Hospital Tifton, GA

Tift Regional Medical Center

Tift Regional Medical Center in Tifton, GA publishes cash prices for 267 common procedures listed here, from its own machine-readable price file updated Aug 11, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the Georgia median for 195 of 265 procedures and above it for 63. By typical cash price it ranks #17 of 64 Georgia hospitals, cheapest first. Click a procedure to compare it with other hospitals nearby.

901 E 18th St, Tifton, GA 31794 Collected Sep 28, 2026 Source price file (229) 382-7120

Acute care hospital No emergency department CMS star rating 3 of 5 CCN 110095 · CMS hospital register NPI 1962462226

CMS price transparency record

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

Mar 1, 2023 Warning notice
Jun 6, 2023 Corrective action plan requested
Sep 28, 2023 Case closed

Warning notice: CMS reviewed the hospital and told it that it had found possible violations of the price transparency rules. Corrective action plan requested: CMS asked the hospital to submit a plan to fix the problems it found. Case closed: CMS closed the case after the hospital addressed the problems.

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

Scans and imaging

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Ankle X-ray, complete, 3 or more views both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral	$374.50	$749.00	$36.53–$749.00	—	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Left	$187.50	$375.00	$36.53–$375.00	28% below	50%
Ankle X-ray, complete, 3 or more views one side CPT 73610 XR Ankle Complete 3+ Views Right	$187.50	$375.00	$36.53–$375.00	28% below	50%
Ankle X-ray, complete, 3 or more views inpatient both sides CPT 73610 XR Ankle Complete 3+ Views Bilateral	$374.50	$749.00	$290.61–$749.00	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Right	$187.50	$375.00	$145.50–$375.00	—	50%
Ankle X-ray, complete, 3 or more views inpatient one side CPT 73610 XR Ankle Complete 3+ Views Left	$187.50	$375.00	$145.50–$375.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV Vascular Acquisition	$171.00	$342.00	$67.09–$342.00	62% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 PVR ARTERIAL 2 LEVELS	$219.00	$438.00	$81.51–$438.00	51% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV VAS LLE PVR wSPP	$356.50	$713.00	$81.51–$713.00	21% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV VAS RLE PVR wSPP	$356.50	$713.00	$81.51–$713.00	21% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV VAS RUE PVR wSPP	$356.50	$713.00	$81.51–$713.00	21% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 CV VAS LUE PVR wSPP	$356.50	$713.00	$81.51–$713.00	21% below	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV Vascular Acquisition	$171.00	$342.00	$132.70–$342.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 PVR ARTERIAL 2 LEVELS	$219.00	$438.00	$169.94–$438.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV VAS RUE PVR wSPP	$356.50	$713.00	$276.64–$713.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV VAS LLE PVR wSPP	$356.50	$713.00	$276.64–$713.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV VAS LUE PVR wSPP	$356.50	$713.00	$276.64–$713.00	—	50%
Ankle-brachial index (ABI), blood pressure test for leg arteries inpatient CPT 93922 CV VAS RLE PVR wSPP	$356.50	$713.00	$276.64–$713.00	—	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 3M XR Esophagus	$155.50	$311.00	$61.01–$311.00	50% below	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR (Cartwright) Barium Swallow/Dysphagia	$318.00	$636.00	$97.48–$636.00	3% above	50%
Barium swallow (esophagus X-ray with contrast) CPT 74220 XR Esophagus	$318.00	$636.00	$97.48–$636.00	3% above	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 3M XR Esophagus	$155.50	$311.00	$120.67–$311.00	—	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR Esophagus	$318.00	$636.00	$246.77–$636.00	—	50%
Barium swallow (esophagus X-ray with contrast) inpatient CPT 74220 XR (Cartwright) Barium Swallow/Dysphagia	$318.00	$636.00	$246.77–$636.00	—	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Imaging Whole Body Injection	$1,362.00	$2,724.00	$266.06–$2,724.00	22% above	50%
Bone scan, whole body (nuclear medicine) CPT 78306 NM Bone Whole Body Scan	$1,362.00	$2,724.00	$266.06–$2,724.00	22% above	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Imaging Whole Body Injection	$1,362.00	$2,724.00	$1,056.91–$2,724.00	—	50%
Bone scan, whole body (nuclear medicine) inpatient CPT 78306 NM Bone Whole Body Scan	$1,362.00	$2,724.00	$1,056.91–$2,724.00	—	50%
Breast ultrasound, complete, one breast both sides CPT 76641 US BREAST COMPLETE BILATERAL	$471.50	$943.00	$91.62–$943.00	—	50%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Left	$236.00	$472.00	$91.62–$472.00	38% below	50%
Breast ultrasound, complete, one breast one side CPT 76641 US Breast Complete Right	$236.00	$472.00	$91.62–$472.00	38% below	50%
Breast ultrasound, complete, one breast inpatient both sides CPT 76641 US BREAST COMPLETE BILATERAL	$471.50	$943.00	$365.88–$943.00	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Left	$236.00	$472.00	$183.14–$472.00	—	50%
Breast ultrasound, complete, one breast inpatient one side CPT 76641 US Breast Complete Right	$236.00	$472.00	$183.14–$472.00	—	50%
Breast ultrasound, limited (one breast or one area) both sides CPT 76642 US BREAST LIMITED BILATERAL	$273.50	$547.00	$76.26–$547.00	—	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Right	$137.50	$275.00	$53.95–$275.00	64% below	50%
Breast ultrasound, limited (one breast or one area) one side CPT 76642 US Breast Limited Left	$137.50	$275.00	$53.95–$275.00	64% below	50%
Breast ultrasound, limited (one breast or one area) inpatient both sides CPT 76642 US BREAST LIMITED BILATERAL	$273.50	$547.00	$212.24–$547.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Right	$137.50	$275.00	$106.70–$275.00	—	50%
Breast ultrasound, limited (one breast or one area) inpatient one side CPT 76642 US Breast Limited Left	$137.50	$275.00	$106.70–$275.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Pulmonary	$909.00	$1,818.00	$153.71–$1,818.00	51% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Angio Chest	$909.00	$1,818.00	$153.71–$1,818.00	51% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest PE Protocol	$1,596.50	$3,193.00	$153.71–$3,193.00	14% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT Chest Pulm Embolism Protocol	$1,596.50	$3,193.00	$153.71–$3,193.00	14% below	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Chest	$909.00	$1,818.00	$705.38–$1,818.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Angio Pulmonary	$909.00	$1,818.00	$705.38–$1,818.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest Pulm Embolism Protocol	$1,596.50	$3,193.00	$1,238.88–$3,193.00	—	50%
CT angiography of the chest (CTA), for blood clots in the lungs inpatient CPT 71275 CT Chest PE Protocol	$1,596.50	$3,193.00	$1,238.88–$3,193.00	—	50%
CT of the heart without contrast dye to measure coronary calcium CPT 75571 CT Heart Calcium Scoring	$50.00	$100.00	$19.62–$306.64	50% below	50%
CT of the heart without contrast dye to measure coronary calcium inpatient CPT 75571 CT Heart Calcium Scoring	$50.00	$100.00	$38.80–$100.00	—	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD/Pelvis w/o Contrast	$2,070.00	$4,140.00	$190.75–$4,140.00	7% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Stone Protocol	$2,070.00	$4,140.00	$190.75–$4,140.00	7% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Abdomen and Pelvis w/o Contrast	$2,070.00	$4,140.00	$190.75–$4,140.00	7% below	50%
CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT Bariatric Protocol	$2,070.00	$4,140.00	$190.75–$4,140.00	7% below	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Bariatric Protocol	$2,070.00	$4,140.00	$1,606.32–$4,140.00	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Abdomen and Pelvis w/o Contrast	$2,070.00	$4,140.00	$1,606.32–$4,140.00	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT ABD/Pelvis w/o Contrast	$2,070.00	$4,140.00	$1,606.32–$4,140.00	—	50%
CT scan of abdomen and pelvis, no contrast dye inpatient CPT 74176 CT Stone Protocol	$2,070.00	$4,140.00	$1,606.32–$4,140.00	—	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Abdomen and Pelvis w/ Contrast	$3,238.00	$6,476.00	$305.72–$6,476.00	2% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT Enterography w/ Contrast	$3,238.00	$6,476.00	$305.72–$6,476.00	2% above	50%
CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD/Pelvis w Contrast	$3,238.00	$6,476.00	$305.72–$6,476.00	2% above	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Abdomen and Pelvis w/ Contrast	$3,238.00	$6,476.00	$2,512.69–$6,476.00	—	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABD/Pelvis w Contrast	$3,238.00	$6,476.00	$2,512.69–$6,476.00	—	50%
CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT Enterography w/ Contrast	$3,238.00	$6,476.00	$2,512.69–$6,476.00	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Urogram	$3,320.50	$6,641.00	$305.72–$6,641.00	6% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$3,320.50	$6,641.00	$305.72–$6,641.00	6% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT Abd + Pelvis w/+w/o Cnt (GI Bleed)	$3,320.50	$6,641.00	$305.72–$6,641.00	6% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD/Pelvis w/wo Contrast	$3,320.50	$6,641.00	$305.72–$6,641.00	6% above	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abd + Pelvis w/+w/o Cnt (GI Bleed)	$3,320.50	$6,641.00	$2,576.71–$6,641.00	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT ABD/Pelvis w/wo Contrast	$3,320.50	$6,641.00	$2,576.71–$6,641.00	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Urogram	$3,320.50	$6,641.00	$2,576.71–$6,641.00	—	50%
CT scan of abdomen and pelvis, without and then with contrast dye inpatient CPT 74178 CT Abdomen and Pelvis w/ + w/o Contrast	$3,320.50	$6,641.00	$2,576.71–$6,641.00	—	50%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w/ Contrast	$1,610.50	$3,221.00	$153.71–$3,221.00	6% below	50%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen w Contrast	$1,610.50	$3,221.00	$153.71–$3,221.00	6% below	50%
CT scan of the abdomen with contrast CPT 74160 CT Abdomen Pancreatic Protocol	$1,644.00	$3,288.00	$153.71–$3,288.00	4% below	50%
CT scan of the abdomen with contrast CPT 74160 CT Liver Protocol	$1,644.00	$3,288.00	$153.71–$3,288.00	4% below	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w Contrast	$1,610.50	$3,221.00	$1,249.75–$3,221.00	—	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen w/ Contrast	$1,610.50	$3,221.00	$1,249.75–$3,221.00	—	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Liver Protocol	$1,644.00	$3,288.00	$1,275.74–$3,288.00	—	50%
CT scan of the abdomen with contrast inpatient CPT 74160 CT Abdomen Pancreatic Protocol	$1,644.00	$3,288.00	$1,275.74–$3,288.00	—	50%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen w/o Contrast	$1,039.00	$2,078.00	$91.62–$2,078.00	23% below	50%
CT scan of the abdomen without contrast CPT 74150 CT Abdomen wo contrast	$1,039.00	$2,078.00	$91.62–$2,078.00	23% below	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen wo contrast	$1,039.00	$2,078.00	$806.26–$2,078.00	—	50%
CT scan of the abdomen without contrast inpatient CPT 74150 CT Abdomen w/o Contrast	$1,039.00	$2,078.00	$806.26–$2,078.00	—	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/ Contrast	$317.00	$634.00	$91.62–$634.00	73% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Sinus w/o Contrast	$317.00	$634.00	$91.62–$634.00	73% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxioface w/o Contrast	$963.50	$1,927.00	$91.62–$1,927.00	17% below	50%
CT scan of the face and sinuses, no contrast dye CPT 70486 CT Maxillofacial w/o Contrast	$963.50	$1,927.00	$91.62–$1,927.00	17% below	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/ Contrast	$317.00	$634.00	$245.99–$634.00	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Sinus w/o Contrast	$317.00	$634.00	$245.99–$634.00	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxioface w/o Contrast	$963.50	$1,927.00	$747.68–$1,927.00	—	50%
CT scan of the face and sinuses, no contrast dye inpatient CPT 70486 CT Maxillofacial w/o Contrast	$963.50	$1,927.00	$747.68–$1,927.00	—	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Brain/Head w/o Contrast	$964.50	$1,929.00	$91.62–$1,929.00	29% below	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT Head w/o contrast	$964.50	$1,929.00	$91.62–$1,929.00	29% below	50%
CT scan of the head or brain, no contrast dye CPT 70450 CT STROKE Head w/o Contrast	$964.50	$1,929.00	$91.62–$1,929.00	29% below	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT STROKE Head w/o Contrast	$964.50	$1,929.00	$748.45–$1,929.00	—	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Head w/o contrast	$964.50	$1,929.00	$748.45–$1,929.00	—	50%
CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT Brain/Head w/o Contrast	$964.50	$1,929.00	$748.45–$1,929.00	—	50%
CT scan of the head with contrast CPT 70460 CT Brain/Head w/ Contrast	$1,333.00	$2,666.00	$153.13–$2,666.00	16% below	50%
CT scan of the head with contrast inpatient CPT 70460 CT Brain/Head w/ Contrast	$1,333.00	$2,666.00	$1,034.41–$2,666.00	—	50%
CT scan of the head without and with contrast CPT 70470 CT Brain/Head w/ + w/o Contrast	$1,646.00	$3,292.00	$153.71–$3,292.00	13% below	50%
CT scan of the head without and with contrast CPT 70470 CT Head w/wo contrast	$1,646.00	$3,292.00	$153.71–$3,292.00	13% below	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT Head w/wo contrast	$1,646.00	$3,292.00	$1,277.30–$3,292.00	—	50%
CT scan of the head without and with contrast inpatient CPT 70470 CT Brain/Head w/ + w/o Contrast	$1,646.00	$3,292.00	$1,277.30–$3,292.00	—	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Spine Lumbar w/o Contrast	$1,329.00	$2,658.00	$91.62–$2,658.00	11% below	50%
CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT Lumbar w/o Contrast	$1,329.00	$2,658.00	$91.62–$2,658.00	11% below	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Lumbar w/o Contrast	$1,329.00	$2,658.00	$1,031.30–$2,658.00	—	50%
CT scan of the lower back (lumbar spine) without contrast inpatient CPT 72131 CT Spine Lumbar w/o Contrast	$1,329.00	$2,658.00	$1,031.30–$2,658.00	—	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Spine Cervical w/o Contrast	$1,329.00	$2,658.00	$91.62–$2,658.00	3% above	50%
CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT Cervical w/o contrast	$1,329.00	$2,658.00	$91.62–$2,658.00	3% above	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Spine Cervical w/o Contrast	$1,329.00	$2,658.00	$1,031.30–$2,658.00	—	50%
CT scan of the neck (cervical spine), no contrast dye inpatient CPT 72125 CT Cervical w/o contrast	$1,329.00	$2,658.00	$1,031.30–$2,658.00	—	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Cystogram	$1,432.00	$2,864.00	$153.71–$2,864.00	11% below	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w/ Contrast	$1,596.50	$3,193.00	$153.71–$3,193.00	at median	50%
CT scan of the pelvis, with contrast dye CPT 72193 CT Pelvis w Contrast	$1,596.50	$3,193.00	$153.71–$3,193.00	at median	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Cystogram	$1,432.00	$2,864.00	$1,111.23–$2,864.00	—	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w Contrast	$1,596.50	$3,193.00	$1,238.88–$3,193.00	—	50%
CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT Pelvis w/ Contrast	$1,596.50	$3,193.00	$1,238.88–$3,193.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 US Carotid Duplex Bilateral	$323.50	$647.00	$126.93–$647.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 CV VAS Carotid Duplex Bilat	$535.00	$1,070.00	$188.90–$1,070.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck one side CPT 93880 US Carotid Duplex Unilat / Ltd	$143.50	$287.00	$56.30–$633.19	80% below	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 US Carotid Duplex Bilateral	$323.50	$647.00	$251.04–$647.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient both sides CPT 93880 CV VAS Carotid Duplex Bilat	$535.00	$1,070.00	$415.16–$1,070.00	—	50%
Carotid artery ultrasound (duplex), both sides of the neck inpatient one side CPT 93880 US Carotid Duplex Unilat / Ltd	$143.50	$287.00	$111.36–$287.00	—	50%
Chest X-ray, 2 views both sides CPT 71046 XR CHEST OBLIQUES BILAT	$189.50	$379.00	$33.82–$379.00	—	50%
Chest X-ray, 2 views both sides CPT 71046 XR CHEST DECUBITUS BILAT	$189.50	$379.00	$33.82–$379.00	—	50%
Chest X-ray, 2 views both sides CPT 71046 XR Chest 2 Views (Decub Bilateral)	$189.50	$379.00	$33.82–$379.00	—	50%
Chest X-ray, 2 views CPT 71046 3M XR Chest Decubitus	$50.00	$100.00	$19.62–$101.21	83% below	50%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views w/ Fluoroscopy	$189.50	$379.00	$33.82–$379.00	34% below	50%
Chest X-ray, 2 views CPT 71046 XR Chest 2 Views	$189.50	$379.00	$33.82–$379.00	34% below	50%
Chest X-ray, 2 views CPT 71046 XR Chest Decubitus	$189.50	$379.00	$33.82–$379.00	34% below	50%
Chest X-ray, 2 views CPT 71046 XR CHEST INSP/EXPIRATION	$189.50	$379.00	$33.82–$379.00	34% below	50%
Chest X-ray, 2 views inpatient both sides CPT 71046 XR CHEST OBLIQUES BILAT	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, 2 views inpatient both sides CPT 71046 XR Chest 2 Views (Decub Bilateral)	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, 2 views inpatient both sides CPT 71046 XR CHEST DECUBITUS BILAT	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, 2 views inpatient CPT 71046 3M XR Chest Decubitus	$50.00	$100.00	$38.80–$100.00	—	50%
Chest X-ray, 2 views inpatient CPT 71046 XR CHEST INSP/EXPIRATION	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views w/ Fluoroscopy	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest Decubitus	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, 2 views inpatient CPT 71046 XR Chest 2 Views	$189.50	$379.00	$147.05–$379.00	—	50%
Chest X-ray, single view CPT 71045 XR Chest 1 View Frontal	$361.50	$723.00	$25.89–$723.00	68% above	50%
Chest X-ray, single view CPT 71045 XR CHEST PORTABLE	$361.50	$723.00	$25.89–$723.00	68% above	50%
Chest X-ray, single view CPT 71045 XR Chest Lordotic	$361.50	$723.00	$25.89–$723.00	68% above	50%
Chest X-ray, single view CPT 71045 IR Chest 1-View	$361.50	$723.00	$25.89–$723.00	68% above	50%
Chest X-ray, single view inpatient CPT 71045 XR Chest 1 View Frontal	$361.50	$723.00	$280.52–$723.00	—	50%
Chest X-ray, single view inpatient CPT 71045 XR CHEST PORTABLE	$361.50	$723.00	$280.52–$723.00	—	50%
Chest X-ray, single view inpatient CPT 71045 IR Chest 1-View	$361.50	$723.00	$280.52–$723.00	—	50%
Chest X-ray, single view inpatient CPT 71045 XR Chest Lordotic	$361.50	$723.00	$280.52–$723.00	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 CV Vascular Acquisition	$413.00	$826.00	$91.62–$826.00	29% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US Renal/Bladder	$513.00	$1,026.00	$91.62–$1,026.00	12% below	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 CV Vascular Acquisition	$413.00	$826.00	$320.49–$826.00	—	50%
Complete ultrasound of the back of the abdomen, such as both kidneys inpatient CPT 76770 US Renal/Bladder	$513.00	$1,026.00	$398.09–$1,026.00	—	50%
DEXA bone density scan of the hip, pelvis or spine CPT 77080 BD Bone Density DEXA Axial Skeleton	$248.00	$496.00	$38.92–$496.00	39% below	50%
DEXA bone density scan of the hip, pelvis or spine inpatient CPT 77080 BD Bone Density DEXA Axial Skeleton	$248.00	$496.00	$192.45–$496.00	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US OB Level II	$296.00	$592.00	$116.14–$592.00	45% below	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US MFM DETAILED SINGLE FETUS	$296.00	$592.00	$116.14–$592.00	45% below	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 MC US MFM Detailed Single Fetus	$355.50	$711.00	$139.49–$711.00	34% below	50%
Detailed fetal anatomy ultrasound, through the belly, one baby CPT 76811 US MFM Detailed Single Fetus	$355.50	$711.00	$139.49–$711.00	34% below	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US OB Level II	$296.00	$592.00	$229.70–$592.00	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US MFM DETAILED SINGLE FETUS	$296.00	$592.00	$229.70–$592.00	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 MC US MFM Detailed Single Fetus	$355.50	$711.00	$275.87–$711.00	—	50%
Detailed fetal anatomy ultrasound, through the belly, one baby inpatient CPT 76811 US MFM Detailed Single Fetus	$355.50	$711.00	$275.87–$711.00	—	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Lung Screening Follow-Up Low Dose	$1,025.00	$2,050.00	$91.62–$2,050.00	20% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Spiration w/o Contrast	$1,025.00	$2,050.00	$91.62–$2,050.00	20% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o Contrast High Resolution	$1,025.00	$2,050.00	$91.62–$2,050.00	20% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Veran w/o Contrast	$1,025.00	$2,050.00	$91.62–$2,050.00	20% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Chest w/o contrast	$1,025.00	$2,050.00	$91.62–$2,050.00	20% below	50%
Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT Thorax w/o Contrast	$1,025.00	$2,050.00	$91.62–$2,050.00	20% below	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o contrast	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Chest w/o Contrast High Resolution	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Spiration w/o Contrast	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Veran w/o Contrast	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Lung Screening Follow-Up Low Dose	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
Diagnostic CT scan of the chest, no contrast dye inpatient CPT 71250 CT Thorax w/o Contrast	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Chest w contrast	$1,437.50	$2,875.00	$153.71–$2,875.00	8% below	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w Contrast	$1,437.50	$2,875.00	$153.71–$2,875.00	8% below	50%
Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT Thorax w/ Contrast	$1,437.50	$2,875.00	$153.71–$2,875.00	8% below	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w/ Contrast	$1,437.50	$2,875.00	$1,115.50–$2,875.00	—	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Thorax w Contrast	$1,437.50	$2,875.00	$1,115.50–$2,875.00	—	50%
Diagnostic CT scan of the chest, with contrast dye inpatient CPT 71260 CT Chest w contrast	$1,437.50	$2,875.00	$1,115.50–$2,875.00	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Mammo Digital Diagnostic Bilat	$178.00	$356.00	$69.84–$476.00	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Digital Diagnostic Bilateral w/ CADX	$266.00	$532.00	$97.24–$532.00	—	50%
Diagnostic mammogram, both breasts both sides CPT 77066 MG Digital Diag Bilat w/CADX	$266.00	$532.00	$97.24–$532.00	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Mammo Digital Diagnostic Bilat	$178.00	$356.00	$138.13–$356.00	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Digital Diagnostic Bilateral w/ CADX	$266.00	$532.00	$206.42–$532.00	—	50%
Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MG Digital Diag Bilat w/CADX	$266.00	$532.00	$206.42–$532.00	—	50%
Diagnostic mammogram, one breast CPT 77065 Mg Digital DIAG Uni w/CADX	$135.00	$270.00	$52.97–$377.79	61% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Screening Left	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Screening Right	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG DIGITAL MAMMOGRAM LEFT	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG DIGITAL MAMMOGRAM RIGHT	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Left	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Mammo Digital Diagnostic Right	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Digital Mammo Unilat RT	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Digital Mammo Unilat LT	$88.00	$176.00	$34.53–$377.79	75% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Digital Diagnostic Left w/ CADX	$266.00	$532.00	$75.74–$532.00	24% below	50%
Diagnostic mammogram, one breast one side CPT 77065 MG Digital Diagnostic Right w/ CADX	$266.00	$532.00	$75.74–$532.00	24% below	50%
Diagnostic mammogram, one breast inpatient CPT 77065 Mg Digital DIAG Uni w/CADX	$135.00	$270.00	$104.76–$270.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Digital Mammo Unilat LT	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Screening Right	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG DIGITAL MAMMOGRAM RIGHT	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Right	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG DIGITAL MAMMOGRAM LEFT	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Diagnostic Left	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Mammo Digital Screening Left	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Digital Mammo Unilat RT	$88.00	$176.00	$68.29–$176.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Digital Diagnostic Right w/ CADX	$266.00	$532.00	$206.42–$532.00	—	50%
Diagnostic mammogram, one breast inpatient one side CPT 77065 MG Digital Diagnostic Left w/ CADX	$266.00	$532.00	$206.42–$532.00	—	50%
Duplex ultrasound of the leg arteries, both legs both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$757.00	$1,514.00	$209.09–$1,514.00	—	50%
Duplex ultrasound of the leg arteries, both legs CPT 93925 CV Vascular Acquisition	$675.00	$1,350.00	$209.09–$1,350.00	18% above	50%
Duplex ultrasound of the leg arteries, both legs inpatient both sides CPT 93925 US Lower Ext Arterial Duplex Bilateral	$757.00	$1,514.00	$587.43–$1,514.00	—	50%
Duplex ultrasound of the leg arteries, both legs inpatient CPT 93925 CV Vascular Acquisition	$675.00	$1,350.00	$523.80–$1,350.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Lower Ext Venous Duplex Bilateral	$700.00	$1,400.00	$185.47–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VAS UE Venous Duplex Bilat	$700.00	$1,400.00	$185.47–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US VAS LE Venous Duplex Bilat	$700.00	$1,400.00	$185.47–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CV VAS UE Venous Duplex Bilat	$700.00	$1,400.00	$185.47–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 CV VAS LE Venous Duplex Bilat	$700.00	$1,400.00	$185.47–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs both sides CPT 93970 US Upper Ext Venous Duplex Bilateral	$700.00	$1,400.00	$185.47–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 CV VAS BLE Venous Reflux	$700.00	$1,400.00	$185.47–$1,400.00	32% below	50%
