICELLA-ZOSTER VIRUS AB | $70.30 | $108.15 | $70.30–$108.15 | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA T DNA SDA | $44.28 | $68.13 | $44.28–$68.13 | 35% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 CHLAMYDIA | $110.37 | $169.80 | $110.37–$169.80 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel | $61.81 | $95.09 | $5.62–$61.81 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $61.81 | $95.09 | $61.81–$95.09 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC WITH AUTO DIFF | $36.27 | $55.80 | $36.27–$55.80 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 COMPLETE BLOOD COUNT | $37.26 | $57.32 | $2.72–$37.26 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Complete Metabolic Profile | $79.44 | $122.21 | $6.10–$79.44 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 CMP | $79.44 | $122.21 | $79.44–$122.21 | 35% |
| Cortisol blood test, total inpatient CPT 82533 CORTISOL FREE | $87.17 | $134.11 | $87.17–$134.11 | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 Creatine Kinase | $36.56 | $56.24 | $2.73–$36.56 | 35% |
| Creatine kinase (CK) blood test, total inpatient CPT 82550 CK | $36.56 | $56.24 | $36.56–$56.24 | 35% |
| Creatinine blood test inpatient CPT 82565 CREATININE | $30.23 | $46.50 | $30.23–$46.50 | 35% |
| Cytomegalovirus (CMV) antibody test inpatient CPT 86644 CMV AB | $89.98 | $138.43 | $89.98–$138.43 | 35% |
| D-dimer blood test (blood clot marker) inpatient CPT 85379 D-DIMER TITRE | $102.26 | $157.33 | $102.26–$157.33 | 35% |
| DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DEHYDROEPIANDROSTERONE SULFATE | $89.98 | $138.43 | $89.98–$138.43 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN NWOSU | $29.25 | $45.00 | $29.25–$45.00 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN COC | $42.25 | $65.00 | $42.25–$65.00 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 ETHANOL | $42.25 | $65.00 | $42.25–$65.00 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DS ETG 80HR | $48.75 | $75.00 | $48.75–$75.00 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 METHAMP D&L ISOMER | $68.25 | $105.00 | $68.25–$105.00 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN HPP | $70.30 | $108.15 | $70.30–$108.15 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN NON-DOT | $71.70 | $110.31 | $71.70–$110.31 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 DRUG SCREEN AFTER HOURS QUEST | $117.00 | $180.00 | $117.00–$180.00 | 35% |
| Drug screen by lab instrument (any number of drug classes) inpatient CPT 80307 Drug Screen | $117.00 | $180.00 | $26.10–$117.00 | 35% |
| Electrolyte panel (sodium, potassium, chloride, CO2) inpatient CPT 80051 ELECTROLYTES | $50.62 | $77.87 | $50.62–$77.87 | 35% |
| Epstein-Barr virus (EBV) antibody test inpatient CPT 86665 EBV VIRAL CAPSID AG | $35.15 | $54.08 | $35.15–$54.08 | 35% |
| Estradiol blood test inpatient CPT 82670 ESTRADIOL | $130.23 | $200.35 | $130.23–$200.35 | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 FOLLICLE STIMULATING HORMONE | $104.08 | $160.12 | $104.08–$160.12 | 35% |
| FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone | $104.08 | $160.12 | $7.80–$104.08 | 35% |
| Fecal calprotectin (stool inflammation test) inpatient CPT 83993 CALPROTECTIN | $130.17 | $200.26 | $130.17–$200.26 | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 FERRITIN | $62.89 | $96.75 | $62.89–$96.75 | 35% |
| Ferritin blood test (iron stores) inpatient CPT 82728 Ferretin | $62.89 | $96.75 | $5.72–$62.89 | 35% |
| Fibrinogen blood test inpatient CPT 85384 FIBRINOGEN | $37.29 | $57.37 | $37.29–$57.37 | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 FOLIC ACID | $82.95 | $127.62 | $82.95–$127.62 | 35% |
| Folate (folic acid) blood test inpatient CPT 82746 Folic Acid | $82.95 | $127.62 | $6.17–$82.95 | 35% |
| Free T3 thyroid hormone test inpatient CPT 84481 FREE T3 | $94.63 | $145.58 | $94.63–$145.58 | 35% |
| Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 FREE T4 | $50.38 | $77.50 | $50.38–$77.50 | 35% |
| Free testosterone test inpatient CPT 84402 TESTOSTERONE, FREE | $114.58 | $176.28 | $10.70–$114.58 | 35% |
| Gamma-glutamyl transferase (GGT) blood test inpatient CPT 82977 GAMMA GLUTAMYL TRANSPEPTIDASE | $49.21 | $75.71 | $49.21–$75.71 | 35% |
| General health panel: metabolic panel, blood count and TSH in one order inpatient CPT 80050 GENERAL HEALTH PANEL | $194.18 | $298.74 | $194.18–$298.74 | 35% |
| Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 GESTATIONAL GLUCOSE SCREEN | $50.62 | $77.87 | $50.62–$77.87 | 35% |
| Glucose tolerance test, 3 samples inpatient CPT 82951 GLUCOSE TOLERANCE TEST 3 SPEC | $134.97 | $207.65 | $7.72–$134.97 | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEIS GONN DNA SDA | $44.28 | $68.13 | $44.28–$68.13 | 35% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 NEISSERIA GONORRHOEAE | $108.96 | $167.63 | $108.96–$167.63 | 35% |
| H. pylori antibody blood test inpatient CPT 86677 H.PYLORI UREASE AB | $64.84 | $99.75 | $64.84–$99.75 | 35% |
| H. pylori stool antigen test inpatient CPT 87338 H.PYLORI STOOL AG | $112.48 | $173.04 | $112.48–$173.04 | 35% |
| HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV RNA PCR | $250.73 | $385.74 | $250.73–$385.74 | 35% |
| HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV 1/2 | $75.92 | $116.80 | $75.92–$116.80 | 35% |
| HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV 1/2 4TH GEN | $22.11 | $34.02 | $22.11–$34.02 | 35% |
| HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV | $130.90 | $201.38 | $130.90–$201.38 | 35% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 GLYCATED HEMOGLOBIN | $39.91 | $61.40 | $39.91–$61.40 | 35% |
| Hemoglobin blood test inpatient CPT 85018 HEMOGLOBIN | $5.03 | $7.74 | $5.03–$7.74 | 35% |
| Hepatitis B core antibody test (total) inpatient CPT 86704 HEPATITIS B CORE AB TOTAL | $92.09 | $141.68 | $92.09–$141.68 | 35% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 HEP B SURFACE ANTIBODY GRP | $52.00 | $80.00 | $52.00–$80.00 | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B OB | $17.58 | $27.04 | $17.58–$27.04 | 35% |
| Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 HEP B SURFACE ANTIGEN GRP | $66.78 | $102.74 | $66.78–$102.74 | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEP C AB W/R TO HCV RNA | $65.95 | $101.46 | $65.95–$101.46 | 35% |
| Hepatitis C antibody blood test (screening) inpatient CPT 86803 HEPATITIS C VIRUS ANTIBODY | $85.06 | $130.86 | $85.06–$130.86 | 35% |
| Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HEPATITIS C PCR | $117.54 | $180.83 | $117.54–$180.83 | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 CSF | $39.96 | $61.47 | $39.96–$61.47 | 35% |
| Herpes blood test, HSV-1 antibody inpatient CPT 86695 HERPES SIMPLEX TYPE 1 | $75.79 | $116.60 | $75.79–$116.60 | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV2 CSF | $35.32 | $54.34 | $35.32–$54.34 | 35% |
| Herpes blood test, HSV-2 antibody inpatient CPT 86696 HERPES SIMPLEX TYPE 2 | $65.38 | $100.58 | $65.38–$100.58 | 35% |
| High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP CARDIAC | $82.49 | $126.90 | $82.49–$126.90 | 35% |
| Homocysteine blood test inpatient CPT 83090 HOMOCYSTEINE | $146.53 | $225.43 | $146.53–$225.43 | 35% |
| Insulin blood test inpatient CPT 83525 INSULIN | $19.12 | $29.41 | $19.12–$29.41 | 35% |
| Iron blood test (serum iron) inpatient CPT 83540 IRON (FE) | $24.90 | $38.31 | $2.72–$24.90 | 35% |
| Iron-binding capacity (TIBC) test inpatient CPT 83550 TOTAL IRON BINDING CAPACITY | $39.49 | $60.76 | $39.49–$60.76 | 35% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $47.10 | $72.46 | $3.65–$47.10 | 35% |
| LH (luteinizing hormone) test inpatient CPT 83002 LUTEINIZING HORMONE | $103.08 | $158.58 | $103.08–$158.58 | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 LACTIC ACID | $77.33 | $118.97 | $77.33–$118.97 | 35% |
| Lactate (lactic acid) blood test inpatient CPT 83605 Lactic Acid | $77.33 | $118.97 | $4.86–$77.33 | 35% |
| Lactate dehydrogenase (LDH) blood test inpatient CPT 83615 LDH | $27.88 | $42.89 | $2.54–$27.88 | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase | $38.43 | $59.13 | $2.89–$38.43 | 35% |
| Lipase blood test (pancreas enzyme) inpatient CPT 83690 LIPASE | $38.43 | $59.13 | $38.43–$59.13 | 35% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $50.62 | $77.87 | $50.62–$77.87 | 35% |
| Lyme disease antibody test inpatient CPT 86618 LYME DISEASE ANTIBODIES | $95.00 | $146.15 | $95.00–$146.15 | 35% |
| Magnesium blood test inpatient CPT 83735 MAGNESIUM | $37.39 | $57.53 | $2.81–$37.39 | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBELLA AB - NWOSU | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Measles (rubeola) antibody test inpatient CPT 86765 RUBELLA AB | $66.08 | $101.66 | $66.08–$101.66 | 35% |
| Mono test (heterophile antibody, Monospot) inpatient CPT 86308 MONOSCREEN-RAPID | $66.08 | $101.66 | $3.11–$66.08 | 35% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB - NWOSU | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Mumps immunity blood test inpatient CPT 86735 MUMPS AB | $56.94 | $87.60 | $56.94–$87.60 | 35% |
| Obstetric blood test panel inpatient CPT 80055 OB PANEL | $70.30 | $108.15 | $70.30–$108.15 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA, Free | $98.42 | $151.41 | $98.42–$151.41 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free | $98.42 | $151.41 | $7.72–$98.42 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC | $98.42 | $151.41 | $98.42–$151.41 | 35% |
| Pap test (liquid-based, automated screening with review) inpatient CPT 88175 THIN PREP PAP | $102.64 | $157.90 | $102.64–$157.90 | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 PAP SMEAR | $102.64 | $157.90 | $102.64–$157.90 | 35% |
| Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Pap Smear | $102.64 | $157.90 | $12.16–$102.64 | 35% |
| Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH | $174.82 | $268.95 | $17.34–$174.82 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PARTIAL THROMBOPLASTIN TIME | $33.55 | $51.62 | $2.52–$33.55 | 35% |
| Phosphorus (phosphate) blood test inpatient CPT 84100 PHOSPHOROUS | $29.30 | $45.08 | $1.99–$29.30 | 35% |
| Potassium blood test inpatient CPT 84132 POTASSIUM | $33.04 | $50.83 | $2.00–$33.04 | 35% |
| Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 QNATAL ADVANCED | $1,768.42 | $2,720.64 | $1,768.42–$2,720.64 | 35% |
| Progesterone blood test inpatient CPT 84144 PROGESTERONE | $102.64 | $157.90 | $8.76–$102.64 | 35% |
