Hospital

Harney District Hospital

Harney District Hospital in Burns, OR publishes cash prices for 332 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 above the Oregon median for 235 of 328 procedures and below it for 86. By typical cash price it ranks #42 of 47 Oregon hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

557 W Washington St, Burns, OR 97720 Collected Sep 28, 2026 Source price file (541) 573-7281

Critical access hospital (rural, 25 beds or fewer) Emergency department CCN 381307 · CMS hospital register NPI 1285742338

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
Abdominal CT scan without and with contrast CPT 74170 HC CT PANCREAS W/WO CONT	$2,378.40	$2,973.00	$211.72–$2,973.00	46% above	20%
Abdominal CT scan without and with contrast CPT 74170 HC CT ABDOMEN W/WO CONT	$2,378.40	$2,973.00	$211.72–$2,973.00	46% above	20%
Abdominal X-ray, 2 views CPT 74019 HC XR ABDOMEN 2 VIEWS	$320.00	$400.00	$29.69–$400.00	8% above	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC XR ANKLE 3V LT	$320.00	$400.00	$29.17–$400.00	28% above	20%
Ankle X-ray, complete, 3 or more views one side CPT 73610 HC XR ANKLE 3V RT	$320.00	$400.00	$29.17–$400.00	28% above	20%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 HC US ANKLE/ARM INDICES	$640.00	$800.00	$65.58–$800.00	27% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT HAND W/O CONT RT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT HUMERUS W/O CONT LT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT ELBOW W/O CONT LT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SHOULDER/SCAP W/O CONT RT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT FOREARM W/O CONT LT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT WRIST W/O CONT LT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT ELBOW W/O CONT RT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT HAND W/O CONT LT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT WRIST W/O CONT RT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT FOREARM W/O CONT RT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT HUMERUS W/O CONT RT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Arm CT scan without contrast (shoulder to hand, any part) one side CPT 73200 HC CT SHOULDER/SCAP W/O CONT LT	$1,585.60	$1,982.00	$131.06–$1,982.00	50% above	20%
Barium swallow (esophagus X-ray with contrast) CPT 74220 HC XR ESOPHAGRAM	$684.00	$855.00	$77.14–$855.00	22% above	20%
Breast ultrasound, complete, one breast both sides CPT 76641 HC US BREAST COMPLETE BILAT	$641.60	$802.00	$81.85–$802.00	—	20%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST COMPLETE RT	$408.00	$510.00	$81.85–$510.00	13% above	20%
Breast ultrasound, complete, one breast one side CPT 76641 HC US BREAST COMPLETE LT	$408.00	$510.00	$81.85–$510.00	13% above	20%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 HC US BREAST LIMITED BILAT	$536.00	$670.00	$67.83–$670.00	—	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST LIMITED RT	$408.00	$510.00	$67.83–$510.00	34% above	20%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 HC US BREAST LIMITED LT	$408.00	$510.00	$67.83–$510.00	34% above	20%
CT angiography (CTA) of the abdomen and pelvis CPT 74174 HC CTA ABDOMEN PELVIS	$2,611.20	$3,264.00	$309.90–$3,264.00	5% above	20%
CT angiography (CTA) of the head CPT 70496 HC CTA BRAIN W CONT	$2,611.20	$3,264.00	$225.60–$3,264.00	40% above	20%
CT angiography (CTA) of the neck CPT 70498 HC CTA CAROTID	$2,611.20	$3,264.00	$225.33–$3,264.00	40% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CTA CHEST W/CONT	$2,611.20	$3,264.00	$229.97–$3,264.00	48% above	20%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 HC CT CHEST PULM ARTERIES W/CONT	$2,866.40	$3,583.00	$229.97–$3,583.00	63% above	20%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 HC CHG CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM	$66.40	$83.00	$33.20–$83.00	57% below	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT URINARY TRACT W/O CONT	$3,037.60	$3,797.00	$149.29–$3,797.00	44% above	20%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 HC CT ABDOMEN AND PELVIS W/O CONT	$3,037.60	$3,797.00	$149.29–$3,797.00	44% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT VENOGRAM ABD/PELVIS	$1,090.40	$1,363.00	$246.27–$1,363.00	55% below	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT APPENDIX STUDY	$3,369.60	$4,212.00	$246.27–$4,212.00	39% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT UROGRAM W/CONT	$3,556.00	$4,445.00	$246.27–$4,445.00	47% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ABDOMEN AND PELVIS W/CONT	$3,556.00	$4,445.00	$246.27–$4,445.00	47% above	20%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT ENTEROGRAPHY	$3,784.00	$4,730.00	$246.27–$4,730.00	57% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN W/WO PELVIS W/WO	$3,853.60	$4,817.00	$275.80–$4,817.00	30% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN WITH & PELVIS W/WO	$3,853.60	$4,817.00	$275.80–$4,817.00	30% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT ABDOMEN W/WO PELVIS W/CONT	$3,853.60	$4,817.00	$275.80–$4,817.00	30% above	20%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 HC CT UROGRAM W/WO CONT	$3,853.60	$4,817.00	$275.80–$4,817.00	30% above	20%
CT scan of the abdomen with contrast CPT 74160 HC CT ABDOMEN W/CONT	$2,004.80	$2,506.00	$188.28–$2,506.00	39% above	20%
CT scan of the abdomen without contrast CPT 74150 HC CT ABDOMEN W/O CONT	$1,585.60	$1,982.00	$111.00–$1,982.00	44% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT MAXILLOFACIAL W/O CONT	$1,585.60	$1,982.00	$104.49–$1,982.00	47% above	20%
CT scan of the face and sinuses, no contrast dye CPT 70486 HC CT SINUSES COMPLETE	$1,585.60	$1,982.00	$104.49–$1,982.00	47% above	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT STROKE BRAIN W/O CONT	$1,585.60	$1,982.00	$86.94–$1,982.00	58% above	20%
CT scan of the head or brain, no contrast dye CPT 70450 HC CT BRAIN W/O CONT	$1,585.60	$1,982.00	$86.94–$1,982.00	58% above	20%
CT scan of the head with contrast CPT 70460 HC CT BRAIN W/CONT	$2,004.80	$2,506.00	$120.93–$2,506.00	55% above	20%
CT scan of the head without and with contrast CPT 70470 HC CT BRAIN W/WO CONT	$2,378.40	$2,973.00	$141.29–$2,973.00	54% above	20%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 HC CT LUMBAR SPINE W/O CONT	$1,585.60	$1,982.00	$105.51–$1,982.00	26% above	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE W/O CONT	$1,585.60	$1,982.00	$106.05–$1,982.00	31% above	20%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 HC CT CERVICAL SPINE POST MYELO	$1,585.60	$1,982.00	$106.05–$1,982.00	31% above	20%
CT scan of the pelvis, with contrast dye CPT 72193 HC CT PELVIS W/CONT	$2,378.40	$2,973.00	$185.18–$2,973.00	61% above	20%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 HC US CAROTID BILAT DOPP	$1,007.20	$1,259.00	$150.57–$1,259.00	—	20%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST W/WO CONT	$2,378.40	$2,973.00	$159.93–$2,973.00	36% above	20%
Chest CT scan without and with contrast CPT 71270 HC CT CHEST HRCT/CHEST W/CONT	$2,378.40	$2,973.00	$159.93–$2,973.00	36% above	20%
Chest X-ray, 2 views CPT 71046 HC XR CHEST 2V	$320.00	$400.00	$26.99–$400.00	19% above	20%
Chest X-ray, single view CPT 71045 HC XR CHEST 1V	$320.00	$400.00	$20.80–$400.00	26% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC XR CLAVICLE RT	$320.00	$400.00	$26.21–$400.00	48% above	20%
Collarbone (clavicle) X-ray, complete one side CPT 73000 HC XR CLAVICLE LT	$320.00	$400.00	$26.21–$400.00	48% above	20%
Complete ultrasound of the back of the abdomen, such as both kidneys both sides CPT 76770 HC US RENAL BILAT	$641.60	$802.00	$86.35–$802.00	—	20%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 HC US RETROPERITONEAL	$641.60	$802.00	$86.35–$802.00	16% above	20%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 HC XR DEXASCAN	$537.60	$672.00	$31.59–$672.00	40% above	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 HC XR DEXASCAN RIGHT	$245.60	$307.00	$25.65–$307.00	at median	20%
DEXA bone density scan of the wrist, heel or finger (peripheral) one side CPT 77081 HC XR DEXASCAN LEFT	$245.60	$307.00	$25.65–$307.00	at median	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION, SNG FETUS	$641.60	$802.00	$142.21–$802.00	2% above	20%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 HC US OB PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION, SNGL FETUS	$905.60	$1,132.00	$142.21–$1,132.00	43% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST HRCT/CHEST W/O	$1,585.60	$1,982.00	$108.35–$1,982.00	31% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST W/O CONT	$1,585.60	$1,982.00	$108.35–$1,982.00	31% above	20%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 HC CT CHEST HRCT W/O	$1,585.60	$1,982.00	$108.35–$1,982.00	31% above	20%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 HC CT CHEST W/CONT	$2,004.80	$2,506.00	$136.03–$2,506.00	35% above	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC MAMM DIAGNOSTIC BILATERAL	$408.80	$511.00	$127.28–$511.00	—	20%
Diagnostic mammogram, both breasts both sides CPT 77066 HC (H)MAMM DIAGNOSTIC BILATERAL	$408.80	$511.00	$127.28–$511.00	—	20%
Diagnostic mammogram, one breast CPT 77065 HC UNI DIAG MAMMO W/CAD	$312.80	$391.00	$100.90–$391.00	at median	20%
Diagnostic mammogram, one breast one side CPT 77065 HC MAMM DIAGNOSTIC UNILATERAL	$312.80	$391.00	$100.90–$391.00	at median	20%
Diagnostic mammogram, one breast one side CPT 77065 HC (H)MAMM DIAGNOSTIC UNILATERAL	$312.80	$391.00	$100.90–$391.00	at median	20%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 HC US EXT ART LOWER BILAT	$1,354.40	$1,693.00	$189.90–$1,693.00	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC US EXT VENOUS LOWER BILAT	$1,037.60	$1,297.00	$148.28–$1,297.00	—	20%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 HC US EXT VENOUS UPPER BILAT	$1,037.60	$1,297.00	$148.28–$1,297.00	—	20%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 HC EC TRANSTHORACIC ECHO COMPLETE	$1,967.20	$2,459.00	$155.62–$2,459.00	29% above	20%
Elbow X-ray, 2 views one side CPT 73070 HC XR ELBOW 2V RT	$320.00	$400.00	$23.51–$400.00	32% above	20%