Duplex ultrasound of the leg veins, both legs CPT 93970 US Extremity Venous Scan	$761.00	$1,522.00	$185.47–$1,522.00	26% below	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Upper Ext Venous Duplex Bilateral	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US Lower Ext Venous Duplex Bilateral	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VAS LE Venous Duplex Bilat	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CV VAS UE Venous Duplex Bilat	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 US VAS UE Venous Duplex Bilat	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient both sides CPT 93970 CV VAS LE Venous Duplex Bilat	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 CV VAS BLE Venous Reflux	$700.00	$1,400.00	$543.20–$1,400.00	—	50%
Duplex ultrasound of the leg veins, both legs inpatient CPT 93970 US Extremity Venous Scan	$761.00	$1,522.00	$590.54–$1,522.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV Ped Newborn Echo Complete	$666.00	$1,332.00	$197.71–$1,436.27	64% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO ACQUISITION W Cont - TECH FEE	$1,653.50	$3,307.00	$197.71–$3,307.00	10% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV Echo Acquisition	$1,653.50	$3,307.00	$197.71–$3,307.00	10% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV Ped Echo TTE W Cont Complet	$1,653.50	$3,307.00	$197.71–$3,307.00	10% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV ECHO TTE With 3D Imaging	$1,653.50	$3,307.00	$197.71–$3,307.00	10% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV Echo TTE With Cardioversion	$1,653.50	$3,307.00	$197.71–$3,307.00	10% below	50%
Echocardiogram through the chest wall, complete, with Doppler CPT 93306 CV Echo TTE Complete with Strain	$1,653.50	$3,307.00	$197.71–$3,307.00	10% below	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV Ped Newborn Echo Complete	$666.00	$1,332.00	$516.82–$1,332.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO ACQUISITION W Cont - TECH FEE	$1,653.50	$3,307.00	$1,283.12–$3,307.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV Echo Acquisition	$1,653.50	$3,307.00	$1,283.12–$3,307.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV ECHO TTE With 3D Imaging	$1,653.50	$3,307.00	$1,283.12–$3,307.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV Echo TTE With Cardioversion	$1,653.50	$3,307.00	$1,283.12–$3,307.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV Ped Echo TTE W Cont Complet	$1,653.50	$3,307.00	$1,283.12–$3,307.00	—	50%
Echocardiogram through the chest wall, complete, with Doppler inpatient CPT 93306 CV Echo TTE Complete with Strain	$1,653.50	$3,307.00	$1,283.12–$3,307.00	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging Injection/Scan	$1,106.00	$2,212.00	$292.18–$2,212.00	at median	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM Hepatobiliary Imaging	$1,106.00	$2,212.00	$292.18–$2,212.00	at median	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 NM HEPATOBILIARY SCAN	$1,106.00	$2,212.00	$292.18–$2,212.00	at median	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging Injection/Scan	$1,106.00	$2,212.00	$858.26–$2,212.00	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM Hepatobiliary Imaging	$1,106.00	$2,212.00	$858.26–$2,212.00	—	50%
HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder inpatient CPT 78226 NM HEPATOBILIARY SCAN	$1,106.00	$2,212.00	$858.26–$2,212.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study Charges - PSG WITH CPAP	$2,246.00	$4,492.00	$752.36–$4,492.00	31% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study Charges - PSG WITH CPAP 6-<18	$2,246.00	$4,492.00	$752.36–$4,492.00	31% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older CPT 95811 Sleep Study Charges - PSG WITH CPAP LESS THAN 6 HO	$2,246.00	$4,492.00	$752.36–$4,492.00	31% below	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Study Charges - PSG WITH CPAP	$2,246.00	$4,492.00	$1,742.90–$4,492.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Study Charges - PSG WITH CPAP 6-<18	$2,246.00	$4,492.00	$1,742.90–$4,492.00	—	50%
In-lab sleep study with CPAP or bilevel titration, age 6 and older inpatient CPT 95811 Sleep Study Charges - PSG WITH CPAP LESS THAN 6 HO	$2,246.00	$4,492.00	$1,742.90–$4,492.00	—	50%
Knee X-ray, 3 views both sides CPT 73562 3M XR Knee 3 Views Bilateral	$82.50	$165.00	$32.37–$165.00	—	50%
Knee X-ray, 3 views both sides CPT 73562 XR Knee 3 Views Bilateral	$449.00	$898.00	$40.78–$898.00	—	50%
Knee X-ray, 3 views one side CPT 73562 3M XR Knee 3 Views Right	$82.50	$165.00	$32.37–$165.00	69% below	50%
Knee X-ray, 3 views one side CPT 73562 3M XR Knee 3 Views Left	$82.50	$165.00	$32.37–$165.00	69% below	50%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Left	$224.00	$448.00	$40.78–$448.00	17% below	50%
Knee X-ray, 3 views one side CPT 73562 XR Knee 3 Views Right	$224.00	$448.00	$40.78–$448.00	17% below	50%
Knee X-ray, 3 views inpatient both sides CPT 73562 3M XR Knee 3 Views Bilateral	$82.50	$165.00	$64.02–$165.00	—	50%
Knee X-ray, 3 views inpatient both sides CPT 73562 XR Knee 3 Views Bilateral	$449.00	$898.00	$348.42–$898.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 3M XR Knee 3 Views Right	$82.50	$165.00	$64.02–$165.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 3M XR Knee 3 Views Left	$82.50	$165.00	$64.02–$165.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Right	$224.00	$448.00	$173.82–$448.00	—	50%
Knee X-ray, 3 views inpatient one side CPT 73562 XR Knee 3 Views Left	$224.00	$448.00	$173.82–$448.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US SPLEEN	$332.00	$664.00	$87.40–$664.00	32% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue of Back	$426.50	$853.00	$87.40–$853.00	13% below	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Peri Wound Abdomen	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US APPENDIX	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 IR US Abdomen Limited	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US PANCREAS	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US LIVER	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US GALLBLADDER	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Appendix	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Abdomen Limited Intussusception	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 US Soft Tissue Abdomen	$527.50	$1,055.00	$87.40–$1,055.00	8% above	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US SPLEEN	$332.00	$664.00	$257.63–$664.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue of Back	$426.50	$853.00	$330.96–$853.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US LIVER	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Peri Wound Abdomen	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Soft Tissue Abdomen	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited Intussusception	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 IR US Abdomen Limited	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US APPENDIX	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US GALLBLADDER	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US PANCREAS	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Appendix	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Limited abdominal ultrasound of one organ or area, such as the gallbladder inpatient CPT 76705 US Abdomen Limited	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT Lung Cancer Screening	$1,025.00	$2,050.00	$91.62–$2,050.00	268% above	50%
Low-dose CT of the chest for lung cancer screening, no contrast dye inpatient CPT 71271 CT Lung Cancer Screening	$1,025.00	$2,050.00	$795.40–$2,050.00	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral	$1,201.00	$2,402.00	$353.49–$2,402.00	—	50%
MRI of both breasts, without and then with contrast dye both sides CPT 77049 MRI BILAT BREAST BX W/WO CONT	$1,201.00	$2,402.00	$353.49–$2,402.00	—	50%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI Breast w/ + w/o Contrast Bilateral	$1,201.00	$2,402.00	$931.98–$2,402.00	—	50%
MRI of both breasts, without and then with contrast dye inpatient both sides CPT 77049 MRI BILAT BREAST BX W/WO CONT	$1,201.00	$2,402.00	$931.98–$2,402.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Right	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Knee w/o Contrast Left	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle/Hindfoot/Calc w/o Contrast Lt	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Left	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle/Hindfoot/Calc w/o Contrast Rt	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Right	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Ankle w/o Contrast Left	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye one side CPT 73721 MRI Hip w/o Contrast Right	$1,713.00	$3,426.00	$208.98–$3,426.00	2% below	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle/Hindfoot/Calc w/o Contrast Lt	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Right	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Left	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Knee w/o Contrast Left	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Right	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle/Hindfoot/Calc w/o Contrast Rt	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Ankle w/o Contrast Right	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, no contrast dye inpatient one side CPT 73721 MRI Hip w/o Contrast Left	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Left	$2,432.50	$4,865.00	$305.72–$4,865.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Right	$2,432.50	$4,865.00	$305.72–$4,865.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Knee w/ + w/o Contrast Left	$2,432.50	$4,865.00	$305.72–$4,865.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle/Hindfoot/Calc w+wo Contrast Rt	$2,432.50	$4,865.00	$305.72–$4,865.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle w/ + w/o Contrast Right	$2,432.50	$4,865.00	$305.72–$4,865.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye one side CPT 73723 MRI Ankle/Hindfoot/Calc w+wo Contrast Lt	$2,432.50	$4,865.00	$305.72–$4,865.00	at median	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Left	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Left	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle w/ + w/o Contrast Right	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Knee w/ + w/o Contrast Right	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle/Hindfoot/Calc w+wo Contrast Lt	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of knee or other lower-limb joint, without and then with contrast dye inpatient one side CPT 73723 MRI Ankle/Hindfoot/Calc w+wo Contrast Rt	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the abdomen without contrast CPT 74181 MRI Abdomen w/o Contrast	$1,713.00	$3,426.00	$202.75–$3,426.00	9% below	50%
MRI of the abdomen without contrast CPT 74181 MRI MRCP Study	$1,713.00	$3,426.00	$202.75–$3,426.00	9% below	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI MRCP Study	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the abdomen without contrast inpatient CPT 74181 MRI Abdomen w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the abdomen, without and then with contrast dye CPT 74183 MRI Abdomen w/ + w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	11% below	50%
MRI of the abdomen, without and then with contrast dye inpatient CPT 74183 MRI Abdomen w/ + w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the brain, no contrast dye CPT 70551 MRI Brain w/o Contrast	$1,713.00	$3,426.00	$203.15–$3,426.00	at median	50%
MRI of the brain, no contrast dye CPT 70551 MRI Stroke Protocol Brain w/o Contrast	$1,713.00	$3,426.00	$203.15–$3,426.00	at median	50%
MRI of the brain, no contrast dye CPT 70551 MRI IAC Brain w/o Contrast	$2,432.50	$4,865.00	$203.15–$4,865.00	42% above	50%
MRI of the brain, no contrast dye CPT 70551 MRI Pituitary Brain w/o Contrast	$2,432.50	$4,865.00	$203.15–$4,865.00	42% above	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Stroke Protocol Brain w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Brain w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI Pituitary Brain w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the brain, no contrast dye inpatient CPT 70551 MRI IAC Brain w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC Brain w+ w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	11% below	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI IAC Brain w/Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	11% below	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI Brain w/ + w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	11% below	50%
MRI of the brain, with and without contrast dye CPT 70553 MRI Pituitary Brain w+ w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	11% below	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC Brain w+ w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Pituitary Brain w+ w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI IAC Brain w/Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI Brain w/ + w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the lower back, no contrast dye CPT 72148 MRI Spine Lumbar w/o Contrast	$1,713.00	$3,426.00	$198.30–$3,426.00	4% below	50%
MRI of the lower back, no contrast dye inpatient CPT 72148 MRI Spine Lumbar w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the lower back, without and then with contrast dye CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	16% below	50%
MRI of the lower back, without and then with contrast dye inpatient CPT 72158 MRI Spine Lumbar w/ + w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI Spine Thoracic w/o Contrast	$1,713.00	$3,426.00	$197.33–$3,426.00	4% below	50%
MRI of the mid back (thoracic spine), no contrast dye inpatient CPT 72146 MRI Spine Thoracic w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the neck (cervical spine) without and with contrast inpatient CPT 72156 MRI Spine Cervical w/ + w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI Spine Cervical w/o Contrast	$1,713.00	$3,426.00	$197.65–$3,426.00	3% below	50%
MRI of the neck (cervical spine), no contrast dye inpatient CPT 72141 MRI Spine Cervical w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Sacrum/Coccyx/SI Jts w/wo	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Bony Pelvis w+ w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis Male/Female Organs w/wo	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis General w+ w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/wo Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the pelvis without and with contrast CPT 72197 MRI Pelvis w/ + w/o Contrast	$2,432.50	$4,865.00	$305.72–$4,865.00	5% below	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/wo Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis w/ + w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis General w+ w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Bony Pelvis w+ w/o Contrast	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Sacrum/Coccyx/SI Jts w/wo	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the pelvis without and with contrast inpatient CPT 72197 MRI Pelvis Male/Female Organs w/wo	$2,432.50	$4,865.00	$1,887.62–$4,865.00	—	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis w/o Contrast	$1,713.00	$3,426.00	$209.09–$3,426.00	5% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Bony Pelvis w/o Contrast	$1,713.00	$3,426.00	$209.09–$3,426.00	5% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis General w/o Contrast	$1,713.00	$3,426.00	$209.09–$3,426.00	5% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Pelvis Male/Female Organs w/o	$1,713.00	$3,426.00	$209.09–$3,426.00	5% below	50%
MRI of the pelvis, no contrast dye CPT 72195 MRI Sacrum/Coccyx/SI Jts w/o	$1,713.00	$3,426.00	$209.09–$3,426.00	5% below	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Sacrum/Coccyx/SI Jts w/o	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis General w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis Male/Female Organs w/o	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Pelvis w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the pelvis, no contrast dye inpatient CPT 72195 MRI Bony Pelvis w/o Contrast	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Thumb/UE Digit W/O Contrast Rt	$683.00	$1,366.00	$209.09–$1,366.00	56% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI SC Joint w/o Contrast Rt	$683.00	$1,366.00	$209.09–$1,366.00	56% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Thumb/UE Digit W/O Contrast Lt	$683.00	$1,366.00	$209.09–$1,366.00	56% below	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Left	$1,713.00	$3,426.00	$209.09–$3,426.00	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Right	$1,713.00	$3,426.00	$209.09–$3,426.00	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Left	$1,713.00	$3,426.00	$209.09–$3,426.00	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Elbow w/o Contrast Left	$1,713.00	$3,426.00	$209.09–$3,426.00	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Wrist w/o Contrast Right	$1,713.00	$3,426.00	$209.09–$3,426.00	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye one side CPT 73221 MRI Shoulder w/o Contrast Right	$1,713.00	$3,426.00	$209.09–$3,426.00	11% above	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Thumb/UE Digit W/O Contrast Rt	$683.00	$1,366.00	$530.01–$1,366.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Thumb/UE Digit W/O Contrast Lt	$683.00	$1,366.00	$530.01–$1,366.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI SC Joint w/o Contrast Rt	$683.00	$1,366.00	$530.01–$1,366.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Right	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Right	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Left	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Wrist w/o Contrast Left	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Elbow w/o Contrast Right	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
MRI of the shoulder, elbow or wrist joint, no contrast dye inpatient one side CPT 73221 MRI Shoulder w/o Contrast Left	$1,713.00	$3,426.00	$1,329.29–$3,426.00	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 CV NM Acquisition	$2,199.50	$4,399.00	$428.85–$4,399.00	38% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 CV NM Cardiac Nuclear Stress Test	$2,327.50	$4,655.00	$428.85–$4,655.00	35% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 CV NM Nuclear Stress	$2,327.50	$4,655.00	$428.85–$4,655.00	35% below	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 CV NM Acquisition	$2,199.50	$4,399.00	$1,706.81–$4,399.00	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 CV NM Cardiac Nuclear Stress Test	$2,327.50	$4,655.00	$1,806.14–$4,655.00	—	50%
Nuclear stress test imaging (SPECT), rest and stress studies inpatient CPT 78452 CV NM Nuclear Stress	$2,327.50	$4,655.00	$1,806.14–$4,655.00	—	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Prostate- Initial (PSMA)	$4,325.00	$8,650.00	$1,253.09–$8,650.00	23% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET Prostate-Restaging (PSMA)	$4,325.00	$8,650.00	$1,253.09–$8,650.00	23% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT Skull Base to Midthigh Restaging	$4,502.00	$9,004.00	$1,253.09–$9,004.00	28% above	50%
PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET CT Skull Base to Midthigh Initial	$4,502.00	$9,004.00	$1,253.09–$9,004.00	28% above	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Prostate-Restaging (PSMA)	$4,325.00	$8,650.00	$3,356.20–$8,650.00	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET Prostate- Initial (PSMA)	$4,325.00	$8,650.00	$3,356.20–$8,650.00	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT Skull Base to Midthigh Restaging	$4,502.00	$9,004.00	$3,493.55–$9,004.00	—	50%
PET/CT scan from the base of the skull to mid-thigh inpatient CPT 78815 PET CT Skull Base to Midthigh Initial	$4,502.00	$9,004.00	$3,493.55–$9,004.00	—	50%
Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US BLADDER	$491.00	$982.00	$50.34–$982.00	26% above	50%
Pelvic ultrasound (not pregnancy), limited or follow-up inpatient CPT 76857 US BLADDER	$491.00	$982.00	$381.02–$982.00	—	50%
Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US PELVIS	$491.00	$982.00	$91.62–$982.00	16% below	50%
Pelvic ultrasound through the belly, complete (not pregnancy) inpatient CPT 76856 US PELVIS	$491.00	$982.00	$381.02–$982.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Bedside Ultrasound Charge - Yes - Second Trimester	$161.00	$322.00	$63.17–$402.84	72% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US MFM >= 14Wks Single Fetus	$527.50	$1,055.00	$91.62–$1,055.00	8% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US OB Greater Than 14 Weeks	$527.50	$1,055.00	$91.62–$1,055.00	8% below	50%
Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US MFM >= 14 WKS SINGLE FETUS	$527.50	$1,055.00	$91.62–$1,055.00	8% below	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Bedside Ultrasound Charge - Yes - Second Trimester	$161.00	$322.00	$124.94–$322.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US MFM >= 14Wks Single Fetus	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US OB Greater Than 14 Weeks	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US MFM >= 14 WKS SINGLE FETUS	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 Bedside Ultrasound Charge - Yes - First Trimester	$161.00	$322.00	$63.17–$349.73	70% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US OB Less Thn 14 wks	$527.50	$1,055.00	$91.62–$1,055.00	2% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US MFM < 14 WKS SINGLE FETUS	$527.50	$1,055.00	$91.62–$1,055.00	2% below	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 MC US MFM <14Wks Single Fetus	$633.00	$1,266.00	$91.62–$1,266.00	17% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby CPT 76801 US MFM <14Wks Single Fetus	$633.00	$1,266.00	$91.62–$1,266.00	17% above	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 Bedside Ultrasound Charge - Yes - First Trimester	$161.00	$322.00	$124.94–$322.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US MFM < 14 WKS SINGLE FETUS	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US OB Less Thn 14 wks	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 US MFM <14Wks Single Fetus	$633.00	$1,266.00	$491.21–$1,266.00	—	50%
Pregnancy ultrasound before 14 weeks, through the belly, one baby inpatient CPT 76801 MC US MFM <14Wks Single Fetus	$633.00	$1,266.00	$491.21–$1,266.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US Gender Reveal OB	$43.50	$87.00	$17.07–$242.51	87% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 3M US OB Limited	$115.50	$231.00	$45.32–$242.51	66% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US MFM LIMITED FETUS(S)	$128.00	$256.00	$50.22–$256.00	63% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US MFM Limited Fetus(s)	$154.00	$308.00	$60.42–$308.00	55% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 MC US MFM Limited Fetus(s)	$154.00	$308.00	$60.42–$308.00	55% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 Bedside Ultrasound Charge - Yes - Third Trimester	$161.00	$322.00	$63.17–$322.00	53% below	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 US OB Limited	$512.00	$1,024.00	$81.83–$1,024.00	50% above	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US Gender Reveal OB	$43.50	$87.00	$33.76–$87.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 3M US OB Limited	$115.50	$231.00	$89.63–$231.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US MFM LIMITED FETUS(S)	$128.00	$256.00	$99.33–$256.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 MC US MFM Limited Fetus(s)	$154.00	$308.00	$119.50–$308.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US MFM Limited Fetus(s)	$154.00	$308.00	$119.50–$308.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 Bedside Ultrasound Charge - Yes - Third Trimester	$161.00	$322.00	$124.94–$322.00	—	50%
Pregnancy ultrasound, limited (heartbeat, position, fluid) inpatient CPT 76815 US OB Limited	$512.00	$1,024.00	$397.31–$1,024.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG CADX Bilateral Screening	$89.00	$178.00	$34.92–$385.81	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG Mammo Digital Screening Bilateral	$178.00	$356.00	$69.84–$385.81	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG Digital Screen Bilat W CADX	$265.50	$531.00	$79.81–$531.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG Digital Screen Uni W Cadx Bilat	$266.00	$532.00	$79.81–$532.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG Digital Screen Bilat w/ CADX Health D	$266.00	$532.00	$79.81–$532.00	—	50%
Screening mammogram, both breasts both sides CPT 77067 MG Digital Screening Bilateral w/ CADX	$266.00	$532.00	$79.81–$532.00	—	50%
Screening mammogram, both breasts CPT 77067 MG Digital Mammo BIL HD	$67.50	$135.00	$26.48–$385.81	69% below	50%
Screening mammogram, both breasts CPT 77067 MG Physician Screening w/ CADX	$266.00	$532.00	$79.81–$532.00	20% above	50%
Screening mammogram, both breasts one side CPT 77067 MG Digital Screen Uni W Cadx Left	$142.00	$284.00	$55.72–$385.81	36% below	50%
Screening mammogram, both breasts one side CPT 77067 MG Digital Screen Uni W Cadx Right	$142.00	$284.00	$55.72–$385.81	36% below	50%
Screening mammogram, both breasts one side CPT 77067 MG Digital Screening Left w/ CADX	$142.00	$284.00	$55.72–$385.81	36% below	50%
Screening mammogram, both breasts one side CPT 77067 MG Digital Screening Right w/ CADX	$142.00	$284.00	$55.72–$385.81	36% below	50%
Screening mammogram, both breasts one side CPT 77067 MG DIGITAL SCREEN UNI W CADX Right	$266.00	$532.00	$79.81–$532.00	20% above	50%
Screening mammogram, both breasts one side CPT 77067 MG DIGITAL SCREEN UNI W CADX Left	$266.00	$532.00	$79.81–$532.00	20% above	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG CADX Bilateral Screening	$89.00	$178.00	$69.06–$178.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Mammo Digital Screening Bilateral	$178.00	$356.00	$138.13–$356.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Digital Screen Bilat W CADX	$265.50	$531.00	$206.03–$531.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Digital Screen Uni W Cadx Bilat	$266.00	$532.00	$206.42–$532.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Digital Screen Bilat w/ CADX Health D	$266.00	$532.00	$206.42–$532.00	—	50%