| Prolactin blood test inpatient CPT 84146 PROLACTIN | $98.42 | $151.41 | $8.14–$98.42 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME PROFILE | $23.20 | $35.69 | $2.57–$23.20 | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG SCREEN QUAL | $39.00 | $60.00 | $39.00–$60.00 | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 Drug Screen Qualitative | $39.00 | $60.00 | $5.29–$39.00 | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 URINE DRUG SCREEN TEST CUP | $39.00 | $60.00 | $39.00–$60.00 | 35% |
| Rapid drug screen read by eye (cup, dipstick or card), per day inpatient CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $39.00 | $60.00 | $39.00–$60.00 | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC FLU A | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA TEST-RAPID | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA ASSAY W/OPTIC FLU B | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Rapid flu test (influenza antigen) inpatient CPT 87804 INFLUENZA A/B | $48.75 | $75.00 | $48.75–$75.00 | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP A ASSAY W/OPTIC | $29.25 | $45.00 | $29.25–$45.00 | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Step Screen | $45.14 | $69.45 | $9.89–$45.14 | 35% |
| Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 STREP SCREEN | $45.14 | $69.45 | $45.14–$69.45 | 35% |
| Renin blood test inpatient CPT 84244 RENIN | $111.77 | $171.96 | $111.77–$171.96 | 35% |
| Rh blood typing inpatient CPT 86901 RH | $21.09 | $32.45 | $1.26–$21.09 | 35% |
| Rheumatoid factor (RF) test inpatient CPT 86431 RHEUMATOID TITER | $32.34 | $49.75 | $32.34–$49.75 | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA OB | $17.58 | $27.04 | $17.58–$27.04 | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgG ANTIBODY - NWOSU | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Rubella antibody test (immunity check) inpatient CPT 86762 RUBELLA IgG ANTIBODY | $57.64 | $88.68 | $57.64–$88.68 | 35% |
| Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 SED RATE MODIFIED | $27.42 | $42.18 | $27.42–$42.18 | 35% |
| Sodium blood test inpatient CPT 84295 SODIUM, BLOOD | $39.36 | $60.56 | $39.36–$60.56 | 35% |
| Stool ova and parasites exam inpatient CPT 87177 OVA AND PARASITE EXAM | $101.74 | $156.53 | $3.74–$101.74 | 35% |
| Stool test for hidden blood (guaiac FOBT) inpatient CPT 82270 OCCULT BLOOD FECAL SCREENING | $27.07 | $41.64 | $2.63–$27.07 | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 RPR TITER | $59.14 | $90.99 | $59.14–$90.99 | 35% |
| Syphilis antibody test (Treponema pallidum) inpatient CPT 86780 FTA-ABS | $63.27 | $97.34 | $63.27–$97.34 | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 RAPID PLASMA REAGIN | $41.48 | $63.81 | $41.48–$63.81 | 35% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL | $63.27 | $97.34 | $63.27–$97.34 | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 TB GOLD NWOSU | $65.00 | $100.00 | $65.00–$100.00 | 35% |
| TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QUANTIFERON TB GOLD | $101.23 | $155.74 | $101.23–$155.74 | 35% |
| Testosterone blood test, total (not free testosterone) inpatient CPT 84403 TESTOSTERONE, TOTAL | $119.08 | $183.20 | $119.08–$183.20 | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 LKM ANTIBODY | $45.21 | $69.56 | $45.21–$69.56 | 35% |
| Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 THYROID PEROXIDASE AB | $80.14 | $123.29 | $80.14–$123.29 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE | $78.47 | $120.73 | $7.06–$78.47 | 35% |
| Total IgE blood test inpatient CPT 82785 IMMUNOGLOBULIN E | $28.12 | $43.26 | $28.12–$43.26 | 35% |
| Total cholesterol blood test inpatient CPT 82465 Cholesterol | $41.48 | $63.81 | $1.83–$41.48 | 35% |
| Total cholesterol blood test inpatient CPT 82465 CHOLESTEROL | $41.48 | $63.81 | $41.48–$63.81 | 35% |
| Total thyroxine (T4) blood test inpatient CPT 84436 THYROXINE (T4) | $56.24 | $86.52 | $2.89–$56.24 | 35% |
| Total triiodothyronine (T3) blood test inpatient CPT 84480 T3 | $78.83 | $121.27 | $5.96–$78.83 | 35% |
| Transferrin blood test inpatient CPT 84466 TRANSFERRIN | $101.23 | $155.74 | $101.23–$155.74 | 35% |
| Trichomonas test (NAAT) inpatient CPT 87661 TRICH RNA | $153.19 | $235.68 | $153.19–$235.68 | 35% |
| Triglycerides blood test inpatient CPT 84478 TRIGLYCERIDES | $35.85 | $55.16 | $35.85–$55.16 | 35% |
| Troponin test, quantitative inpatient CPT 84484 Troponin | $96.31 | $148.17 | $5.24–$96.31 | 35% |
| Troponin test, quantitative inpatient CPT 84484 TROPONIN I | $96.31 | $148.17 | $96.31–$148.17 | 35% |
| Uric acid blood test inpatient CPT 84550 URIC ACID, BLOOD | $28.82 | $44.34 | $1.90–$28.82 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS, AUTO W/SCOPE | $42.90 | $66.00 | $42.90–$66.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 UA | $46.40 | $71.38 | $1.90–$46.40 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS | $46.40 | $71.38 | $46.40–$71.38 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS | $9.75 | $15.00 | $2.41–$9.75 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS-UCC MCR | $9.75 | $15.00 | $9.75–$15.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS (MACRO) | $23.90 | $36.77 | $23.90–$36.77 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 SPECIFIC GRAVITY | $23.90 | $36.77 | $1.35–$23.90 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINE-NO MICRO | $19.50 | $30.00 | $19.50–$30.00 | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 Urine Culture | $42.27 | $65.03 | $3.39–$42.27 | 35% |