Elbow X-ray, 2 views one side CPT 73070 HC XR ELBOW 2V LT	$320.00	$400.00	$23.51–$400.00	32% above	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC XR ELBOW 3V RT	$320.00	$400.00	$26.20–$400.00	31% above	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC XR ELBOW 4V LT	$320.00	$400.00	$26.20–$400.00	31% above	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC XR ELBOW 4V RT	$320.00	$400.00	$26.20–$400.00	31% above	20%
Elbow X-ray, complete, 3 or more views one side CPT 73080 HC XR ELBOW 3V LT	$320.00	$400.00	$26.20–$400.00	31% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT IACS W/O CONT	$1,585.60	$1,982.00	$129.41–$1,982.00	58% above	20%
Eye socket (orbit) CT scan without contrast CPT 70480 HC CT ORBITS W/O CONT	$1,585.60	$1,982.00	$129.41–$1,982.00	58% above	20%
Facial bones X-ray, complete, 3 or more views CPT 70150 HC XR FACIAL BONES	$320.00	$400.00	$37.51–$400.00	4% below	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC XR FOREARM 2V RT	$320.00	$400.00	$23.51–$400.00	34% above	20%
Forearm X-ray (radius and ulna), 2 views one side CPT 73090 HC XR FOREARM 2V LT	$320.00	$400.00	$23.51–$400.00	34% above	20%
Hand X-ray, 2 views both sides CPT 73120 HC XR HAND 1V/2V BILAT	$320.00	$400.00	$25.13–$400.00	—	20%
Hand X-ray, 2 views one side CPT 73120 HC XR HAND 1V/2V LT	$320.00	$400.00	$25.13–$400.00	31% above	20%
Hand X-ray, 2 views one side CPT 73120 HC XR HAND 1V/2V RT	$320.00	$400.00	$25.13–$400.00	31% above	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC XR HEEL RT	$320.00	$400.00	$22.70–$400.00	55% above	20%
Heel bone (calcaneus) X-ray, 2 or more views one side CPT 73650 HC XR HEEL LT	$320.00	$400.00	$22.70–$400.00	55% above	20%
Home sleep apnea test, unattended, recording breathing and oxygen CPT 95806 HC (H)RT SLEEP STUDY UNATTENDED HOME	$753.60	$942.00	$76.91–$942.00	27% above	20%
Knee X-ray, 3 views one side CPT 73562 HC XR KNEE 3V LT	$320.00	$400.00	$32.68–$400.00	13% above	20%
Knee X-ray, 3 views one side CPT 73562 HC XR KNEE 3V RT	$320.00	$400.00	$32.68–$400.00	13% above	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC XR KNEE 4V LT	$320.00	$400.00	$38.06–$400.00	10% below	20%
Knee X-ray, complete, 4 or more views one side CPT 73564 HC XR KNEE 4V RT	$320.00	$400.00	$38.06–$400.00	10% below	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT ANKLE W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT FEMUR W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT ANKLE W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT TIB-FIB W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT TIB-FIB W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT CALCANEUS W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT FOOT W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT FEMUR W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT CALCANEUS W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT HIP W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT FOOT W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT KNEE W/O CONT LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT KNEE W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT EXT LOWER W/O LT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT EXT LOWER W/O RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Leg CT scan without contrast (hip to foot, any part) one side CPT 73700 HC CT HIP W/O CONT RT	$1,585.60	$1,982.00	$105.78–$1,982.00	57% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US STOMACH/PYLORIS	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US PANCREAS	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US LIVER	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US SPLEEN	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMINAL FAST SCAN	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US ABDOMEN LTD	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US GALLBLADDER	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 HC US APPENDIX	$641.60	$802.00	$69.59–$802.00	34% above	20%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 HC US EXT NONVASC UPPER BILAT	$641.60	$802.00	$51.36–$802.00	—	20%
Limited ultrasound of an arm or leg (non-vascular) both sides CPT 76882 HC US EXT NONVASC LOWER BILAT	$641.60	$802.00	$51.36–$802.00	—	20%
Limited ultrasound of an arm or leg (non-vascular) CPT 76882 HC US GROIN	$408.00	$510.00	$51.36–$510.00	39% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXT NONVASC UPPER LT	$641.60	$802.00	$51.36–$802.00	118% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXT NONVASC LOWER LT	$641.60	$802.00	$51.36–$802.00	118% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXT NONVASC LOWER RT	$641.60	$802.00	$51.36–$802.00	118% above	20%
Limited ultrasound of an arm or leg (non-vascular) one side CPT 76882 HC US EXT NONVASC UPPER RT	$641.60	$802.00	$51.36–$802.00	118% above	20%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 HC CT THORAX LUNG CANCER SCR C-	$1,585.60	$1,982.00	$112.04–$1,982.00	484% above	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC XR TIBIA FIBULA LT	$320.00	$400.00	$25.40–$400.00	29% above	20%
Lower leg X-ray (tibia and fibula), 2 views one side CPT 73590 HC XR TIBIA FIBULA RT	$320.00	$400.00	$25.40–$400.00	29% above	20%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA BRAIN MRV W/O CONT	$2,482.40	$3,103.00	$175.89–$3,103.00	33% above	20%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRV BRAIN W/O	$2,482.40	$3,103.00	$175.89–$3,103.00	33% above	20%
MR angiography (MRA) of the head without contrast CPT 70544 HC MRA BRAIN W/O CONT	$2,482.40	$3,103.00	$175.89–$3,103.00	33% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI KNEE W/O CONT RT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI HIP W/O CONT RT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI HIP W/O CONT LT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI KNEE W/O CONT LT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI ANKLE W/O CONT RT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI ANKLE W/O CONT LT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI HIND FOOT W/O CONT LT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 HC MRI HIND FOOT W/O CONT RT	$2,482.40	$3,103.00	$165.74–$3,103.00	40% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI KNEE W/WO CONT RT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI HIND FOOT W/WO CONT LT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI KNEE W/WO CONT LT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI ANKLE W/WO CONT LT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI HIP W/WO CONT LT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI ANKLE W/WO CONT RT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI HIP W/WO CONT RT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 HC MRI HIND FOOT W/WO CONT RT	$3,552.80	$4,441.00	$312.81–$4,441.00	33% above	20%
MRI of the abdomen without contrast CPT 74181 HC MRI ABD MRCP W/O CONT BILIARY	$2,482.40	$3,103.00	$159.21–$3,103.00	38% above	20%
MRI of the abdomen without contrast CPT 74181 HC MRI ABDOMEN W/O CONT	$2,482.40	$3,103.00	$159.21–$3,103.00	38% above	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABDOMEN W/WO CONT	$3,552.80	$4,441.00	$275.26–$4,441.00	24% above	20%
MRI of the abdomen, without and then with contrast dye CPT 74183 HC MRI ABD MRCP W/WO CONT	$3,552.80	$4,441.00	$275.26–$4,441.00	24% above	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN MS W/O CONT	$2,482.40	$3,103.00	$160.02–$3,103.00	36% above	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN W/O CONT	$2,482.40	$3,103.00	$160.02–$3,103.00	36% above	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN SEIZURE W/O CONT	$2,482.40	$3,103.00	$160.02–$3,103.00	36% above	20%
MRI of the brain, no contrast dye CPT 70551 HC MRI BRAIN STROKE WITHOUT	$2,482.40	$3,103.00	$160.02–$3,103.00	36% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN MS W/WO CONT	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN W/WO CONT	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN SEIZURE W/WO CONT	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN PITUITARY	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI BRAIN IACS	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI TEMPORAL BONES W/WO	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the brain, with and without contrast dye CPT 70553 HC MRI IACS W/WO	$3,552.80	$4,441.00	$259.74–$4,441.00	14% above	20%
MRI of the lower back, no contrast dye CPT 72148 HC MRI LUMBAR SP W/O CONT	$2,482.40	$3,103.00	$155.70–$3,103.00	37% above	20%
MRI of the lower back, without and then with contrast dye CPT 72158 HC MRI LUMBAR SP W/WO CONT	$3,248.00	$4,060.00	$260.01–$4,060.00	7% above	20%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 HC MRI THORACIC SPINE W/O CONT	$2,482.40	$3,103.00	$155.43–$3,103.00	36% above	20%
MRI of the neck (cervical spine) without and with contrast CPT 72156 HC MRI CERVICAL SP W/WO CONT	$3,248.00	$4,060.00	$260.55–$4,060.00	13% above	20%
MRI of the neck (cervical spine), no contrast dye CPT 72141 HC MRI CERVICAL SP W/O CONT	$2,482.40	$3,103.00	$155.16–$3,103.00	40% above	20%
MRI of the pelvis without and with contrast CPT 72197 HC MRI LUMBOSACRAL PLEXUS W WO CONT	$3,248.00	$4,060.00	$274.18–$4,060.00	22% above	20%
MRI of the pelvis without and with contrast CPT 72197 HC MRI PELVIS W/WO CONT	$3,248.00	$4,060.00	$274.18–$4,060.00	22% above	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI PELVIS W/O CONT	$2,482.40	$3,103.00	$185.95–$3,103.00	40% above	20%
MRI of the pelvis, no contrast dye CPT 72195 HC MRI APPENDIX W/O	$2,482.40	$3,103.00	$185.95–$3,103.00	40% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI WRIST W/O CONT RT	$2,482.40	$3,103.00	$166.01–$3,103.00	40% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI SHOULDER W/O CONT LT	$2,482.40	$3,103.00	$166.01–$3,103.00	40% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI SHOULDER W/O CONT RT	$2,482.40	$3,103.00	$166.01–$3,103.00	40% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI ELBOW W/O CONT RT	$2,482.40	$3,103.00	$166.01–$3,103.00	40% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI ELBOW W/O CONT LT	$2,482.40	$3,103.00	$166.01–$3,103.00	40% above	20%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 HC MRI WRIST W/O CONT LT	$2,482.40	$3,103.00	$166.01–$3,103.00	40% above	20%
Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 HC XR CERVICAL SP 4V	$584.00	$730.00	$43.44–$730.00	55% above	20%
Neck soft tissue CT scan with contrast CPT 70491 HC CT NECK W/CONT	$2,004.80	$2,506.00	$149.89–$2,506.00	39% above	20%
Neck soft tissue CT scan without contrast CPT 70490 HC CT NECK W/O CONT	$1,585.60	$1,982.00	$122.21–$1,982.00	53% above	20%
Neck soft tissue X-ray CPT 70360 HC XR NECK SOFT TISS	$320.00	$400.00	$25.12–$400.00	32% above	20%
Pelvic CT scan without contrast CPT 72192 HC CT PELVIS W/O CONT	$1,585.60	$1,982.00	$108.35–$1,982.00	40% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US OVULATION STUDY	$408.00	$510.00	$40.02–$510.00	28% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US PELVIS LIMITED	$408.00	$510.00	$40.02–$510.00	28% above	20%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 HC US BLADDER	$641.60	$802.00	$40.02–$802.00	102% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS TRANSABDOMINAL LINKED	$641.60	$802.00	$84.03–$802.00	23% above	20%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 HC US PELVIS TRANSABDOMINAL	$641.60	$802.00	$84.03–$802.00	23% above	20%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC US OB PREG UTERUS AFTER 1ST TRIMEST, SINGLE FETUS	$408.00	$510.00	$107.58–$510.00	21% below	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB 1ST TRI TA < 14 WKS	$641.60	$802.00	$93.36–$802.00	40% above	20%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 HC US OB 1ST TRI <14WK MULT GEST	$641.60	$802.00	$93.36–$802.00	40% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED MULTIPLE GESTATION	$408.00	$510.00	$64.70–$510.00	15% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB FETAL VIABILITY	$408.00	$510.00	$64.70–$510.00	15% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB FETAL PRESENTATION	$408.00	$510.00	$64.70–$510.00	15% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB AMNIOTIC FLUID INDEX	$408.00	$510.00	$64.70–$510.00	15% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB COMPLETE MULT GEST F/U EA/A	$408.00	$510.00	$64.70–$510.00	15% above	20%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 HC US OB LIMITED	$408.00	$510.00	$64.70–$510.00	15% above	20%
Rib X-ray, one side, 2 views one side CPT 71100 HC XR RIBS 2V LT	$320.00	$400.00	$29.42–$400.00	21% above	20%
Rib X-ray, one side, 2 views one side CPT 71100 HC XR RIBS 2V RT	$320.00	$400.00	$29.42–$400.00	21% above	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC XR RIBS RT INCL CHEST	$484.00	$605.00	$33.72–$605.00	49% above	20%
Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 HC XR RIBS LT INCL CHEST	$484.00	$605.00	$33.72–$605.00	49% above	20%
Screening mammogram, both breasts both sides CPT 77067 HC (H)MAMM SCREEN IMPLANT BILATERAL	$340.80	$426.00	$103.17–$426.00	—	20%
Screening mammogram, both breasts both sides CPT 77067 HC (H)MAMM SCREEN BILATERAL	$340.80	$426.00	$103.17–$426.00	—	20%
Screening mammogram, both breasts one side CPT 77067 HC MAMM SCREEN UNILATERAL	$284.00	$355.00	$103.17–$355.00	15% below	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC XR SHOULDER 4V LT	$320.00	$400.00	$27.82–$400.00	14% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC XR SHOULDER 2/3V LT	$320.00	$400.00	$27.82–$400.00	14% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC XR SHOULDER 4V RT	$320.00	$400.00	$27.82–$400.00	14% above	20%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 HC XR SHOULDER 2/3V RT	$320.00	$400.00	$27.82–$400.00	14% above	20%
Sinus X-ray, complete, 3 or more views CPT 70220 HC XR SINUSES	$320.00	$400.00	$30.23–$400.00	11% above	20%
Skull X-ray, fewer than 4 views CPT 70250 HC XR SKULL LESS THAN 4V	$320.00	$400.00	$28.90–$400.00	14% above	20%
Stress echocardiogram, complete, including the stress test and supervision CPT 93351 HC EC STRESS ECHO	$1,486.40	$1,858.00	$184.21–$1,858.00	at median	20%
Swallow study (modified barium swallow, video X-ray) CPT 74230 HC XR SPEECH THERAPY BARIUM SWALLOW	$724.80	$906.00	$97.96–$906.00	33% above	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC XR FEMUR RT 2 OR MORE VIEWS	$320.00	$400.00	$28.63–$400.00	26% above	20%
Thigh bone (femur) X-ray, 2 or more views one side CPT 73552 HC XR FEMUR LT 2 OR MORE VIEWS	$320.00	$400.00	$28.63–$400.00	26% above	20%
Thoracic spine (mid back) CT scan without contrast CPT 72128 HC CT THORACIC SPINE W/O CONT	$1,585.60	$1,982.00	$105.78–$1,982.00	31% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE RT THIRD	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE LT GREAT	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOES RT 2 OR MORE VIEWS	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE RT SECOND	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE LT FOURTH	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE LT SECOND	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE LT FIFTH	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOES LT 2 OR MORE VIEWS	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE RT FIFTH	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE LT THIRD	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE RT GREAT	$320.00	$400.00	$23.25–$400.00	59% above	20%
Toe X-ray, 2 or more views one side CPT 73660 HC XR TOE RT FOURTH	$320.00	$400.00	$23.25–$400.00	59% above	20%
Transvaginal pelvic ultrasound CPT 76830 HC US PELVIS TRANSVAGINAL	$641.60	$802.00	$94.56–$802.00	37% above	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB CERVICAL LENGTH	$408.00	$510.00	$73.57–$510.00	13% above	20%
Transvaginal ultrasound during pregnancy CPT 76817 HC US OB 1ST TRI EV < 14 WEEKS	$641.60	$802.00	$73.57–$802.00	77% above	20%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE	$905.60	$1,132.00	$92.53–$1,132.00	50% above	20%
Ultrasound of the abdomen, complete CPT 76700 HC US ABDOMEN COMPLETE (59)	$905.60	$1,132.00	$92.53–$1,132.00	50% above	20%
Ultrasound of the scrotum and testicles CPT 76870 HC US SCROTUM	$641.60	$802.00	$80.00–$802.00	21% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US HEAD AND NECK SOFT TISSUE	$641.60	$802.00	$87.86–$802.00	34% above	20%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 HC US THYROID	$641.60	$802.00	$87.86–$802.00	34% above	20%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 HC XR UGI W/O ABD	$645.60	$807.00	$96.95–$807.00	13% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC XR HUMERUS LT	$320.00	$400.00	$25.67–$400.00	34% above	20%
Upper arm X-ray (humerus), 2 views one side CPT 73060 HC XR HUMERUS RT	$320.00	$400.00	$25.67–$400.00	34% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 HC US EXT VENOUS LIMITED	$641.60	$802.00	$94.93–$802.00	1% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC US EXT VENOUS LOWER LT	$641.60	$802.00	$94.93–$802.00	1% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC US EXT VENOUS LOWER RT	$641.60	$802.00	$94.93–$802.00	1% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC US EXT VENOUS UPPER RT	$641.60	$802.00	$94.93–$802.00	1% above	20%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 HC US EXT VENOUS UPPER LT	$641.60	$802.00	$94.93–$802.00	1% above	20%
Wrist X-ray, 2 views one side CPT 73100 HC XR WRIST 2V LT	$320.00	$400.00	$27.02–$400.00	42% above	20%
Wrist X-ray, 2 views one side CPT 73100 HC XR WRIST 2V RT	$320.00	$400.00	$27.02–$400.00	42% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC XR NAVICULAR RT	$320.00	$400.00	$33.22–$400.00	25% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC XR WRIST 3V RT W/NAVICULAR	$320.00	$400.00	$33.22–$400.00	25% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC XR WRIST 3V LT W/NAVICULAR	$320.00	$400.00	$33.22–$400.00	25% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC XR NAVICULAR LT	$320.00	$400.00	$33.22–$400.00	25% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC XR WRIST 3V RT	$320.00	$400.00	$33.22–$400.00	25% above	20%
Wrist X-ray, complete, 3 or more views one side CPT 73110 HC XR WRIST 3V LT	$320.00	$400.00	$33.22–$400.00	25% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XR PELVIS LAT HIP RT 2-3 VIEWS	$320.00	$400.00	$38.33–$400.00	18% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XR PELVIS LAT HIP LT 2-3 VIEWS	$320.00	$400.00	$38.33–$400.00	18% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XR HIP RT 2-3 VIEWS	$320.00	$400.00	$38.33–$400.00	18% above	20%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 HC XR HIP LT 2-3 VIEWS	$320.00	$400.00	$38.33–$400.00	18% above	20%
X-ray of the abdomen, 1 view CPT 74018 HC XR ABDOMEN 1V	$320.00	$400.00	$24.04–$400.00	28% above	20%
X-ray of the ankle, 2 views one side CPT 73600 HC XR ANKLE 1V/2V RT	$320.00	$400.00	$25.67–$400.00	30% above	20%
X-ray of the ankle, 2 views one side CPT 73600 HC XR ANKLE 1V/2V LT	$320.00	$400.00	$25.67–$400.00	30% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER RT FOURTH	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER RT THIRD	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGERS RT 2 OR MORE	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGERS LT 2 OR MORE	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER RT THUMB (FIRST)	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER LT SECOND	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER LT THIRD	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER LT FIFTH	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER LT THUMB (FIRST)	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER LT FOURTH	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER RT FIFTH	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the finger(s), 2 or more views one side CPT 73140 HC XR FINGER RT SECOND	$320.00	$400.00	$30.81–$400.00	46% above	20%
X-ray of the foot, 2 views one side CPT 73620 HC XR FOOT 2V RT	$320.00	$400.00	$22.70–$400.00	43% above	20%
X-ray of the foot, 2 views one side CPT 73620 HC XR FOOT 2V LT	$320.00	$400.00	$22.70–$400.00	43% above	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC XR FOOT 3V RT	$320.00	$400.00	$27.28–$400.00	25% above	20%
X-ray of the foot, complete, 3 or more views one side CPT 73630 HC XR FOOT 3V LT	$320.00	$400.00	$27.28–$400.00	25% above	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC XR HAND 3V LT	$320.00	$400.00	$29.98–$400.00	12% above	20%