Screening mammogram, both breasts inpatient both sides CPT 77067 MG Digital Screening Bilateral w/ CADX	$266.00	$532.00	$206.42–$532.00	—	50%
Screening mammogram, both breasts inpatient CPT 77067 MG Digital Mammo BIL HD	$67.50	$135.00	$52.38–$135.00	—	50%
Screening mammogram, both breasts inpatient CPT 77067 MG Physician Screening w/ CADX	$266.00	$532.00	$206.42–$532.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Digital Screen Uni W Cadx Right	$142.00	$284.00	$110.19–$284.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Digital Screening Left w/ CADX	$142.00	$284.00	$110.19–$284.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Digital Screening Right w/ CADX	$142.00	$284.00	$110.19–$284.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 MG Digital Screen Uni W Cadx Left	$142.00	$284.00	$110.19–$284.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 MG DIGITAL SCREEN UNI W CADX Left	$266.00	$532.00	$206.42–$532.00	—	50%
Screening mammogram, both breasts inpatient one side CPT 77067 MG DIGITAL SCREEN UNI W CADX Right	$266.00	$532.00	$206.42–$532.00	—	50%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 3M XR Shoulder Complete 2+ Views Bilateral	$133.00	$266.00	$34.96–$266.00	—	50%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder Complete 2+ Views Bilateral	$378.50	$757.00	$34.96–$757.00	—	50%
Shoulder X-ray, complete, 2 or more views both sides CPT 73030 XR Shoulder 2 Views Bilat	$378.50	$757.00	$34.96–$757.00	—	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Right	$190.50	$381.00	$34.96–$381.00	39% below	50%
Shoulder X-ray, complete, 2 or more views one side CPT 73030 XR Shoulder Complete 2+ Views Left	$190.50	$381.00	$34.96–$381.00	39% below	50%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 3M XR Shoulder Complete 2+ Views Bilateral	$133.00	$266.00	$103.21–$266.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder 2 Views Bilat	$378.50	$757.00	$293.72–$757.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient both sides CPT 73030 XR Shoulder Complete 2+ Views Bilateral	$378.50	$757.00	$293.72–$757.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Right	$190.50	$381.00	$147.83–$381.00	—	50%
Shoulder X-ray, complete, 2 or more views inpatient one side CPT 73030 XR Shoulder Complete 2+ Views Left	$190.50	$381.00	$147.83–$381.00	—	50%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study Charges - PSG	$1,972.50	$3,945.00	$719.66–$3,945.00	36% below	50%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study Charges - PSG 6-<18	$1,972.50	$3,945.00	$719.66–$3,945.00	36% below	50%
Sleep study in a lab (polysomnography) CPT 95810 Sleep Study Charges - PSG LESS THAN 6 HOURS	$1,972.50	$3,945.00	$719.66–$3,945.00	36% below	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study Charges - PSG LESS THAN 6 HOURS	$1,972.50	$3,945.00	$1,530.66–$3,945.00	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study Charges - PSG 6-<18	$1,972.50	$3,945.00	$1,530.66–$3,945.00	—	50%
Sleep study in a lab (polysomnography) inpatient CPT 95810 Sleep Study Charges - PSG	$1,972.50	$3,945.00	$1,530.66–$3,945.00	—	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR MBASW w/o Speech	$222.00	$444.00	$87.10–$444.00	65% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function with Speech	$318.00	$636.00	$123.75–$636.00	49% below	50%
Swallow study (modified barium swallow, video X-ray) CPT 74230 XR Swallowing Function w/ Speech	$318.00	$636.00	$123.75–$636.00	49% below	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR MBASW w/o Speech	$222.00	$444.00	$172.27–$444.00	—	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function with Speech	$318.00	$636.00	$246.77–$636.00	—	50%
Swallow study (modified barium swallow, video X-ray) inpatient CPT 74230 XR Swallowing Function w/ Speech	$318.00	$636.00	$246.77–$636.00	—	50%
Transvaginal pelvic ultrasound CPT 76830 3M US Transvaginal Non-OB	$165.50	$331.00	$64.94–$353.74	68% below	50%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB Limited	$166.50	$333.00	$65.33–$353.74	67% below	50%
Transvaginal pelvic ultrasound CPT 76830 US Transvaginal Non-OB	$527.50	$1,055.00	$91.62–$1,055.00	3% above	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 3M US Transvaginal Non-OB	$165.50	$331.00	$128.43–$331.00	—	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB Limited	$166.50	$333.00	$129.20–$333.00	—	50%
Transvaginal pelvic ultrasound inpatient CPT 76830 US Transvaginal Non-OB	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal Limited	$132.50	$265.00	$51.99–$275.58	59% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 US Transvaginal OB Limited	$132.50	$265.00	$51.99–$275.58	59% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 ZZUS 1st Trimester PRG Addl Fetus	$235.00	$470.00	$91.62–$470.00	27% below	50%
Transvaginal ultrasound during pregnancy CPT 76817 US OB Transvaginal	$527.50	$1,055.00	$91.62–$1,055.00	64% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 US MFM TRANSVAGINAL W/ IMAGE DOC	$527.50	$1,055.00	$91.62–$1,055.00	64% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 MC US MFM TRANSVAGINAL W/ IMAGE DOC	$633.00	$1,266.00	$91.62–$1,266.00	97% above	50%
Transvaginal ultrasound during pregnancy CPT 76817 US MFM Transvaginal w/Image Doc	$633.00	$1,266.00	$91.62–$1,266.00	97% above	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal Limited	$132.50	$265.00	$102.82–$265.00	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US Transvaginal OB Limited	$132.50	$265.00	$102.82–$265.00	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 ZZUS 1st Trimester PRG Addl Fetus	$235.00	$470.00	$182.36–$470.00	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US OB Transvaginal	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US MFM TRANSVAGINAL W/ IMAGE DOC	$527.50	$1,055.00	$409.34–$1,055.00	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 US MFM Transvaginal w/Image Doc	$633.00	$1,266.00	$491.21–$1,266.00	—	50%
Transvaginal ultrasound during pregnancy inpatient CPT 76817 MC US MFM TRANSVAGINAL W/ IMAGE DOC	$633.00	$1,266.00	$491.21–$1,266.00	—	50%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen COMPLETE	$853.00	$1,706.00	$91.62–$1,706.00	7% above	50%
Ultrasound of the abdomen, complete CPT 76700 US ABDOMEN FOR ASCITIES	$853.00	$1,706.00	$91.62–$1,706.00	7% above	50%
Ultrasound of the abdomen, complete CPT 76700 US GALLBLADDER/LIVER/PANCREAS	$853.00	$1,706.00	$91.62–$1,706.00	7% above	50%
Ultrasound of the abdomen, complete CPT 76700 US Abdomen Complete	$853.00	$1,706.00	$91.62–$1,706.00	7% above	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen COMPLETE	$853.00	$1,706.00	$661.93–$1,706.00	—	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US Abdomen Complete	$853.00	$1,706.00	$661.93–$1,706.00	—	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMEN FOR ASCITIES	$853.00	$1,706.00	$661.93–$1,706.00	—	50%
Ultrasound of the abdomen, complete inpatient CPT 76700 US GALLBLADDER/LIVER/PANCREAS	$853.00	$1,706.00	$661.93–$1,706.00	—	50%
Ultrasound of the scrotum and testicles CPT 76870 US Scrotum	$297.50	$595.00	$91.62–$595.00	46% below	50%
Ultrasound of the scrotum and testicles CPT 76870 US SCROTUM	$297.50	$595.00	$91.62–$595.00	46% below	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US SCROTUM	$297.50	$595.00	$230.86–$595.00	—	50%
Ultrasound of the scrotum and testicles inpatient CPT 76870 US Scrotum	$297.50	$595.00	$230.86–$595.00	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Thyroid	$297.50	$595.00	$91.62–$595.00	51% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US Head/Neck Soft Tissue	$297.50	$595.00	$91.62–$595.00	51% below	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Head/Neck Soft Tissue	$297.50	$595.00	$230.86–$595.00	—	50%
Ultrasound of the soft tissues of the head and neck, such as the thyroid inpatient CPT 76536 US Thyroid	$297.50	$595.00	$230.86–$595.00	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI	$354.50	$709.00	$123.05–$709.00	28% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI + KUB	$354.50	$709.00	$123.05–$709.00	28% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UPPER GI SERIES	$354.50	$709.00	$123.05–$709.00	28% below	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR Upper GI w/ Small Bowel	$820.50	$1,641.00	$123.05–$1,641.00	67% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) CPT 74240 XR UGI/SBFT	$820.50	$1,641.00	$123.05–$1,641.00	67% above	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI	$354.50	$709.00	$275.09–$709.00	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI + KUB	$354.50	$709.00	$275.09–$709.00	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UPPER GI SERIES	$354.50	$709.00	$275.09–$709.00	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR UGI/SBFT	$820.50	$1,641.00	$636.71–$1,641.00	—	50%
Upper GI series (X-ray of esophagus, stomach and duodenum with contrast) inpatient CPT 74240 XR Upper GI w/ Small Bowel	$820.50	$1,641.00	$636.71–$1,641.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 CV VAS RLE Venous Reflux	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 CV VAS LLE Venous Reflux	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Right	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VAS UE Venous Duplex Rt	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Right	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VAS UE Venous Duplex Lt	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VAS UE Venous Duplex RT	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VAS LE Venous Duplex Lt	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 CV VAS LE Venous Duplex Rt	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Upper Ext Venous Duplex Left	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VAS LE Venous Duplex LT	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VAS LE Venous Duplex RT	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US Lower Ext Venous Duplex Left	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study one side CPT 93971 US VAS UE Venous Duplex LT	$483.00	$966.00	$91.62–$966.00	24% below	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 CV VAS RLE Venous Reflux	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient CPT 93971 CV VAS LLE Venous Reflux	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VAS UE Venous Duplex Lt	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Right	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Left	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Upper Ext Venous Duplex Right	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US Lower Ext Venous Duplex Left	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VAS LE Venous Duplex Lt	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VAS UE Venous Duplex Rt	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 CV VAS LE Venous Duplex Rt	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VAS LE Venous Duplex LT	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VAS LE Venous Duplex RT	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VAS UE Venous Duplex LT	$483.00	$966.00	$374.81–$966.00	—	50%
Vein ultrasound (duplex) of one arm or leg, or a limited study inpatient one side CPT 93971 US VAS UE Venous Duplex RT	$483.00	$966.00	$374.81–$966.00	—	50%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 3M XR Wrist Complete 3+ Views Bilateral	$72.50	$145.00	$28.45–$145.00	—	50%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist 4 Views Bilat	$381.00	$762.00	$41.06–$762.00	—	50%
Wrist X-ray, complete, 3 or more views both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral	$381.00	$762.00	$41.06–$762.00	—	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 3M XR Wrist Complete 3+ Views Right	$72.50	$145.00	$28.45–$145.00	69% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 3M XR Wrist Complete 3+ Views Left	$72.50	$145.00	$28.45–$145.00	69% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Right	$191.00	$382.00	$41.06–$382.00	19% below	50%
Wrist X-ray, complete, 3 or more views one side CPT 73110 XR Wrist Complete 3+ Views Left	$191.00	$382.00	$41.06–$382.00	19% below	50%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 3M XR Wrist Complete 3+ Views Bilateral	$72.50	$145.00	$56.26–$145.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist 4 Views Bilat	$381.00	$762.00	$295.66–$762.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient both sides CPT 73110 XR Wrist Complete 3+ Views Bilateral	$381.00	$762.00	$295.66–$762.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 3M XR Wrist Complete 3+ Views Right	$72.50	$145.00	$56.26–$145.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 3M XR Wrist Complete 3+ Views Left	$72.50	$145.00	$56.26–$145.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Right	$191.00	$382.00	$148.22–$382.00	—	50%
Wrist X-ray, complete, 3 or more views inpatient one side CPT 73110 XR Wrist Complete 3+ Views Left	$191.00	$382.00	$148.22–$382.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR Hips/Pelv Child Frogleg (2 Views)	$118.00	$236.00	$46.30–$236.00	38% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 XR HIP JOINTS JUDET	$288.50	$577.00	$47.43–$577.00	53% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip w/ or w/o Pelvis 2-3 Views Right	$118.00	$236.00	$46.30–$236.00	38% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip w/ or w/o Pelvis 2-3 Views Left	$118.00	$236.00	$46.30–$236.00	38% below	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Right	$296.50	$593.00	$47.43–$593.00	57% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views Left	$296.50	$593.00	$47.43–$593.00	57% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Right	$296.50	$593.00	$47.43–$593.00	57% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Left	$296.50	$593.00	$47.43–$593.00	57% above	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR Hips/Pelv Child Frogleg (2 Views)	$118.00	$236.00	$91.57–$236.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient CPT 73502 XR HIP JOINTS JUDET	$288.50	$577.00	$223.88–$577.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip w/ or w/o Pelvis 2-3 Views Right	$118.00	$236.00	$91.57–$236.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip w/ or w/o Pelvis 2-3 Views Left	$118.00	$236.00	$91.57–$236.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Right	$296.50	$593.00	$230.08–$593.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views Left	$296.50	$593.00	$230.08–$593.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Left	$296.50	$593.00	$230.08–$593.00	—	50%
X-ray of one hip, 2 or 3 views, with the pelvis when included inpatient one side CPT 73502 XR Hip 2-3 Views w/AP Pelvis Right	$296.50	$593.00	$230.08–$593.00	—	50%
X-ray of the abdomen, 1 view CPT 74018 XR Abdomen KUB 1 View	$180.00	$360.00	$30.42–$360.00	37% below	50%
X-ray of the abdomen, 1 view inpatient CPT 74018 XR Abdomen KUB 1 View	$180.00	$360.00	$139.68–$360.00	—	50%
X-ray of the ankle, 2 views both sides CPT 73600 XR Ankle 2 Views Bilateral	$163.50	$327.00	$32.27–$327.00	—	50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Left	$110.00	$220.00	$32.27–$220.00	45% below	50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 2 Views Right	$110.00	$220.00	$32.27–$220.00	45% below	50%
X-ray of the ankle, 2 views one side CPT 73600 XR Ankle 1 View Left	$110.00	$220.00	$32.27–$220.00	45% below	50%
X-ray of the ankle, 2 views one side CPT 73600 XR ANKLE 1 VIEW RIGHT	$110.00	$220.00	$32.27–$220.00	45% below	50%
X-ray of the ankle, 2 views inpatient both sides CPT 73600 XR Ankle 2 Views Bilateral	$163.50	$327.00	$126.88–$327.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Left	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR ANKLE 1 VIEW RIGHT	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 1 View Left	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the ankle, 2 views inpatient one side CPT 73600 XR Ankle 2 Views Right	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 3M XR Finger(s) 2+ Views Right	$41.50	$83.00	$16.28–$115.24	77% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 3M XR Finger(s) 2+ Views Left	$41.50	$83.00	$16.28–$115.24	77% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Left	$110.00	$220.00	$37.98–$220.00	40% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR Finger(s) 2+ Views Right	$110.00	$220.00	$37.98–$220.00	40% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER LEFT	$112.50	$225.00	$37.98–$225.00	38% below	50%
X-ray of the finger(s), 2 or more views one side CPT 73140 XR FINGER RIGHT	$112.50	$225.00	$37.98–$225.00	38% below	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 3M XR Finger(s) 2+ Views Right	$41.50	$83.00	$32.20–$83.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 3M XR Finger(s) 2+ Views Left	$41.50	$83.00	$32.20–$83.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Left	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR Finger(s) 2+ Views Right	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER LEFT	$112.50	$225.00	$87.30–$225.00	—	50%
X-ray of the finger(s), 2 or more views inpatient one side CPT 73140 XR FINGER RIGHT	$112.50	$225.00	$87.30–$225.00	—	50%
X-ray of the foot, 2 views both sides CPT 73620 3M XR Foot 2 Views Bilateral	$35.50	$71.00	$13.93–$85.18	—	50%
X-ray of the foot, 2 views both sides CPT 73620 XR Foot 2 Views Bilateral	$181.00	$362.00	$28.71–$362.00	—	50%
X-ray of the foot, 2 views one side CPT 73620 3M XR Foot 2 Views Left	$35.50	$71.00	$13.93–$85.18	81% below	50%
X-ray of the foot, 2 views one side CPT 73620 3M XR Foot 2 Views Right	$35.50	$71.00	$13.93–$85.18	81% below	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Left	$110.00	$220.00	$28.71–$220.00	41% below	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 1 View Right	$110.00	$220.00	$28.71–$220.00	41% below	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 1 View Left	$110.00	$220.00	$28.71–$220.00	41% below	50%
X-ray of the foot, 2 views one side CPT 73620 XR Foot 2 Views Right	$110.00	$220.00	$28.71–$220.00	41% below	50%
X-ray of the foot, 2 views inpatient both sides CPT 73620 3M XR Foot 2 Views Bilateral	$35.50	$71.00	$27.55–$71.00	—	50%
X-ray of the foot, 2 views inpatient both sides CPT 73620 XR Foot 2 Views Bilateral	$181.00	$362.00	$140.46–$362.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 3M XR Foot 2 Views Right	$35.50	$71.00	$27.55–$71.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 3M XR Foot 2 Views Left	$35.50	$71.00	$27.55–$71.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 1 View Right	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Right	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 1 View Left	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the foot, 2 views inpatient one side CPT 73620 XR Foot 2 Views Left	$110.00	$220.00	$85.36–$220.00	—	50%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 3M XR Foot Complete 3+ Views Bilateral	$71.00	$142.00	$27.86–$142.00	—	50%
X-ray of the foot, complete, 3 or more views both sides CPT 73630 XR Foot Complete 3+ Views Bilateral	$374.50	$749.00	$34.26–$749.00	—	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 3M XR Foot Complete 3+ Views Left	$71.00	$142.00	$27.86–$142.00	73% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 3M XR Foot Complete 3+ Views Right	$71.00	$142.00	$27.86–$142.00	73% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Left	$187.50	$375.00	$34.26–$375.00	28% below	50%
X-ray of the foot, complete, 3 or more views one side CPT 73630 XR Foot Complete 3+ Views Right	$187.50	$375.00	$34.26–$375.00	28% below	50%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 3M XR Foot Complete 3+ Views Bilateral	$71.00	$142.00	$55.10–$142.00	—	50%
X-ray of the foot, complete, 3 or more views inpatient both sides CPT 73630 XR Foot Complete 3+ Views Bilateral	$374.50	$749.00	$290.61–$749.00	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 3M XR Foot Complete 3+ Views Left	$71.00	$142.00	$55.10–$142.00	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 3M XR Foot Complete 3+ Views Right	$71.00	$142.00	$55.10–$142.00	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Right	$187.50	$375.00	$145.50–$375.00	—	50%
X-ray of the foot, complete, 3 or more views inpatient one side CPT 73630 XR Foot Complete 3+ Views Left	$187.50	$375.00	$145.50–$375.00	—	50%
X-ray of the hand, 3 or more views both sides CPT 73130 3M XR Hand Complete 3+ Views Bilateral	$72.50	$145.00	$28.45–$145.00	—	50%
X-ray of the hand, 3 or more views both sides CPT 73130 XR Hand Complete 3+ Views Bilateral	$381.00	$762.00	$37.17–$762.00	—	50%
X-ray of the hand, 3 or more views one side CPT 73130 3M XR Hand Complete 3+ Views Left	$72.50	$145.00	$28.45–$145.00	73% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 3M XR Hand Complete 3+ Views Right	$72.50	$145.00	$28.45–$145.00	73% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Right	$191.00	$382.00	$37.17–$382.00	28% below	50%
X-ray of the hand, 3 or more views one side CPT 73130 XR Hand Complete 3+ Views Left	$191.00	$382.00	$37.17–$382.00	28% below	50%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 3M XR Hand Complete 3+ Views Bilateral	$72.50	$145.00	$56.26–$145.00	—	50%
X-ray of the hand, 3 or more views inpatient both sides CPT 73130 XR Hand Complete 3+ Views Bilateral	$381.00	$762.00	$295.66–$762.00	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 3M XR Hand Complete 3+ Views Left	$72.50	$145.00	$56.26–$145.00	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 3M XR Hand Complete 3+ Views Right	$72.50	$145.00	$56.26–$145.00	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Right	$191.00	$382.00	$148.22–$382.00	—	50%
X-ray of the hand, 3 or more views inpatient one side CPT 73130 XR Hand Complete 3+ Views Left	$191.00	$382.00	$148.22–$382.00	—	50%
X-ray of the knee, 1 or 2 views both sides CPT 73560 3M XR Knee 1 or 2 Views Bilateral	$75.00	$150.00	$29.43–$150.00	—	50%
X-ray of the knee, 1 or 2 views both sides CPT 73560 XR Knee 1 or 2 Views Bilateral	$397.00	$794.00	$34.22–$794.00	—	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 3M XR Knee 1 or 2 Views Right	$75.00	$150.00	$29.43–$150.00	59% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 3M XR Knee 1 or 2 Views Left	$75.00	$150.00	$29.43–$150.00	59% below	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Left	$198.00	$396.00	$34.22–$396.00	8% above	50%
X-ray of the knee, 1 or 2 views one side CPT 73560 XR Knee 1 or 2 Views Right	$198.00	$396.00	$34.22–$396.00	8% above	50%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 3M XR Knee 1 or 2 Views Bilateral	$75.00	$150.00	$58.20–$150.00	—	50%
X-ray of the knee, 1 or 2 views inpatient both sides CPT 73560 XR Knee 1 or 2 Views Bilateral	$397.00	$794.00	$308.07–$794.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 3M XR Knee 1 or 2 Views Right	$75.00	$150.00	$58.20–$150.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 3M XR Knee 1 or 2 Views Left	$75.00	$150.00	$58.20–$150.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Left	$198.00	$396.00	$153.65–$396.00	—	50%
X-ray of the knee, 1 or 2 views inpatient one side CPT 73560 XR Knee 1 or 2 Views Right	$198.00	$396.00	$153.65–$396.00	—	50%
X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$271.50	$543.00	$39.98–$543.00	21% below	50%
X-ray of the lower back (lumbar spine), 2 or 3 views inpatient CPT 72100 XR Spine Lumbosacral 2 or 3 Views	$271.50	$543.00	$210.68–$543.00	—	50%
X-ray of the lower back, 4 or more views CPT 72110 3M XR Spine Lumbosacral 4+ Views	$75.50	$151.00	$29.62–$156.33	85% below	50%
X-ray of the lower back, 4 or more views CPT 72110 XR Spine Lumbosacral 4+ Views	$358.50	$717.00	$51.81–$717.00	29% below	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 3M XR Spine Lumbosacral 4+ Views	$75.50	$151.00	$58.59–$151.00	—	50%
X-ray of the lower back, 4 or more views inpatient CPT 72110 XR Spine Lumbosacral 4+ Views	$358.50	$717.00	$278.20–$717.00	—	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 3M XR Spine Thoracic 2 Views	$59.00	$118.00	$23.15–$118.00	82% below	50%
X-ray of the mid back (thoracic spine), 2 views CPT 72070 XR Spine Thoracic 2 Views	$132.50	$265.00	$33.10–$265.00	59% below	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 3M XR Spine Thoracic 2 Views	$59.00	$118.00	$45.78–$118.00	—	50%
X-ray of the mid back (thoracic spine), 2 views inpatient CPT 72070 XR Spine Thoracic 2 Views	$132.50	$265.00	$102.82–$265.00	—	50%
X-ray of the nasal bones, 3 or more views CPT 70160 3M XR Nasal Bones 3+ Views	$188.00	$376.00	$37.51–$376.00	27% below	50%
X-ray of the nasal bones, 3 or more views CPT 70160 XR Nasal Bones 3+ Views	$197.50	$395.00	$37.51–$395.00	23% below	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 3M XR Nasal Bones 3+ Views	$188.00	$376.00	$145.89–$376.00	—	50%
X-ray of the nasal bones, 3 or more views inpatient CPT 70160 XR Nasal Bones 3+ Views	$197.50	$395.00	$153.26–$395.00	—	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 3M XR Spine Cervical 2 or 3 Views	$111.00	$222.00	$39.66–$222.00	68% below	50%
X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 XR Spine Cervical 2 or 3 Views	$291.50	$583.00	$39.66–$583.00	17% below	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 3M XR Spine Cervical 2 or 3 Views	$111.00	$222.00	$86.14–$222.00	—	50%
X-ray of the neck (cervical spine), 2 or 3 views inpatient CPT 72040 XR Spine Cervical 2 or 3 Views	$291.50	$583.00	$226.20–$583.00	—	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 3M XR Pelvis 1 or 2 Views	$36.00	$72.00	$14.13–$84.18	85% below	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR INLET-OUTLET PELVIS	$244.50	$489.00	$28.11–$489.00	1% above	50%
X-ray of the pelvis, 1 or 2 views CPT 72170 XR Pelvis 1 or 2 Views	$251.00	$502.00	$28.11–$502.00	3% above	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 3M XR Pelvis 1 or 2 Views	$36.00	$72.00	$27.94–$72.00	—	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR INLET-OUTLET PELVIS	$244.50	$489.00	$189.73–$489.00	—	50%
X-ray of the pelvis, 1 or 2 views inpatient CPT 72170 XR Pelvis 1 or 2 Views	$251.00	$502.00	$194.78–$502.00	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 3M XR Sacrum/Coccyx 2+ Views	$36.00	$72.00	$14.13–$98.21	87% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 XR Sacrum/Coccyx 2+ Views	$236.50	$473.00	$32.65–$473.00	18% below	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 3M XR Sacrum/Coccyx 2+ Views	$36.00	$72.00	$27.94–$72.00	—	50%
X-ray of the tailbone (sacrum and coccyx), 2 or more views inpatient CPT 72220 XR Sacrum/Coccyx 2+ Views	$236.50	$473.00	$183.52–$473.00	—	50%