| Urine culture for bacteria, with colony count inpatient CPT 87086 URINE CULTURE | $42.27 | $65.03 | $42.27–$65.03 | 35% |
| Urine microalbumin (albumin) test inpatient CPT 82043 MICROALBUMIN | $26.72 | $41.10 | $26.72–$41.10 | 35% |
| Urine pregnancy test, read by color change inpatient CPT 81025 URINE PREGNANCY TEST | $16.25 | $25.00 | $5.17–$16.25 | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B-12 | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 VITAMIN B12 | $55.64 | $85.60 | $55.64–$85.60 | 35% |
| Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level | $55.64 | $85.60 | $6.33–$55.64 | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 VITAMIN D | $143.41 | $220.63 | $143.41–$220.63 | 35% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D | $143.41 | $220.63 | $12.43–$143.41 | 35% |
| Vitamin D, 1,25-dihydroxy blood test inpatient CPT 82652 VIT D 1 | $152.55 | $234.69 | $16.17–$152.55 | 35% |
| Zinc blood test inpatient CPT 84630 ZINC (ZI) | $66.08 | $101.66 | $66.08–$101.66 | 35% |
| hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG TOTAL QN | $108.26 | $166.55 | $9.03–$108.26 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL RELEASE | $804.61 | $1,237.86 | $804.61–$1,237.86 | 35% |
| Carpal tunnel release, open surgery inpatient CPT 64721 CARPAL TUNNEL MEDIAN NERVE | $3,505.16 | $5,392.56 | $3,505.16–$5,392.56 | 35% |
| Cataract surgery with lens implant inpatient CPT 66984 XCAPSI CTRC RMVL W/O ECP | $4,329.68 | $6,661.05 | $4,329.68–$6,661.05 | 35% |
| Circumcision by surgical excision, older than 28 days (children and adults) inpatient CPT 54161 CIRCUMCISION > 28 DAYS | $219.70 | $338.00 | $219.70–$338.00 | 35% |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION | $219.70 | $338.00 | $219.70–$338.00 | 35% |
| Circumcision, surgical, older than a newborn inpatient CPT 54160 CIRCUMCISION < 28 DAYS | $219.70 | $338.00 | $219.70–$338.00 | 35% |
| Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 REDUCE WRIST FX WO MAN 25600 | $121.28 | $186.59 | $121.28 | 35% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLONOSCOPY W/REMOVAL BY SNARE | $467.40 | $719.07 | $467.40–$719.07 | 35% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/SINGLE | $369.10 | $567.84 | $369.10–$567.84 | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY DIAGNOSTIC PRO | $220.60 | $339.39 | $220.60–$339.39 | 35% |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTROY BENIGN/PREMLG LESION | $78.00 | $120.00 | $78.00–$120.00 | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE EAR WAX IRRIGATION UNI | $52.00 | $80.00 | $52.00–$80.00 | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE CERUMEN BIL 69209 | $138.49 | $213.06 | $138.49–$213.06 | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE CERUMEN UNI 69209 | $138.49 | $213.06 | $138.49–$213.06 | 35% |
| Earwax removal by irrigation (rinsing), one ear inpatient CPT 69209 REMOVE CERUMEN 69209 | $138.49 | $213.06 | $138.49–$213.06 | 35% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE EAR WAX INSTRUMENT UNI | $52.00 | $80.00 | $52.00–$80.00 | 35% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE EAR WAX INSTRUMENT | $52.00 | $80.00 | $52.00–$80.00 | 35% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN INST BIL 69210 | $138.49 | $213.06 | $138.49–$213.06 | 35% |
| Earwax removal with instruments, one ear inpatient CPT 69210 REMOVE CERUMEN INSTRU 69210 | $138.49 | $213.06 | $138.49–$213.06 | 35% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 CHOLECYSTECTOMY LAPAROSCOPY | $1,220.88 | $1,878.27 | $1,220.88–$1,878.27 | 35% |
| Gallbladder removal, open surgery through a larger incision inpatient CPT 47600 CHOLECYSTECTOMY OPEN | $1,962.27 | $3,018.87 | $1,962.27–$3,018.87 | 35% |
| Hammertoe correction surgery inpatient CPT 28285 REPAIR OF HAMMERTOE | $6,326.99 | $9,733.83 | $6,326.99–$9,733.83 | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABSCESS DRAINAGE SIMPLE | $143.00 | $220.00 | $143.00–$220.00 | 35% |
| Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAIN CYST/LESION 10060 | $632.68 | $973.35 | $91.73–$632.68 | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 PR INJ TENDON SHEATH/LIG PRO | $72.99 | $112.29 | $72.99–$112.29 | 35% |
| Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT | $103.72 | $159.57 | $103.72–$159.57 | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient both sides CPT 20610 ASP/INJ MAJOR JOINT BILAT | $78.00 | $120.00 | $78.00–$120.00 | 35% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ASP/INJ MAJOR JOINT | $78.00 | $120.00 | $78.00–$120.00 | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient both sides CPT 20605 ASP/INJ INTERMED JOINT BILAT | $61.75 | $95.00 | $61.75–$95.00 | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMEDIATE JOINT | $61.75 | $95.00 | $61.75–$95.00 | 35% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ASP/INJ INTERMEDIATE JOINT CLI | $61.75 | $95.00 | $61.75–$95.00 | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient both sides CPT 20600 ASP/INJ SM JOINT BILAT | $48.75 | $75.00 | $48.75–$75.00 | 35% |
| Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ASP/INJ SMALL JOINT | $48.75 | $75.00 | $48.75–$75.00 | 35% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHRSCOPY, KNEE W/MENISCECTOM | $1,001.13 | $1,540.20 | $1,001.13–$1,540.20 | 35% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 ARTHROSCOPY,KNEE W/MENISCECTOM | $6,326.99 | $9,733.83 | $6,326.99–$9,733.83 | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC RPR SCLP/TRUNK/EXT TO 2.5 | $211.59 | $325.53 | $211.59–$325.53 | 35% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAC REPAIR INTERM 12031 | $211.59 | $325.53 | $211.59–$325.53 | 35% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 EXC TR-EXT B9 MARG 0.5 < CM | $121.55 | $187.00 | $121.55–$187.00 | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE | $60.07 | $92.41 | $60.07–$92.41 | 35% |
| Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVE NAIL PLATE 11730 | $318.45 | $489.92 | $318.45–$489.92 | 35% |
| Partial knee replacement (one compartment) inpatient CPT 27446 REVISION KNEE JOINT | $2,069.61 | $3,184.02 | $2,069.61–$3,184.02 | 35% |
| Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED | $135.87 | $209.03 | $135.87–$209.03 | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 FB REMOVAL SUB Q SIMPLE | $123.50 | $190.00 | $123.50–$190.00 | 35% |
| Removal of a foreign object under the skin, simple inpatient CPT 10120 REMOVE FB SUBQ 10120 | $212.30 | $326.61 | $212.30–$326.61 | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 CAST APPL SHORT ARM 29075 | $142.00 | $218.46 | $142.00–$218.46 | 35% |
| Short arm cast (elbow to hand) inpatient CPT 29075 CAST APP SHORT ARM -CLINIC | $142.00 | $218.46 | $142.00–$218.46 | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 APPLY FOREARM SPLINT | $93.60 | $144.00 | $93.60–$144.00 | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 SPLINT APPL SHORT ARM 29125 | $227.77 | $350.41 | $227.77–$350.41 | 35% |
| Short arm splint (forearm and hand) inpatient CPT 29125 Splint Application Short Arm | $227.77 | $350.41 | $35.55–$227.77 | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 CLI APPLY SHORT LEG CAST | $144.87 | $222.87 | $144.87–$222.87 | 35% |
| Short leg cast (below the knee) inpatient CPT 29405 CAST APPL LOW LEG 29405 | $156.63 | $240.97 | $156.63–$240.97 | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION LOWER LEG SPLINT | $104.00 | $160.00 | $104.00–$160.00 | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 Splint Application Short Leg | $230.57 | $354.73 | $44.20–$230.57 | 35% |
| Short leg splint (calf to foot) inpatient CPT 29515 SPLINT APPL SHORT LEG 29515 | $230.57 | $354.73 | $230.57–$354.73 | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC REPAIR SIMPLE 12001 | $164.58 | $253.20 | $164.58–$253.20 | 35% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 LAC RPR SCLP/TRUNK/EXT TO 2.5 | $164.58 | $253.20 | $164.58–$253.20 | 35% |
| Skin biopsy, punch, one lesion inpatient CPT 11104 PUNCH BX SKIN SINGLE LESION | $99.29 | $152.76 | $99.29–$152.76 | 35% |
| Skin tag removal, up to 15 tags inpatient CPT 11200 REMOVE SKIN TAGS 1-15 | $97.50 | $150.00 | $97.50–$150.00 | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC REPAIR SIMPLE 12002 | $171.53 | $263.89 | $171.53–$263.89 | 35% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 LAC RPR SCLP/TRUNK/EXT 2.6-7.5 | $234.00 | $360.00 | $234.00–$360.00 | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC FACE/EAR/LIP 2.5 CM OR LES | $157.30 | $242.00 | $157.30–$242.00 | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC REPAIR FACIAL 12011 | $157.47 | $242.26 | $157.47–$242.26 | 35% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 LAC RPR FACE/EAR/LIP TO 2.5 | $217.22 | $334.18 | $217.22–$334.18 | 35% |
| Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGNTL BX SKIN SINGLE LES | $86.61 | $133.24 | $86.61–$133.24 | 35% |
| Trigger finger release surgery inpatient CPT 26055 PR INCISE FINGER TENDON SHEATH | $538.79 | $828.90 | $538.79–$828.90 | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 CLI INJ TRIGGER POINT 1-2 MUS | $66.77 | $102.72 | $66.77–$102.72 | 35% |
| Trigger point injections, 1 or 2 muscles inpatient CPT 20552 INJECT TRIGGER POINT, 1 OR 2 | $530.19 | $815.67 | $530.19–$815.67 | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD DIAGNOST W/BIOP | $254.03 | $390.81 | $254.03–$390.81 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAG BRUSH WASH | $1,828.24 | $2,812.68 | $1,828.24–$2,812.68 | 35% |
| Wart removal, up to 14 warts inpatient CPT 17110 DESTRUCT OTHER LESION 1-14 | $110.50 | $170.00 | $110.50–$170.00 | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRID SUBQ TISSUE 1ST 20 SQCM | $104.00 | $160.00 | $104.00–$160.00 | 35% |
| Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT <20 11042 | $177.61 | $273.24 | $177.61–$273.24 | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD TRANSFUSION SVC | $447.80 | $688.92 | $30.55–$447.80 | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 INHALATION TREATMENT-MULTIPLE | $153.40 | $236.00 | $153.40–$236.00 | 35% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AEROSOL TREATMENT | $153.40 | $236.00 | $6.89–$153.40 | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 Critical Care Time 30-74 minutes | $1,133.20 | $1,743.38 | $199.61–$1,133.20 | 35% |
| Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE FIRST 30-74 MIN | $1,133.20 | $1,743.38 | $1,133.20–$1,743.38 | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM, TRACING | $109.20 | $168.00 | $109.20–$168.00 | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM W/MAGNETS | $171.14 | $263.29 | $171.14–$263.29 | 35% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 ELECTROCARDIOGRAM | $171.14 | $263.29 | $5.18–$171.14 | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER-LEVEL I | $83.48 | $128.43 | $83.48–$128.43 | 35% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER Level I | $83.48 | $128.43 | $10.60–$83.48 | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER-LEVEL II | $101.06 | $155.47 | $101.06–$155.47 | 35% |
| Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER Level II | $101.06 | $155.47 | $39.05–$101.06 | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER Level III | $210.89 | $324.45 | $59.13–$210.89 | 35% |
| Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER-LEVEL III | $210.89 | $324.45 | $210.89–$324.45 | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER Level IV | $358.52 | $551.57 | $112.68–$358.52 | 35% |
| Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER-LEVEL IV | $358.52 | $551.57 | $358.52–$551.57 | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER Level V | $527.23 | $811.13 | $163.46–$527.23 | 35% |
| Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER-LEVEL V | $527.23 | $811.13 | $527.23–$811.13 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTHERAPY W/PT 50 MIN | $549.25 | $845.00 | $549.25–$845.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTHERAPY W/O PT 50 MN | $523.25 | $805.00 | $523.25–$805.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY | $477.75 | $735.00 | $477.75–$735.00 | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION | $146.53 | $225.43 | $146.53–$225.43 | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL | $146.53 | $225.43 | $27.38–$146.53 | 35% |
| IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 IV HYDRATION INITIAL 96360 | $146.53 | $225.43 | $146.53–$225.43 | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL | $133.09 | $204.75 | $133.09–$204.75 | 35% |
| IV infusion of a medicine, first hour inpatient CPT 96365 IV INFUSION INITIAL 96365 | $133.09 | $204.75 | $133.09–$204.75 | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 MED INJECTION IV PUSH INITIAL | $150.15 | $231.00 | $150.15–$231.00 | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 IV INJECT PUSH INITIAL 96374 | $154.65 | $237.93 | $154.65–$237.93 | 35% |
| IV push of a medicine, first drug inpatient CPT 96374 IV PUSH INITIAL 96374 | $154.65 | $237.93 | $154.65–$237.93 | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THER/PROPH/DIAG INJ, SC/IM | $32.50 | $50.00 | $32.50–$50.00 | 35% |
| Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION MED ADMIN IM/SC | $65.38 | $100.58 | $12.80–$65.38 | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT NEURO RE-ED | $55.54 | $85.44 | $55.54–$85.44 | 35% |
| Neuromuscular re-education, 15 minutes inpatient CPT 97112 NEUROMUSC RE-ED / 15 MIN | $55.54 | $85.44 | $55.54–$85.44 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office Visit, New Pt., Lvl 3 | $208.00 | $320.00 | $208.00–$320.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 RHC Off Vst, New Pt, Level 3 | $208.00 | $320.00 | $208.00–$320.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office Visit, New Pt., Lvl 4 | $312.00 | $480.00 | $312.00–$480.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 RHC OFF VST, NEW PT LEVEL 4 | $312.00 | $480.00 | $312.00–$480.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 RHC OFF VST, NEW PT LEVEL 5 | $409.50 | $630.00 | $409.50–$630.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office Visit, New Pt., Lvl 5 | $409.50 | $630.00 | $409.50–$630.00 | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 Office Visit, New Pt., Lvl 2 | $136.50 | $210.00 | $136.50–$210.00 | 35% |
| New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 RHC Off Vst, New Pt, Level 2 | $136.50 | $210.00 | $136.50–$210.00 | 35% |
| Occupational therapy evaluation, low complexity inpatient CPT 97165 OT - EVAL LOW | $88.21 | $135.70 | $88.21–$135.70 | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 Physical Therapy High | $88.20 | $135.70 | $61.09–$88.20 | 35% |
| Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT HIGH | $88.21 | $135.70 | $88.21–$135.70 | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 Physical Therapy Low | $88.20 | $135.70 | $61.09–$88.20 | 35% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT LOW | $88.21 | $135.70 | $88.21–$135.70 | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 Physical Therapy Mod | $88.20 | $135.70 | $61.09–$88.20 | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT MOD | $88.21 | $135.70 | $88.21–$135.70 | 35% |
| Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 MCD PT EVAL MOD | $88.21 | $135.70 | $88.21–$135.70 | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 MANUAL THERAPY / 15 MIN | $45.70 | $70.30 | $45.70–$70.30 | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT - MANUAL PT | $45.70 | $70.30 | $45.70–$70.30 | 35% |
| Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 Physical Therapy MANUAL THERAPY / 15 MIN | $45.70 | $70.30 | $23.54–$45.70 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Physical Therapy - Therapeutic Exercise | $52.55 | $80.84 | $25.11–$52.55 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EXERC | $52.55 | $80.84 | $52.55–$80.84 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERAPEUTIC EXERCISE/ 15 MIN | $52.55 | $80.84 | $52.55–$80.84 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 Prvntv Cre New Pt Age 18-39 | $334.56 | $514.71 | $334.56–$514.71 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 PRVNTV NEW 18-39 YRS W/MOD | $334.56 | $514.71 | $334.56–$514.71 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 Prvntv Cre New Pt Age 40-64 | $387.99 | $596.91 | $387.99–$596.91 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 PRVNTV NEW 40-64 YRS W/MOD | $387.99 | $596.91 | $387.99–$596.91 | 35% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 PRVNTV NEW 65+ W/MOD | $178.75 | $275.00 | $178.75–$275.00 | 35% |
| Preventive checkup, new patient aged 65 or older inpatient CPT 99387 Prvntv Care New Pt. Age 65+ | $420.79 | $647.37 | $420.79–$647.37 | 35% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 PRVNTV EST 18-39 YRS W/MOD | $302.70 | $465.69 | $302.70–$465.69 | 35% |
| Preventive checkup, returning patient aged 18–39 inpatient CPT 99395 Prvntv Care Est Pt. Age 18-39 | $302.70 | $465.69 | $302.70–$465.69 | 35% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 PRVNTV EST 40-64 YRS W/MOD | $322.39 | $495.99 | $322.39–$495.99 | 35% |
| Preventive checkup, returning patient aged 40–64 inpatient CPT 99396 Prvntv Cre Est Pt Age 40-64 | $322.39 | $495.99 | $322.39–$495.99 | 35% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 Prvntv Care Est Pt. Age 65+ | $344.88 | $530.58 | $344.88–$530.58 | 35% |
| Preventive checkup, returning patient aged 65 or older inpatient CPT 99397 PRVNTV EST 65+ W/MOD | $344.88 | $530.58 | $344.88–$530.58 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY IND 16-37 MINS | $396.50 | $610.00 | $396.50–$610.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY INDV 38-52 MINS | $490.75 | $755.00 | $490.75–$755.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY INDV 53-67 MINS | $500.50 | $770.00 | $500.50–$770.00 | 35% |
| Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10MIN | $57.88 | $89.04 | $57.88–$89.04 | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 TREATMENT ROOM LEV 5 | $331.50 | $510.00 | $331.50–$510.00 | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OFFICE VST, EST LVL 5 W/MOD | $331.50 | $510.00 | $331.50–$510.00 | 35% |
| Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Office Visit, Est Pt., Lvl 5 | $331.50 | $510.00 | $331.50–$510.00 | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RHC Off Vst, Est Pt, Level 3 | $169.00 | $260.00 | $169.00–$260.00 | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Office Visit, Est Pt., Lvl 3 | $169.00 | $260.00 | $169.00–$260.00 | 35% |
| Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 TREATMENT ROOM LEV 3 | $169.00 | $260.00 | $169.00–$260.00 | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Office Visit, Est Pt., Lvl 4 | $240.50 | $370.00 | $240.50–$370.00 | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 RHC Off Vst, Est Pt, Level 4 | $240.50 | $370.00 | $240.50–$370.00 | 35% |
| Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 TREATMENT ROOM LEV 4 | $240.50 | $370.00 | $240.50–$370.00 | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Office Visit, Est Pt., Lvl 2 | $104.00 | $160.00 | $104.00–$160.00 | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 TREATMENT ROOM LEV 2 | $104.00 | $160.00 | $104.00–$160.00 | 35% |
| Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RHC Off Vst, Est Pt, Level 2 | $104.00 | $160.00 | $104.00–$160.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes inpatient CPT 99243 Office Consultation Level 3 | $162.50 | $250.00 | $162.50–$250.00 | 35% |
| Spirometry (breathing test) inpatient CPT 94010 SPIROMETRY | $114.00 | $175.39 | $114.00–$175.39 | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 THERAPEUTIC ACTIVITIES/15 MIN | $46.75 | $71.92 | $46.75–$71.92 | 35% |
| Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT - THER ACTIVITIES | $91.39 | $140.60 | $91.39–$140.60 | 35% |
| Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 PHLEB THERAPEUTIC | $104.74 | $161.14 | $77.43–$104.74 | 35% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | Off list |
|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older inpatient CPT 90653 FLUAD FLU VACC 65+ YR24-25 | $162.81 | $250.47 | $162.81–$250.47 | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VAC 4-6(Kinrix) VFC | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) inpatient CPT 90696 DTAP-IPV VACC 4-6 (Kinrix) | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTaP (Infanrix) | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 inpatient CPT 90700 DTaP (Infanrix) VFC PROGRAM | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEP B-IPV(Pediarix) VFC | $82.55 | $127.00 | $82.55–$127.00 | 35% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) inpatient CPT 90723 DTAP-HEP B-IPV VACC (Pediarix) | $82.55 | $127.00 | $82.55–$127.00 | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 DTAP-IPV-HIB-HEPB VACCINE IM | $102.95 | $158.38 | $102.95–$158.38 | 35% |
| DTaP, polio, Hib and hepatitis B combination vaccine (Vaxelis) inpatient CPT 90697 VAXELIS VACCINE | $253.50 | $390.00 | $253.50–$390.00 | 35% |