X-ray of the hand, 3 or more views one side CPT 73130 HC XR HAND 3V RT	$320.00	$400.00	$29.98–$400.00	12% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC XR KNEE 1V/2V RT	$320.00	$400.00	$27.29–$400.00	31% above	20%
X-ray of the knee, 1 or 2 views one side CPT 73560 HC XR KNEE 1V/2V LT	$320.00	$400.00	$27.29–$400.00	31% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR LUMBAR SP 2V/3V	$584.00	$730.00	$31.85–$730.00	87% above	20%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 HC XR LUMBAR SP FLEX/EXT	$584.00	$730.00	$31.85–$730.00	87% above	20%
X-ray of the lower back, 4 or more views CPT 72110 HC XR LUM SP COMPL OBL (MIN 4 VWS)	$584.00	$730.00	$41.83–$730.00	45% above	20%
X-ray of the lower back, 4 or more views CPT 72110 HC XR LUMBAR 4 VIEW MINIMUM	$584.00	$730.00	$41.83–$730.00	45% above	20%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 HC XR THORACIC SP 2V	$320.00	$400.00	$26.46–$400.00	11% above	20%
X-ray of the nasal bones, 3 or more views CPT 70160 HC XR NASAL BONES	$320.00	$400.00	$30.25–$400.00	45% above	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR CERVICAL SP 2V/3V	$584.00	$730.00	$31.85–$730.00	126% above	20%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 HC XR CERVICAL SP FLEXION/EXTENSION	$584.00	$730.00	$31.85–$730.00	126% above	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS JUDET VIEW	$320.00	$400.00	$22.42–$400.00	18% above	20%
X-ray of the pelvis, 1 or 2 views CPT 72170 HC XR PELVIS 1V	$320.00	$400.00	$22.42–$400.00	18% above	20%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 HC XR SACRUM COCCYX	$251.20	$314.00	$26.20–$314.00	at median	20%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
ACTH blood test CPT 82024 HC ACTH (ADRENOCORTICOTROPIC HORMONE) LEVEL, MAYO	$305.60	$382.00	$30.90–$382.00	141% above	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC FLFFT ALANINE AMINO (ALT) (SGPT) MAYO	$48.80	$61.00	$4.24–$61.00	103% above	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC COMBO SGPT (ALT)	$108.80	$136.00	$4.24–$136.00	353% above	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC SGPT INPANEL	$108.80	$136.00	$4.24–$136.00	353% above	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC ALT (SGPT)	$108.80	$136.00	$4.24–$136.00	353% above	20%
ALT (alanine aminotransferase) liver enzyme test CPT 84460 HC HCVFS ALT (SGPT)	$124.80	$156.00	$4.24–$156.00	420% above	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC AST (SGOT)	$108.80	$136.00	$4.14–$136.00	282% above	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC COMBO SGOT (AST)	$108.80	$136.00	$4.14–$136.00	282% above	20%
AST (aspartate aminotransferase) enzyme test CPT 84450 HC SGOT INPANEL	$108.80	$136.00	$4.14–$136.00	282% above	20%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 HC HEPATITIS ACUTE PANEL	$342.40	$428.00	$38.10–$428.00	54% above	20%
Albumin blood test CPT 82040 HC ALBUMIN LEVEL	$84.80	$106.00	$3.96–$106.00	233% above	20%
Aldosterone blood test CPT 82088 HC ALDOSTERONE HORMONE, URINE	$150.40	$188.00	$32.60–$188.00	74% above	20%
Aldosterone blood test CPT 82088 HC ALDS ALDOSTERONE BLOOD, MAYO	$150.40	$188.00	$32.60–$188.00	74% above	20%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALKALINE PHOSPHATASE ASSAY	$73.60	$92.00	$4.14–$92.00	221% above	20%
Alkaline phosphatase (ALP) blood test CPT 84075 HC ALK PHOS ASSAY INPANEL	$73.60	$92.00	$4.14–$92.00	221% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC PR741 ALLERGENS FOOD IGE, 27, MAYO	$15.20	$19.00	$4.18–$19.00	19% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC ALLERGEN SPECIFIC IGE, EA MAYO	$26.40	$33.00	$4.18–$33.00	107% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC FARMERS LUNG ALLERGEN SPECIFIC IGE, ARUP 3001561	$40.80	$51.00	$4.18–$51.00	220% above	20%
Allergy blood test, specific IgE, per allergen CPT 86003 HC FOOD ALLERGEN SPECIFIC IGE, EA MAYO	$51.20	$64.00	$4.18–$64.00	302% above	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC PRS4 ALPHA-FETOPROTEIN (AFP) MATERNAL	$50.40	$63.00	$13.42–$63.00	31% below	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC QUAD1 SCRN 2ND TRI AFP, MAYO MANUAL BILLING	$156.80	$196.00	$13.42–$196.00	116% above	20%
Alpha-fetoprotein (AFP) blood test CPT 82105 HC AFP ALPHA-FETOPROTEIN, SERUM, MAYO	$156.80	$196.00	$13.42–$196.00	116% above	20%
Ammonia blood test CPT 82140 HC SUP24 AMMONIUM 24HR UR INPANEL MAYO	$84.80	$106.00	$11.66–$106.00	3% below	20%
Ammonia blood test CPT 82140 HC SSATR PED AMMONIUM 24HR UR IN PANEL MAYO	$84.80	$106.00	$11.66–$106.00	3% below	20%
Ammonia blood test CPT 82140 HC AMMONIA ASSAY	$120.80	$151.00	$11.66–$151.00	39% above	20%
Amylase blood test CPT 82150 HC AMYISO AMYLASE REF LAB	$72.00	$90.00	$5.18–$90.00	50% above	20%
Amylase blood test CPT 82150 HC AMYLASE ASSAY	$95.20	$119.00	$5.18–$119.00	98% above	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CTDC CYCLIC CITRULLINATED PEPTIDE AB, S, MAYO	$20.80	$26.00	$10.36–$26.00	61% below	20%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 HC CCP CYCLIC CITRULLINATED PEP AB, MAYO	$68.00	$85.00	$10.36–$85.00	29% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC CTDC ANTINUCLEAR AB, S, MAYO	$20.00	$25.00	$9.67–$25.00	65% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC CTD ANA REF LAB INPANEL	$54.40	$68.00	$9.67–$68.00	6% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANR CENTROMERE B AB INPANEL	$54.40	$68.00	$9.67–$68.00	6% below	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA2 ANTINUCLEAR AB, S, MAYO	$96.80	$121.00	$9.67–$121.00	67% above	20%
Antinuclear antibody (ANA) blood test, screen CPT 86038 HC ANA	$96.80	$121.00	$9.67–$121.00	67% above	20%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 HC BNP NATRIURETIC PEPTIDE ASSAY	$204.80	$256.00	$31.41–$256.00	30% above	20%
Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 HC CULTURE BACTERIAL AEROBIC EXCEPT URINE BLOOD STOOL	$78.40	$98.00	$6.90–$98.00	50% above	20%
Basic metabolic panel (blood test) CPT 80048 HC BASIC METABOLIC PANEL	$125.60	$157.00	$6.77–$157.00	162% above	20%
Bilirubin blood test, total CPT 82247 HC FLFFT BILIRUBIN TOTAL MAYO	$64.00	$80.00	$4.02–$80.00	151% above	20%
Bilirubin blood test, total CPT 82247 HC COMBO BILIRUBIN TOTAL	$83.20	$104.00	$4.02–$104.00	226% above	20%
Bilirubin blood test, total CPT 82247 HC BILIRUBIN TOTAL	$97.60	$122.00	$4.02–$122.00	283% above	20%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 HC LEVEL 4 SURG PATH	$167.20	$209.00	$57.56–$209.00	15% below	20%
Blood culture for bacteria CPT 87040 HC CULTURE BLOOD	$169.60	$212.00	$8.26–$212.00	54% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW VENIPUNCTURE	$11.20	$14.00	$3.00–$14.00	44% below	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC OB NURSE BLOOD DRAW (OP)	$25.60	$32.00	$3.00–$32.00	27% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW/HANDLING	$25.60	$32.00	$3.00–$32.00	27% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC BLOOD DRAW COLLECTION & PROCESSING	$49.60	$62.00	$3.00–$62.00	146% above	20%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 HC ER COLLECT VENOUS BLOOD BY VENIPUNCTURE	$52.00	$65.00	$3.00–$65.00	158% above	20%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE PUBLIC SCREEN	$20.80	$26.00	$3.14–$26.00	7% below	20%
Blood glucose (sugar) test CPT 82947 HC GLUCOSE - QUANTITATIVE, BLOOD	$83.20	$104.00	$3.14–$104.00	271% above	20%
Blood lead test CPT 83655 HC HMDB HEAVY METAL LEAD, W/DEMOGRAPHICS, MAYO	$18.40	$23.00	$9.20–$23.00	49% below	20%
Blood lead test CPT 83655 HC PBDV LEAD, VENOUS, W/DEMOGRAPHICS, MAYO	$92.80	$116.00	$9.69–$116.00	155% above	20%
Blood lead test CPT 83655 HC LEAD, CAPILLARY, FILTER PAPER, LABCORP 791280 (H83655)	$92.80	$116.00	$9.69–$116.00	155% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC BETA HCG QUALITATIVE	$95.20	$119.00	$6.02–$119.00	38% above	20%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HC SERUM PREGNANCY TEST-POC	$95.20	$119.00	$6.02–$119.00	38% above	20%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 HC ABO BLOOD TYPING	$74.40	$93.00	$2.39–$93.00	34% above	20%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN BLOOD UREA NITROGEN	$51.20	$64.00	$3.16–$64.00	101% above	20%
Blood urea nitrogen (BUN) test CPT 84520 HC BUN BLOOD UREA NITROGEN 1	$83.20	$104.00	$3.16–$104.00	226% above	20%
Blood urea nitrogen (BUN) test CPT 84520 HC COMBO BUN	$83.20	$104.00	$3.16–$104.00	226% above	20%
C-peptide blood test CPT 84681 HC CRP C-PEPTIDE LEVEL, MAYO	$161.60	$202.00	$16.65–$202.00	80% above	20%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 HC C REACTIVE PROTEIN	$73.60	$92.00	$4.14–$92.00	95% above	20%
C. difficile toxin gene test (stool PCR) CPT 87493 HC C DIFFICILE BY PCR	$132.00	$165.00	$29.82–$165.00	14% below	20%
CA 19-9 blood test (tumor marker) CPT 86301 HC CA19 CARBOHYDRATE ANTIGEN 19-9, MAYO	$92.80	$116.00	$16.65–$116.00	1% below	20%
CA-125 blood test (ovarian cancer marker) CPT 86304 HC CA 125	$154.40	$193.00	$16.65–$193.00	41% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID 19, SARS-COV-2 AMP PROBE TQ, PCR CEPHEID	$156.00	$195.00	$41.05–$195.00	30% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID 19, SARS-COV-2/2019-NCOV NON-CDC REF LAB	$156.00	$195.00	$41.05–$195.00	30% above	20%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 HC COVID 19, SARS-COV-2 AMP PROBE TQ, NAA/RNA, HOLOGIC	$156.00	$195.00	$41.05–$195.00	30% above	20%
Calcium blood test, total CPT 82310 HC COMBO CALCIUM LEVEL	$69.60	$87.00	$4.13–$87.00	174% above	20%
Calcium blood test, total CPT 82310 HC CALCIUM LEVEL	$73.60	$92.00	$4.13–$92.00	189% above	20%
Carcinoembryonic antigen (CEA) test CPT 82378 HC CEA (CARCINOEMBRYONIC ANTIGEN)	$188.80	$236.00	$15.17–$236.00	131% above	20%
Chickenpox (varicella) immunity blood test CPT 86787 HC MMRV VARICELLA-ZOSTER AB, IGG, S, MAYO	$27.20	$34.00	$10.30–$34.00	55% below	20%
Chickenpox (varicella) immunity blood test CPT 86787 HC VARICELLA ZOSTER ANTIBODY IGG	$96.80	$121.00	$10.30–$121.00	59% above	20%
Chickenpox (varicella) immunity blood test CPT 86787 HC VZGM VARICELLA ZOSTER ANTIBODY IGG/IGM MAYO	$96.80	$121.00	$10.30–$121.00	59% above	20%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 HC CHLAMYDIA PROBE BY TMA	$65.60	$82.00	$28.07–$82.00	30% below	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL PUBLIC SCREEN	$80.80	$101.00	$10.71–$101.00	40% above	20%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC LIPID PANEL	$156.80	$196.00	$10.71–$196.00	172% above	20%