Lab tests

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALT	$55.00	$110.00	$3.71–$110.00	25% above	50%
ALT (alanine aminotransferase) liver enzyme test inpatient CPT 84460 ALT	$55.00	$110.00	$42.68–$110.00	—	50%
AST (aspartate aminotransferase) enzyme test CPT 84450 AST	$57.00	$114.00	$3.63–$114.00	50% above	50%
AST (aspartate aminotransferase) enzyme test inpatient CPT 84450 AST	$57.00	$114.00	$44.23–$114.00	—	50%
Acute hepatitis panel (hepatitis A, B and C) CPT 80074 Acute Hepatitis Panel	$264.50	$529.00	$33.35–$529.00	26% below	50%
Acute hepatitis panel (hepatitis A, B and C) inpatient CPT 80074 Acute Hepatitis Panel	$264.50	$529.00	$205.25–$529.00	—	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Peanut-RL	$34.00	$68.00	$3.65–$68.00	8% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Kiwi IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tomato IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Watermelon IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tuna IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Cow Hair/ Dander IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Alpha-Lactalbumin IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Horse Hair/ Dander IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Beta-lactoglobulin IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, F. solani-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Casein IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Asper flavus-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Almond IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Turmeric-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Brazil Nut IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Black Bean -RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cashew IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Blackberry-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Hazelnut IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Coriander/Cilantro-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pecan IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Botrytis cinerea-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chestnut IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Nettle-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lobster IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, White Mulberry Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Blue Mussel IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Scale-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Oyster IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Raspberry-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Apple IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Alder Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg Whole IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Garlic-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Green Bean (string) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pineapple-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pea IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Cocklebur-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bent/Redtop Grass IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Zucchini-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bermuda Grass IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Summer Squash-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Johnson Grass IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Clove-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, June/Kentucky Blue IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cucumber-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Meadow Fescue IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Ginger-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Orchard/Cocksfoot IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Poplar White-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Perennial Rye IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Cephalosporium-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Timothy Grass IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Fire Ant, Imported-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Cat Dander IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Hickory Shagbark-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Dog Dander IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Crayfish-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bahia IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Thyme-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Pecan Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Nutmeg-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Pigweed IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Oregano-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Common/Short Ragweed IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Basil-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Nettle IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Bay Leaf-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Sheep Sorrel IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tea-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Mouse Epithelium IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Honeydew/Cantaloupe-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, M. racemosus IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pepper C. frutescens-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Sesame Seed IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Phoma betae-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Phoma betae IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Sweet Gum Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cashew-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Kiwi-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Almond-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chickpea (Garbanzo)-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chocolate-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Japanese Cedar Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Mustard-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Watermelon-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pistachio-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Olive Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cinnamon-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, American Beech-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Rye-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Acacia Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Black Pepper-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Mesquite Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pine (Pinon) Nut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Eucalyptus Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Sheep Sorrel-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Cockroach, American-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Sagebrush/Wormwood-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Timothy Grass-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Elm Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Cedar/Red Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Vanilla-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Walnut Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Hazelnut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Sycamore Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Brazil Nut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Pine/Australian Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Peach-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Dandelion-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Apple-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Willow Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Oyster-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Paper Wasp-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Strawberry-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Western Ragweed-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Gulf Flounder-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Russian Thistle-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Pork-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Mugwort-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Carrot-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Kochia/Firebush-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chicken-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, False Ragweed-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Grape-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pepper C. annuum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Orange-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Marsh Elder-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tomato-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, S. botryosum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Oat-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Green Bean (string)-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Potato-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Occupational, Latex IgE Enh.-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Rice-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Epicoccum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Barley-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Gluten-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, A. fumigatus-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Catfish-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Baker's/Brewer's Yeast-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Virginia Live Oak-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cabbage-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Aureob. pullulans-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pear-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Curvularia lunata-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chestnut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Fus. moniliforme-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Blueberry-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Common/Short Ragweed-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Macadamia Nut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Horse Hair/ Dander-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Sweet Potato-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Perennial Rye Grass-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Whitefish-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Mountain Cedar Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Halibut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Privet Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Celery-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Johnson Grass-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Coconut-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Asparagus-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Clam-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Muco racemosus-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Scallop-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, R. nigrican-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cheese, Cheddar-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Goldenrod-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cheese Mold-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Lamb's Quarters-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Turkey-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Grapefruit-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Perch-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Trout-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lima Bean/White Bean-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Box Elder/Maple Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Pigweed-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, White Pine Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Giant Ragweed-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Pecan (White Hickory) Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Helminthosporium-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, A. alternatas-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Candida albicans-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Cottonwood Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Hormodendrum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, English Plantain-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Birch Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites, D. pteronyssinus-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites, D. farinae-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, White Ash Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, P. notatum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cod IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Cat Dander-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Soy Bean IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Crab-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Gliadin IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg White-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cow's Milk IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cow Milk-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cashew (tree nut) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Hazelnut (tree nut) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Peanut IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Shrimp-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Scallop (shellfish) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Soybean-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Shrimp (shellfish) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Wheat-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Sesame Seed IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Codfish-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Peanut IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Oak Tree-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Total IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tuna-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Nettle (weed pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bermuda Grass-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Sheep sorrel (weed pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Corn-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Common pigweed (weed pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Cockroach, German-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Common ragweed (weed pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Beef-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Elm (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Grass, Bahia-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Mulberry (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Goose Feathers-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Oak (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Walnut (Juglans sp)-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Mountain juniper (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg Yolk-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Common silver birch (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Hickory pecan (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Box-elder (tree pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Chicken Feather-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Timothy grass (grass pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Bermuda grass (grass pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Bahia grass (grass pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Johnson grass (grass pollen)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Yellow Dye-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Avocado IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pork IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Celery IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Rice IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Papaya IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Rye IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Potato IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cockroach, German (insect)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg Whole-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 D. farinae (dust mite)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Tilapia-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 D. pteronyssinus (dust mite)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Duck Feathers-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Mouse urine proteins (epidermal)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lobster-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Dog dander (epidermal)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Dog Dander-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cat dander (epidermal)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pecan-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Penicillium chrysogenum (mold)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Banana-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Cladosporium herbarum (mold)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Salmon-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Aspergillus fumigatus (mold)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Sesame Seed-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Alternaria alternata (mold)	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pea-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Beet Root IgE - RL - BILL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Birch Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Venison IgE - RL - BILL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Walnut Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lamb - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Box Elder/Maple Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Squid - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Cottonwood Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pumpkin-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Elm Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cherry-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Mountain Cedar Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, YellowDock (Rumex crispus) - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Sycamore Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Mango - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Oak Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Green Olive, IgE - RL Bill	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Willow Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Black Olive- RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Eucalyptus Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cranberry - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Mesquite Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Haddock - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, Olive Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lentil - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Tree, White Ash Tree IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Bass Black - RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, A. alternata IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Grouper, - RL Bill	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, A. fumigatus IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Mosquito-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, A. pullulans IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect. Flea-RL Bill	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, C. lunata IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Blue Mussel-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Epicoccum IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Profile, Walnut, IgE with Components-RL B	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, F. moniliforme IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Trout IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Helminthospor. IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Salmon IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, Hormodendrum IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Mackerel IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, P. notatum IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Halibut IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Fungi/Mold, R. nigricans IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Guar Gum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites, D. pteronyssinus IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Occupation, Gum Caragee-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Cockroach, German IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen Specific IgE each	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Mites, D. farinae IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Yellow Jacket Venom-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, House Dust Stier IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Honey Bee Venom-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Banana IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, White-Faced Hornet-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg White IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Insect, Yellow-Faced Hornet-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Egg Yolk IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Plum-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Corn IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Mandarin-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Gluten IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lime-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Milk (Cow) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lemon-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Strawberry IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Goldenrod IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Soybean IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Mugwort IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Wheat IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Kochia/Firebush IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Shrimp IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Western Ragweed IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Walnut (Juglans spp) IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Sagebrush/Wormwood IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Clam IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, Russian Thistle IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Codfish IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, House Dust Greer IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Scallop IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Weed, False Ragweed	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Barley IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Whey-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Beef IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Occupational, Tobacco-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Pepper C. annuum IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Animal, Mouse Epithelium-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Cabbage IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Onion-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Carrot IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Mushroom-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Chicken IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 zzSheep Milk-ARUP	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Crab IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Goat Milk-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Grape IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lettuce-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Lettuce IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Coffee-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Navy Bean IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Broccoli-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Oat IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Avocado-RL	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen CPT 86003 Allergen, Food, Orange IgE	$35.50	$71.00	$3.65–$71.00	4% below	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Peanut-RL	$34.00	$68.00	$26.38–$68.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Celery-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cod IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Soy Bean IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Gliadin IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cow's Milk IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cashew (tree nut) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Hazelnut (tree nut) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Peanut IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Scallop (shellfish) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Shrimp (shellfish) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sesame Seed IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Peanut IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Total IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Nettle (weed pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Sheep sorrel (weed pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common pigweed (weed pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common ragweed (weed pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Elm (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mulberry (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Oak (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mountain juniper (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Common silver birch (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Hickory pecan (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Box-elder (tree pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Timothy grass (grass pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bermuda grass (grass pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Bahia grass (grass pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Johnson grass (grass pollen)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cockroach, German (insect)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. farinae (dust mite)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 D. pteronyssinus (dust mite)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Mouse urine proteins (epidermal)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Dog dander (epidermal)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cat dander (epidermal)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Penicillium chrysogenum (mold)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Cladosporium herbarum (mold)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Aspergillus fumigatus (mold)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Alternaria alternata (mold)	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Beet Root IgE - RL - BILL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Venison IgE - RL - BILL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lamb - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Squid - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pumpkin-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cherry-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, YellowDock (Rumex crispus) - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Mango - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Green Olive, IgE - RL Bill	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Black Olive- RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cranberry - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Haddock - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lentil - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Bass Black - RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Grouper, - RL Bill	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Mosquito-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect. Flea-RL Bill	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Blue Mussel-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Profile, Walnut, IgE with Components-RL B	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Trout IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Salmon IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Mackerel IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Halibut IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Guar Gum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Occupation, Gum Caragee-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen Specific IgE each	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Yellow Jacket Venom-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Honey Bee Venom-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, White-Faced Hornet-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Yellow-Faced Hornet-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Plum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Mandarin-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lime-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lemon-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Goldenrod IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Mugwort IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Kochia/Firebush IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Western Ragweed IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Sagebrush/Wormwood IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Russian Thistle IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, House Dust Greer IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, False Ragweed	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Whey-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Occupational, Tobacco-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Mouse Epithelium-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Onion-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Mushroom-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 zzSheep Milk-ARUP	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Goat Milk-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lettuce-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Coffee-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Broccoli-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Avocado-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Yellow Dye-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Avocado IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Celery IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Papaya IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Kiwi IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Watermelon IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Cow Hair/ Dander IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Horse Hair/ Dander IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, F. solani-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Asper flavus-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Turmeric-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Black Bean -RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Blackberry-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Coriander/Cilantro-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Botrytis cinerea-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Nettle-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, White Mulberry Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Scale-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Raspberry-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Alder Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Garlic-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pineapple-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Cocklebur-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Zucchini-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Summer Squash-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Clove-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cucumber-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Ginger-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Poplar White-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Cephalosporium-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Fire Ant, Imported-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Hickory Shagbark-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Crayfish-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Thyme-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Nutmeg-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Oregano-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Basil-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Bay Leaf-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tea-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Honeydew/Cantaloupe-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pepper C. frutescens-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Phoma betae-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Sweet Gum Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Kiwi-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chickpea (Garbanzo)-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Japanese Cedar Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Watermelon-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Olive Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, American Beech-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Acacia Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Mesquite Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Eucalyptus Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Walnut Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Sycamore Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Pine/Australian Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Dandelion-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Willow Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Paper Wasp-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Western Ragweed-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Russian Thistle-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Mugwort-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Kochia/Firebush-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, False Ragweed-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pepper C. annuum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Marsh Elder-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, S. botryosum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Green Bean (string)-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Occupational, Latex IgE Enh.