| Flu shot, standard dose, preservative-free, for age 6 months and older inpatient CPT 90656 FLUZONE 6M+ PRSV-FREE YR24-25 | $43.58 | $67.05 | $43.58–$67.05 | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACCINE 9 VAL IM | $201.18 | $309.50 | $201.18–$309.50 | 35% |
| HPV vaccine, 9-valent (Gardasil 9) inpatient CPT 90651 HPV VIRUS VACC 9 VAL IM VFC | $201.18 | $309.50 | $201.18–$309.50 | 35% |
| Hepatitis A vaccine, adult dose inpatient CPT 90632 Hep A, adult | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A VACC, PED/ADOL, 2 DOSE | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) inpatient CPT 90633 HEP A VAC,PED/ADOL,2DOSE VFC | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| Hepatitis B vaccine, adult dose (3-dose schedule) inpatient CPT 90746 Hep B adult for intrmsclr use | $48.75 | $75.00 | $48.75–$75.00 | 35% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) inpatient CPT 90739 HEP B VACC ADULT 2 DOSE IM | $112.45 | $173.00 | $112.45–$173.00 | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hep B,Child(11-19),3dose VFC | $26.00 | $40.00 | $26.00–$40.00 | 35% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) inpatient CPT 90744 Hep B, Child (11-19), 3 dose | $26.00 | $40.00 | $26.00–$40.00 | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HIB VACCINE, PRP-OMP, IM VFC | $20.80 | $32.00 | $20.80–$32.00 | 35% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) inpatient CPT 90647 HIB VACCINE, PRP-OMP, IM | $20.80 | $32.00 | $20.80–$32.00 | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR VFC PROGRAM | $42.25 | $65.00 | $42.25–$65.00 | 35% |
| MMR vaccine (measles, mumps and rubella), live inpatient CPT 90707 MMR | $42.25 | $65.00 | $42.25–$65.00 | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococcal MCV4O (CVX 114) | $97.50 | $150.00 | $97.50–$150.00 | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 MENINGOCOCCAL VACCINE, IM | $97.50 | $150.00 | $97.50–$150.00 | 35% |
| Meningococcal ACWY (MenACWY) vaccine inpatient CPT 90734 Meningococ MCV4O(CVX114) VFC | $97.50 | $150.00 | $97.50–$150.00 | 35% |
| Meningococcal ACWY vaccine (MenQuadfi) inpatient CPT 90619 MENINGOCOCCAL | $370.50 | $570.00 | $370.50–$570.00 | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO | $273.00 | $420.00 | $273.00–$420.00 | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 TRUMENBA | $273.00 | $420.00 | $273.00–$420.00 | 35% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule inpatient CPT 90620 BEXSERO VACCINE | $592.80 | $912.00 | $592.80–$912.00 | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PREVNAR 13 | $151.29 | $232.76 | $151.29–$232.76 | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCCAL VACC 13 VAL IM | $266.50 | $410.00 | $266.50–$410.00 | 35% |
| Pneumonia vaccine, 13-valent conjugate (Prevnar 13) inpatient CPT 90670 PNEUMOCOCC VAC 13 VAL IM VFC | $266.50 | $410.00 | $266.50–$410.00 | 35% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) inpatient CPT 90671 PNEUMOCOCCAL (VAXNEUVANCE) | $299.68 | $461.04 | $299.68–$461.04 | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 Pnmococcal plysachrde PPV23 | $45.50 | $70.00 | $45.50–$70.00 | 35% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) inpatient CPT 90732 PNEUMOVAX | $76.10 | $117.08 | $76.10–$117.08 | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS, IPV, SC VFC | $22.75 | $35.00 | $22.75–$35.00 | 35% |
| Polio vaccine, inactivated (IPV) inpatient CPT 90713 POLIOVIRUS, IPV, SC | $22.75 | $35.00 | $22.75–$35.00 | 35% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) inpatient CPT 90381 RSV ANTB SEASON 1ML IM | $1,012.05 | $1,557.00 | $1,012.05–$1,557.00 | 35% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) inpatient CPT 90380 RSV ANTB SEASON 0.5 ML IM | $1,014.00 | $1,560.00 | $1,014.00–$1,560.00 | 35% |
| Rabies vaccine, one dose inpatient CPT 90675 RABAVERT | $690.30 | $1,062.00 | $690.30–$1,062.00 | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS VFC PROGRAM | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) inpatient CPT 90680 ROTAVIRUS | $16.25 | $25.00 | $16.25–$25.00 | 35% |
| Shingles vaccine (Shingrix), recombinant, one dose inpatient CPT 90750 HZV VACC RECOMBINANT IM NJX | $225.55 | $347.00 | $225.55–$347.00 | 35% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older inpatient CPT 90714 TD VACCINE NO PRSRV >/= 7 IM | $47.45 | $73.00 | $47.45–$73.00 | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 IM | $47.45 | $73.00 | $47.45–$73.00 | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 TDAP VACCINE >7 IM VFC | $47.45 | $73.00 | $47.45–$73.00 | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 DTAP Adult | $183.95 | $283.00 | $34.35–$183.95 | 35% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older inpatient CPT 90715 BOOSTRIX .5 ML SYRINGE | $183.95 | $283.00 | $183.95–$283.00 | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMIN | $27.95 | $43.00 | $27.95–$43.00 | 35% |
| Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INJECTION VACCINE-ER | $65.68 | $101.05 | $14.82–$65.68 | 35% |
| Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN, EACH ADD | $22.75 | $35.00 | $22.75–$35.00 | 35% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://www.smcok.com/s/730765084_Share-Medical-Center_standardcharges.csv