Complete blood count (CBC) with differential CPT 85025 HC CBC W AUTO DIFFERENTIAL	$95.20	$119.00	$6.22–$119.00	130% above	20%
Complete blood count (CBC), no differential CPT 85027 HC CBC (HEMOGRAM) NO AUTO DIFF	$95.20	$119.00	$5.18–$119.00	208% above	20%
Comprehensive metabolic panel (blood test) CPT 80053 HC COMPREHENSIVE METABOLIC PANEL	$190.40	$238.00	$8.45–$238.00	280% above	20%
Cortisol blood test, total CPT 82533 HC CORTISOL TOTAL	$156.80	$196.00	$13.04–$196.00	89% above	20%
Cortisol blood test, total CPT 82533 HC SALCT CORTISOL, SALIVA MAYO	$156.80	$196.00	$13.04–$196.00	89% above	20%
Creatine kinase (CK) blood test, total CPT 82550 HC CREATINE KINASE (CK), (CPK) TOTAL	$95.20	$119.00	$5.21–$119.00	134% above	20%
Creatine kinase (CK) blood test, total CPT 82550 HC COMBO CPK (CK)	$95.20	$119.00	$5.21–$119.00	134% above	20%
Creatine kinase (CK) blood test, total CPT 82550 HC CKELR CREATINE KINASE ISOENZYME REFLEX MAYO	$95.20	$119.00	$5.21–$119.00	134% above	20%
Creatinine blood test CPT 82565 HC CREATININE LEVEL	$52.80	$66.00	$4.10–$66.00	114% above	20%
Cytomegalovirus (CMV) antibody test CPT 86644 HC CMVP CYTOMEGALOVIRUS AB, IGG, MAYO	$103.20	$129.00	$11.51–$129.00	76% above	20%
Cytomegalovirus (CMV) antibody test CPT 86644 HC TRCHG CYTOMEGALOVIRUS AB, IGG, MAYO	$103.20	$129.00	$11.51–$129.00	76% above	20%
D-dimer blood test (blood clot marker) CPT 85379 HC AATHR D-DIMER, P, MAYO	$129.60	$162.00	$8.14–$162.00	at median	20%
D-dimer blood test (blood clot marker) CPT 85379 HC BDIAL D-DIMER, P MAYO	$129.60	$162.00	$8.14–$162.00	at median	20%
D-dimer blood test (blood clot marker) CPT 85379 HC D-DIMER QUANTITATIVE	$133.60	$167.00	$8.14–$167.00	3% above	20%
DHEA sulfate (DHEA-S) blood test CPT 82627 HC DHES1 (DHEA)DEHYDROEPIANDROSTERONE SULFATE, S, MAYO	$195.20	$244.00	$17.78–$244.00	133% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC CDAU7 CONFIRMED DRUG ABUSE PANEL 9, U MAYO	$39.20	$49.00	$19.60–$49.71	32% below	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC CSMPU DRUG TEST PRSMV CHEM ANLYZR, MAYO	$83.20	$104.00	$41.60–$104.00	44% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC FABI ALCOHOL BIOMARKERS MAYO	$92.00	$115.00	$46.00–$115.00	59% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC PDSU DRUG SCREEN, PRESCRIPTION.OTC URINE MAYO	$108.00	$135.00	$49.71–$135.00	87% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC CONFIRMED DRUG ABUSE PANEL5, COC, U MAYO	$136.80	$171.00	$49.71–$171.00	137% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG SCREEN MECONIUM 5 DRUGS	$144.00	$180.00	$49.71–$180.00	149% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC ACETAMINOPHEN LEVEL	$154.40	$193.00	$49.71–$193.00	167% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST ALCOHOL, ETHYL BLOOD	$159.20	$199.00	$49.71–$199.00	176% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZR HARNEY	$228.00	$285.00	$49.71–$285.00	295% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC DRUG TEST PRSMV CHEM ANLYZER--MUE 80307	$228.00	$285.00	$49.71–$285.00	295% above	20%
Drug screen by lab instrument (any number of drug classes) CPT 80307 HC FCDSU COMPREHENSIVE DRUG SCREEN, UC, MAYO	$266.40	$333.00	$49.71–$333.00	361% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL	$96.80	$121.00	$5.61–$121.00	170% above	20%
Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 HC ELECTROLYTE PANEL 1	$96.80	$121.00	$5.61–$121.00	170% above	20%
Epstein-Barr virus (EBV) antibody test CPT 86665 HC EBVAB SEBV CAPSID VCA IGG/IGM, S, MAYO	$71.20	$89.00	$14.51–$89.00	4% below	20%
Estradiol blood test CPT 82670 HC ESTRADIOL LEVEL	$153.60	$192.00	$22.35–$192.00	44% above	20%
FSH (follicle-stimulating hormone) test CPT 83001 HC FSH (FOLLICLE STIMULATING HORMONE	$83.20	$104.00	$14.86–$104.00	7% above	20%
Fecal calprotectin (stool inflammation test) CPT 83993 HC CALPR CALPROTECTIN FECAL, MAYO	$294.40	$368.00	$15.70–$368.00	204% above	20%
Ferritin blood test (iron stores) CPT 82728 HC THEV1 ASSAY OF FERRITIN, MAYO	$64.00	$80.00	$10.90–$80.00	15% above	20%
Ferritin blood test (iron stores) CPT 82728 HC FERRITIN	$80.80	$101.00	$10.90–$101.00	46% above	20%
Fibrinogen blood test CPT 85384 HC AATHR FIBRINOGEN, CLAUSS, P, MAYO	$40.00	$50.00	$7.78–$50.00	37% below	20%
Fibrinogen blood test CPT 85384 HC BDIAL FIBRINOGEN, P MAYO	$54.40	$68.00	$7.78–$68.00	14% below	20%
Fibrinogen blood test CPT 85384 HC FIBRINOGEN	$133.60	$167.00	$7.78–$167.00	110% above	20%
Folate (folic acid) blood test CPT 82746 HC FOLATE LEVEL	$109.60	$137.00	$11.76–$137.00	25% above	20%
Free T3 thyroid hormone test CPT 84481 HC T3 FREE	$143.20	$179.00	$13.55–$179.00	101% above	20%
Free T4 (free thyroxine) thyroid blood test CPT 84439 HC T4 FREE (THYROXINE FREE)	$96.80	$121.00	$7.22–$121.00	112% above	20%
Free testosterone test CPT 84402 HC TTFB TESTOSTERONE,FREE,S MAYO	$77.60	$97.00	$20.38–$97.00	34% above	20%
Free testosterone test CPT 84402 HC TGRP FREE TESTOSTERONE, MAYO	$93.60	$117.00	$20.38–$117.00	61% above	20%
Free testosterone test CPT 84402 HC TETFRF TESTOSTERONE FREE, F/C	$145.60	$182.00	$20.38–$182.00	151% above	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC FLFFT GGT MAYO	$36.80	$46.00	$5.76–$46.00	24% above	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC GAMMA GT	$49.60	$62.00	$5.76–$62.00	67% above	20%
Gamma-glutamyl transferase (GGT) blood test CPT 82977 HC HCVFIS GAMMA GT	$124.80	$156.00	$5.76–$156.00	319% above	20%
General health panel: metabolic panel, blood count and TSH in one order CPT 80050 HC (H)GENERAL HEALTH PANEL	$388.80	$486.00	$36.75–$486.00	87% above	20%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 HC GLUCOSE - POST GLUCOSE DOSE (INCLUDES GLUCOSE)	$48.80	$61.00	$3.80–$61.00	41% above	20%
Glucose tolerance test, 3 samples CPT 82951 HC GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS	$321.60	$402.00	$10.30–$402.00	310% above	20%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 HC GC PROBE BY TMA	$65.60	$82.00	$28.07–$82.00	30% below	20%
H. pylori antibody blood test CPT 86677 HC HELICOBACTER PYLORI ANTIBODY	$82.40	$103.00	$13.48–$103.00	14% above	20%
H. pylori antibody blood test CPT 86677 HC HPYGA HELICOBACTER PYLORI ANTIBODY	$82.40	$103.00	$13.48–$103.00	14% above	20%
H. pylori stool antigen test CPT 87338 HC H PYLORI ANTIGEN STOOL	$104.00	$130.00	$11.50–$130.00	57% above	20%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HC HIVQN HIV-1 ULTRASENSITIVE RNA PCR, MAYO	$248.80	$311.00	$68.08–$311.00	10% below	20%
HIV-1 and HIV-2 antibody test CPT 86703 HC HIV 1/2 ANTIBODY SCREEN	$76.80	$96.00	$10.97–$96.00	16% above	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV1 AG AND HIV1/2 ANTIBODIES WITH REFLEX	$76.80	$96.00	$19.26–$96.00	4% below	20%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HC HIV1/2 AB, P24 AG - HDH	$96.80	$121.00	$19.26–$121.00	21% above	20%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HC HEMOGLOBIN A1C GLYCO	$108.80	$136.00	$7.77–$136.00	127% above	20%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN PUBLIC SCREEN	$20.00	$25.00	$1.90–$25.00	16% above	20%
Hemoglobin blood test CPT 85018 HC HEMOGLOBIN LEVEL	$54.40	$68.00	$1.90–$68.00	215% above	20%
Hepatitis B core antibody test (total) CPT 86704 HC HEPATITIS B CORE AB TOTAL	$56.80	$71.00	$9.64–$71.00	15% below	20%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HC HEPATITIS B SURFACE ANTIBODY	$43.20	$54.00	$8.59–$54.00	31% below	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HBAG HEPATITIS B SURFACE AG, MAYO	$65.60	$82.00	$8.26–$82.00	19% above	20%
Hepatitis B surface antigen (HBsAg) test CPT 87340 HC HEPATITIS B SURFACE ANTIGEN	$72.80	$91.00	$8.26–$91.00	32% above	20%
Hepatitis C antibody blood test (screening) CPT 86803 HC HEPATITIS C ANTIBODY	$69.60	$87.00	$11.42–$87.00	8% below	20%
Hepatitis C antibody blood test (screening) CPT 86803 HC EXPOSURE PANEL PMH	$112.00	$140.00	$11.42–$140.00	47% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HEPATITIS C RNA QUANT	$264.00	$330.00	$34.27–$330.00	35% above	20%
Hepatitis C viral load (HCV RNA) test CPT 87522 HC HCVQN OR HCVQG HCV RNA DETECT/QUANT, S, MAYO	$487.20	$609.00	$34.27–$609.00	148% above	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSVG (HS1G) HSV TYPE 1 AB, IGG, S, MAYO	$35.20	$44.00	$10.55–$44.00	41% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC TRCHG HSV TYPE 1 AB, IGG, MAYO	$35.20	$44.00	$10.55–$44.00	41% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSV 1 GLYCOPROTEIN IGG	$35.20	$44.00	$10.55–$44.00	41% below	20%
Herpes blood test, HSV-1 antibody CPT 86695 HC HSGM 1 GLYCOPRO IGG INPANEL	$35.20	$44.00	$10.55–$44.00	41% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSV HERPES SIMPLEX TYPE 2 TEST	$35.20	$44.00	$15.48–$44.00	52% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC TRCHG HSV TYPE 2 AB, IGG, MAYO	$35.20	$44.00	$15.48–$44.00	52% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC SGM 2 GLYCOPRO IGG INPANEL	$35.20	$44.00	$15.48–$44.00	52% below	20%
Herpes blood test, HSV-2 antibody CPT 86696 HC HSVG (HS2G) HSV TYPE 2 AB, IGG, S, MAYO	$35.20	$44.00	$15.48–$44.00	52% below	20%
High-sensitivity CRP (hs-CRP) test CPT 86141 HC C REACTIVE PROTEIN HIGH SENS	$68.80	$86.00	$10.36–$86.00	13% above	20%
Homocysteine blood test CPT 83090 HC HOMOCYSTEINE ASSAY	$165.60	$207.00	$14.34–$207.00	96% above	20%
Insulin blood test CPT 83525 HC INSULIN ASSAY	$143.20	$179.00	$9.14–$179.00	165% above	20%
Iron blood test (serum iron) CPT 83540 HC IRON ASSAY	$49.60	$62.00	$5.18–$62.00	42% above	20%
Iron-binding capacity (TIBC) test CPT 83550 HC IRON BINDING CAPACITY	$55.20	$69.00	$6.99–$69.00	29% above	20%
Kidney function blood test panel CPT 80069 HC RENAL PANEL	$108.80	$136.00	$6.94–$136.00	127% above	20%
LH (luteinizing hormone) test CPT 83002 HC LH LUTEINIZING HORMONE	$161.60	$202.00	$14.82–$202.00	98% above	20%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID 1	$134.40	$168.00	$9.26–$168.00	95% above	20%
Lactate (lactic acid) blood test CPT 83605 HC LACTIC ACID ASSAY	$134.40	$168.00	$9.26–$168.00	95% above	20%
Lactate dehydrogenase (LDH) blood test CPT 83615 HC LDH	$102.40	$128.00	$4.83–$128.00	234% above	20%
Lipase blood test (pancreas enzyme) CPT 83690 HC LIPASE ASSAY	$83.20	$104.00	$5.51–$104.00	31% above	20%