-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Epicoccum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Gluten-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Catfish-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Virginia Live Oak-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Aureob. pullulans-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Curvularia lunata-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Fus. moniliforme-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Common/Short Ragweed-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Horse Hair/ Dander-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Perennial Rye Grass-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Mountain Cedar Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Privet Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Johnson Grass-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Asparagus-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Muco racemosus-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, R. nigrican-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Goldenrod-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Lamb's Quarters-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Cedar/Red Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Elm Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Timothy Grass-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Sagebrush/Wormwood-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Cockroach, American-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Sheep Sorrel-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, P. notatum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, White Ash Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites, D. farinae-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites, D. pteronyssinus-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Birch Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, English Plantain-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Hormodendrum-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Cottonwood Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Candida albicans-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, A. alternatas-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Helminthosporium-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Pecan (White Hickory) Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Giant Ragweed-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, White Pine Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Pigweed-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Box Elder/Maple Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lima Bean/White Bean-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Trout-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Perch-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Grapefruit-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Turkey-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cheese Mold-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cheese, Cheddar-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Scallop-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Clam-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Coconut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Halibut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Whitefish-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Sweet Potato-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Macadamia Nut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Blueberry-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chestnut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pear-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cabbage-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Baker's/Brewer's Yeast-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, A. fumigatus-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Barley-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Rice-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Potato-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Oat-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tomato-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Orange-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Grape-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chicken-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Carrot-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Pork-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Gulf Flounder-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Strawberry-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Oyster-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Apple-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Peach-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Brazil Nut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Hazelnut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Vanilla-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pine (Pinon) Nut-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Black Pepper-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Rye-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cinnamon-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pistachio-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Mustard-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chocolate-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Almond-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cashew-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Phoma betae IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Sesame Seed IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, M. racemosus IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Mouse Epithelium IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Sheep Sorrel IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Nettle IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Common/Short Ragweed IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Weed, Pigweed IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Pecan Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bahia IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Dog Dander IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Cat Dander IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Timothy Grass IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Perennial Rye IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Orchard/Cocksfoot IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Meadow Fescue IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, June/Kentucky Blue IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Johnson Grass IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bermuda Grass IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bent/Redtop Grass IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pea IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Green Bean (string) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg Whole IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Apple IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Oyster IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Blue Mussel IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lobster IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chestnut IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pecan IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Hazelnut IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cashew IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Brazil Nut IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Almond IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Casein IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Beta-lactoglobulin IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Alpha-Lactalbumin IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tuna IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tomato IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Rye IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Rice IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pork IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Potato IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Orange IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Oat IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Navy Bean IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lettuce IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Grape IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Crab IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Chicken IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Carrot IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cabbage IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pepper C. annuum IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Beef IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Barley IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Scallop IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Codfish IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Clam IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Walnut (Juglans spp) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Shrimp IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Wheat IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Soybean IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Strawberry IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Milk (Cow) IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Gluten IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Corn IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg Yolk IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg White IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Banana IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, House Dust Stier IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites, D. farinae IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Cockroach, German IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Mites, D. pteronyssinus IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, R. nigricans IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, P. notatum IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Hormodendrum IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Helminthospor. IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, F. moniliforme IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, Epicoccum IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, C. lunata IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, A. pullulans IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, A. fumigatus IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Fungi/Mold, A. alternata IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, White Ash Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Olive Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Mesquite Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Eucalyptus Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Willow Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Oak Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Sycamore Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Mountain Cedar Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Elm Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Cottonwood Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Box Elder/Maple Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Walnut Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Birch Tree IgE	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pea-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Sesame Seed-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Salmon-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Banana-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Pecan-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Dog Dander-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Lobster-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Duck Feathers-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tilapia-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg Whole-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Chicken Feather-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg Yolk-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Walnut (Juglans sp)-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Goose Feathers-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bahia-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Beef-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Insect, Cockroach, German-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Corn-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Grass, Bermuda Grass-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Tuna-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Tree, Oak Tree-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Codfish-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Wheat-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Soybean-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Shrimp-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Cow Milk-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Egg White-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Food, Crab-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Allergy blood test, specific IgE, per allergen inpatient CPT 86003 Allergen, Animal, Cat Dander-RL	$35.50	$71.00	$27.55–$71.00	—	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide Ab IgG and IgA-RL	$55.50	$111.00	$9.07–$111.00	57% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 Cyclic Citrullinated Peptide (CCP) Antibody IgG	$55.50	$111.00	$9.07–$111.00	57% below	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibody	$220.50	$441.00	$9.07–$441.00	71% above	50%
Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP Antibodies, IgA, IgG, ELISA - RL Bill	$220.50	$441.00	$9.07–$441.00	71% above	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide Ab IgG and IgA-RL	$55.50	$111.00	$43.07–$111.00	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 Cyclic Citrullinated Peptide (CCP) Antibody IgG	$55.50	$111.00	$43.07–$111.00	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibody	$220.50	$441.00	$171.11–$441.00	—	50%
Anti-CCP antibody test (rheumatoid arthritis) inpatient CPT 86200 CCP Antibodies, IgA, IgG, ELISA - RL Bill	$220.50	$441.00	$171.11–$441.00	—	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 Symphony IgG	$150.00	$300.00	$8.47–$300.00	16% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA, IgG ELISA w/ Reflex to ANA,HEp-2 IgG, IFA-RL	$150.00	$300.00	$8.47–$300.00	16% above	50%
Antinuclear antibody (ANA) blood test, screen CPT 86038 ANA 12 Plus Profile (RDL) - RL Bill	$150.00	$300.00	$8.47–$300.00	16% above	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA, IgG ELISA w/ Reflex to ANA,HEp-2 IgG, IFA-RL	$150.00	$300.00	$116.40–$300.00	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 Symphony IgG	$150.00	$300.00	$116.40–$300.00	—	50%
Antinuclear antibody (ANA) blood test, screen inpatient CPT 86038 ANA 12 Plus Profile (RDL) - RL Bill	$150.00	$300.00	$116.40–$300.00	—	50%
BNP or NT-proBNP blood test (heart failure marker) CPT 83880 B-Type Natriuretic Peptide(BNP)	$138.00	$276.00	$27.48–$276.00	at median	50%
BNP or NT-proBNP blood test (heart failure marker) inpatient CPT 83880 B-Type Natriuretic Peptide(BNP)	$138.00	$276.00	$107.09–$276.00	—	50%
Basic metabolic panel (blood test) CPT 80048 Basic Metabolic Panel	$116.50	$233.00	$5.92–$233.00	42% above	50%
Basic metabolic panel (blood test) inpatient CPT 80048 Basic Metabolic Panel	$116.50	$233.00	$90.40–$233.00	—	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Stomach Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Ovary Biopsy/Wedge Resection	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 BREAST BX NO MICRO FOR SURG MARG	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Synovium	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Spleen	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Testis-Not Tumor/BX/Castration	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Thyroglossal Duct/Brach Cleft Cys	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Soft Tissue not TU/MS/Lip/Debrid	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tongue Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Tonsil Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Small Intestine Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Trachea Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Ureter Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Skin-Other than Cyst/Tag/Debridem	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Urethra Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Urinary Bladder Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Uterus w/wo t/o for prolapse	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Sinus Paranasal Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Salivary Gland Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Prostate - Tur	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Abortion-Spontaneous/Missed	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Artery Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bone Exostosis	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bone Marrow Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Prostate Needle Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Vagina Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Bronchus Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cell Block/Any Source	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Vulva/Labia Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Cervix Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Colon Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Breast Reduction Mammoplasty	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Duodenum Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Endocervix-Curettings/Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Foreign Body ID	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Endometrium-Curettings/Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Esophagus Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Polyp-Stomach/Small Bowel	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Extremity Amputation/Traumatic	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Fallopian Tube Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 NERVE BIOPSY	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Polyp-Colorectal	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Fallopian Tube-Ectopic Pregnancy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Femoral Head-Fracture	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Polyp-Cervical/Endometrial	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Gingiva/Oral Mucosa Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 FINGERS/TOES-AMPUTATION/NON-TRAUM	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Joint Resection	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Pleura/Pericardium-Biopsy/Tissue	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Kidney Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Larynx Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Placenta-Other than 3rd Trimester	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Leiomyomas Ute Myomectomy-No Uter	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 CERVIX BIOSPY	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Lip Biopsy/Wedge Resection	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Peritoneum Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Lung Transbronchial Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Lymph Node Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Nasal Mucosa Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Nasopharynx/Oropharynx Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Odontogenic/Dental Cyst	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Parathyroid Gland	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Omentum Biopsy	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 Ovary w/wo Tube Non-Neoplastic	$164.00	$328.00	$30.39–$328.00	47% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 RENAL BIOPSY - NEPHROPATH	$281.00	$562.00	$30.39–$562.00	152% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 NERVE BIOPSY/REF LAB	$1,046.00	$2,092.00	$30.39–$2,092.00	838% above	50%
Biopsy tissue exam by a pathologist (level IV) CPT 88305 MUSCLE BIOPSY/REF LAB	$1,046.00	$2,092.00	$30.39–$2,092.00	838% above	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Extremity Amputation/Traumatic	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Parathyroid Gland	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Peritoneum Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Polyp-Stomach/Small Bowel	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Fallopian Tube Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Lymph Node Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 CERVIX BIOSPY	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Fallopian Tube-Ectopic Pregnancy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 BREAST BX NO MICRO FOR SURG MARG	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Lung Transbronchial Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Esophagus Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Ovary Biopsy/Wedge Resection	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Tonsil Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Endocervix-Curettings/Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Foreign Body ID	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Soft Tissue not TU/MS/Lip/Debrid	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Endometrium-Curettings/Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Omentum Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Tongue Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Polyp-Colorectal	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Femoral Head-Fracture	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 NERVE BIOPSY	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Nasal Mucosa Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Thyroglossal Duct/Brach Cleft Cys	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Gingiva/Oral Mucosa Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Polyp-Cervical/Endometrial	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Stomach Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Joint Resection	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Nasopharynx/Oropharynx Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Kidney Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Salivary Gland Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Abortion-Spontaneous/Missed	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Prostate - Tur	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Spleen	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Sinus Paranasal Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Artery Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Vagina Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Ovary w/wo Tube Non-Neoplastic	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Skin-Other than Cyst/Tag/Debridem	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bone Exostosis	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Uterus w/wo t/o for prolapse	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Urinary Bladder Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bone Marrow Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Urethra Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Larynx Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Pleura/Pericardium-Biopsy/Tissue	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Bronchus Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 FINGERS/TOES-AMPUTATION/NON-TRAUM	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Ureter Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Cell Block/Any Source	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Vulva/Labia Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Leiomyomas Ute Myomectomy-No Uter	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Small Intestine Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Cervix Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Odontogenic/Dental Cyst	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Testis-Not Tumor/BX/Castration	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Trachea Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Colon Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Breast Reduction Mammoplasty	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Placenta-Other than 3rd Trimester	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Prostate Needle Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Duodenum Biopsy	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Lip Biopsy/Wedge Resection	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 Synovium	$164.00	$328.00	$127.26–$328.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 RENAL BIOPSY - NEPHROPATH	$281.00	$562.00	$218.06–$562.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 MUSCLE BIOPSY/REF LAB	$1,046.00	$2,092.00	$811.70–$2,092.00	—	50%
Biopsy tissue exam by a pathologist (level IV) inpatient CPT 88305 NERVE BIOPSY/REF LAB	$1,046.00	$2,092.00	$811.70–$2,092.00	—	50%
Blood culture for bacteria CPT 87040 Culture Blood	$258.00	$516.00	$7.22–$516.00	184% above	50%
Blood culture for bacteria inpatient CPT 87040 Culture Blood	$258.00	$516.00	$200.21–$516.00	—	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 MR Lab Draw	$20.00	$40.00	$1.80–$40.00	53% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 CT Lab Draw	$20.00	$40.00	$1.80–$40.00	53% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE	$22.00	$44.00	$1.80–$44.00	69% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLLECTION: Venous Draw	$22.00	$44.00	$1.80–$44.00	69% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 RAD Lab Draw Nursing - Radiology Lab Draw	$22.00	$44.00	$1.80–$44.00	69% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood collection - Butterfly	$23.00	$46.00	$1.80–$46.00	76% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 VENIPUNCTURE ED	$23.00	$46.00	$1.80–$46.00	76% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Venipuncture	$23.00	$46.00	$1.80–$46.00	76% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 INF Venipuncture	$23.00	$46.00	$1.80–$46.00	76% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood collection - Venipuncture	$23.00	$46.00	$1.80–$46.00	76% above	50%
Blood draw from a vein (venipuncture), collection fee only CPT 36415 Blood collection - Redraw	$23.00	$46.00	$1.80–$46.00	76% above	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 MR Lab Draw	$20.00	$40.00	$15.52–$40.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 CT Lab Draw	$20.00	$40.00	$15.52–$40.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE	$22.00	$44.00	$17.07–$44.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 COLLECTION: Venous Draw	$22.00	$44.00	$17.07–$44.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 RAD Lab Draw Nursing - Radiology Lab Draw	$22.00	$44.00	$17.07–$44.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 INF Venipuncture	$23.00	$46.00	$17.85–$46.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 VENIPUNCTURE ED	$23.00	$46.00	$17.85–$46.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood collection - Butterfly	$23.00	$46.00	$17.85–$46.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood collection - Redraw	$23.00	$46.00	$17.85–$46.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Blood collection - Venipuncture	$23.00	$46.00	$17.85–$46.00	—	50%
Blood draw from a vein (venipuncture), collection fee only inpatient CPT 36415 Venipuncture	$23.00	$46.00	$17.85–$46.00	—	50%
Blood glucose (sugar) test CPT 82947 Hemocue Blood Glucose (POCT)	$9.50	$19.00	$2.76–$19.00	74% below	50%
Blood glucose (sugar) test CPT 82947 Glucose Level	$57.00	$114.00	$2.76–$114.00	55% above	50%
Blood glucose (sugar) test CPT 82947 Fasting Glucose	$57.00	$114.00	$2.76–$114.00	55% above	50%
Blood glucose (sugar) test CPT 82947 2HR Post Prandial Glucose Level	$57.00	$114.00	$2.76–$114.00	55% above	50%
Blood glucose (sugar) test inpatient CPT 82947 Hemocue Blood Glucose (POCT)	$9.50	$19.00	$7.37–$19.00	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Glucose Level	$57.00	$114.00	$44.23–$114.00	—	50%
Blood glucose (sugar) test inpatient CPT 82947 2HR Post Prandial Glucose Level	$57.00	$114.00	$44.23–$114.00	—	50%
Blood glucose (sugar) test inpatient CPT 82947 Fasting Glucose	$57.00	$114.00	$44.23–$114.00	—	50%
Blood lead test CPT 83655 Lead, Capillary Blood - RL	$27.00	$54.00	$8.48–$54.00	55% below	50%
Blood lead test CPT 83655 Lead, Blood	$104.00	$208.00	$8.48–$208.00	73% above	50%
Blood lead test CPT 83655 Lead, Whole Blood Venous-RL	$104.00	$208.00	$8.48–$208.00	73% above	50%
Blood lead test CPT 83655 Lead, Urine	$104.00	$208.00	$8.48–$208.00	73% above	50%
Blood lead test inpatient CPT 83655 Lead, Capillary Blood - RL	$27.00	$54.00	$20.95–$54.00	—	50%
Blood lead test inpatient CPT 83655 Lead, Whole Blood Venous-RL	$104.00	$208.00	$80.70–$208.00	—	50%
Blood lead test inpatient CPT 83655 Lead, Urine	$104.00	$208.00	$80.70–$208.00	—	50%
Blood lead test inpatient CPT 83655 Lead, Blood	$104.00	$208.00	$80.70–$208.00	—	50%
Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 HCG Qualitative Serum	$107.50	$215.00	$5.26–$215.00	20% below	50%
Blood pregnancy test (hCG, qualitative: yes or no) inpatient CPT 84703 HCG Qualitative Serum	$107.50	$215.00	$83.42–$215.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO/Rh	$51.50	$103.00	$2.10–$103.00	23% below	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 ABO Only	$154.50	$309.00	$2.10–$309.00	132% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Cord ABO/Rh	$154.50	$309.00	$2.10–$309.00	132% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Neonatal ABO/Rh	$154.50	$309.00	$2.10–$309.00	132% above	50%
Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 Post TR ABO/Rh	$154.50	$309.00	$2.10–$309.00	132% above	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO/Rh	$51.50	$103.00	$39.96–$103.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Cord ABO/Rh	$154.50	$309.00	$119.89–$309.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 ABO Only	$154.50	$309.00	$119.89–$309.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Neonatal ABO/Rh	$154.50	$309.00	$119.89–$309.00	—	50%
Blood type test, ABO group only (Rh factor is a separate test) inpatient CPT 86900 Post TR ABO/Rh	$154.50	$309.00	$119.89–$309.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reative Protein-SF	$61.00	$122.00	$3.63–$122.00	56% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-Reactive Protein	$61.00	$122.00	$3.63–$122.00	56% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 Synovasure SF CRP	$61.00	$122.00	$3.63–$122.00	56% below	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reative Protein-SF	$61.00	$122.00	$47.34–$122.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 C-Reactive Protein	$61.00	$122.00	$47.34–$122.00	—	50%
C-reactive protein (CRP) blood test, standard (not high-sensitivity) inpatient CPT 86140 Synovasure SF CRP	$61.00	$122.00	$47.34–$122.00	—	50%
C. difficile toxin gene test (stool PCR) CPT 87493 C. Difficile/Epi by PCR	$142.50	$285.00	$26.10–$285.00	60% above	50%
C. difficile toxin gene test (stool PCR) inpatient CPT 87493 C. Difficile/Epi by PCR	$142.50	$285.00	$110.58–$285.00	—	50%
CA 19-9 blood test (tumor marker) CPT 86301 Cancer Antigen-GI (CA 19-9)-RL	$56.00	$112.00	$14.57–$112.00	35% below	50%
CA 19-9 blood test (tumor marker) inpatient CPT 86301 Cancer Antigen-GI (CA 19-9)-RL	$56.00	$112.00	$43.46–$112.00	—	50%
CA-125 blood test (ovarian cancer marker) CPT 86304 Cancer Antigen 125-RL	$195.00	$390.00	$14.57–$390.00	39% above	50%
CA-125 blood test (ovarian cancer marker) inpatient CPT 86304 Cancer Antigen 125-RL	$195.00	$390.00	$151.32–$390.00	—	50%
COVID-19 PCR test (SARS-CoV-2 lab test) CPT 87635 zzCOVID-19 (SARS-CoV-2), PCR	$115.50	$231.00	$35.92–$231.00	5% below	50%
COVID-19 PCR test (SARS-CoV-2 lab test) inpatient CPT 87635 zzCOVID-19 (SARS-CoV-2), PCR	$115.50	$231.00	$89.63–$231.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trachomatis by TMA	$72.00	$144.00	$24.57–$144.00	4% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trachomatis by TMA, SurePath	$72.00	$144.00	$24.57–$144.00	4% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 C. trachomatis by TMA, M4/UTM	$72.00	$144.00	$24.57–$144.00	4% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia Trach DNA AMP Probe	$72.00	$144.00	$24.57–$144.00	4% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia by APT	$72.00	$144.00	$24.57–$144.00	4% below	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 Chlamydia trachomatis and Neisseria gonorrhoeae by	$143.00	$286.00	$24.57–$286.00	91% above	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia by APT	$72.00	$144.00	$55.87–$144.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia Trach DNA AMP Probe	$72.00	$144.00	$55.87–$144.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trachomatis by TMA, SurePath	$72.00	$144.00	$55.87–$144.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trachomatis by TMA, M4/UTM	$72.00	$144.00	$55.87–$144.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 C. trachomatis by TMA	$72.00	$144.00	$55.87–$144.00	—	50%
Chlamydia test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87491 Chlamydia trachomatis and Neisseria gonorrhoeae by	$143.00	$286.00	$110.97–$286.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel	$178.00	$356.00	$9.38–$356.00	111% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Profile-ARUP	$178.00	$356.00	$9.38–$356.00	111% above	50%
Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid Panel (Chol, Trig, HDL, LDLC, VLDL)	$178.00	$356.00	$9.38–$356.00	111% above	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Profile-ARUP	$178.00	$356.00	$138.13–$356.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel	$178.00	$356.00	$138.13–$356.00	—	50%
Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid Panel (Chol, Trig, HDL, LDLC, VLDL)	$178.00	$356.00	$138.13–$356.00	—	50%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Diff Oncology	$36.00	$72.00	$5.45–$72.00	45% below	50%
Complete blood count (CBC) with differential CPT 85025 INF CBC w/ Diff	$38.50	$77.00	$5.45–$77.00	41% below	50%
Complete blood count (CBC) with differential CPT 85025 CBC W/Diff	$40.50	$81.00	$5.45–$81.00	38% below	50%
Complete blood count (CBC) with differential CPT 85025 CBC w/ Differential	$112.00	$224.00	$5.45–$224.00	72% above	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Diff Oncology	$36.00	$72.00	$27.94–$72.00	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 INF CBC w/ Diff	$38.50	$77.00	$29.88–$77.00	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC W/Diff	$40.50	$81.00	$31.43–$81.00	—	50%
Complete blood count (CBC) with differential inpatient CPT 85025 CBC w/ Differential	$112.00	$224.00	$86.91–$224.00	—	50%
Complete blood count (CBC), no differential CPT 85027 CBC	$102.50	$205.00	$4.54–$205.00	115% above	50%
Complete blood count (CBC), no differential inpatient CPT 85027 CBC	$102.50	$205.00	$79.54–$205.00	—	50%
Comprehensive metabolic panel (blood test) CPT 80053 Comprehensive Metabolic Panel	$155.50	$311.00	$7.39–$311.00	45% above	50%
Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehensive Metabolic Panel	$155.50	$311.00	$120.67–$311.00	—	50%
D-dimer blood test (blood clot marker) CPT 85379 D Dimer, Qnt	$61.00	$122.00	$7.13–$122.00	43% below	50%
D-dimer blood test (blood clot marker) inpatient CPT 85379 D Dimer, Qnt	$61.00	$122.00	$47.34–$122.00	—	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA-S-LC	$33.00	$66.00	$15.57–$66.00	81% below	50%
DHEA sulfate (DHEA-S) blood test CPT 82627 DHEA Sulfate-RL	$255.00	$510.00	$15.57–$510.00	49% above	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA-S-LC	$33.00	$66.00	$25.61–$66.00	—	50%
DHEA sulfate (DHEA-S) blood test inpatient CPT 82627 DHEA Sulfate-RL	$255.00	$510.00	$197.88–$510.00	—	50%
Estradiol blood test CPT 82670 Estradiol Level-LC	$41.50	$83.00	$19.56–$83.00	61% below	50%
Estradiol blood test CPT 82670 Estradiol, Adult Premenopausal Female-RL	$150.00	$300.00	$19.56–$300.00	43% above	50%
Estradiol blood test CPT 82670 Estradiol, Adult Male/Child/Postmeno Female-RL	$150.00	$300.00	$19.56–$300.00	43% above	50%
Estradiol blood test inpatient CPT 82670 Estradiol Level-LC	$41.50	$83.00	$32.20–$83.00	—	50%
Estradiol blood test inpatient CPT 82670 Estradiol, Adult Premenopausal Female-RL	$150.00	$300.00	$116.40–$300.00	—	50%
Estradiol blood test inpatient CPT 82670 Estradiol, Adult Male/Child/Postmeno Female-RL	$150.00	$300.00	$116.40–$300.00	—	50%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone Level-LC	$28.00	$56.00	$13.01–$56.00	82% below	50%
FSH (follicle-stimulating hormone) test CPT 83001 Follicle Stimulating Hormone-RL	$114.00	$228.00	$13.01–$228.00	26% below	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone Level-LC	$28.00	$56.00	$21.73–$56.00	—	50%
FSH (follicle-stimulating hormone) test inpatient CPT 83001 Follicle Stimulating Hormone-RL	$114.00	$228.00	$88.46–$228.00	—	50%
Fecal calprotectin (stool inflammation test) CPT 83993 Calprotectin Stool-RL	$404.50	$809.00	$13.75–$809.00	10% above	50%
Fecal calprotectin (stool inflammation test) inpatient CPT 83993 Calprotectin Stool-RL	$404.50	$809.00	$313.89–$809.00	—	50%
Ferritin blood test (iron stores) CPT 82728 Ferritin-RL	$106.50	$213.00	$9.55–$213.00	20% below	50%
Ferritin blood test (iron stores) CPT 82728 Ferritin Level	$106.50	$213.00	$9.55–$213.00	20% below	50%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin Level	$106.50	$213.00	$82.64–$213.00	—	50%
Ferritin blood test (iron stores) inpatient CPT 82728 Ferritin-RL	$106.50	$213.00	$82.64–$213.00	—	50%
Folate (folic acid) blood test CPT 82746 Folate-SpectraCell	$115.50	$231.00	$10.29–$231.00	22% below	50%
Folate (folic acid) blood test CPT 82746 Folate Level	$115.50	$231.00	$10.29–$231.00	22% below	50%
Folate (folic acid) blood test inpatient CPT 82746 Folate-SpectraCell	$115.50	$231.00	$89.63–$231.00	—	50%
Folate (folic acid) blood test inpatient CPT 82746 Folate Level	$115.50	$231.00	$89.63–$231.00	—	50%
Free T3 thyroid hormone test CPT 84481 Free T3 Level	$133.50	$267.00	$11.86–$267.00	19% below	50%
Free T3 thyroid hormone test inpatient CPT 84481 Free T3 Level	$133.50	$267.00	$103.60–$267.00	—	50%
Free T4 (free thyroxine) thyroid blood test CPT 84439 Free T4 Level	$118.50	$237.00	$6.31–$237.00	14% below	50%
Free T4 (free thyroxine) thyroid blood test inpatient CPT 84439 Free T4 Level	$118.50	$237.00	$91.96–$237.00	—	50%
Free testosterone test CPT 84402 Testosterone Free Female/Child-RL	$94.00	$188.00	$17.84–$188.00	55% below	50%
Free testosterone test CPT 84402 Testosterone Free, Adult Male-RL	$94.00	$188.00	$17.84–$188.00	55% below	50%
Free testosterone test CPT 84402 Testosterone Free, Female/Child	$94.00	$188.00	$17.84–$188.00	55% below	50%
Free testosterone test CPT 84402 Testosterone Free, Adult Male	$94.00	$188.00	$17.84–$188.00	55% below	50%
Free testosterone test inpatient CPT 84402 Testosterone Free, Adult Male	$94.00	$188.00	$72.94–$188.00	—	50%
Free testosterone test inpatient CPT 84402 Testosterone Free, Female/Child	$94.00	$188.00	$72.94–$188.00	—	50%
Free testosterone test inpatient CPT 84402 Testosterone Free, Adult Male-RL	$94.00	$188.00	$72.94–$188.00	—	50%
Free testosterone test inpatient CPT 84402 Testosterone Free Female/Child-RL	$94.00	$188.00	$72.94–$188.00	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose 1 Hour Challenge	$57.00	$114.00	$3.33–$114.00	27% below	50%
Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 Glucose Tolerance Test 2 Hour	$93.00	$186.00	$3.33–$186.00	20% above	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose 1 Hour Challenge	$57.00	$114.00	$44.23–$114.00	—	50%
Glucose challenge test (1-hour glucose after a sugar drink) inpatient CPT 82950 Glucose Tolerance Test 2 Hour	$93.00	$186.00	$72.17–$186.00	—	50%
Glucose tolerance test, 3 samples CPT 82951 Glucose Tolerance Test 3 Hour	$206.50	$413.00	$9.02–$413.00	91% above	50%
Glucose tolerance test, 3 samples CPT 82951 Tolerance Test 3 Specimens	$206.50	$413.00	$9.02–$413.00	91% above	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Glucose Tolerance Test 3 Hour	$206.50	$413.00	$160.24–$413.00	—	50%
Glucose tolerance test, 3 samples inpatient CPT 82951 Tolerance Test 3 Specimens	$206.50	$413.00	$160.24–$413.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N Gonorrhoeae DNA AMP Probe	$72.00	$144.00	$23.96–$144.00	4% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 GC by APT	$72.00	$144.00	$23.96–$144.00	4% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. gonorrhoeae by TMA, M4/UTM	$72.00	$144.00	$23.96–$144.00	4% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. gonorrhoeae by TMA, SurePath	$72.00	$144.00	$23.96–$144.00	4% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N. gonorrhoeae by TMA	$72.00	$144.00	$23.96–$144.00	4% below	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. gonorrhoeae by TMA	$72.00	$144.00	$55.87–$144.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N Gonorrhoeae DNA AMP Probe	$72.00	$144.00	$55.87–$144.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 GC by APT	$72.00	$144.00	$55.87–$144.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. gonorrhoeae by TMA, M4/UTM	$72.00	$144.00	$55.87–$144.00	—	50%
Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) inpatient CPT 87591 N. gonorrhoeae by TMA, SurePath	$72.00	$144.00	$55.87–$144.00	—	50%
H. pylori stool antigen test CPT 87338 Helicobacter pylori Ag, Stool by EIA-RL	$140.00	$280.00	$10.07–$280.00	19% below	50%
H. pylori stool antigen test inpatient CPT 87338 Helicobacter pylori Ag, Stool by EIA-RL	$140.00	$280.00	$108.64–$280.00	—	50%
HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 RNA by Quantitative-RL	$648.00	$1,296.00	$59.57–$1,296.00	134% above	50%
HIV viral load test (HIV-1 RNA, quantitative) inpatient CPT 87536 HIV-1 RNA by Quantitative-RL	$648.00	$1,296.00	$502.85–$1,296.00	—	50%
HIV-1 and HIV-2 antibody test CPT 86703 HIV Antibody Stat Screen	$165.00	$330.00	$9.60–$330.00	144% above	50%
HIV-1 and HIV-2 antibody test CPT 86703 zzHIV-1,2 Ab-ARUP	$207.00	$414.00	$9.60–$414.00	207% above	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 HIV Antibody Stat Screen	$165.00	$330.00	$128.04–$330.00	—	50%
HIV-1 and HIV-2 antibody test inpatient CPT 86703 zzHIV-1,2 Ab-ARUP	$207.00	$414.00	$160.63–$414.00	—	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) CPT 87389 HIV-1,2 Antigen/Antibody Combo, Reflex Panel-RL	$32.00	$64.00	$16.86–$64.00	67% below	50%
HIV-1/2 antigen and antibody combination blood test (4th generation) inpatient CPT 87389 HIV-1,2 Antigen/Antibody Combo, Reflex Panel-RL	$32.00	$64.00	$24.83–$64.00	—	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HR w/16 and 18 by NAA, ThinPrep - RL	$138.00	$276.00	$20.42–$276.00	25% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High-Risk Types	$138.00	$276.00	$20.42–$276.00	25% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV High Risk with 16 and 18 by PCR, SurePath-RL	$138.00	$276.00	$20.42–$276.00	25% above	50%
HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV DNA-NEO	$184.00	$368.00	$20.42–$368.00	67% above	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV HR w/16 and 18 by NAA, ThinPrep - RL	$138.00	$276.00	$107.09–$276.00	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV High Risk with 16 and 18 by PCR, SurePath-RL	$138.00	$276.00	$107.09–$276.00	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV High-Risk Types	$138.00	$276.00	$107.09–$276.00	—	50%
HPV test for high-risk types, one combined (pooled) result inpatient CPT 87624 HPV DNA-NEO	$184.00	$368.00	$142.78–$368.00	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1c (Glycosylated)	$40.50	$81.00	$6.80–$81.00	56% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 Hemoglobin A1C-RL	$40.50	$81.00	$6.80–$81.00	56% below	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1c (Glycosylated)	$40.50	$81.00	$31.43–$81.00	—	50%
Hemoglobin A1C blood test (average blood sugar over about 3 months) inpatient CPT 83036 Hemoglobin A1C-RL	$40.50	$81.00	$31.43–$81.00	—	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 Hepatitis B Surface Antibody	$118.00	$236.00	$7.52–$236.00	45% above	50%
Hepatitis B surface antibody (anti-HBs) test, immunity check inpatient CPT 86706 Hepatitis B Surface Antibody	$118.00	$236.00	$91.57–$236.00	—	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen w/reflex confirmation	$186.00	$372.00	$7.24–$372.00	184% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Dialysis Hepatitis B Surface Antigen	$186.00	$372.00	$7.24–$372.00	184% above	50%
Hepatitis B surface antigen (HBsAg) test CPT 87340 Hepatitis B Surface Antigen	$186.00	$372.00	$7.24–$372.00	184% above	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Dialysis Hepatitis B Surface Antigen	$186.00	$372.00	$144.34–$372.00	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen w/reflex confirmation	$186.00	$372.00	$144.34–$372.00	—	50%
Hepatitis B surface antigen (HBsAg) test inpatient CPT 87340 Hepatitis B Surface Antigen	$186.00	$372.00	$144.34–$372.00	—	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Virus Ab w/Rflx to HCV NAAT-RL	$77.00	$154.00	$10.00–$154.00	45% below	50%
Hepatitis C antibody blood test (screening) CPT 86803 Hepatitis C Antibody	$186.50	$373.00	$10.00–$373.00	33% above	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Virus Ab w/Rflx to HCV NAAT-RL	$77.00	$154.00	$59.75–$154.00	—	50%
Hepatitis C antibody blood test (screening) inpatient CPT 86803 Hepatitis C Antibody	$186.50	$373.00	$144.72–$373.00	—	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 zzHep C (PCR)-ARUP	$568.00	$1,136.00	$29.99–$1,136.00	175% above	50%
Hepatitis C viral load (HCV RNA) test CPT 87522 HCV by Quantitative NAAT-RL	$568.00	$1,136.00	$29.99–$1,136.00	175% above	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 zzHep C (PCR)-ARUP	$568.00	$1,136.00	$440.77–$1,136.00	—	50%
Hepatitis C viral load (HCV RNA) test inpatient CPT 87522 HCV by Quantitative NAAT-RL	$568.00	$1,136.00	$440.77–$1,136.00	—	50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 Glycoprotein G Ab, IgG - RL Bill	$48.00	$96.00	$9.24–$96.00	50% below	50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 IgG Ab-RL	$204.50	$409.00	$9.24–$409.00	112% above	50%
Herpes blood test, HSV-1 antibody CPT 86695 HSV 1 Glyco G-Specific, IgG	$204.50	$409.00	$9.24–$409.00	112% above	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 Glycoprotein G Ab, IgG - RL Bill	$48.00	$96.00	$37.25–$96.00	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 IgG Ab-RL	$204.50	$409.00	$158.69–$409.00	—	50%
Herpes blood test, HSV-1 antibody inpatient CPT 86695 HSV 1 Glyco G-Specific, IgG	$204.50	$409.00	$158.69–$409.00	—	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Glycoprotein G Ab, IgG - RL Bill	$57.00	$114.00	$13.55–$114.00	41% below	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 Glyco G-Specific, IgG	$233.00	$466.00	$13.55–$466.00	142% above	50%
Herpes blood test, HSV-2 antibody CPT 86696 HSV 2 IgG Ab-RL	$233.00	$466.00	$13.55–$466.00	142% above	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Glycoprotein G Ab, IgG - RL Bill	$57.00	$114.00	$44.23–$114.00	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 IgG Ab-RL	$233.00	$466.00	$180.81–$466.00	—	50%
Herpes blood test, HSV-2 antibody inpatient CPT 86696 HSV 2 Glyco G-Specific, IgG	$233.00	$466.00	$180.81–$466.00	—	50%
High-sensitivity CRP (hs-CRP) test CPT 86141 CRP, High Sensitivity-RL	$115.50	$231.00	$9.07–$231.00	26% above	50%
High-sensitivity CRP (hs-CRP) test inpatient CPT 86141 CRP, High Sensitivity-RL	$115.50	$231.00	$89.63–$231.00	—	50%
Homocysteine blood test CPT 83090 Homocysteine Total-RL	$375.00	$750.00	$12.54–$750.00	29% above	50%
Homocysteine blood test inpatient CPT 83090 Homocysteine Total-RL	$375.00	$750.00	$291.00–$750.00	—	50%
Insulin blood test CPT 83525 Insulin F-RL	$18.50	$37.00	$8.01–$37.00	71% below	50%
Insulin blood test CPT 83525 Insulin, Fasting-RL	$18.50	$37.00	$8.01–$37.00	71% below	50%
Insulin blood test CPT 83525 Insulin, 120 Minutes - RL	$18.50	$37.00	$8.01–$37.00	71% below	50%
Insulin blood test CPT 83525 Assay of Insulin	$84.00	$168.00	$8.01–$168.00	32% above	50%
Insulin blood test inpatient CPT 83525 Insulin, 120 Minutes - RL	$18.50	$37.00	$14.36–$37.00	—	50%
Insulin blood test inpatient CPT 83525 Insulin F-RL	$18.50	$37.00	$14.36–$37.00	—	50%
Insulin blood test inpatient CPT 83525 Insulin, Fasting-RL	$18.50	$37.00	$14.36–$37.00	—	50%
Insulin blood test inpatient CPT 83525 Assay of Insulin	$84.00	$168.00	$65.18–$168.00	—	50%
Iron blood test (serum iron) CPT 83540 Iron-ARUP	$61.00	$122.00	$4.54–$122.00	25% above	50%
Iron blood test (serum iron) CPT 83540 Iron Level	$61.00	$122.00	$4.54–$122.00	25% above	50%
Iron blood test (serum iron) CPT 83540 Iron	$61.00	$122.00	$4.54–$122.00	25% above	50%
Iron blood test (serum iron) CPT 83540 Iron, Plasma or Serum-RL	$61.00	$122.00	$4.54–$122.00	25% above	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron Level	$61.00	$122.00	$47.34–$122.00	—	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron, Plasma or Serum-RL	$61.00	$122.00	$47.34–$122.00	—	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron-ARUP	$61.00	$122.00	$47.34–$122.00	—	50%
Iron blood test (serum iron) inpatient CPT 83540 Iron	$61.00	$122.00	$47.34–$122.00	—	50%
Iron-binding capacity (TIBC) test CPT 83550 Iron Binding Capacity	$56.50	$113.00	$6.12–$113.00	52% below	50%
Iron-binding capacity (TIBC) test inpatient CPT 83550 Iron Binding Capacity	$56.50	$113.00	$43.84–$113.00	—	50%
Kidney function blood test panel CPT 80069 Renal Function Panel	$186.50	$373.00	$6.08–$373.00	29% above	50%
Kidney function blood test panel inpatient CPT 80069 Renal Function Panel	$186.50	$373.00	$144.72–$373.00	—	50%
LH (luteinizing hormone) test CPT 83002 Luteinizing Hormone-RL	$114.00	$228.00	$12.96–$228.00	30% above	50%
LH (luteinizing hormone) test inpatient CPT 83002 Luteinizing Hormone-RL	$114.00	$228.00	$88.46–$228.00	—	50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase Level	$60.50	$121.00	$4.83–$121.00	51% below	50%
Lipase blood test (pancreas enzyme) CPT 83690 Lipase, Fluid-RL	$60.50	$121.00	$4.83–$121.00	51% below	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase, Fluid-RL	$60.50	$121.00	$46.95–$121.00	—	50%
Lipase blood test (pancreas enzyme) inpatient CPT 83690 Lipase Level	$60.50	$121.00	$46.95–$121.00	—	50%
Liver function blood test panel CPT 80076 Hepatic (Liver) Function Panel - LFTs	$205.50	$411.00	$5.73–$411.00	93% above	50%
Liver function blood test panel inpatient CPT 80076 Hepatic (Liver) Function Panel - LFTs	$205.50	$411.00	$159.47–$411.00	—	50%
Lyme disease antibody test CPT 86618 B. burgdorferi VlsE1/pepC10 Abs ELISA - RL	$69.00	$138.00	$11.93–$138.00	12% below	50%
Lyme disease antibody test CPT 86618 B. burgdorferi C6 Pep Abs, ELISA-RL Bill	$361.00	$722.00	$11.93–$722.00	363% above	50%
Lyme disease antibody test CPT 86618 B. burgdorferi Ab CSF by ELISA-RL	$361.00	$722.00	$11.93–$722.00	363% above	50%
Lyme disease antibody test inpatient CPT 86618 B. burgdorferi VlsE1/pepC10 Abs ELISA - RL	$69.00	$138.00	$53.54–$138.00	—	50%
Lyme disease antibody test inpatient CPT 86618 B. burgdorferi Ab CSF by ELISA-RL	$361.00	$722.00	$280.14–$722.00	—	50%
Lyme disease antibody test inpatient CPT 86618 B. burgdorferi C6 Pep Abs, ELISA-RL Bill	$361.00	$722.00	$280.14–$722.00	—	50%
Magnesium blood test CPT 83735 Magnesium Urine	$90.50	$181.00	$4.69–$181.00	39% above	50%
Magnesium blood test CPT 83735 Magnesium Urine-RL	$90.50	$181.00	$4.69–$181.00	39% above	50%
Magnesium blood test CPT 83735 Magnesium Level	$90.50	$181.00	$4.69–$181.00	39% above	50%
Magnesium blood test CPT 83735 Magnesium-SpectraCell	$90.50	$181.00	$4.69–$181.00	39% above	50%
Magnesium blood test CPT 83735 Magnesium, RBC-RL	$90.50	$181.00	$4.69–$181.00	39% above	50%
Magnesium blood test inpatient CPT 83735 Magnesium Urine	$90.50	$181.00	$70.23–$181.00	—	50%
Magnesium blood test inpatient CPT 83735 Magnesium, RBC-RL	$90.50	$181.00	$70.23–$181.00	—	50%
Magnesium blood test inpatient CPT 83735 Magnesium-SpectraCell	$90.50	$181.00	$70.23–$181.00	—	50%
Magnesium blood test inpatient CPT 83735 Magnesium Level	$90.50	$181.00	$70.23–$181.00	—	50%
Magnesium blood test inpatient CPT 83735 Magnesium Urine-RL	$90.50	$181.00	$70.23–$181.00	—	50%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IgM Antibody-RL	$39.00	$78.00	$9.02–$78.00	35% below	50%
Measles (rubeola) antibody test CPT 86765 Measles (Rubeola) IgG Antibody-RL	$39.00	$78.00	$9.02–$78.00	35% below	50%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IgG Antibody-RL	$39.00	$78.00	$30.26–$78.00	—	50%
Measles (rubeola) antibody test inpatient CPT 86765 Measles (Rubeola) IgM Antibody-RL	$39.00	$78.00	$30.26–$78.00	—	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Heterophile AB by Latex Aggl with Reflex to Titer	$53.50	$107.00	$3.63–$107.00	33% below	50%
Mono test (heterophile antibody, Monospot) CPT 86308 Mononucleosis Screen	$53.50	$107.00	$3.63–$107.00	33% below	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Heterophile AB by Latex Aggl with Reflex to Titer	$53.50	$107.00	$41.52–$107.00	—	50%
Mono test (heterophile antibody, Monospot) inpatient CPT 86308 Mononucleosis Screen	$53.50	$107.00	$41.52–$107.00	—	50%
Obstetric blood test panel CPT 80055 Prenatal Profile	$160.00	$320.00	$28.08–$320.00	26% above	50%
Obstetric blood test panel inpatient CPT 80055 Prenatal Profile	$160.00	$320.00	$124.16–$320.00	—	50%
PSA (prostate-specific antigen) blood test, free CPT 84154 PSA Free	$82.50	$165.00	$12.88–$165.00	38% below	50%
PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA Free	$82.50	$165.00	$64.02–$165.00	—	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen (Total)	$85.50	$171.00	$12.88–$171.00	50% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Screen (normal prostate hx)	$85.50	$171.00	$12.88–$171.00	50% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Total (Diagnostic)	$160.00	$320.00	$12.88–$320.00	6% below	50%
PSA (prostate-specific antigen) blood test, total CPT 84153 PSA Diagnostic (abnormal prostate hx)	$160.00	$320.00	$12.88–$320.00	6% below	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen (Total)	$85.50	$171.00	$66.35–$171.00	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Screen (normal prostate hx)	$85.50	$171.00	$66.35–$171.00	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Diagnostic (abnormal prostate hx)	$160.00	$320.00	$124.16–$320.00	—	50%
PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA Total (Diagnostic)	$160.00	$320.00	$124.16–$320.00	—	50%
Pap test (liquid-based, automated screening with review) CPT 88175 Cytopath C/V Auto Fluid Redo	$42.00	$84.00	$18.63–$84.00	64% below	50%
Pap test (liquid-based, automated screening with review) inpatient CPT 88175 Cytopath C/V Auto Fluid Redo	$42.00	$84.00	$32.59–$84.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Gyn SurePath Liquid-Based Pap w/Rfx to HPV HR 16/1	$42.00	$84.00	$14.18–$84.00	42% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Gyn ThinPrep Pap Test w/Rfx to HPV HR16/18 by NAA-	$42.00	$84.00	$14.18–$84.00	42% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Gyn SurePath +HPV Cytology-RL	$42.00	$84.00	$14.18–$84.00	42% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Gyn ThinPrep +HPV Cytology-RL	$42.00	$84.00	$14.18–$84.00	42% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology/Gyn Thin Prep/Screening	$50.50	$101.00	$14.18–$101.00	31% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 Cytology/Gyn Thin Prep/Diagnostic	$50.50	$101.00	$14.18–$101.00	31% below	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Gyn SurePath Liquid-Based Pap w/Rfx to HPV HR 16/1	$42.00	$84.00	$32.59–$84.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Gyn ThinPrep Pap Test w/Rfx to HPV HR16/18 by NAA-	$42.00	$84.00	$32.59–$84.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Gyn ThinPrep +HPV Cytology-RL	$42.00	$84.00	$32.59–$84.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Gyn SurePath +HPV Cytology-RL	$42.00	$84.00	$32.59–$84.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology/Gyn Thin Prep/Screening	$50.50	$101.00	$39.19–$101.00	—	50%
Pap test lab reading: liquid-based cervical sample, manual screening inpatient CPT 88142 Cytology/Gyn Thin Prep/Diagnostic	$50.50	$101.00	$39.19–$101.00	—	50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact	$192.00	$384.00	$28.90–$384.00	10% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 PTH Intact	$192.00	$384.00	$28.90–$384.00	10% below	50%
Parathyroid hormone (PTH) blood test CPT 83970 Parathyroid Hormone Intact Intraoperative	$192.00	$384.00	$28.90–$384.00	10% below	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact	$192.00	$384.00	$148.99–$384.00	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 PTH Intact	$192.00	$384.00	$148.99–$384.00	—	50%
Parathyroid hormone (PTH) blood test inpatient CPT 83970 Parathyroid Hormone Intact Intraoperative	$192.00	$384.00	$148.99–$384.00	—	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT	$77.50	$155.00	$4.21–$155.00	67% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 Partial Thromboplastin Time	$77.50	$155.00	$4.21–$155.00	67% above	50%
Partial thromboplastin time (PTT) clotting test CPT 85730 PTT-ARUP	$77.50	$155.00	$4.21–$155.00	67% above	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT	$77.50	$155.00	$60.14–$155.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Partial Thromboplastin Time	$77.50	$155.00	$60.14–$155.00	—	50%
Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 PTT-ARUP	$77.50	$155.00	$60.14–$155.00	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal Aneuploidy - RL	$599.50	$1,199.00	$465.21–$1,518.10	38% below	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NIPT Screen by cell-free DNA Sequencing (Multiple	$1,010.50	$2,021.00	$531.34–$2,021.00	4% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 FAS MD	$1,038.50	$2,077.00	$531.34–$2,077.00	7% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 zzNIPT Multiple Fetus Aneuploidy-RL	$1,156.50	$2,313.00	$531.34–$2,313.00	20% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 Fetal Aneuploidy Genomic Sequence	$1,186.50	$2,373.00	$531.34–$2,373.00	23% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) CPT 81420 NIPT Fetal Aneuploidy - RL Bill	$1,186.50	$2,373.00	$531.34–$2,373.00	23% above	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Fetal Aneuploidy - RL	$599.50	$1,199.00	$465.21–$1,199.00	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NIPT Screen by cell-free DNA Sequencing (Multiple	$1,010.50	$2,021.00	$784.15–$2,021.00	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 FAS MD	$1,038.50	$2,077.00	$805.88–$2,077.00	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 zzNIPT Multiple Fetus Aneuploidy-RL	$1,156.50	$2,313.00	$897.44–$2,313.00	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 NIPT Fetal Aneuploidy - RL Bill	$1,186.50	$2,373.00	$920.72–$2,373.00	—	50%
Prenatal cell-free DNA screen for trisomy 21, 18 and 13 (NIPT) inpatient CPT 81420 Fetal Aneuploidy Genomic Sequence	$1,186.50	$2,373.00	$920.72–$2,373.00	—	50%
Progesterone blood test CPT 84144 PROGEST	$31.00	$62.00	$14.60–$62.00	81% below	50%
Progesterone blood test CPT 84144 Progesterone Quant-RL	$136.00	$272.00	$14.60–$272.00	18% below	50%
Progesterone blood test inpatient CPT 84144 PROGEST	$31.00	$62.00	$24.06–$62.00	—	50%
Progesterone blood test inpatient CPT 84144 Progesterone Quant-RL	$136.00	$272.00	$105.54–$272.00	—	50%
Prolactin blood test CPT 84146 Prolactin-RL	$91.00	$182.00	$13.57–$182.00	51% below	50%
Prolactin blood test CPT 84146 Prolactin, Dilution Study - RL Bill	$97.00	$194.00	$13.57–$194.00	48% below	50%
Prolactin blood test CPT 84146 Assay of Prolactin	$97.00	$194.00	$13.57–$194.00	48% below	50%
Prolactin blood test inpatient CPT 84146 Prolactin-RL	$91.00	$182.00	$70.62–$182.00	—	50%
Prolactin blood test inpatient CPT 84146 Assay of Prolactin	$97.00	$194.00	$75.27–$194.00	—	50%
Prolactin blood test inpatient CPT 84146 Prolactin, Dilution Study - RL Bill	$97.00	$194.00	$75.27–$194.00	—	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT & INR	$55.00	$110.00	$3.01–$110.00	43% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin Time and INR	$55.00	$110.00	$3.01–$110.00	43% above	50%
Prothrombin time (PT/INR) clotting test CPT 85610 PT & INR-ARUP	$55.00	$110.00	$3.01–$110.00	43% above	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT & INR-ARUP	$55.00	$110.00	$42.68–$110.00	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin Time and INR	$55.00	$110.00	$42.68–$110.00	—	50%
Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PT & INR	$55.00	$110.00	$42.68–$110.00	—	50%
Rapid flu test (influenza antigen) CPT 87804 Influenza B	$23.50	$47.00	$11.59–$47.00	68% below	50%
Rapid flu test (influenza antigen) CPT 87804 Influenza A	$23.50	$47.00	$11.59–$47.00	68% below	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza A	$23.50	$47.00	$18.24–$47.00	—	50%
Rapid flu test (influenza antigen) inpatient CPT 87804 Influenza B	$23.50	$47.00	$18.24–$47.00	—	50%
Rapid strep A antigen test from a throat swab, read visually CPT 87880 Rapid Group A Strep Screen	$46.00	$92.00	$11.58–$92.00	39% below	50%
Rapid strep A antigen test from a throat swab, read visually inpatient CPT 87880 Rapid Group A Strep Screen	$46.00	$92.00	$35.70–$92.00	—	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) Antibody IgA	$53.50	$107.00	$3.98–$107.00	33% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor Quantitative	$53.50	$107.00	$3.98–$107.00	33% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor (RF) Antibody IgM	$53.50	$107.00	$3.98–$107.00	33% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor	$53.50	$107.00	$3.98–$107.00	33% below	50%
Rheumatoid factor (RF) test CPT 86431 Rheumatoid Factor-RL	$53.50	$107.00	$3.98–$107.00	33% below	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor-RL	$53.50	$107.00	$41.52–$107.00	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor	$53.50	$107.00	$41.52–$107.00	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) Antibody IgM	$53.50	$107.00	$41.52–$107.00	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor (RF) Antibody IgA	$53.50	$107.00	$41.52–$107.00	—	50%
Rheumatoid factor (RF) test inpatient CPT 86431 Rheumatoid Factor Quantitative	$53.50	$107.00	$41.52–$107.00	—	50%
Rubella antibody test (immunity check) CPT 86762 Rubella IgG	$55.50	$111.00	$10.08–$111.00	23% below	50%
Rubella antibody test (immunity check) CPT 86762 Rubella IgM Antibody-RL	$55.50	$111.00	$10.08–$111.00	23% below	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgM Antibody-RL	$55.50	$111.00	$43.07–$111.00	—	50%
Rubella antibody test (immunity check) inpatient CPT 86762 Rubella IgG	$55.50	$111.00	$43.07–$111.00	—	50%
Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 ESR	$27.00	$54.00	$1.89–$54.00	31% below	50%
Sed rate (ESR, erythrocyte sedimentation rate) inpatient CPT 85652 ESR	$27.00	$54.00	$20.95–$54.00	—	50%
Stool ova and parasites exam CPT 87177 Smear for Parasites	$39.50	$79.00	$6.23–$79.00	58% below	50%
Stool ova and parasites exam inpatient CPT 87177 Smear for Parasites	$39.50	$79.00	$30.65–$79.00	—	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood ( POCT)	$28.00	$56.00	$11.14–$56.00	73% below	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood (POCT) ONC	$28.00	$56.00	$11.14–$56.00	73% below	50%
Stool test for hidden blood by immunoassay (FIT) CPT 82274 Fecal Occult Blood (iFOB)	$30.50	$61.00	$11.14–$61.00	71% below	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood (POCT) ONC	$28.00	$56.00	$21.73–$56.00	—	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood ( POCT)	$28.00	$56.00	$21.73–$56.00	—	50%
Stool test for hidden blood by immunoassay (FIT) inpatient CPT 82274 Fecal Occult Blood (iFOB)	$30.50	$61.00	$23.67–$61.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL with Reflex to Titer CSF-RL	$110.00	$220.00	$3.00–$220.00	175% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 Rapid Plasma Reagin	$110.00	$220.00	$3.00–$220.00	175% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 VDRL with Reflex to Titer, Serum-RL	$110.00	$220.00	$3.00–$220.00	175% above	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL with Reflex to Titer, Serum-RL	$110.00	$220.00	$85.36–$220.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 VDRL with Reflex to Titer CSF-RL	$110.00	$220.00	$85.36–$220.00	—	50%
Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result inpatient CPT 86592 Rapid Plasma Reagin	$110.00	$220.00	$85.36–$220.00	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 zzQFT-ARUP	$201.00	$402.00	$43.39–$402.00	13% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 QuantiFERON-TB Plus-RL	$201.00	$402.00	$43.39–$402.00	13% above	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 zzQFT-ARUP	$201.00	$402.00	$155.98–$402.00	—	50%
TB blood test measuring immune response (IGRA, gamma interferon) inpatient CPT 86480 QuantiFERON-TB Plus-RL	$201.00	$402.00	$155.98–$402.00	—	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total Female/Child -RL	$179.00	$358.00	$18.07–$358.00	6% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone, Total Adult Male-RL	$186.00	$372.00	$18.07–$372.00	10% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total, Adult Male	$191.50	$383.00	$18.07–$383.00	13% above	50%
Testosterone blood test, total (not free testosterone) CPT 84403 Testosterone Total, Female/Child	$191.50	$383.00	$18.07–$383.00	13% above	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total Female/Child -RL	$179.00	$358.00	$138.90–$358.00	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone, Total Adult Male-RL	$186.00	$372.00	$144.34–$372.00	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total, Female/Child	$191.50	$383.00	$148.60–$383.00	—	50%
Testosterone blood test, total (not free testosterone) inpatient CPT 84403 Testosterone Total, Adult Male	$191.50	$383.00	$148.60–$383.00	—	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Microsomal Ab, IgG by ELISA	$170.00	$340.00	$10.19–$340.00	39% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Antibody-RL	$170.00	$340.00	$10.19–$340.00	39% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Liver-Kidney Microsome IgG Abs-RL	$170.00	$340.00	$10.19–$340.00	39% above	50%
Thyroid peroxidase (TPO) antibody test CPT 86376 Thyroid Peroxidase (TPO) Antibody	$170.00	$340.00	$10.19–$340.00	39% above	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Antibody	$170.00	$340.00	$131.92–$340.00	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Thyroid Peroxidase (TPO) Antibody-RL	$170.00	$340.00	$131.92–$340.00	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Liver-Kidney Microsome IgG Abs-RL	$170.00	$340.00	$131.92–$340.00	—	50%
Thyroid peroxidase (TPO) antibody test inpatient CPT 86376 Microsomal Ab, IgG by ELISA	$170.00	$340.00	$131.92–$340.00	—	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Neonatal TSH 3rd Generation - RL	$173.50	$347.00	$11.76–$347.00	11% above	50%
Thyroid-stimulating hormone (TSH) blood test CPT 84443 Thyroid Stimulating Hormone	$173.50	$347.00	$11.76–$347.00	11% above	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Thyroid Stimulating Hormone	$173.50	$347.00	$134.64–$347.00	—	50%
Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Neonatal TSH 3rd Generation - RL	$173.50	$347.00	$134.64–$347.00	—	50%
Trichomonas test (NAAT) CPT 87661 T Vaginalis AMP Probe	$111.00	$222.00	$23.96–$222.00	15% above	50%
Trichomonas test (NAAT) CPT 87661 Trichomonas vaginalis by TMA-RL	$111.00	$222.00	$23.96–$222.00	15% above	50%
Trichomonas test (NAAT) inpatient CPT 87661 T Vaginalis AMP Probe	$111.00	$222.00	$86.14–$222.00	—	50%
Trichomonas test (NAAT) inpatient CPT 87661 Trichomonas vaginalis by TMA-RL	$111.00	$222.00	$86.14–$222.00	—	50%
Uric acid blood test CPT 84550 Uric Acid Level	$57.00	$114.00	$3.16–$114.00	23% below	50%
Uric acid blood test inpatient CPT 84550 Uric Acid Level	$57.00	$114.00	$44.23–$114.00	—	50%
Urinalysis with microscope exam, automated CPT 81001 Urinalysis with Microscopic	$54.00	$108.00	$2.23–$108.00	31% above	50%
Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis with Microscopic	$54.00	$108.00	$41.90–$108.00	—	50%
Urine pregnancy test, read by color change CPT 81025 Urine Pregnancy	$25.00	$50.00	$6.03–$50.00	68% below	50%
Urine pregnancy test, read by color change CPT 81025 INF Urine Pregnancy Test	$25.00	$50.00	$6.03–$50.00	68% below	50%
Urine pregnancy test, read by color change CPT 81025 HCG Qualitative Urine (POCT)	$46.50	$93.00	$6.03–$93.00	41% below	50%
Urine pregnancy test, read by color change CPT 81025 HCG Qualitative Urine	$107.50	$215.00	$6.03–$215.00	37% above	50%
Urine pregnancy test, read by color change inpatient CPT 81025 INF Urine Pregnancy Test	$25.00	$50.00	$19.40–$50.00	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 Urine Pregnancy	$25.00	$50.00	$19.40–$50.00	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG Qualitative Urine (POCT)	$46.50	$93.00	$36.08–$93.00	—	50%
Urine pregnancy test, read by color change inpatient CPT 81025 HCG Qualitative Urine	$107.50	$215.00	$83.42–$215.00	—	50%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12 Level	$111.50	$223.00	$10.56–$223.00	4% below	50%
Vitamin B12 (cobalamin) blood test CPT 82607 Vitamin B12-SpectraCell	$111.50	$223.00	$10.56–$223.00	4% below	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12-SpectraCell	$111.50	$223.00	$86.52–$223.00	—	50%
Vitamin B12 (cobalamin) blood test inpatient CPT 82607 Vitamin B12 Level	$111.50	$223.00	$86.52–$223.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 D2,D3 Vitamin-RL	$96.50	$193.00	$20.72–$193.00	56% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 25 Hydroxyvitaman D2&D3 by TMS- RL Bill	$96.50	$193.00	$20.72–$193.00	56% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 Vitamin D 25 Hydroxy Level	$96.50	$193.00	$20.72–$193.00	56% below	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 Vitamin D 25 Hydroxy Level	$96.50	$193.00	$74.88–$193.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 25 Hydroxyvitaman D2&D3 by TMS- RL Bill	$96.50	$193.00	$74.88–$193.00	—	50%
Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) inpatient CPT 82306 D2,D3 Vitamin-RL	$96.50	$193.00	$74.88–$193.00	—	50%
Zinc blood test CPT 84630 Zinc-SpectraCell	$145.50	$291.00	$7.98–$291.00	31% above	50%
Zinc blood test CPT 84630 Zinc Level-RL	$145.50	$291.00	$7.98–$291.00	31% above	50%
Zinc blood test inpatient CPT 84630 Zinc Level-RL	$145.50	$291.00	$112.91–$291.00	—	50%
Zinc blood test inpatient CPT 84630 Zinc-SpectraCell	$145.50	$291.00	$112.91–$291.00	—	50%
hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 HCG Quantitative	$170.00	$340.00	$9.03–$340.00	7% above	50%
hCG pregnancy hormone blood test, quantitative (measures the level) inpatient CPT 84702 HCG Quantitative	$170.00	$340.00	$131.92–$340.00	—	50%