Liver function blood test panel CPT 80076 HC HEPATIC FUNCTION PANEL	$71.20	$89.00	$6.54–$89.00	71% above	20%
Magnesium blood test CPT 83735 HC SSATR PED MAGNESIUM 24HR UR IN PANEL MAYO	$64.00	$80.00	$5.36–$80.00	101% above	20%
Magnesium blood test CPT 83735 HC SUP24 MAGNESIUM 24HR UR IN PANEL MAYO	$64.00	$80.00	$5.36–$80.00	101% above	20%
Magnesium blood test CPT 83735 HC MAGNESIUM ASSAY	$64.00	$80.00	$5.36–$80.00	101% above	20%
Measles (rubeola) antibody test CPT 86765 HC MMRV MEASLES (RUBEOLA) AB, IGG, S, MAYO	$27.20	$34.00	$10.30–$34.00	54% below	20%
Mono test (heterophile antibody, Monospot) CPT 86308 HC MONONUCLEOSIS SCREEN	$74.40	$93.00	$4.14–$93.00	50% above	20%
Mumps immunity blood test CPT 86735 HC MMRV MUMPS AB, IGG, S, MAYO	$27.20	$34.00	$10.44–$34.00	41% below	20%
Mumps immunity blood test CPT 86735 HC MMPM MUMPS VIRUS ANTIBODY, IGM, MAYO	$40.00	$50.00	$10.44–$50.00	13% below	20%
Obstetric blood test panel CPT 80055 HC PRENATAL PROFILE, COMPLETE	$180.80	$226.00	$38.25–$226.00	2% above	20%
PSA (prostate-specific antigen) blood test, free CPT 84154 HC PSA FREE	$88.80	$111.00	$14.71–$111.00	19% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA-COMMUNITY/ SCREEN	$102.40	$128.00	$14.71–$128.00	37% above	20%
PSA (prostate-specific antigen) blood test, total CPT 84153 HC PSA TOTAL	$102.40	$128.00	$14.71–$128.00	37% above	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH PARATHORMONE ASSAY	$83.20	$104.00	$33.02–$104.00	50% below	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH2 PARATHYROID HORMONE (PTH), MAYO	$113.60	$142.00	$33.02–$142.00	31% below	20%
Parathyroid hormone (PTH) blood test CPT 83970 HC PTH INTRAOPERATIVE EA SPECIMEN	$154.40	$193.00	$33.02–$193.00	7% below	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC ALUPPR ACTIVATED PART THROMBOPL, MAYO	$21.60	$27.00	$4.81–$27.00	60% below	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC FLUPV LUPUS ANTICOAGULANT, MAYO	$71.20	$89.00	$4.81–$89.00	30% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC AATHR ACTIVATED PARTIAL THROMBOPL TIME, P, MAYO	$71.20	$89.00	$4.81–$89.00	30% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC BDIAL ACTIVATED PARTIAL THROMBOPL TIME, P MAYO	$71.20	$89.00	$4.81–$89.00	30% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC PTT REF LAB	$71.20	$89.00	$4.81–$89.00	30% above	20%
Partial thromboplastin time (PTT) clotting test CPT 85730 HC APTT (ACTIVATED PARTIAL THROMBOPLASTIN TIME)	$92.80	$116.00	$4.81–$116.00	70% above	20%
Phosphorus (phosphate) blood test CPT 84100 HC EFPO PHOSPHOROUS, MAYO	$83.20	$104.00	$3.79–$104.00	184% above	20%
Phosphorus (phosphate) blood test CPT 84100 HC PHOSPHORUS ASSAY	$83.20	$104.00	$3.79–$104.00	184% above	20%
Potassium blood test CPT 84132 HC POTASSIUM ASSAY	$83.20	$104.00	$3.81–$104.00	283% above	20%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 HC FMT21 MATERNIT21 PLUS(FETAL CHRMOML ANEUPLOIDY), MAYO	$1,336.80	$1,671.00	$607.24–$1,671.00	6% above	20%
Progesterone blood test CPT 84144 HC PROGESTERONE ASSAY	$152.00	$190.00	$16.69–$190.00	55% above	20%
Prolactin blood test CPT 84146 HC PROLACTIN ASSAY	$131.20	$164.00	$15.50–$164.00	63% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC ALUPPR PROTHROMBIN TIME, MAYO	$18.40	$23.00	$3.43–$23.00	36% below	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC INR, POC	$33.60	$42.00	$3.43–$42.00	16% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC BDIAL PROTHROMBIN TIME (PT), P MAYO	$35.20	$44.00	$3.43–$44.00	22% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC AATHR PROTHROMBIN TIME, P, MAYO	$36.80	$46.00	$3.43–$46.00	28% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTIME REF LAB	$36.80	$46.00	$3.43–$46.00	28% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC APSBAS PROTHROMBIN TIME	$49.60	$62.00	$3.43–$62.00	72% above	20%
Prothrombin time (PT/INR) clotting test CPT 85610 HC PROTIME PROTHROMBIN TIME	$56.80	$71.00	$3.43–$71.00	97% above	20%
Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 HC (H)DRUG SCREEN HDH-PUBLIC SCREEN	$51.20	$64.00	$10.08–$64.00	24% below	20%
Rapid flu test (influenza antigen) CPT 87804 HC INFLUENZA A/B RAPID ASSAY W OPTIC (SOFIA)	$96.00	$120.00	$13.24–$120.00	35% above	20%
Rapid flu test (influenza antigen) CPT 87804 HC (H) RAPID INFLU A INPANEL	$96.00	$120.00	$13.24–$120.00	35% above	20%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 HC (H) RHC QUICK STREP	$42.40	$53.00	$13.22–$53.00	23% below	20%
Renin blood test CPT 84244 HC PRA RENIN ACTIVITY, P, MAYO	$162.40	$203.00	$17.59–$203.00	155% above	20%
Rh blood typing CPT 86901 HC RH TYPE	$54.40	$68.00	$2.39–$68.00	31% above	20%
Rheumatoid factor (RF) test CPT 86431 HC RHEUMATOID FACTOR QUANTITATIVE	$14.40	$18.00	$4.54–$18.00	65% below	20%
Rheumatoid factor (RF) test CPT 86431 HC RHUT RHEUMATOID FACTOR QUANTITATIVE TITER, MAYO	$73.60	$92.00	$4.54–$92.00	80% above	20%
Rubella antibody test (immunity check) CPT 86762 HC MMRV RUBELLA AB, IGG, S, MAYO	$28.80	$36.00	$11.51–$36.00	37% below	20%
Rubella antibody test (immunity check) CPT 86762 HC RUBELLA ANTIBODY IGG	$54.40	$68.00	$11.51–$68.00	20% above	20%
Rubella antibody test (immunity check) CPT 86762 HC TRCHG RUBELLA AB, IGG, MAYO	$54.40	$68.00	$11.51–$68.00	20% above	20%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 HC SEDIMENTATION RATE	$72.80	$91.00	$2.16–$91.00	159% above	20%
Sodium blood test CPT 84295 HC SODIUM BLOOD ASSAY	$73.60	$92.00	$3.85–$92.00	189% above	20%
Sodium blood test CPT 84295 HC SODIUM 1	$129.60	$162.00	$3.85–$162.00	408% above	20%
Stool ova and parasites exam CPT 87177 HC OPE OVA AND PARASITES SMEARS MAYO	$31.20	$39.00	$7.12–$39.00	42% below	20%
Stool ova and parasites exam CPT 87177 HC OVA AND PARASITES SMEARS	$43.20	$54.00	$7.12–$54.00	20% below	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC (H)HC OCCULT BLOOD STOOL PUBLIC SCREEN	$44.80	$56.00	$3.50–$56.00	30% above	20%
Stool test for hidden blood (guaiac FOBT) CPT 82270 HC OCCULT BLOOD STOOL	$49.60	$62.00	$3.50–$62.00	44% above	20%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 HC OCCULT BLOOD STOOL ULTRA FOB	$62.40	$78.00	$12.74–$78.00	12% above	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPH1 SYPHILIS IGG W/ REFLEX, EIA, S, MAYO	$55.20	$69.00	$10.59–$69.00	67% above	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC SYPHILIS TEST TREPONEMA PALLIDUM	$59.20	$74.00	$10.59–$74.00	79% above	20%
Syphilis antibody test (Treponema pallidum) CPT 86780 HC RTPPA/TPPA TPPA SYPHILIS AB BY TP-PA, S	$69.60	$87.00	$10.59–$87.00	110% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC VDSF VDRL, CSF, MAYO	$52.80	$66.00	$3.42–$66.00	83% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC SYPHILIS TEST NON-TREP QUAL RPR,VDRL	$52.80	$66.00	$3.42–$66.00	83% above	20%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 HC RPR SCREEN, RESPONSE TO THERAPY, SERUM, MAYO	$68.00	$85.00	$3.42–$85.00	136% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB GOLD, MAYO	$213.60	$267.00	$49.58–$267.00	29% above	20%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 HC QUANTIFERON TB GOLD	$213.60	$267.00	$49.58–$267.00	29% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESTOSTERONE, TOTAL	$82.40	$103.00	$20.65–$103.00	15% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TTFB TESTOSTERONE, TOTAL ONLY, MAYO	$124.80	$156.00	$20.65–$156.00	75% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESBFC TESTOSTERONE TOTAL	$124.80	$156.00	$20.65–$156.00	75% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TESBFM TESTOSTERONE TOTAL	$124.80	$156.00	$20.65–$156.00	75% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TGRP TOTAL TESTOSTERONE, MAYO	$124.80	$156.00	$20.65–$156.00	75% above	20%
Testosterone blood test, total (not free testosterone) CPT 84403 HC TETFRF TESTOSTERONE TOTAL, FC	$124.80	$156.00	$20.65–$156.00	75% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC TPO THYROID PEROXIDASE ANTIBODY, MAYO	$44.00	$55.00	$11.64–$55.00	36% below	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC FCUIP CU (CHRONIC URTICARIA) INDEX PANEL, MICROSOMAL ANTIBODY, MAYO	$109.60	$137.00	$11.64–$137.00	61% above	20%
Thyroid peroxidase (TPO) antibody test CPT 86376 HC TAB THYROIDPEROZIDASE TPO, MAYO	$124.80	$156.00	$11.64–$156.00	83% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC TSH	$88.80	$111.00	$13.44–$111.00	26% above	20%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC FCUIP CU (CHRONIC URTICARIA) INDEX PANEL, TSH, MAYO	$128.00	$160.00	$13.44–$160.00	82% above	20%
Total IgE blood test CPT 82785 HC IGE IMMUNOGLOBULIN E (IGE), S MAYO	$159.20	$199.00	$13.17–$199.00	192% above	20%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL PUBLIC SCREEN	$14.40	$18.00	$3.48–$18.00	40% below	20%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL BODY FLUID	$28.80	$36.00	$3.48–$36.00	20% above	20%
Total cholesterol blood test CPT 82465 HC CHOLESTEROL TOTAL	$59.20	$74.00	$3.48–$74.00	146% above	20%
Total thyroxine (T4) blood test CPT 84436 HC T4 THYROXINE TOTAL	$50.40	$63.00	$5.50–$63.00	80% above	20%
Total triiodothyronine (T3) blood test CPT 84480 HC T3 TOTAL, MAYO	$67.20	$84.00	$11.34–$84.00	9% below	20%
Transferrin blood test CPT 84466 HC TRANSFERRIN IN PANEL	$65.60	$82.00	$10.21–$82.00	26% above	20%
Transferrin blood test CPT 84466 HC TRANSFERRIN	$92.80	$116.00	$10.21–$116.00	78% above	20%
Trichomonas test (NAAT) CPT 87661 HC IADNA TRICHOMONAS VAGINALIS AMPLIFIED	$72.00	$90.00	$28.07–$90.00	50% above	20%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES ASSAY	$54.40	$68.00	$4.59–$68.00	113% above	20%
Triglycerides blood test CPT 84478 HC COMBO TRIGLYCERIDES	$54.40	$68.00	$4.59–$68.00	113% above	20%
Triglycerides blood test CPT 84478 HC TRIGLYCERIDES INPANEL	$54.40	$68.00	$4.59–$68.00	113% above	20%
Troponin test, quantitative CPT 84484 HC TROPONIN ASSAY QUANTITATIVE	$137.60	$172.00	$9.98–$172.00	31% above	20%
Uric acid blood test CPT 84550 HC URIC ACID INPANEL	$83.20	$104.00	$3.62–$104.00	226% above	20%
Uric acid blood test CPT 84550 HC COMBO URIC ACID	$83.20	$104.00	$3.62–$104.00	226% above	20%
Uric acid blood test CPT 84550 HC URIC ACID BLOOD ASSAY	$83.20	$104.00	$3.62–$104.00	226% above	20%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS WITH CULTURE IF INDICATED	$55.20	$69.00	$2.54–$69.00	71% above	20%
Urinalysis with microscope exam, automated CPT 81001 HC URINALYSIS COMPLETE W MICROSCOPIC	$144.00	$180.00	$2.54–$180.00	346% above	20%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTOMATED DIP ONLY	$48.80	$61.00	$1.80–$61.00	150% above	20%
Urinalysis without microscope exam, automated CPT 81003 HC URINALYSIS AUTOMATED DIP ONLY SCFCC	$48.80	$61.00	$1.80–$61.00	150% above	20%
Urine culture for bacteria, with colony count CPT 87086 HC CULTURE URINE QUANTITATIVE COLONY COUNT	$48.00	$60.00	$6.46–$60.00	9% below	20%
Urine microalbumin (albumin) test CPT 82043 HC ALBUMIN URINE MICROALBUMIN QUANTIATIVE	$120.80	$151.00	$4.62–$151.00	173% above	20%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREG TEST PUBLIC SCREEN	$22.40	$28.00	$6.89–$28.00	58% below	20%
Urine pregnancy test, read by color change CPT 81025 HC (H)RHC URINE PREG TEST	$65.60	$82.00	$6.89–$82.00	23% above	20%
Urine pregnancy test, read by color change CPT 81025 HC URINE PREGNANCY TEST	$65.60	$82.00	$6.89–$82.00	23% above	20%
Vitamin B12 (cobalamin) blood test CPT 82607 HC VITAMIN B-12 LEVEL	$100.80	$126.00	$12.06–$126.00	30% above	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC 25HDN 25-HYDROXYVITAMIN D2 AND D3, SERUM MAYO	$100.00	$125.00	$23.68–$125.00	at median	20%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 HC VITAMIN D25 HYDROXY	$192.00	$240.00	$23.68–$240.00	92% above	20%
Vitamin D, 1,25-dihydroxy blood test CPT 82652 HC DHVD FV125 VITAMIN D 1 25 DIHYDROXY LEVEL, MAYO	$260.00	$325.00	$30.80–$325.00	144% above	20%
Zinc blood test CPT 84630 HC ZN_S ZINC ASSAY MAYO	$46.40	$58.00	$9.11–$58.00	63% above	20%
Zinc blood test CPT 84630 HC ZINC, RBC, LABCORP 070029	$166.40	$208.00	$9.11–$208.00	484% above	20%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HC BETA HCG QUANTITATIVE	$108.80	$136.00	$12.04–$136.00	61% above	20%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 HC (H) ORTHO CLSD TX DIS FIBULA W/O MANI	$412.00	$515.00	$103.14–$515.00	25% below	20%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 HC (H) CLOSED TX METATARSAL FRACTURE W/O MANIPULATION	$412.00	$515.00	$170.15–$515.00	12% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION	$710.40	$888.00	$84.35–$888.00	48% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL	$1,290.40	$1,613.00	$84.35–$1,613.00	5% below	20%
Cardioversion, elective (restoring heart rhythm) CPT 92960 HC ER CARDIOVERSION EXTERNAL	$1,338.40	$1,673.00	$84.35–$1,673.00	1% below	20%
Cataract surgery with lens implant CPT 66984 HC (H)CATARACT SURG. W/IOL, 1S	$5,782.40	$7,228.00	$971.45–$7,228.00	1% above	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC (H) CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANIPULATION	$412.00	$515.00	$206.00–$515.00	21% below	20%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 HC ER CLSD TX DISTAL RADIAL FX W/O MNP	$865.60	$1,082.00	$272.69–$1,082.00	66% above	20%
Complex cataract surgery with lens implant CPT 66982 HC (H)CATARACT REMV COMPLX	$6,420.00	$8,025.00	$971.45–$8,025.00	239% above	20%
Earwax removal by irrigation (rinsing), one ear CPT 69209 HC ER REMOVE IMPACTED EAR WAX UNI	$76.80	$96.00	$12.60–$96.00	at median	20%
Earwax removal with instruments, one ear CPT 69210 HC ER REMOVE IMPACTED EAR WAX	$228.00	$285.00	$25.01–$285.00	108% above	20%
Endoscopic sinus surgery: opening the frontal sinus CPT 31276 HC (H) ER NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS	$6,856.80	$8,571.00	$1,940.67–$8,571.00	at median	20%
Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 HC (H)INJECT SPINE CT W/IMA	$412.00	$515.00	$84.18–$515.00	79% below	20%
Facet joint injection, lower back, one level, with imaging guidance CPT 64493 HC (H)INJ. PARAVERT F JNT	$412.00	$515.00	$206.00–$515.00	80% below	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC ER I&D ABSCESS SIMPLE	$339.20	$424.00	$85.76–$424.00	5% above	20%
Incision and drainage of a simple or single skin abscess CPT 10060 HC DRAINAGE ABSCESS CU/SUBCU	$412.00	$515.00	$85.76–$515.00	27% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC AN INJ TENDON SHEATH/LIGAMENT	$412.00	$515.00	$30.34–$515.00	96% above	20%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 HC (H) AN INJ TENDON SHEATH/LIGAMENT	$412.00	$515.00	$30.34–$515.00	96% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC ER DRAIN/INJECT MAJOR JOINT BURSA	$290.40	$363.00	$26.91–$363.00	4% below	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN/INJECT, JOINT/	$412.00	$515.00	$26.91–$515.00	37% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC (H) DRAIN/INJ JOINT/BURSA W/O US	$412.00	$515.00	$26.91–$515.00	37% above	20%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 HC DRAIN/INJECT JOINT/BURSA	$545.60	$682.00	$26.91–$682.00	81% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC DRAIN/INJECT JOINT/BURSA	$412.00	$515.00	$28.67–$515.00	29% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC (H) DRAIN/INJECT JOINT/BURSA	$412.00	$515.00	$28.67–$515.00	29% above	20%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 HC ER DRAIN/INJECT INTER JOINT BURSA	$642.40	$803.00	$28.67–$803.00	101% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC DRAIN/INJ SM JNT BURSA	$412.00	$515.00	$27.87–$515.00	31% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC (H) DRAIN/INJ SM JNT BURSA	$412.00	$515.00	$27.87–$515.00	31% above	20%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 HC ER DRAIN/INJECT SMALL JOINT BURSA	$642.40	$803.00	$27.87–$803.00	104% above	20%
Laser treatment of clouding after cataract surgery (YAG) CPT 66821 HC (H)CATARACT LASER SURGERY	$1,236.00	$1,545.00	$235.62–$1,545.00	1% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC (H)REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<	$412.00	$515.00	$120.31–$515.00	35% below	20%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 HC ER INTMD REPAIR TRUNK UP TO 2.5CM	$646.40	$808.00	$120.31–$808.00	3% above	20%
Lower-back epidural injection, with imaging guidance CPT 62323 HC (H)INJECT SPINE LS/CD W/IMA	$412.00	$515.00	$77.85–$515.00	73% below	20%
Lower-back epidural injection, without imaging guidance CPT 62322 HC (H)INJECT SPINE LS/CD W/O	$412.00	$515.00	$61.04–$515.00	73% below	20%
Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC INJ. FORAMEN EPIDURA	$412.00	$515.00	$206.00–$515.00	74% below	20%
Nail removal (partial or complete), one nail CPT 11730 HC ER REMOVAL OF NAIL PLATE SINGLE	$339.20	$424.00	$42.29–$424.00	71% above	20%
Occipital nerve block (injection for headaches) CPT 64405 HC (H)ANES N BLOCK INJ OCCIPITAL	$412.00	$515.00	$40.47–$515.00	at median	20%
Paracentesis with imaging guidance CPT 49083 HC ABD PARACENTESIS W/IMAGING	$1,560.80	$1,951.00	$402.71–$1,951.00	35% above	20%
Paracentesis with imaging guidance CPT 49083 HC ER ABDOMINAL PARACENTESIS	$1,560.80	$1,951.00	$402.71–$1,951.00	35% above	20%
Removal of a foreign object under the skin, simple CPT 10120 HC INC & REM FB SQ; SMPL	$412.00	$515.00	$84.49–$515.00	2% above	20%
Removal of a foreign object under the skin, simple CPT 10120 HC ER REMOVAL FB SQ TISSUE SIMPLE	$646.40	$808.00	$84.49–$808.00	59% above	20%
Short arm cast (elbow to hand) CPT 29075 HC APPLICATION CAST ELBOW FINGER SHORT ARM	$412.00	$515.00	$47.10–$515.00	56% above	20%
Short arm cast (elbow to hand) CPT 29075 HC ER APPLICATION FOREARM CAST	$596.00	$745.00	$47.10–$745.00	126% above	20%
Short arm splint (forearm and hand) CPT 29125 HC ER APPLICATION FOREARM SPLINT	$261.60	$327.00	$32.25–$327.00	57% above	20%
Short arm splint (forearm and hand) CPT 29125 HC (H) APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC	$412.00	$515.00	$32.25–$515.00	147% above	20%
Short leg cast (below the knee) CPT 29405 HC (H) APPLICATION SHORT LEG CAST BELOW KNEE-TOE	$412.00	$515.00	$46.78–$515.00	41% above	20%
Short leg cast (below the knee) CPT 29405 HC (H)ER APPLICATION SHORT LEG CAST	$596.00	$745.00	$46.78–$745.00	105% above	20%
Short leg splint (calf to foot) CPT 29515 HC ER APPLICATION OF LOWER LEG SPLINT	$341.60	$427.00	$39.61–$427.00	66% above	20%
Short leg splint (calf to foot) CPT 29515 HC APPLY SHORT LEG SPLINT	$412.00	$515.00	$39.61–$515.00	100% above	20%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 HC ER SIMPLE REPAIR SCALP TO 2.5CM	$339.20	$424.00	$34.33–$424.00	at median	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC (H)SPINAL PUNCTURE, LUMBAR	$412.00	$515.00	$206.00–$515.00	58% below	20%
Spinal tap (lumbar puncture), diagnostic CPT 62270 HC ER SPINAL FLUID TAP DIAGNOSTIC	$1,676.80	$2,096.00	$297.40–$2,096.00	71% above	20%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 HC ER SIMPLE REPAIR SCALP 2.6-7.5CM	$339.20	$424.00	$44.98–$424.00	13% below	20%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 HC ER SIMPLE REPAIR FACE UP TO 2.5CM	$393.60	$492.00	$42.67–$492.00	16% above	20%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 HC (H) ER TANGENTIAL BIOPSY SKIN SINGLE LESION	$204.00	$255.00	$57.97–$255.00	6% below	20%
Thoracentesis with imaging guidance CPT 32555 HC ER THORACENTESIS W GUIDANCE	$612.80	$766.00	$265.85–$766.00	57% below	20%
Thoracentesis with imaging guidance CPT 32555 HC (H)ER ASPIRATE PLEURA W/IMA	$1,384.00	$1,730.00	$265.85–$1,730.00	3% below	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC INJ. TRIGGER POINT,	$412.00	$515.00	$21.74–$515.00	72% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC (H) INJ. TRIGGER TRIGGER POINT, 1-2 MUSCLES	$412.00	$515.00	$21.74–$515.00	72% above	20%
Trigger point injections, 1 or 2 muscles CPT 20552 HC ER INJ TRIGGER POINTS 1 OR 2 MUSCLES	$642.40	$803.00	$21.74–$803.00	169% above	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC US PERCUT NDL W/LMG GUIDE LT	$418.40	$523.00	$209.20–$566.62	86% below	20%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 HC US PERCUT NDL W/LMG GUIDE RT	$418.40	$523.00	$209.20–$566.62	86% below	20%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 HC ER DEBRIDE SKIN TISSUE	$646.40	$808.00	$171.51–$808.00	33% above	20%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