Surgery and procedures

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Botox injections for chronic migraine CPT 64615 EEG Charges - CHEMODENERVATION FOR CHRONIC MIGRAIN	$358.00	$716.00	$140.47–$716.00	54% below	50%
Botox injections for chronic migraine CPT 64615 CHEMODENERVATION FOR CHRONIC MIGRAINE	$358.00	$716.00	$140.47–$716.00	54% below	50%
Botox injections for chronic migraine inpatient CPT 64615 CHEMODENERVATION FOR CHRONIC MIGRAINE	$358.00	$716.00	$277.81–$716.00	—	50%
Botox injections for chronic migraine inpatient CPT 64615 EEG Charges - CHEMODENERVATION FOR CHRONIC MIGRAIN	$358.00	$716.00	$277.81–$716.00	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Stereotactic Breast Biopsy RT	$2,242.00	$4,484.00	$195.83–$4,484.00	18% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$2,242.00	$4,484.00	$195.83–$4,484.00	18% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$2,242.00	$4,484.00	$195.83–$4,484.00	18% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion one side CPT 19081 MG Stereotactic Breast Biopsy LT	$2,242.00	$4,484.00	$195.83–$4,484.00	18% below	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Left	$2,242.00	$4,484.00	$1,739.79–$4,484.00	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Stereotactic Breast Biopsy RT	$2,242.00	$4,484.00	$1,739.79–$4,484.00	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Stereotactic Breast Biopsy LT	$2,242.00	$4,484.00	$1,739.79–$4,484.00	—	50%
Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion inpatient one side CPT 19081 MG Breast Biopsy w/ Stereo Guide Right	$2,242.00	$4,484.00	$1,739.79–$4,484.00	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TX ANKLE FX WO MANIPULATION BOTH 27786	$1,662.50	$3,325.00	$216.16–$3,325.00	170% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 TX ANKLE FX WO MANIPULATION RT 27786	$831.50	$1,663.00	$216.16–$1,663.00	35% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting one side CPT 27786 TX ANKLE FX WO MANIPULATION LT 27786	$831.50	$1,663.00	$216.16–$1,663.00	35% above	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient CPT 27786 TX ANKLE FX WO MANIPULATION BOTH 27786	$1,662.50	$3,325.00	$1,290.10–$3,325.00	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 TX ANKLE FX WO MANIPULATION RT 27786	$831.50	$1,663.00	$645.24–$1,663.00	—	50%
Broken ankle (outer ankle bone) treatment without surgery or setting inpatient one side CPT 27786 TX ANKLE FX WO MANIPULATION LT 27786	$831.50	$1,663.00	$645.24–$1,663.00	—	50%
Broken foot (metatarsal) treatment without surgery or setting CPT 28470 CLST TMT METATARSAL FX W/O MANIP BOTH 28470	$569.50	$1,139.00	$216.16–$1,139.00	29% below	50%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLST TMT METATARSAL FX W/O MANIP RT 28470	$285.00	$570.00	$111.82–$570.00	65% below	50%
Broken foot (metatarsal) treatment without surgery or setting one side CPT 28470 CLST TMT METATARSAL FX W/O MANIPU LT 28470	$285.00	$570.00	$111.82–$570.00	65% below	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient CPT 28470 CLST TMT METATARSAL FX W/O MANIP BOTH 28470	$569.50	$1,139.00	$441.93–$1,139.00	—	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient one side CPT 28470 CLST TMT METATARSAL FX W/O MANIP RT 28470	$285.00	$570.00	$221.16–$570.00	—	50%
Broken foot (metatarsal) treatment without surgery or setting inpatient one side CPT 28470 CLST TMT METATARSAL FX W/O MANIPU LT 28470	$285.00	$570.00	$221.16–$570.00	—	50%
Cardiac catheterization with coronary angiogram one side CPT 93458 Left Heart Cath 93458	$4,651.00	$9,302.00	$1,197.45–$9,302.00	53% below	50%
Cardiac catheterization with coronary angiogram inpatient one side CPT 93458 Left Heart Cath 93458	$4,651.00	$9,302.00	$3,609.18–$9,302.00	—	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT 92960	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 Cardioversion 92960	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 WH Bedside Procedure Type - Cardioversion	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION - ER PHYSICIAN 92960	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CV Cath Acquisition	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) CPT 92960 CV CCL Cardioversion	$785.50	$1,571.00	$131.24–$1,714.15	62% below	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CV Cath Acquisition	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION ELECTRIC EXT 92960	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 Cardioversion 92960	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 WH Bedside Procedure Type - Cardioversion	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CARDIOVERSION - ER PHYSICIAN 92960	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Cardioversion, elective (restoring heart rhythm) inpatient CPT 92960 CV CCL Cardioversion	$785.50	$1,571.00	$609.55–$1,571.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Type - Mogen	$2,458.00	$4,916.00	$121.80–$5,015.14	59% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Type - Gomco	$2,458.00	$4,916.00	$121.80–$5,015.14	59% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 Circumcision Clamp Type - Plastibell	$2,458.00	$4,916.00	$121.80–$5,015.14	59% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns CPT 54150 CIRCUMCISION PROCEDURE 54150	$2,458.00	$4,916.00	$121.80–$5,015.14	59% above	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 CIRCUMCISION PROCEDURE 54150	$2,458.00	$4,916.00	$1,907.41–$4,916.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Clamp Type - Gomco	$2,458.00	$4,916.00	$1,907.41–$4,916.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Clamp Type - Plastibell	$2,458.00	$4,916.00	$1,907.41–$4,916.00	—	50%
Circumcision with a clamp or device and a numbing nerve block, usually newborns inpatient CPT 54150 Circumcision Clamp Type - Mogen	$2,458.00	$4,916.00	$1,907.41–$4,916.00	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLS TX DIST RAD FX W/WO FX ULNAR BOTH 25600	$569.50	$1,139.00	$216.16–$1,139.00	9% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLS TX DIST RAD FX W/WO FX ULNAR RT 25600	$285.00	$570.00	$111.82–$570.00	54% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting one side CPT 25600 CLS TX DIST RAD FX W/WO FX ULNAR LT 25600	$285.00	$570.00	$111.82–$570.00	54% below	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient CPT 25600 CLS TX DIST RAD FX W/WO FX ULNAR BOTH 25600	$569.50	$1,139.00	$441.93–$1,139.00	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 CLS TX DIST RAD FX W/WO FX ULNAR RT 25600	$285.00	$570.00	$221.16–$570.00	—	50%
Closed treatment of a wrist (distal radius) fracture, no resetting inpatient one side CPT 25600 CLS TX DIST RAD FX W/WO FX ULNAR LT 25600	$285.00	$570.00	$221.16–$570.00	—	50%
Coronary stent placement, one artery CPT 92928 Coronary Stent Initial Vessel 92928	$13,276.50	$26,553.00	$727.37–$26,553.00	53% above	50%
Coronary stent placement, one artery inpatient CPT 92928 Coronary Stent Initial Vessel 92928	$13,276.50	$26,553.00	$10,302.56–$26,553.00	—	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion CPT 17000 DESTRUCTION FIRST LESION 17000	$242.00	$484.00	$64.74–$520.49	102% above	50%
Destruction of a precancerous skin lesion (actinic keratosis), first lesion inpatient CPT 17000 DESTRUCTION FIRST LESION 17000	$242.00	$484.00	$187.79–$484.00	—	50%
Earwax removal by irrigation (rinsing), one ear both sides CPT 69209 REMOVE IMPACTED EAR WAX - BILATERAL 69209	$147.50	$295.00	$18.17–$295.00	—	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED EAR WAX - LEFT 69209	$74.50	$149.00	$18.17–$155.60	50% below	50%
Earwax removal by irrigation (rinsing), one ear one side CPT 69209 REMOVE IMPACTED EAR WAX - RIGHT 69209	$74.50	$149.00	$18.17–$155.60	50% below	50%
Earwax removal by irrigation (rinsing), one ear inpatient both sides CPT 69209 REMOVE IMPACTED EAR WAX - BILATERAL 69209	$147.50	$295.00	$114.46–$295.00	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACTED EAR WAX - RIGHT 69209	$74.50	$149.00	$57.81–$149.00	—	50%
Earwax removal by irrigation (rinsing), one ear inpatient one side CPT 69209 REMOVE IMPACTED EAR WAX - LEFT 69209	$74.50	$149.00	$57.81–$149.00	—	50%
Earwax removal with instruments, one ear both sides CPT 69210 REMOVE IMPACTED CERUMEN BILAT	$147.50	$295.00	$40.39–$295.00	—	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACTED CERUMEN RT	$74.50	$149.00	$29.23–$155.60	71% below	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVE IMPACTED CERUMEN LT	$74.50	$149.00	$29.23–$155.60	71% below	50%
Earwax removal with instruments, one ear one side CPT 69210 REMOVAL IMPACTED CERUMEN UNILAT	$101.50	$203.00	$39.82–$203.00	60% below	50%
Earwax removal with instruments, one ear inpatient both sides CPT 69210 REMOVE IMPACTED CERUMEN BILAT	$147.50	$295.00	$114.46–$295.00	—	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE IMPACTED CERUMEN RT	$74.50	$149.00	$57.81–$149.00	—	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVE IMPACTED CERUMEN LT	$74.50	$149.00	$57.81–$149.00	—	50%
Earwax removal with instruments, one ear inpatient one side CPT 69210 REMOVAL IMPACTED CERUMEN UNILAT	$101.50	$203.00	$78.76–$203.00	—	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 ENDOMETRIAL BIOPSY 58100	$241.00	$482.00	$77.55–$482.00	44% below	50%
Endometrial biopsy (uterine lining sample) without dilating the cervix inpatient CPT 58100 ENDOMETRIAL BIOPSY 58100	$241.00	$482.00	$187.02–$482.00	—	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes CPT 58340 INJ PROC FOR HSG	$64.00	$128.00	$25.11–$128.00	90% below	50%
Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes inpatient CPT 58340 INJ PROC FOR HSG	$64.00	$128.00	$49.66–$128.00	—	50%
Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABCESS SIMPLE OR SINGLE 10060	$242.00	$484.00	$94.95–$484.00	56% below	50%
Incision and drainage of a simple or single skin abscess CPT 10060 DRAINAGE OF SKIN ABSCESS SIMPLE (SINGLE)	$314.00	$628.00	$123.20–$628.00	43% below	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 I&D ABCESS SIMPLE OR SINGLE 10060	$242.00	$484.00	$187.79–$484.00	—	50%
Incision and drainage of a simple or single skin abscess inpatient CPT 10060 DRAINAGE OF SKIN ABSCESS SIMPLE (SINGLE)	$314.00	$628.00	$243.66–$628.00	—	50%
Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT 20550	$358.00	$716.00	$49.48–$716.00	72% below	50%
Injection into a tendon sheath or ligament (for example trigger finger) inpatient CPT 20550 INJ TENDON SHEATH/LIGAMENT 20550	$358.00	$716.00	$277.81–$716.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US 20610	$358.00	$716.00	$57.69–$716.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 ARTHROCEN/MAJOR W/O US GUIDE 20610	$358.00	$716.00	$57.69–$716.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Aspiration / Inj Major Joint or Bursa	$358.00	$716.00	$57.69–$716.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 XR Ndl Placmnt Hip Asp/Inj wo US Guid	$358.50	$717.00	$57.69–$717.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 Arthrocent Aspir&/Inj Major Jt w/o US 20610	$358.50	$717.00	$57.69–$717.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR Hip Injection/Aspiration Left	$344.63	$689.25	$57.69–$689.25	60% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR Hip Injection/Aspiration Left?	$358.50	$717.00	$57.69–$717.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR Hip Injection/Aspiration Right	$358.50	$717.00	$57.69–$717.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound one side CPT 20610 IR Hip Injection/Aspiration Right?	$358.50	$717.00	$57.69–$717.00	58% below	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Aspiration / Inj Major Joint or Bursa	$358.00	$716.00	$277.81–$716.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 ARTHROCEN/MAJOR W/O US GUIDE 20610	$358.00	$716.00	$277.81–$716.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 DRAIN/INJ JOINT/BURSA W/O US 20610	$358.00	$716.00	$277.81–$716.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 XR Ndl Placmnt Hip Asp/Inj wo US Guid	$358.50	$717.00	$278.20–$717.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient CPT 20610 Arthrocent Aspir&/Inj Major Jt w/o US 20610	$358.50	$717.00	$278.20–$717.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR Hip Injection/Aspiration Left	$344.63	$689.25	$267.43–$689.25	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR Hip Injection/Aspiration Right	$358.50	$717.00	$278.20–$717.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR Hip Injection/Aspiration Left?	$358.50	$717.00	$278.20–$717.00	—	50%
Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound inpatient one side CPT 20610 IR Hip Injection/Aspiration Right?	$358.50	$717.00	$278.20–$717.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US 20	$224.00	$448.00	$46.72–$483.28	70% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 IR JOINT ASPIR/INJ - INTERMEDIATE	$358.00	$716.00	$46.72–$716.00	53% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJECT JOINT W/O US GUIDE 20605	$358.00	$716.00	$46.72–$716.00	53% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 Joint Aspiration / Inj Intermediate Joint	$358.00	$716.00	$46.72–$716.00	53% below	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US 20	$224.00	$448.00	$173.82–$448.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 DRAIN/INJECT JOINT W/O US GUIDE 20605	$358.00	$716.00	$277.81–$716.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 Joint Aspiration / Inj Intermediate Joint	$358.00	$716.00	$277.81–$716.00	—	50%
Joint injection or drainage, medium joint (wrist, elbow, ankle) inpatient CPT 20605 IR JOINT ASPIR/INJ - INTERMEDIATE	$358.00	$716.00	$277.81–$716.00	—	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Joint Aspiration / Inj Small Joint	$358.00	$716.00	$45.46–$716.00	41% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 Joint/Bursa aspir w/o US Guide 20600	$358.00	$716.00	$45.46–$716.00	41% below	50%
Joint injection or drainage, small joint (fingers, toes) CPT 20600 ATHROCNTSIS/ASP/INJ SM JT/BRS/CYS W/O US GUIDE 206	$358.00	$716.00	$45.46–$716.00	41% below	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Joint Aspiration / Inj Small Joint	$358.00	$716.00	$277.81–$716.00	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 ATHROCNTSIS/ASP/INJ SM JT/BRS/CYS W/O US GUIDE 206	$358.00	$716.00	$277.81–$716.00	—	50%
Joint injection or drainage, small joint (fingers, toes) inpatient CPT 20600 Joint/Bursa aspir w/o US Guide 20600	$358.00	$716.00	$277.81–$716.00	—	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 LAYER CLOSURE/WOUND UP TO 2 5CM 12031	$481.50	$963.00	$179.52–$963.00	35% below	50%
Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs inpatient CPT 12031 LAYER CLOSURE/WOUND UP TO 2 5CM 12031	$481.50	$963.00	$373.64–$963.00	—	50%
Left heart catheterization, diagnostic one side CPT 93452 Left Heart Cath w/LV Injection 93452	$3,933.00	$7,866.00	$1,030.08–$7,866.00	49% below	50%
Left heart catheterization, diagnostic inpatient one side CPT 93452 Left Heart Cath w/LV Injection 93452	$3,933.00	$7,866.00	$3,052.01–$7,866.00	—	50%
Lower-back epidural injection, without imaging guidance CPT 62322 INJ SPINE LUMBAR/SACRAL 62311	$1,341.50	$2,683.00	$98.32–$2,683.00	23% below	50%
Lower-back epidural injection, without imaging guidance inpatient CPT 62322 INJ SPINE LUMBAR/SACRAL 62311	$1,341.50	$2,683.00	$1,041.00–$2,683.00	—	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 Benign lesion excision less than or equal 0.5 cm 1	$849.00	$1,698.00	$99.54–$1,698.00	36% above	50%
Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm inpatient CPT 11400 Benign lesion excision less than or equal 0.5 cm 1	$849.00	$1,698.00	$658.82–$1,698.00	—	50%
Nail removal (partial or complete), one nail CPT 11730 AVULSION NAIL PART/COMPL SIMP/SGL 11730	$242.00	$484.00	$64.97–$520.49	42% below	50%
Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE 11730	$242.00	$484.00	$64.97–$520.49	42% below	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 REMOVAL OF NAIL PLATE 11730	$242.00	$484.00	$187.79–$484.00	—	50%
Nail removal (partial or complete), one nail inpatient CPT 11730 AVULSION NAIL PART/COMPL SIMP/SGL 11730	$242.00	$484.00	$187.79–$484.00	—	50%
Occipital nerve block (injection for headaches) CPT 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$358.00	$716.00	$66.44–$716.00	54% below	50%
Occipital nerve block (injection for headaches) CPT 64405 INJ ANES NRV GREAT OCCIPIT 64405	$358.00	$716.00	$66.44–$716.00	54% below	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJ ANES NRV GREAT OCCIPIT 64405	$358.00	$716.00	$277.81–$716.00	—	50%
Occipital nerve block (injection for headaches) inpatient CPT 64405 INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV	$358.00	$716.00	$277.81–$716.00	—	50%
Pacemaker implant (dual chamber) CPT 33208 Insert Pacer Generator-Dual Lead 33208	$14,456.00	$28,912.00	$636.50–$28,912.00	26% above	50%
Pacemaker implant (dual chamber) CPT 33208 CV CCL Insert CRT-P Dual	$14,456.00	$28,912.00	$636.50–$28,912.00	26% above	50%
Pacemaker implant (dual chamber) CPT 33208 CV CCL Insert CRT-P	$14,456.00	$28,912.00	$636.50–$28,912.00	26% above	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 CV CCL Insert CRT-P Dual	$14,456.00	$28,912.00	$11,217.86–$28,912.00	—	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 Insert Pacer Generator-Dual Lead 33208	$14,456.00	$28,912.00	$11,217.86–$28,912.00	—	50%
Pacemaker implant (dual chamber) inpatient CPT 33208 CV CCL Insert CRT-P	$14,456.00	$28,912.00	$11,217.86–$28,912.00	—	50%
Paracentesis with imaging guidance CPT 49083 PARACENTESIS W/IMAGING GUIDANCE 49083	$1,094.00	$2,188.00	$126.70–$2,188.00	23% below	50%
Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING 49083	$1,096.50	$2,193.00	$126.70–$2,193.00	23% below	50%
Paracentesis with imaging guidance CPT 49083 IR US PARACENTESIS W / IMG	$1,120.50	$2,241.00	$126.70–$2,241.00	21% below	50%
Paracentesis with imaging guidance CPT 49083 US Guide ABD Paracentesis	$1,120.50	$2,241.00	$126.70–$2,241.00	21% below	50%
Paracentesis with imaging guidance CPT 49083 IR CT PARACENTESIS W / IMG	$1,120.50	$2,241.00	$126.70–$2,241.00	21% below	50%
Paracentesis with imaging guidance CPT 49083 US Paracentesis	$1,120.50	$2,241.00	$126.70–$2,241.00	21% below	50%
Paracentesis with imaging guidance CPT 49083 IR CT Paracentesis Abdomi w/ CT Guidance	$1,120.50	$2,241.00	$126.70–$2,241.00	21% below	50%
Paracentesis with imaging guidance CPT 49083 IR PARACENTESIS W/ IMG	$1,120.50	$2,241.00	$126.70–$2,241.00	21% below	50%
Paracentesis with imaging guidance inpatient CPT 49083 PARACENTESIS W/IMAGING GUIDANCE 49083	$1,094.00	$2,188.00	$848.94–$2,188.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 ABD PARACENTESIS W/IMAGING 49083	$1,096.50	$2,193.00	$850.88–$2,193.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 US Paracentesis	$1,120.50	$2,241.00	$869.51–$2,241.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 IR CT Paracentesis Abdomi w/ CT Guidance	$1,120.50	$2,241.00	$869.51–$2,241.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 US Guide ABD Paracentesis	$1,120.50	$2,241.00	$869.51–$2,241.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 IR CT PARACENTESIS W / IMG	$1,120.50	$2,241.00	$869.51–$2,241.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 IR PARACENTESIS W/ IMG	$1,120.50	$2,241.00	$869.51–$2,241.00	—	50%
Paracentesis with imaging guidance inpatient CPT 49083 IR US PARACENTESIS W / IMG	$1,120.50	$2,241.00	$869.51–$2,241.00	—	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 EXC NAIL/MTRX PRT/CMPLT PERM RMV 11750	$481.50	$963.00	$121.74–$963.00	35% below	50%
Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED PARTIAL OR COMPLETE	$733.50	$1,467.00	$121.74–$1,467.00	2% below	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 EXC NAIL/MTRX PRT/CMPLT PERM RMV 11750	$481.50	$963.00	$373.64–$963.00	—	50%
Permanent removal of a nail and nail root (partial or complete) inpatient CPT 11750 REMOVAL OF NAIL BED PARTIAL OR COMPLETE	$733.50	$1,467.00	$569.20–$1,467.00	—	50%
Removal of a foreign object under the skin, simple CPT 10120 INCS & RMV FB SQ TISSUE SIMPLE	$424.50	$849.00	$124.98–$849.00	56% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INCS & RMV FB SQ TISSUE SIMPLE 10120	$481.50	$963.00	$124.98–$963.00	50% below	50%
Removal of a foreign object under the skin, simple CPT 10120 INCS & RMV FB SQ TISSUE SIMPLE BOTH 10120	$481.50	$963.00	$124.98–$963.00	50% below	50%
Removal of a foreign object under the skin, simple CPT 10120 CV CCL Foreign Body Removal Simple	$483.00	$966.00	$124.98–$966.00	50% below	50%
Removal of a foreign object under the skin, simple CPT 10120 Foreign Body Removal SubQ Tissue 10120	$483.00	$966.00	$124.98–$966.00	50% below	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCS & RMV FB SQ TISSUE SIMPLE	$424.50	$849.00	$329.41–$849.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCS & RMV FB SQ TISSUE SIMPLE BOTH 10120	$481.50	$963.00	$373.64–$963.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 INCS & RMV FB SQ TISSUE SIMPLE 10120	$481.50	$963.00	$373.64–$963.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 Foreign Body Removal SubQ Tissue 10120	$483.00	$966.00	$374.81–$966.00	—	50%
Removal of a foreign object under the skin, simple inpatient CPT 10120 CV CCL Foreign Body Removal Simple	$483.00	$966.00	$374.81–$966.00	—	50%
Short arm cast (elbow to hand) CPT 29075 APPLIC ELBOW TO FINGER BOTH 29075	$648.00	$1,296.00	$78.19–$1,296.00	34% below	50%
Short arm cast (elbow to hand) one side CPT 29075 APPLIC ELBOW TO FINGER RT 29075	$324.00	$648.00	$78.19–$648.00	67% below	50%
Short arm cast (elbow to hand) one side CPT 29075 APPLIC ELBOW TO FINGER LT 29075	$324.00	$648.00	$78.19–$648.00	67% below	50%
Short arm cast (elbow to hand) inpatient CPT 29075 APPLIC ELBOW TO FINGER BOTH 29075	$648.00	$1,296.00	$502.85–$1,296.00	—	50%
Short arm cast (elbow to hand) inpatient one side CPT 29075 APPLIC ELBOW TO FINGER RT 29075	$324.00	$648.00	$251.42–$648.00	—	50%
Short arm cast (elbow to hand) inpatient one side CPT 29075 APPLIC ELBOW TO FINGER LT 29075	$324.00	$648.00	$251.42–$648.00	—	50%
Short arm splint (forearm and hand) CPT 29125 Orthopedic Device Application Charge - Short Arm S	$154.50	$309.00	$50.41–$337.65	60% below	50%
Short arm splint (forearm and hand) CPT 29125 Application Short Arm Splint Units	$214.00	$428.00	$50.41–$428.00	44% below	50%
Short arm splint (forearm and hand) CPT 29125 APPLICATION SHORT ARM SPLINT BOTH 29125	$308.50	$617.00	$50.41–$617.00	20% below	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION SHORT ARM SPLINT LT 29125	$110.00	$220.00	$43.16–$337.65	71% below	50%
Short arm splint (forearm and hand) one side CPT 29125 APPLICATION SHORT ARM SPLINT RT 29125	$154.50	$309.00	$50.41–$337.65	60% below	50%
Short arm splint (forearm and hand) inpatient CPT 29125 Orthopedic Device Application Charge - Short Arm S	$154.50	$309.00	$119.89–$309.00	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 Application Short Arm Splint Units	$214.00	$428.00	$166.06–$428.00	—	50%
Short arm splint (forearm and hand) inpatient CPT 29125 APPLICATION SHORT ARM SPLINT BOTH 29125	$308.50	$617.00	$239.40–$617.00	—	50%
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLICATION SHORT ARM SPLINT LT 29125	$110.00	$220.00	$85.36–$220.00	—	50%
Short arm splint (forearm and hand) inpatient one side CPT 29125 APPLICATION SHORT ARM SPLINT RT 29125	$154.50	$309.00	$119.89–$309.00	—	50%
Short leg cast (below the knee) CPT 29405 Orthopedic Device Application Charge - Short Leg C	$324.00	$648.00	$73.51–$648.00	61% below	50%
Short leg cast (below the knee) CPT 29405 APPLICATION SHORT LEG CAST BOTH 29405	$648.00	$1,296.00	$73.51–$1,296.00	21% below	50%
Short leg cast (below the knee) one side CPT 29405 APPLICATION SHORT LEG CAST RT 29405	$324.00	$648.00	$73.51–$648.00	61% below	50%
Short leg cast (below the knee) one side CPT 29405 APPLICATION SHORT LEG CAST LT 29405	$324.00	$648.00	$73.51–$648.00	61% below	50%
Short leg cast (below the knee) inpatient CPT 29405 Orthopedic Device Application Charge - Short Leg C	$324.00	$648.00	$251.42–$648.00	—	50%
Short leg cast (below the knee) inpatient CPT 29405 APPLICATION SHORT LEG CAST BOTH 29405	$648.00	$1,296.00	$502.85–$1,296.00	—	50%
Short leg cast (below the knee) inpatient one side CPT 29405 APPLICATION SHORT LEG CAST LT 29405	$324.00	$648.00	$251.42–$648.00	—	50%
Short leg cast (below the knee) inpatient one side CPT 29405 APPLICATION SHORT LEG CAST RT 29405	$324.00	$648.00	$251.42–$648.00	—	50%
Short leg splint (calf to foot) CPT 29515 APPLICATION SHORT LEG SPLINT BOTH 29515	$296.50	$593.00	$62.57–$593.00	23% below	50%
Short leg splint (calf to foot) CPT 29515 OT Short Leg Splint Units	$384.50	$769.00	$62.57–$769.00	at median	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION SHORT LEG SPLINT LT 29515	$191.00	$382.00	$62.57–$382.00	50% below	50%
Short leg splint (calf to foot) one side CPT 29515 APPLICATION SHORT LEG SPLINT RT 29515	$191.00	$382.00	$62.57–$382.00	50% below	50%
Short leg splint (calf to foot) inpatient CPT 29515 APPLICATION SHORT LEG SPLINT BOTH 29515	$296.50	$593.00	$230.08–$593.00	—	50%
Short leg splint (calf to foot) inpatient CPT 29515 OT Short Leg Splint Units	$384.50	$769.00	$298.37–$769.00	—	50%
Short leg splint (calf to foot) inpatient one side CPT 29515 APPLICATION SHORT LEG SPLINT LT 29515	$191.00	$382.00	$148.22–$382.00	—	50%
Short leg splint (calf to foot) inpatient one side CPT 29515 APPLICATION SHORT LEG SPLINT RT 29515	$191.00	$382.00	$148.22–$382.00	—	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 REP SUPERFICIAL WOUND UP TO 2 5CM 12001	$242.00	$484.00	$55.08–$520.49	29% below	50%
Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs inpatient CPT 12001 REP SUPERFICIAL WOUND UP TO 2 5CM 12001	$242.00	$484.00	$187.79–$484.00	—	50%
Skin biopsy, punch, one lesion CPT 11104 Punch Biopsy Skin Single Lesion 11104 WC	$481.50	$963.00	$56.27–$963.00	14% below	50%
Skin biopsy, punch, one lesion inpatient CPT 11104 Punch Biopsy Skin Single Lesion 11104 WC	$481.50	$963.00	$373.64–$963.00	—	50%
Skin tag removal, up to 15 tags CPT 11200 REMVAL SKIN TAGS 1-15 LESIONS 11200	$94.50	$189.00	$37.08–$520.49	76% below	50%
Skin tag removal, up to 15 tags CPT 11200 Skin Tag Removal 1-15 lesions 11200	$242.00	$484.00	$90.01–$520.49	40% below	50%
Skin tag removal, up to 15 tags CPT 11200 WH Bedside Procedure Type - Skin tag removal	$242.00	$484.00	$90.01–$520.49	40% below	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 REMVAL SKIN TAGS 1-15 LESIONS 11200	$94.50	$189.00	$73.33–$189.00	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 Skin Tag Removal 1-15 lesions 11200	$242.00	$484.00	$187.79–$484.00	—	50%
Skin tag removal, up to 15 tags inpatient CPT 11200 WH Bedside Procedure Type - Skin tag removal	$242.00	$484.00	$187.79–$484.00	—	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 SPINAL PUNCTURE LUMBAR DX 62270	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Spi Pnxr Lmbr Dx 62270	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Neurology Lumbar Puncture Procedure	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 Lumbar Puncture Bedside	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 IR Procedures - RAD LUMBAR PUNCTURE DIAGNOSTIC	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 XR Lumbar Puncture	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 IR Fluoro Lumbar Puncture	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 INF Lumbar Puncture	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 EEG Charges - LUMBAR PUNCTURE	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 XR Lumbar Puncture Invasive	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic CPT 62270 WH Bedside Procedure Type - LUMBAR PUNCTURE	$834.50	$1,669.00	$80.40–$1,669.00	59% below	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 EEG Charges - LUMBAR PUNCTURE	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 SPINAL PUNCTURE LUMBAR DX 62270	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 XR Lumbar Puncture Invasive	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Spi Pnxr Lmbr Dx 62270	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 WH Bedside Procedure Type - LUMBAR PUNCTURE	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Neurology Lumbar Puncture Procedure	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 Lumbar Puncture Bedside	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IR Procedures - RAD LUMBAR PUNCTURE DIAGNOSTIC	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 XR Lumbar Puncture	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 IR Fluoro Lumbar Puncture	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Spinal tap (lumbar puncture), diagnostic inpatient CPT 62270 INF Lumbar Puncture	$834.50	$1,669.00	$647.57–$1,669.00	—	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 REP SUPERFICIAL WOUND 2 6CM 7 5CM 12002	$242.00	$484.00	$72.62–$520.49	37% below	50%
Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs inpatient CPT 12002 REP SUPERFICIAL WOUND 2 6CM 7 5CM 12002	$242.00	$484.00	$187.79–$484.00	—	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 REP SUP WD FACE/MM UP TO 2 5CM 12011	$242.00	$484.00	$68.49–$520.49	31% below	50%
Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair inpatient CPT 12011 REP SUP WD FACE/MM UP TO 2 5CM 12011	$242.00	$484.00	$187.79–$484.00	—	50%
Tangential (shave-style) skin biopsy, one lesion CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION 11102 WC	$317.00	$634.00	$45.18–$634.00	41% below	50%
Tangential (shave-style) skin biopsy, one lesion inpatient CPT 11102 TANGENTIAL BIOPSY SKIN SINGLE LESION 11102 WC	$317.00	$634.00	$245.99–$634.00	—	50%
Thoracentesis with imaging guidance both sides CPT 32555 THORACENTESIS W/IMAGING (BILAT) 32555	$1,517.00	$3,034.00	$131.18–$3,034.00	—	50%
Thoracentesis with imaging guidance both sides CPT 32555 DS THORACENTESIS W/ IMAGING BILAT	$1,517.00	$3,034.00	$131.18–$3,034.00	—	50%
Thoracentesis with imaging guidance CPT 32555 IR Thoracentesis	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance CPT 32555 US Thoracentesis	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS W/IMAGING GUIDANCE 32555	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING 32555	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance CPT 32555 IR CT Thoracentesis w/ CT Guidance	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance CPT 32555 Thoracentesis w/Imaging 32555	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance CPT 32555 IR THORACENTESIS W/ IMG	$869.00	$1,738.00	$131.18–$1,738.00	65% below	50%
Thoracentesis with imaging guidance one side CPT 32555 THORACENTESIS W/IMAGING (UNILATERAL) 32555	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance one side CPT 32555 DS THORACENTESIS W/ IMAGING UNILAT	$758.50	$1,517.00	$131.18–$1,517.00	70% below	50%
Thoracentesis with imaging guidance inpatient both sides CPT 32555 DS THORACENTESIS W/ IMAGING BILAT	$1,517.00	$3,034.00	$1,177.19–$3,034.00	—	50%
Thoracentesis with imaging guidance inpatient both sides CPT 32555 THORACENTESIS W/IMAGING (BILAT) 32555	$1,517.00	$3,034.00	$1,177.19–$3,034.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 Thoracentesis w/Imaging 32555	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS W/IMAGING GUIDANCE 32555	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 IR Thoracentesis	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 IR CT Thoracentesis w/ CT Guidance	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 US Thoracentesis	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING 32555	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient CPT 32555 IR THORACENTESIS W/ IMG	$869.00	$1,738.00	$674.34–$1,738.00	—	50%
Thoracentesis with imaging guidance inpatient one side CPT 32555 DS THORACENTESIS W/ IMAGING UNILAT	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Thoracentesis with imaging guidance inpatient one side CPT 32555 THORACENTESIS W/IMAGING (UNILATERAL) 32555	$758.50	$1,517.00	$588.60–$1,517.00	—	50%
Trigger point injections, 1 or 2 muscles CPT 20552 TRIGGER POINT INJ 20552	$114.00	$228.00	$44.73–$483.28	90% below	50%
Trigger point injections, 1 or 2 muscles inpatient CPT 20552 TRIGGER POINT INJ 20552	$114.00	$228.00	$88.46–$228.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US Breast BX Perc 1st Lesion	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US Bard Breast BX Exam	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US Biopsy BREAST Clip Place FIRST LESION	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 US Breast Breast Biopsy Perc 1st Lesion	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion CPT 19083 IR US GUIDED BREAST BX 1ST LESION	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Right	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Device Plcmnt w/US Guide Left	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Device Plcmnt w/US Guide Right	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion one side CPT 19083 US Breast Biopsy w/ US Guide Left	$2,090.50	$4,181.00	$185.33–$4,181.00	23% below	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US Bard Breast BX Exam	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 IR US GUIDED BREAST BX 1ST LESION	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US Biopsy BREAST Clip Place FIRST LESION	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US Breast Breast Biopsy Perc 1st Lesion	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient CPT 19083 US Breast BX Perc 1st Lesion	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Right	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Device Plcmnt w/US Guide Right	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Device Plcmnt w/US Guide Left	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Ultrasound-guided breast needle biopsy with marker clip, first lesion inpatient one side CPT 19083 US Breast Biopsy w/ US Guide Left	$2,090.50	$4,181.00	$1,622.23–$4,181.00	—	50%
Upper endoscopy (EGD), diagnostic CPT 43235 EGD DIAGNOSTIC BRUSHING OR WASH 43235	$1,094.00	$2,188.00	$146.54–$2,188.00	at median	50%
Upper endoscopy (EGD), diagnostic inpatient CPT 43235 EGD DIAGNOSTIC BRUSHING OR WASH 43235	$1,094.00	$2,188.00	$848.94–$2,188.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 Debrid SubQ tissue less or equal 20 sq cm 11042	$481.50	$963.00	$72.91–$963.00	48% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDE SKIN/SUBUCTANEOUS TISSUE 11042	$481.50	$963.00	$72.91–$963.00	48% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 MG Debridement Breast Tissue	$481.50	$963.00	$72.91–$963.00	48% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DEBRIDEMENT SUBQ 1ST 20SQ CM OR LESS	$481.50	$963.00	$72.91–$963.00	48% below	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 Debrid SubQ tissue less or equal 20 sq cm 11042	$481.50	$963.00	$373.64–$963.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDE SKIN/SUBUCTANEOUS TISSUE 11042	$481.50	$963.00	$373.64–$963.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 MG Debridement Breast Tissue	$481.50	$963.00	$373.64–$963.00	—	50%
Wound debridement, skin and tissue under it, first 20 sq cm inpatient CPT 11042 DEBRIDEMENT SUBQ 1ST 20SQ CM OR LESS	$481.50	$963.00	$373.64–$963.00	—	50%