Blood transfusion (giving blood or blood components) CPT 36430 HC BLOOD ADMIN	$476.80	$596.00	$32.61–$596.00	42% below	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC (H)ER AIRWAY INHALATION TREATMENT	$129.60	$162.00	$6.39–$162.00	at median	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC PFT NEBULIZER TREATMENT	$162.40	$203.00	$6.39–$203.00	25% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC ER AIRWAY INHALATION TREATMENT	$429.60	$537.00	$6.39–$537.00	232% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 HC AIRWAY INHALATION TREATMENT	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT PEP THERAPY INITIAL	$162.40	$203.00	$6.39–$203.00	25% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT NEB SUBSEQUENT TX	$162.40	$203.00	$6.39–$203.00	25% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT NEB INITIAL	$162.40	$203.00	$6.39–$203.00	25% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT MDI/DPI SUBSEQUENT TX	$162.40	$203.00	$6.39–$203.00	25% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT PEP THERAPY SUBSEQUENT	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT AERONEB INITIAL	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT AERONEB SUBSEQUENT	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT COUGH ASSIST DEVICE	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT IPV INITIAL TX	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT IPV SUBESQUENT TX	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT PEP THERAPY WITH MEDS INITIAL	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT PEP THERAPY WITH MEDS SUBSEQ	$610.40	$763.00	$6.39–$763.00	372% above	20%
Breathing treatment (nebulizer or inhaler) for airway obstruction one side CPT 94640 HC RT SPUTUM INDUCTION	$610.40	$763.00	$6.39–$763.00	372% above	20%
Chemotherapy IV infusion, first hour CPT 96413 HC CHEMO IV INFUSION INITIAL HR	$625.60	$782.00	$98.95–$782.00	19% below	20%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE FIRST 30-74 MIN	$2,464.80	$3,081.00	$165.74–$3,081.00	3% below	20%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE E/M 30-74	$2,464.80	$3,081.00	$165.74–$3,081.00	3% below	20%
Critical care, first 30 to 74 minutes CPT 99291 HC ER CRITICAL CARE E/M 30-74 (25)	$2,464.80	$3,081.00	$165.74–$3,081.00	3% below	20%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 HC EKG ROUTINE	$219.20	$274.00	$5.04–$274.00	7% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER MINIMAL	$152.00	$190.00	$8.80–$190.00	6% below	20%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 HC ER MINIMAL (25)	$152.00	$190.00	$8.80–$190.00	6% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER LIMITED SERV (25)	$294.40	$368.00	$32.43–$368.00	35% below	20%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 HC ER LIMITED SERV EA	$294.40	$368.00	$32.43–$368.00	35% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER LIMITED PLUS EA	$418.40	$523.00	$54.81–$523.00	52% below	20%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 HC ER LIMITED PLUS (25)	$418.40	$523.00	$54.81–$523.00	52% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER INTERMEDIATE SERV EA	$781.60	$977.00	$93.35–$977.00	32% below	20%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 HC ER INTERMEDIATE SERV (25)	$781.60	$977.00	$93.35–$977.00	32% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER MAJOR SERV (25)	$1,248.00	$1,560.00	$135.25–$1,560.00	35% below	20%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 HC ER MAJOR SERV 1HR	$1,248.00	$1,560.00	$135.25–$1,560.00	35% below	20%
Exercise stress test, tracing only, the hospital charge CPT 93017 HC STRESS TREADMILL TRACE ONLY	$403.20	$504.00	$30.86–$504.00	40% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC (H)ER IV HYDRATION >30&<91 MIN	$258.40	$323.00	$24.95–$323.00	34% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC IV HYDRATION INITIAL HOUR (OP)	$258.40	$323.00	$24.95–$323.00	34% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC (H)IV HYDRATION >30&<91 MIN	$258.40	$323.00	$24.95–$323.00	34% below	20%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HC (H)ER IV HYDRATE MAIN SRVC >30 & <90 MIN	$264.80	$331.00	$24.95–$331.00	33% below	20%
IV infusion of a medicine, first hour CPT 96365 HC (H)IV INFUSION THERAPY >15&<91 MIN	$307.20	$384.00	$47.87–$384.00	23% below	20%
IV infusion of a medicine, first hour CPT 96365 HC IV INFUSION THERAPY 1 HOUR (OP)	$307.20	$384.00	$47.87–$384.00	23% below	20%
IV infusion of a medicine, first hour CPT 96365 HC (H)ER IV INFUSION THERAPY >15&<91 MIN	$307.20	$384.00	$47.87–$384.00	23% below	20%
IV infusion of a medicine, first hour CPT 96365 HC ER IV INFUSION INITIAL UP TO 1 HR	$496.80	$621.00	$47.87–$621.00	25% above	20%
IV infusion of a medicine, first hour CPT 96365 HC (H)ER IV THERAPY MAIN SRVC >15 & <90 MIN	$496.80	$621.00	$47.87–$621.00	25% above	20%
IV push of a medicine, first drug CPT 96374 HC (H)IV INJECTION <15 MIN	$246.40	$308.00	$28.09–$308.00	1% below	20%
IV push of a medicine, first drug CPT 96374 HC INJECTION INTRAVENOUS (OP)	$246.40	$308.00	$28.09–$308.00	1% below	20%
IV push of a medicine, first drug CPT 96374 HC IV INJECTION (OP)	$246.40	$308.00	$28.09–$308.00	1% below	20%
IV push of a medicine, first drug CPT 96374 HC (H)ER IV PUSH/DRIP MAIN SERVICE <=15 MIN	$246.40	$308.00	$28.09–$308.00	1% below	20%
IV push of a medicine, first drug CPT 96374 HC (H)ER IV INJECTION <15 MIN	$246.40	$308.00	$28.09–$308.00	1% below	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC (H)ER THERAPEUTIC INJECTION	$121.60	$152.00	$11.45–$152.00	27% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC INJECTION SC/IM (OP)	$156.00	$195.00	$11.45–$195.00	62% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC (H)IM/SUBQ INJECTION	$156.00	$195.00	$11.45–$195.00	62% above	20%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 HC (H)ER IM/SUBQ INJECTION	$156.00	$195.00	$11.45–$195.00	62% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC PT NEUROMUS RE-EDUCATION 15M	$109.60	$137.00	$26.43–$137.00	10% above	20%
Neuromuscular re-education, 15 minutes CPT 97112 HC OT HAND NEUROMUSCULAR RE-ED 15M	$109.60	$137.00	$26.43–$137.00	10% above	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC (H) ORTHO OFFICE OUTPATIENT NEW 20 MINUTES	$69.60	$87.00	$34.80–$87.00	48% below	20%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 HC OFFICE OUTPATIENT NEW 20 MINUTES	$103.20	$129.00	$36.76–$129.00	23% below	20%
Occupational therapy evaluation, low complexity CPT 97165 HC OT EVAL LOW COMPLEX	$144.80	$181.00	$72.40–$181.00	43% below	20%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 HC PT EVAL HIGH COMPLEX	$432.80	$541.00	$80.81–$541.00	44% above	20%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 HC PT EVAL LOW COMPLEX	$144.80	$181.00	$72.40–$181.00	41% below	20%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 HC PT EVAL MOD COMPLEX SOUTH CLINIC	$289.60	$362.00	$80.81–$362.00	4% below	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC OT MANUAL THERAPY 15M	$116.00	$145.00	$22.41–$145.00	23% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC PT MANUAL THERAPY 15M	$116.00	$145.00	$22.41–$145.00	23% above	20%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 HC (H)PT MANUAL THER 30 MIN	$200.80	$251.00	$22.41–$251.00	113% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC OT THERAPEUTIC EXERCISE 15M	$109.60	$137.00	$23.75–$137.00	15% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC PT THERAPY EXERCISE 15M	$109.60	$137.00	$23.75–$137.00	15% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC (H)PT EXERCISE-45 MIN	$161.60	$202.00	$23.75–$202.00	70% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC (H)PT EXERCISE-30 MIN	$196.00	$245.00	$23.75–$245.00	106% above	20%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC (H)PT EXERCISE-60 MIN	$214.40	$268.00	$23.75–$268.00	125% above	20%
Speech and language evaluation CPT 92523 HC SP LANGUAGE EVAL	$248.80	$311.00	$124.40–$311.00	28% below	20%
Speech and language evaluation CPT 92523 HC (H)SPEECH SOUND LANG CO	$319.20	$399.00	$159.60–$399.00	8% below	20%
Speech therapy session, individual CPT 92507 HC (H)SPEECH VISIT 60 MIN O/P	$229.60	$287.00	$61.83–$287.00	17% below	20%
Speech therapy session, individual CPT 92507 HC (H)SPEECH VISIT 30 MIN O/P	$229.60	$287.00	$61.83–$287.00	17% below	20%
Speech therapy session, individual CPT 92507 HC SP LANGUAGE/VOICE TX	$264.80	$331.00	$61.83–$331.00	4% below	20%
Spirometry (breathing test) one side CPT 94010 HC RT BEDSIDE SPIROMETRY	$196.80	$246.00	$21.88–$246.00	12% below	20%
Spirometry before and after a bronchodilator one side CPT 94060 HC RT BEDSIDE SPIROMETRY PRE/POST	$356.80	$446.00	$31.31–$446.00	13% below	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUTIC ACTIVITIES 15M	$102.40	$128.00	$28.62–$128.00	16% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC PT THERAPEUTIC ACTIVITIES 15M	$109.60	$137.00	$28.62–$137.00	25% above	20%
Therapeutic activities (functional training), 15 minutes CPT 97530 HC OT THERAPEUTIC ACTIVITY IPR 15 M	$109.60	$137.00	$28.62–$137.00	25% above	20%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 HC PHLEB THERAPY	$131.20	$164.00	$65.60–$164.00	34% below	20%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Oregon	Off list
DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DIPH,PERTUS(ACEL),TET PEDI (PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SUSP	$57.98	$72.47	$28.73–$72.47	13% below	20%
DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE	$150.00	$187.50	$75.00–$187.50	45% above	20%
Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE	$190.89	$238.61	$95.44–$238.61	26% above	20%
Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPATITIS B VIRUS ADULT VACCINE 20 MCG/ML	$113.38	$141.72	$56.69–$141.72	7% above	20%
MMR vaccine (measles, mumps and rubella), live CPT 90707 MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT	$146.19	$182.74	$73.10–$182.74	23% below	20%
Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE	$375.69	$469.61	$187.84–$469.61	15% above	20%
RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE	$720.91	$901.14	$360.46–$901.14	14% above	20%
Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE	$83.37	$104.21	$39.81–$104.21	15% above	20%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HC IMM ADM SINGLE VACCINE/TOXOID	$61.60	$77.00	$16.58–$77.00	6% above	20%

Source file: https://hospitalpricetransparencyfiles.com/harney-district-hospital/936002332_Harney-District-Hospital_standardcharges.csv