Doctor visits and therapy

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Blood transfusion (giving blood or blood components) CPT 36430 PS INF Blood Transfusion	$524.00	$1,048.00	$51.74–$1,145.19	32% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 Blood Product Administration	$581.00	$1,162.00	$51.74–$1,162.00	25% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPONENTS 36430	$610.50	$1,221.00	$51.74–$1,221.00	21% below	50%
Blood transfusion (giving blood or blood components) CPT 36430 BLOOD ADMIN. PROCEDURE 36430	$622.00	$1,244.00	$51.74–$1,244.00	20% below	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 PS INF Blood Transfusion	$524.00	$1,048.00	$406.62–$1,048.00	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 Blood Product Administration	$581.00	$1,162.00	$450.86–$1,162.00	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 TRANSFUSION BLD/BLD COMPONENTS 36430	$610.50	$1,221.00	$473.75–$1,221.00	—	50%
Blood transfusion (giving blood or blood components) inpatient CPT 36430 BLOOD ADMIN. PROCEDURE 36430	$622.00	$1,244.00	$482.67–$1,244.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE Aerosol Therapy - Subsequent	$258.00	$516.00	$8.95–$532.78	37% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 AIRWAY INHALATION TREATMENT - 94640	$258.00	$516.00	$8.95–$532.78	37% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI/DPI - DPI Initial	$258.00	$516.00	$8.95–$532.78	37% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT CHARGE MDI/DPI - Subsequent	$258.00	$516.00	$8.95–$532.78	37% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 RT NEBULIZER/AEROSOL TREATMENT	$258.00	$516.00	$8.95–$532.78	37% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction CPT 94640 MDI TREATMENT	$258.00	$516.00	$8.95–$532.78	37% above	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT - 94640	$258.00	$516.00	$200.21–$516.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 MDI TREATMENT	$258.00	$516.00	$200.21–$516.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE Aerosol Therapy - Subsequent	$258.00	$516.00	$200.21–$516.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI/DPI - Subsequent	$258.00	$516.00	$200.21–$516.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT NEBULIZER/AEROSOL TREATMENT	$258.00	$516.00	$200.21–$516.00	—	50%
Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 RT CHARGE MDI/DPI - DPI Initial	$258.00	$516.00	$200.21–$516.00	—	50%
Chemotherapy IV infusion, first hour CPT 96413 INF/C IV Infusion initial/single	$409.00	$818.00	$148.18–$868.86	41% below	50%
Chemotherapy IV infusion, first hour CPT 96413 PS INF/C IV Infusion Initial/Single	$409.00	$818.00	$148.18–$868.86	41% below	50%
Chemotherapy IV infusion, first hour CPT 96413 Chemo Infusion Initial 1st Hour	$409.00	$818.00	$148.18–$868.86	41% below	50%
Chemotherapy IV infusion, first hour CPT 96413 CHEMO ADMIN IV INF INITIAL 1ST HR 96413	$409.00	$818.00	$148.18–$868.86	41% below	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 Chemo Infusion Initial 1st Hour	$409.00	$818.00	$317.38–$818.00	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 INF/C IV Infusion initial/single	$409.00	$818.00	$317.38–$818.00	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 CHEMO ADMIN IV INF INITIAL 1ST HR 96413	$409.00	$818.00	$317.38–$818.00	—	50%
Chemotherapy IV infusion, first hour inpatient CPT 96413 PS INF/C IV Infusion Initial/Single	$409.00	$818.00	$317.38–$818.00	—	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE 99291	$1,071.00	$2,142.00	$284.21–$2,142.00	54% below	50%
Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE WITH MODIFIER	$1,071.00	$2,142.00	$284.21–$2,142.00	54% below	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE 99291	$1,071.00	$2,142.00	$831.10–$2,142.00	—	50%
Critical care, first 30 to 74 minutes inpatient CPT 99291 CRITICAL CARE WITH MODIFIER	$1,071.00	$2,142.00	$831.10–$2,142.00	—	50%
EEG (brain wave test), awake and drowsy, routine CPT 95816 EEG Charges - AWAKE AND DROWSY (EEG)	$481.00	$962.00	$188.73–$962.00	40% below	50%
EEG (brain wave test), awake and drowsy, routine inpatient CPT 95816 EEG Charges - AWAKE AND DROWSY (EEG)	$481.00	$962.00	$373.26–$962.00	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CHARGE Outpatient Cardiac Rehab - EKG	$132.50	$265.00	$7.25–$265.00	51% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 CV Electrocardiogram 12 Lead	$151.50	$303.00	$7.25–$303.00	44% below	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CHARGE Outpatient Cardiac Rehab - EKG	$132.50	$265.00	$102.82–$265.00	—	50%
Electrocardiogram (ECG/EKG), tracing only, the hospital charge inpatient CPT 93005 CV Electrocardiogram 12 Lead	$151.50	$303.00	$117.56–$303.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 NON EMERGENT TRIAGE 99281	$107.00	$214.00	$15.44–$307.67	52% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 ER FEE LEVEL I 99281	$107.00	$214.00	$15.44–$307.67	52% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 SUTURE/STAPLE REMOVAL 99281	$107.00	$214.00	$15.44–$307.67	52% below	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 NON EMERGENT TRIAGE 99281	$107.00	$214.00	$83.03–$214.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 ER FEE LEVEL I 99281	$107.00	$214.00	$83.03–$214.00	—	50%
Emergency room visit, level 1 of 5, minor problem that may not need a doctor inpatient CPT 99281 SUTURE/STAPLE REMOVAL 99281	$107.00	$214.00	$83.03–$214.00	—	50%
Emergency room visit, level 2 of 5, straightforward problem CPT 99282 ER FEE LEVEL II 99282	$208.50	$417.00	$56.29–$417.00	39% below	50%
Emergency room visit, level 2 of 5, straightforward problem inpatient CPT 99282 ER FEE LEVEL II 99282	$208.50	$417.00	$161.80–$417.00	—	50%
Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 ER FEE LEVEL III 99283	$345.00	$690.00	$95.87–$690.00	46% below	50%
Emergency room visit, level 3 of 5, low-complexity problem inpatient CPT 99283 ER FEE LEVEL III 99283	$345.00	$690.00	$267.72–$690.00	—	50%
Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 ER FEE LEVEL IV 99284	$534.50	$1,069.00	$163.23–$1,069.00	39% below	50%
Emergency room visit, level 4 of 5, moderate-complexity problem inpatient CPT 99284 ER FEE LEVEL IV 99284	$534.50	$1,069.00	$414.77–$1,069.00	—	50%
Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 ER FEE LEVEL V 99285	$775.50	$1,551.00	$236.60–$1,551.00	36% below	50%
Emergency room visit, level 5 of 5, high-complexity problem inpatient CPT 99285 ER FEE LEVEL V 99285	$775.50	$1,551.00	$601.79–$1,551.00	—	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CHARGE Outpatient Cardiac Rehab - STRESS TEST	$521.00	$1,042.00	$42.74–$1,042.00	15% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 Cardiology Charges - Treadmill Only Stress Test	$567.50	$1,135.00	$42.74–$1,135.00	8% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV ECG Portion for NM Stress	$596.00	$1,192.00	$42.74–$1,192.00	3% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV Stress Acquisition	$596.00	$1,192.00	$42.74–$1,192.00	3% below	50%
Exercise stress test, tracing only, the hospital charge CPT 93017 CV ECG Exercise Stress Test BATCH ENTRY	$596.00	$1,192.00	$42.74–$1,192.00	3% below	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CHARGE Outpatient Cardiac Rehab - STRESS TEST	$521.00	$1,042.00	$404.30–$1,042.00	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 Cardiology Charges - Treadmill Only Stress Test	$567.50	$1,135.00	$440.38–$1,135.00	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV Stress Acquisition	$596.00	$1,192.00	$462.50–$1,192.00	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV ECG Portion for NM Stress	$596.00	$1,192.00	$462.50–$1,192.00	—	50%
Exercise stress test, tracing only, the hospital charge inpatient CPT 93017 CV ECG Exercise Stress Test BATCH ENTRY	$596.00	$1,192.00	$462.50–$1,192.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION HYDRATION INIT 1 HR	$259.00	$518.00	$37.46–$551.90	12% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INFUSION HYDRATION INIT 1 HR W/MOD 96360	$259.00	$518.00	$37.46–$551.90	12% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 INF/H IV Inf 31 - 60 min	$259.00	$518.00	$37.46–$551.90	12% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ?Hydration infusion Initial 1st Hour	$259.00	$518.00	$37.46–$551.90	12% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 RAD INFUSION HYDRATION INIT 1 HR	$259.00	$518.00	$37.46–$551.90	12% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 ITX Hydration Infusion initial 1st hour	$259.00	$518.00	$37.46–$551.90	12% below	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ?Hydration infusion Initial 1st Hour	$259.00	$518.00	$200.98–$518.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 ITX Hydration Infusion initial 1st hour	$259.00	$518.00	$200.98–$518.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 RAD INFUSION HYDRATION INIT 1 HR	$259.00	$518.00	$200.98–$518.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INF/H IV Inf 31 - 60 min	$259.00	$518.00	$200.98–$518.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION HYDRATION INIT 1 HR W/MOD 96360	$259.00	$518.00	$200.98–$518.00	—	50%
IV hydration (fluids through a vein), first 31 to 60 minutes inpatient CPT 96360 INFUSION HYDRATION INIT 1 HR	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAP INITIAL 1 HR	$259.00	$518.00	$72.23–$551.90	12% below	50%
IV infusion of a medicine, first hour CPT 96365 THERAPEUTIC Infusion Initial 1st Hour	$259.00	$518.00	$72.23–$551.90	12% below	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAP INITIAL 1 HR W/MOD 96365	$259.00	$518.00	$55.94–$551.90	12% below	50%
IV infusion of a medicine, first hour CPT 96365 INFUSION THERAP INITIAL 1 HR (ENDO)	$259.00	$518.00	$72.23–$551.90	12% below	50%
IV infusion of a medicine, first hour CPT 96365 INF/NC IV Infusion Ther Initial	$259.00	$518.00	$72.23–$551.90	12% below	50%
IV infusion of a medicine, first hour CPT 96365 ITX Therapeutic Infusion initial 1st Hour	$259.00	$518.00	$72.23–$551.90	12% below	50%
IV infusion of a medicine, first hour CPT 96365 RAD INFUSION THERAP INITIAL 1 HR	$259.00	$518.00	$72.23–$551.90	12% below	50%
IV infusion of a medicine, first hour inpatient CPT 96365 ITX Therapeutic Infusion initial 1st Hour	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAP INITIAL 1 HR (ENDO)	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 THERAPEUTIC Infusion Initial 1st Hour	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 RAD INFUSION THERAP INITIAL 1 HR	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAP INITIAL 1 HR	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 INFUSION THERAP INITIAL 1 HR W/MOD 96365	$259.00	$518.00	$200.98–$518.00	—	50%
IV infusion of a medicine, first hour inpatient CPT 96365 INF/NC IV Infusion Ther Initial	$259.00	$518.00	$200.98–$518.00	—	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 PACU INJECTION IM/SQ	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INF/NC SQ/IM Injection	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 NM Thyrogen Inject	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 THERAP/PROPHYLACTIC/DX INJ SQ/IM 96372	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SQ	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 IM/SQ Injection	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 NM Thyrogen Inj w/ Pharma Dose 2	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 NM Thyrogen Inj w/ Pharma Dose 1	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 Injection IM/SC	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 RAD INJECTION IM OR SQ	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ITX INJECTION IM OR SUBQ WITH MOD	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 ITX Injection IM/SQ	$85.50	$171.00	$17.14–$186.43	6% above	50%
Injection under the skin or into a muscle, for treatment or testing CPT 96372 INJECTION IM OR SUBQ	$104.00	$208.00	$17.14–$208.00	29% above	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 PACU INJECTION IM/SQ	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SQ	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 NM Thyrogen Inj w/ Pharma Dose 1	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 NM Thyrogen Inj w/ Pharma Dose 2	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 Injection IM/SC	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 IM/SQ Injection	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ITX INJECTION IM OR SUBQ WITH MOD	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INF/NC SQ/IM Injection	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 RAD INJECTION IM OR SQ	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 THERAP/PROPHYLACTIC/DX INJ SQ/IM 96372	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 ITX Injection IM/SQ	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 NM Thyrogen Inject	$85.50	$171.00	$66.35–$171.00	—	50%
Injection under the skin or into a muscle, for treatment or testing inpatient CPT 96372 INJECTION IM OR SUBQ	$104.00	$208.00	$80.70–$208.00	—	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 EEG Procedure/Code - NRV CNDCTN STDS, 7-8 ST: 9591	$378.50	$757.00	$148.51–$815.71	53% below	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 Nerve Conduction Velocities 2 Extremity Lower	$1,820.00	$3,640.00	$208.54–$3,640.00	127% above	50%
Nerve conduction study, 7 or 8 nerve studies CPT 95910 EEG Charges - NERVE CONDUCTION 7-8 STUDIES	$1,820.00	$3,640.00	$208.54–$3,640.00	127% above	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 EEG Procedure/Code - NRV CNDCTN STDS, 7-8 ST: 9591	$378.50	$757.00	$293.72–$757.00	—	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 EEG Charges - NERVE CONDUCTION 7-8 STUDIES	$1,820.00	$3,640.00	$1,412.32–$3,640.00	—	50%
Nerve conduction study, 7 or 8 nerve studies inpatient CPT 95910 Nerve Conduction Velocities 2 Extremity Lower	$1,820.00	$3,640.00	$1,412.32–$3,640.00	—	50%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units KX	$53.50	$107.00	$20.99–$107.00	39% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 OT Neuromuscular Reeducation Units	$53.50	$107.00	$20.99–$107.00	39% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units	$56.50	$113.00	$22.17–$113.00	36% below	50%
Neuromuscular re-education, 15 minutes CPT 97112 PT Neuromuscular Reeducation Units KX	$56.50	$113.00	$22.17–$113.00	36% below	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units	$53.50	$107.00	$41.52–$107.00	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 OT Neuromuscular Reeducation Units KX	$53.50	$107.00	$41.52–$107.00	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units KX	$56.50	$113.00	$43.84–$113.00	—	50%
Neuromuscular re-education, 15 minutes inpatient CPT 97112 PT Neuromuscular Reeducation Units	$56.50	$113.00	$43.84–$113.00	—	50%
New patient office visit, about 30 minutes CPT 99203 OP NEW PT LEVEL 3 VISIT	$199.50	$399.00	$78.28–$399.00	10% below	50%
New patient office visit, about 30 minutes CPT 99203 INF New Pt. Level 3	$233.00	$466.00	$91.42–$466.00	5% above	50%
New patient office visit, about 30 minutes CPT 99203 New PT Visit Level 3	$248.50	$497.00	$97.50–$497.00	12% above	50%
New patient office visit, about 30 minutes inpatient CPT 99203 OP NEW PT LEVEL 3 VISIT	$199.50	$399.00	$154.81–$399.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 INF New Pt. Level 3	$233.00	$466.00	$233.00–$466.00	—	50%
New patient office visit, about 30 minutes inpatient CPT 99203 New PT Visit Level 3	$248.50	$497.00	$248.50–$497.00	—	50%
New patient office visit, about 45 minutes CPT 99204 OP NEW PT LEVEL 4 VISIT	$264.00	$528.00	$103.58–$528.00	26% above	50%
New patient office visit, about 45 minutes CPT 99204 INF New Pt. Level 4	$413.00	$826.00	$162.05–$826.00	98% above	50%
New patient office visit, about 45 minutes CPT 99204 New PT Visit Level 4	$419.00	$838.00	$164.40–$838.00	101% above	50%
New patient office visit, about 45 minutes inpatient CPT 99204 OP NEW PT LEVEL 4 VISIT	$264.00	$528.00	$204.86–$528.00	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 INF New Pt. Level 4	$413.00	$826.00	$413.00–$826.00	—	50%
New patient office visit, about 45 minutes inpatient CPT 99204 New PT Visit Level 4	$419.00	$838.00	$419.00–$838.00	—	50%
New patient office visit, about 60 minutes CPT 99205 OP NEW PT LEVEL 5 VISIT	$361.50	$723.00	$141.84–$723.00	34% above	50%
New patient office visit, about 60 minutes CPT 99205 INF New Pt. Level 5	$486.50	$973.00	$190.88–$973.00	80% above	50%
New patient office visit, about 60 minutes CPT 99205 New PT Level 5	$496.50	$993.00	$194.81–$993.00	84% above	50%
New patient office visit, about 60 minutes inpatient CPT 99205 OP NEW PT LEVEL 5 VISIT	$361.50	$723.00	$280.52–$723.00	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 INF New Pt. Level 5	$486.50	$973.00	$486.50–$973.00	—	50%
New patient office visit, about 60 minutes inpatient CPT 99205 New PT Level 5	$496.50	$993.00	$496.50–$993.00	—	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 OP NEW PT LEVEL 2 VISIT	$152.00	$304.00	$59.64–$304.00	5% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 INF New Pt. Level 2	$155.00	$310.00	$60.82–$310.00	3% below	50%
New patient office visit, straightforward problem or 15+ minutes CPT 99202 New PT Visit Level 2	$175.00	$350.00	$62.94–$350.00	10% above	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 OP NEW PT LEVEL 2 VISIT	$152.00	$304.00	$117.95–$304.00	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 INF New Pt. Level 2	$155.00	$310.00	$155.00–$310.00	—	50%
New patient office visit, straightforward problem or 15+ minutes inpatient CPT 99202 New PT Visit Level 2	$175.00	$350.00	$175.00–$350.00	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 Medical Nutrition Therapy-Initial-Indiv w/Patient,	$28.50	$57.00	$11.18–$74.13	32% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes CPT 97802 RDN Initial Visit, Individual Ea 15min	$28.50	$57.00	$11.18–$74.13	32% below	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 RDN Initial Visit, Individual Ea 15min	$28.50	$57.00	$22.12–$57.00	—	50%
Nutrition counseling (medical nutrition therapy), first visit, 15 minutes inpatient CPT 97802 Medical Nutrition Therapy-Initial-Indiv w/Patient,	$28.50	$57.00	$22.12–$57.00	—	50%
Occupational therapy evaluation, low complexity CPT 97165 OT Evaluation Units, Low Complexity	$170.00	$340.00	$66.70–$340.00	11% above	50%
Occupational therapy evaluation, low complexity inpatient CPT 97165 OT Evaluation Units, Low Complexity	$170.00	$340.00	$131.92–$340.00	—	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) CPT 97163 PT Evaluation Units, High Complexity	$213.00	$426.00	$83.57–$426.00	4% above	50%
Physical therapy evaluation, high complexity (typically about 45 minutes) inpatient CPT 97163 PT Evaluation Units, High Complexity	$213.00	$426.00	$165.29–$426.00	—	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT Evaluation Units, Low Complexity	$164.50	$329.00	$64.54–$329.00	1% below	50%
Physical therapy evaluation, low complexity (typically about 20 minutes) inpatient CPT 97161 PT Evaluation Units, Low Complexity	$164.50	$329.00	$127.65–$329.00	—	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) CPT 97162 PT Evaluation Units, Moderate Complexity	$189.00	$378.00	$74.16–$378.00	at median	50%
Physical therapy evaluation, moderate complexity (typically about 30 minutes) inpatient CPT 97162 PT Evaluation Units, Moderate Complexity	$189.00	$378.00	$146.66–$378.00	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units	$98.00	$196.00	$25.96–$196.00	1% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 PT Manual Therapy Units KX	$98.00	$196.00	$25.96–$196.00	1% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units KX	$98.00	$196.00	$25.96–$196.00	1% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 OT Manual Therapy Units	$98.00	$196.00	$25.96–$196.00	1% above	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units	$98.00	$196.00	$76.05–$196.00	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 OT Manual Therapy Units KX	$98.00	$196.00	$76.05–$196.00	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units	$98.00	$196.00	$76.05–$196.00	—	50%
Physical therapy, hands-on manual therapy (15-minute unit) inpatient CPT 97140 PT Manual Therapy Units KX	$98.00	$196.00	$76.05–$196.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units	$63.50	$127.00	$24.92–$127.00	28% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT Therapeutic Exercise Units KX	$63.50	$127.00	$24.92–$127.00	28% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units KX	$63.50	$127.00	$24.92–$127.00	28% below	50%
Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT Therapeutic Exercise Units	$63.50	$127.00	$24.92–$127.00	28% below	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units KX	$63.50	$127.00	$49.28–$127.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units	$63.50	$127.00	$49.28–$127.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT Therapeutic Exercise Units KX	$63.50	$127.00	$49.28–$127.00	—	50%
Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT Therapeutic Exercise Units	$63.50	$127.00	$49.28–$127.00	—	50%
Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN 99406	$43.50	$87.00	$15.68–$87.00	16% below	50%
Quit-smoking counseling, 3 to 10 minutes inpatient CPT 99406 BEHAV CHNG SMOKING 3-10 MIN 99406	$43.50	$87.00	$33.76–$87.00	—	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Sleep Study Charges - SLEEP VISIT LEVEL 5	$121.50	$243.00	$47.67–$243.00	45% below	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OP EST PT LEVEL 5 VISIT	$361.50	$723.00	$141.84–$723.00	63% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OBB TREATMENT ROOM LEVEL 5	$486.50	$973.00	$190.88–$973.00	119% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 INF Visit Level 5	$486.50	$973.00	$190.88–$973.00	119% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 OBB TREATMENT ROOM CHARGE - Level 5 - OBB Treatmen	$486.50	$973.00	$190.88–$973.00	119% above	50%
Returning patient office visit, high complexity or 40+ minutes CPT 99215 Est PT Level 5	$496.50	$993.00	$191.11–$993.00	124% above	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Sleep Study Charges - SLEEP VISIT LEVEL 5	$121.50	$243.00	$121.50–$243.00	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OP EST PT LEVEL 5 VISIT	$361.50	$723.00	$280.52–$723.00	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OBB TREATMENT ROOM CHARGE - Level 5 - OBB Treatmen	$486.50	$973.00	$377.52–$973.00	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 OBB TREATMENT ROOM LEVEL 5	$486.50	$973.00	$377.52–$973.00	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 INF Visit Level 5	$486.50	$973.00	$486.50–$973.00	—	50%
Returning patient office visit, high complexity or 40+ minutes inpatient CPT 99215 Est PT Level 5	$496.50	$993.00	$496.50–$993.00	—	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Sleep Study Charges - SLEEP VISIT LEVEL 3	$91.50	$183.00	$35.90–$183.00	50% below	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OP EST PT LEVEL 3 VISIT	$199.50	$399.00	$78.28–$399.00	10% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Est PT Visit Level 3	$220.00	$440.00	$86.32–$440.00	21% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 Day Surgery Outpatient Level 3	$220.50	$441.00	$86.52–$441.00	21% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 RT EDUCATION CHARGE > 15 MIN	$225.50	$451.00	$87.42–$451.00	24% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OUTPATIENT VISIT LEVEL 3 - RAD OUPATIENT VISIT LEV	$231.50	$463.00	$87.42–$463.00	28% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 INF Visit Level 3	$233.00	$466.00	$87.42–$466.00	28% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 INF Chemo Education	$233.00	$466.00	$87.42–$466.00	28% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 ITX EDUCATION > 15 MIN	$233.00	$466.00	$87.42–$466.00	28% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 DOCUMENTED EDUCATION >15 MINS 99213	$237.00	$474.00	$87.42–$474.00	31% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OBB TREATMENT ROOM LEVEL 3	$242.50	$485.00	$87.42–$485.00	34% above	50%
Returning patient office visit, low complexity or 20+ minutes CPT 99213 OBB TREATMENT ROOM CHARGE - Level 3 - OBB Treatmen	$242.50	$485.00	$87.42–$485.00	34% above	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Sleep Study Charges - SLEEP VISIT LEVEL 3	$91.50	$183.00	$91.50–$183.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OP EST PT LEVEL 3 VISIT	$199.50	$399.00	$154.81–$399.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Est PT Visit Level 3	$220.00	$440.00	$220.00–$440.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 Day Surgery Outpatient Level 3	$220.50	$441.00	$220.50–$441.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 RT EDUCATION CHARGE > 15 MIN	$225.50	$451.00	$174.99–$451.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OUTPATIENT VISIT LEVEL 3 - RAD OUPATIENT VISIT LEV	$231.50	$463.00	$179.64–$463.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 INF Chemo Education	$233.00	$466.00	$233.00–$466.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 INF Visit Level 3	$233.00	$466.00	$233.00–$466.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 ITX EDUCATION > 15 MIN	$233.00	$466.00	$180.81–$466.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 DOCUMENTED EDUCATION >15 MINS 99213	$237.00	$474.00	$183.91–$474.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OBB TREATMENT ROOM LEVEL 3	$242.50	$485.00	$188.18–$485.00	—	50%
Returning patient office visit, low complexity or 20+ minutes inpatient CPT 99213 OBB TREATMENT ROOM CHARGE - Level 3 - OBB Treatmen	$242.50	$485.00	$188.18–$485.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Sleep Study Charges - SLEEP VISIT LEVEL 4	$106.50	$213.00	$41.79–$213.00	37% below	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OP EST PT LEVEL 4 VISIT	$264.00	$528.00	$103.58–$528.00	57% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OBB TREATMENT ROOM LEVEL 4	$277.50	$555.00	$108.88–$555.00	65% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 OBB TREATMENT ROOM CHARGE - Level 4 - OBB Treatmen	$277.50	$555.00	$108.88–$555.00	65% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 Est PT Visit Level 4	$389.50	$779.00	$128.83–$779.00	132% above	50%
Returning patient office visit, moderate complexity or 30+ minutes CPT 99214 INF Visit Level 4	$413.00	$826.00	$128.83–$826.00	146% above	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Sleep Study Charges - SLEEP VISIT LEVEL 4	$106.50	$213.00	$106.50–$213.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OP EST PT LEVEL 4 VISIT	$264.00	$528.00	$204.86–$528.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OBB TREATMENT ROOM LEVEL 4	$277.50	$555.00	$215.34–$555.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 OBB TREATMENT ROOM CHARGE - Level 4 - OBB Treatmen	$277.50	$555.00	$215.34–$555.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 Est PT Visit Level 4	$389.50	$779.00	$389.50–$779.00	—	50%
Returning patient office visit, moderate complexity or 30+ minutes inpatient CPT 99214 INF Visit Level 4	$413.00	$826.00	$413.00–$826.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Sleep Study Charges - SLEEP VISIT LEVEL 2	$76.50	$153.00	$30.02–$153.00	40% below	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Est PT Visit Level 2	$146.00	$292.00	$46.93–$292.00	14% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 RT EDUCATION CHARGE < 15 MIN	$151.50	$303.00	$46.93–$303.00	19% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OP EST PT LEVEL 2 VISIT	$152.00	$304.00	$46.93–$304.00	19% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PICC VISIT LEVEL 2 - Yes	$155.00	$310.00	$46.93–$310.00	22% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ITX EDUCATION < 15 MIN	$155.00	$310.00	$46.93–$310.00	22% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 INF Visit Level 2	$155.00	$310.00	$46.93–$310.00	22% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PICC CENTRAL LINE CHECK - Yes	$155.00	$310.00	$46.93–$310.00	22% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 DOCUMENTED EDUCATION < 15 MINS 99212	$158.50	$317.00	$46.93–$317.00	24% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 Day Surgery Outpatient Level 2	$172.50	$345.00	$46.93–$345.00	35% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OBB TREATMENT ROOM CHARGE - Level 2 - OBB Treatmen	$181.00	$362.00	$46.93–$362.00	42% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OBB TREATMENT ROOM LEVEL 2 - Level 2	$181.00	$362.00	$46.93–$362.00	42% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PICC Removal	$233.00	$466.00	$46.93–$466.00	83% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 ITX PICC REMOVAL	$233.00	$466.00	$46.93–$466.00	83% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PICC REMOVAL NON TUNNELED - Yes	$233.00	$466.00	$46.93–$466.00	83% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 PICC CENTRAL LINE DRESSING CHANGE - Yes	$233.00	$466.00	$46.93–$466.00	83% above	50%
Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 INF PICC Removal	$233.00	$466.00	$46.93–$466.00	83% above	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Sleep Study Charges - SLEEP VISIT LEVEL 2	$76.50	$153.00	$76.50–$153.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Est PT Visit Level 2	$146.00	$292.00	$146.00–$292.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 RT EDUCATION CHARGE < 15 MIN	$151.50	$303.00	$117.56–$303.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OP EST PT LEVEL 2 VISIT	$152.00	$304.00	$117.95–$304.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 INF Visit Level 2	$155.00	$310.00	$155.00–$310.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PICC CENTRAL LINE CHECK - Yes	$155.00	$310.00	$120.28–$310.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PICC VISIT LEVEL 2 - Yes	$155.00	$310.00	$120.28–$310.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ITX EDUCATION < 15 MIN	$155.00	$310.00	$120.28–$310.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 DOCUMENTED EDUCATION < 15 MINS 99212	$158.50	$317.00	$123.00–$317.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 Day Surgery Outpatient Level 2	$172.50	$345.00	$172.50–$345.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OBB TREATMENT ROOM LEVEL 2 - Level 2	$181.00	$362.00	$140.46–$362.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 OBB TREATMENT ROOM CHARGE - Level 2 - OBB Treatmen	$181.00	$362.00	$140.46–$362.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 ITX PICC REMOVAL	$233.00	$466.00	$180.81–$466.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PICC Removal	$233.00	$466.00	$233.00–$466.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PICC CENTRAL LINE DRESSING CHANGE - Yes	$233.00	$466.00	$180.81–$466.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 PICC REMOVAL NON TUNNELED - Yes	$233.00	$466.00	$180.81–$466.00	—	50%
Returning patient office visit, straightforward problem or 10+ minutes inpatient CPT 99212 INF PICC Removal	$233.00	$466.00	$233.00–$466.00	—	50%
Speech and language evaluation CPT 92523 SLP Eval Lang Comprehension,Express Unit	$148.50	$297.00	$58.27–$465.66	39% below	50%
Speech and language evaluation inpatient CPT 92523 SLP Eval Lang Comprehension,Express Unit	$148.50	$297.00	$115.24–$297.00	—	50%
Speech therapy session, individual CPT 92507 SLP Auditory Processing Tx Units	$99.50	$199.00	$39.04–$199.00	41% below	50%
Speech therapy session, individual inpatient CPT 92507 SLP Auditory Processing Tx Units	$99.50	$199.00	$77.21–$199.00	—	50%
Spirometry (breathing test) CPT 94010 RT CHARGE PFT - Simple Spirometry	$189.00	$378.00	$31.23–$409.85	54% below	50%
Spirometry (breathing test) CPT 94010 CHARGE Outpatient Cardiac Rehab - PFT SPIROMETRY	$189.00	$378.00	$31.23–$409.85	54% below	50%
Spirometry (breathing test) CPT 94010 PFT/W/BOX-SIMPLE SPIROMETRY	$189.00	$378.00	$31.23–$409.85	54% below	50%
Spirometry (breathing test) CPT 94010 CHARGE Pulmonary Rehab - BREATHING CAPACITY TEST -	$189.00	$378.00	$31.23–$409.85	54% below	50%
Spirometry (breathing test) CPT 94010 RT CHARGE PFT - Bedside Spirometry	$189.00	$378.00	$31.23–$409.85	54% below	50%
Spirometry (breathing test) CPT 94010 Spirometry 94010	$189.00	$378.00	$31.23–$409.85	54% below	50%
Spirometry (breathing test) inpatient CPT 94010 CHARGE Pulmonary Rehab - BREATHING CAPACITY TEST -	$189.00	$378.00	$146.66–$378.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 Spirometry 94010	$189.00	$378.00	$146.66–$378.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 CHARGE Outpatient Cardiac Rehab - PFT SPIROMETRY	$189.00	$378.00	$146.66–$378.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 RT CHARGE PFT - Simple Spirometry	$189.00	$378.00	$146.66–$378.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 RT CHARGE PFT - Bedside Spirometry	$189.00	$378.00	$146.66–$378.00	—	50%
Spirometry (breathing test) inpatient CPT 94010 PFT/W/BOX-SIMPLE SPIROMETRY	$189.00	$378.00	$146.66–$378.00	—	50%
Spirometry before and after a bronchodilator CPT 94060 RT CHARGE PFT - Pre & Post Spirometry	$378.50	$757.00	$44.38–$815.71	38% below	50%
Spirometry before and after a bronchodilator CPT 94060 CHARGE Outpatient Cardiac Rehab - PFT/W/BOX-B&A BR	$378.50	$757.00	$44.38–$815.71	38% below	50%
Spirometry before and after a bronchodilator CPT 94060 PFT/W/BOX-B&A BRONCHODILATOR	$378.50	$757.00	$44.38–$815.71	38% below	50%
Spirometry before and after a bronchodilator CPT 94060 CHARGE Pulmonary Rehab - EVALUATION OF WHEEZING -	$378.50	$757.00	$44.38–$815.71	38% below	50%
Spirometry before and after a bronchodilator CPT 94060 Spiro w/ Bronch 94060	$378.50	$757.00	$44.38–$815.71	38% below	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 CHARGE Pulmonary Rehab - EVALUATION OF WHEEZING -	$378.50	$757.00	$293.72–$757.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 RT CHARGE PFT - Pre & Post Spirometry	$378.50	$757.00	$293.72–$757.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 PFT/W/BOX-B&A BRONCHODILATOR	$378.50	$757.00	$293.72–$757.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 CHARGE Outpatient Cardiac Rehab - PFT/W/BOX-B&A BR	$378.50	$757.00	$293.72–$757.00	—	50%
Spirometry before and after a bronchodilator inpatient CPT 94060 Spiro w/ Bronch 94060	$378.50	$757.00	$293.72–$757.00	—	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units	$72.00	$144.00	$28.25–$144.00	8% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units	$72.00	$144.00	$28.25–$144.00	8% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 PT Therapeutic Activity Units KX	$72.00	$144.00	$28.25–$144.00	8% below	50%
Therapeutic activities (functional training), 15 minutes CPT 97530 OT Therapeutic Activities Units KX	$72.00	$144.00	$28.25–$144.00	8% below	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units	$72.00	$144.00	$55.87–$144.00	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units	$72.00	$144.00	$55.87–$144.00	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 PT Therapeutic Activity Units KX	$72.00	$144.00	$55.87–$144.00	—	50%
Therapeutic activities (functional training), 15 minutes inpatient CPT 97530 OT Therapeutic Activities Units KX	$72.00	$144.00	$55.87–$144.00	—	50%
Therapeutic phlebotomy (removing blood as treatment) CPT 99195 INF Ther Phlebotomy	$154.50	$309.00	$60.62–$337.65	at median	50%
Therapeutic phlebotomy (removing blood as treatment) inpatient CPT 99195 INF Ther Phlebotomy	$154.50	$309.00	$119.89–$309.00	—	50%

Vaccines

Procedure	Cash price	List price	Insurers pay	vs Georgia	Off list
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 ITX Immunization/Vaccine Admin Fee	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 TETANUS/RABIES VACCINE ADMIN FEE	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMINISTRATION	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 PNEUMOCOCCAL IMMUNIZATION ADMIN 90471	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 INF Immunization Administration	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 90471 Initial Immunization Admin Charge	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 FLU IMMUNIZATION ADMIN 90471	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION/VACCINE ADMIN FEE 90471	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 HEPATITIS B IMMUNIZATION ADMIN 90471	$85.50	$171.00	$24.29–$186.43	36% above	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 PNEUMOCOCCAL IMMUNIZATION ADMIN 90471	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 INF Immunization Administration	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION ADMINISTRATION	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 ITX Immunization/Vaccine Admin Fee	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 TETANUS/RABIES VACCINE ADMIN FEE	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 FLU IMMUNIZATION ADMIN 90471	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 HEPATITIS B IMMUNIZATION ADMIN 90471	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 IMMUNIZATION/VACCINE ADMIN FEE 90471	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee (giving the shot), first vaccine of the visit inpatient CPT 90471 90471 Initial Immunization Admin Charge	$85.50	$171.00	$66.35–$171.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 INF Immunization Administration Add'l	$21.50	$43.00	$16.68–$43.00	37% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 TETANUS RABIES VACCINE #2 INJECTION	$26.50	$53.00	$17.42–$53.00	22% below	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD 90472	$42.00	$84.00	$17.42–$84.00	24% above	50%
Vaccine administration fee, each additional vaccine at the same visit CPT 90472 90472 Immunization Admin Charge Each Addl	$42.50	$85.00	$17.42–$85.00	25% above	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 INF Immunization Administration Add'l	$21.50	$43.00	$16.68–$43.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 TETANUS RABIES VACCINE #2 INJECTION	$26.50	$53.00	$20.56–$53.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 IMMUNIZATION ADMIN EACH ADD 90472	$42.00	$84.00	$32.59–$84.00	—	50%
Vaccine administration fee, each additional vaccine at the same visit inpatient CPT 90472 90472 Immunization Admin Charge Each Addl	$42.50	$85.00	$32.98–$85.00	—	50%

Source file: https://s3.amazonaws.com/assets.bbmconnect.com/Southwell/453072990_TiftRegionalMedicalCenter_standardcharges.csv